INTERAKSI OBAT PADA PASIEN PPOK: TINJAUAN SISTEMATIS DAN META-ANALISIS
DOI:
https://doi.org/10.31004/jkt.v6i3.47561Keywords:
ICS, Interaksi obat, literatur review, PPOKAbstract
Penyakit paru obstruktif kronik (PPOK) merupakan kondisi inflamasi kronis yang bersifat progresif dan membutuhkan pengelolaan terapi jangka panjang. Penatalaksanaan PPOK umumnya melibatkan penggunaan kombinasi obat-obatan seperti bronkodilator, kortikosteroid inhalasi (ICS), antibiotik, dan agen farmakologis lainnya. Namun, penggunaan beberapa obat secara bersamaan meningkatkan risiko terjadinya interaksi obat yang dapat menurunkan efektivitas terapi dan menimbulkan efek samping serius. Penelitian ini bertujuan untuk mengidentifikasi dan menganalisis interaksi obat yang paling umum terjadi pada pasien PPOK melalui pendekatan tinjauan sistematis dan meta-analisis. Artikel diperoleh melalui pencarian literatur di tiga basis data elektronik (PubMed, Scopus, dan Cochrane) dengan metode seleksi berdasarkan panduan PRISMA 2020. Dari 1.200 artikel awal, 16 studi memenuhi kriteria inklusi dan dianalisis lebih lanjut secara deskriptif dan kuantitatif menggunakan forest plot dan funnel plot. Hasil menunjukkan bahwa interaksi paling sering melibatkan ICS (fluticasone, budesonide) dengan inhibitor enzim CYP3A4 seperti ritonavir dan klaritromisin, bronkodilator β2-agonis dengan β-blocker nonselektif, kombinasi antikolinergik, serta theophylline dengan antibiotik makrolida. Efek klinis yang umum dilaporkan mencakup supresi adrenal, bronkospasme, pneumonia, dan toksisitas sistemik. Temuan ini menekankan pentingnya pemantauan terapi secara ketat pada pasien PPOK, terutama dalam penggunaan kombinasi obat. Apoteker klinis memiliki peran penting dalam mendeteksi dan mencegah interaksi obat untuk meningkatkan keamanan dan keberhasilan terapi. Oleh karena itu, pemahaman yang komprehensif terhadap interaksi obat menjadi aspek penting dalam manajemen pasien PPOK.References
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