STUDI INTERAKSI OBAT-OBAT JANTUNG YANG DILAKUKAN TERHADAP ORANG SEHAT: TINJAUAN SISTEMATIS
Isi Artikel Utama
Pasien dengan penyakit kardiovaskular memiliki prevalensi interaksi obat yang lebih tinggi dibandingkan kelompok pasien lain karena jumlah dan penggunaan obat yang komplek. Interaksi obat merupakan perubahan efek kerja dari suatu obat karena adanya obat lain ketika diberikan bersamaan. Jenis interaksi obat terdiri dari interaksi farmakokinetik, farmakodinamik, dan farmasetik. Studi ini berupa tinjauan sistematis yang bertujuan untuk mengidentifikasi interaksi obat yang berkaitan dengan obat-obat jantung. Proses penelusuran artikel dilakukan pada database PubMed dan ScienceDirect untuk mengidentifikasi semua artikel mengenai studi interaksi obat-obat jantung. Penelusuran artikel dibatasi pada tahun 2013 hingga 2023. Kata kunci yang digunakan dalam penelusuran artikel sebagai berikut: drug-drug interactions, cardiac patient, cardiac drug, cardiovascular drug, pharmacokinetics interaction, pharmacodynamic interaction dikombinasikan dengan boolean operator yaitu AND. Studi artikel yang telah memenuhi syarat, dimasukkan ke dalam penelitian untuk ditinjau. Jumlah keseluruhan artikel yang telah teridentifikasi dari database yang digunakan yaitu sebanyak 805 artikel, 7 artikel duplikasi dikeluarkan, 82 artikel tersedia teks lengkap, namun hanya 20 artikel sesuai dengan inklusi yang dilakukan review. Dari 20 artikel, 18 publikasi mengidentifikasi interaksi obat secara farmakokinetik, sedangkan interaksi secara farmakodinamik dilaporkan dalam 2 publikasi. Interaksi farmakokinetik banyak terjadi pada golongan obat Angiotensin II Reseptor Bloker (ARB). Selain itu terjadi pada golongan obat angiotensin receptor-neprilysin inhibitor (ARNI), calcium channel blocker, penghambat reseptor mineralkortikoid nonsteroid selektif, diuretik, beta-blocker, antikoagulan, dan antiplatelet. Interaksi farmakodinamik terjadi pada golongan obat calcium channel blocker dan beta-blocker. Untuk menghindari terjadinya interaksi obat, perlu pengetahuan mengenai mekanisme terjadinya interaksi obat dan efeknya terhadap pengobatan.
Kata kunci : Farmakodinamik, farmakokinetik, interaksi obat, kardiovaskular.
Abstract
Patients with cardiovascular diseases have a higher prevalence of drug interactions than other patient groups due to the number and complex use of drugs. Drug interactions are changes in the effect of a drug due to the presence of another drug when administered together. Types of drug interactions consist of pharmacokinetic, pharmacodynamic, and pharmaceutical interactions. This study is a systematic review that aims to identify drug interactions related to cardiac drugs. The article search process was conducted on PubMed and ScienceDirect databases to identify all articles on cardiac drug-drug interaction studies. Article searches were limited to the years 2013 to 2023. The keywords used in the article search were as follows: drug-drug interactions, cardiac patient, cardiac drug, cardiovascular drug, pharmacokinetics interaction, pharmacodynamic interaction combined with the boolean operator AND. Eligible study articles were included in the study for review. A total of 805 articles were identified from the database used, 7 duplicate articles were excluded, 82 articles were available in full text, however, only 20 articles that met the inclusion criteria were reviewed. Of the 20 articles, 18 publications identified pharmacokinetic drug interactions, while pharmacodynamic interactions were reported in 2 publications. Pharmacokinetic interactions mostly occurred in the Angiotensin II Receptor Blocker (ARB) drug class. In addition, angiotensin receptor-neprilysin inhibitors (ARNI), calcium channel blockers, selective nonsteroidal mineralocorticoid receptor blockers, diuretics, beta-blockers, anticoagulants, and antiplatelets were also reported. Pharmacodynamic interactions occur with calcium channel blockers and beta-blockers. To avoid drug interactions, it is necessary to know the mechanism of drug interactions and their effects on treatment.
Keywords: Pharmacodynamics, pharmacokinetics, drug Interactions, cardiovascular.
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