Analisis Rasionalitas Penggunaan Antiplatelet Aspirin Dan Clopidrogel Sebagai Monoterapi Pada Pasien Stroke Iskemik
Keywords:
antiplatetet, rasionalitas, stroke iskemik
Abstract
Stroke termasuk faktor utama disabilitas dan kematian nomor dua di dunia. Antiplatelet yaitu pengobatan untuk stroke iskemik dilakukan dengan memberi obat anti-agregasi platelet yang bertujuan untuk menghambat penggumpalan trombosit, sehingga mencegah terbentuknya trombus yang sering terjadi pada sistem arteri. Aspirin dan clopidogrel termasuk agen antiplatelet yang direkomendasikan oleh kementerian kesehatan melalui Pedoman Nasional Pelayanan Kedokteran Tata Laksana Stroke Tahun 2019. Tujuan penelitian ini supaya tahu rasionalitas pemakaian antiplatelet aspirin dan clopidrogel sebagai monoterapi pada pasien Rawat inap stroke iskemik di RSUD Prof. Dr. Margono Soekarjo. Penelitian ini yakni deskriptif kuantitatif dengan pendekatan secara retsrospektif dengan memakai data sekunder yaitu rekam medis pasien di RSUD Prof. Dr. Margono. Hasil penelitian dari total 100 pasien stroke iskemik mayoritas laki laki banyaknya 60 pasien (60%) dan wanita banyaknya 40 pasien (40%). Usia pasien mayoritas 56 – 65 tahun banyaknya 41 pasien (41%). Pemakaian obat antiplatelet yang paling banyak dipakai yaitu clopidogrel banyaknya 83%. Evaluasi rasionalitas sesuai tepat pasien 100%, tepat obat 83%, tepat dosis 100%, dan tepat interval 100%.
References
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Minhas, J.S. et al. (2022) “Oral antiplatelet therapy for acute ischaemic stroke,” Cochrane Database of Systematic Reviews. John Wiley and Sons Ltd. Available at: https://doi.org/10.1002/14651858.CD000029.pub4.
Paciaroni, M. et al. (2019) “Benefits and Risks of Clopidogrel vs. Aspirin Monotherapy after Recent Ischemic Stroke: A Systematic Review and Meta-Analysis,” Cardiovascular Therapeutics. Hindawi Limited. Available at: https://doi.org/10.1155/2019/1607181.
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Permatasari, D. et al. (2021) “Evaluasi Rasionalitas Penggunaan Obat Neuroprotektif pada Pasien Stroke Iskemik di Rumah Sakit Stroke Nasional Bukittinggi Rationality of Neuroprotective Drug Use in Ischemic Stroke Patients at the Bukittinggi National Stroke Hospital,” Jurnal Farmasi Dan Ilmu Kefarmasian Indonesia, 8(2), p. 162.
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Zhang, C. et al. (2020) “Follicle-Stimulating Hormone Positively Associates with Metabolic Factors in Perimenopausal Women,” International Journal of Endocrinology, 2020. Available at: https://doi.org/10.1155/2020/7024321.
Zhong, X. et al. (2023) “Immunomodulatory role of estrogen in ischemic stroke: neuroinflammation and effect of sex,” Frontiers in Immunology. Frontiers Media S.A. Available at: https://doi.org/10.3389/fimmu.2023.1164258.
Agustina, S. et al. (2023) “Studi Pasien Stroke Iskemik dengan Terapi Antiplatelet di Poliklinik Saraf Rumah Sakit Tingkat III Brawijaya Surabaya, Indonesia, Agustus–November 2022,” CDK-319 [Preprint].
Budiyanti, N.A., Hapsari, I. and Nurhidayati, F.S. (2024) “Evaluation of drug use in stroke patients at the inpatient unit of Brebes Hospital, Central Java,” Acta Pharmaciae Indonesia, 12(1), p. 11944. Available at: https://doi.org/10.20884/1.api.2024.12.01.11944.
Diana, D.M.I. et al. (2020) “The Effect Of Citicolin In Motoric Improvement Of Acute Ischemic Stroke Patients In Siti Khodijah Sepanjang Hospital,” Medical and Health Science Journal, 4(1), pp. 47–54. Available at: https://doi.org/10.33086/mhsj.v4i1.1415.
Diana, K. et al. (2021) “Evaluasi Penggunaan Obat Berdasarkan Indikator Peresepan dan Pelayanan Pasien di Rumah Sakit Tora Belo,” Jurnal Farmasi Dan Ilmu Kefarmasian Indonesia, p. 13.
DiPiro et al. (2021) PHARMACOTHERAPY Editions 11.
Efriani, L., Irawan, A. and Anwar, M. (2024) Analisis Drug Related Problems (DRPs) Pada Pasien Angina Pektoris RS X Kota Cirebon Tahun 2023 Analysis of Drug Related Problems (DRPs) in Patients Angina Pectoris at X Hospital Cirebon City in 2023, Journal of Pharmacy.
Endarwati, T. et al. (2025) “Comparison of effectiveness of aspirin, clopidogrel and cilostazol monotherapy treatment in ischaemic stroke,” in BIO Web of Conferences. EDP Sciences. Available at: https://doi.org/10.1051/bioconf/202515201001.
Feigin, V.L. et al. (2024) “Global, regional, and national burden of stroke and its risk factors, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021,” The Lancet Neurology, 23(10), pp. 973–1003. Available at: https://doi.org/10.1016/S1474-4422(24)00369-7.
Fledderus, J. et al. (2021) “The endothelium as a target for anti-atherogenic therapy: A focus on the epigenetic enzymes EZH2 and sirt1,” Journal of Personalized Medicine. MDPI AG, pp. 1–21. Available at: https://doi.org/10.3390/jpm11020103.
Frank, D. et al. (2022) “The Development of Novel Drug Treatments for Stroke Patients: A Review,” International Journal of Molecular Sciences. MDPI. Available at: https://doi.org/10.3390/ijms23105796.
Genge, A.K. et al. (2019) “Vascular endothelial cell biology: An update,” International Journal of Molecular Sciences. MDPI AG. Available at: https://doi.org/10.3390/ijms20184411.
Giovane, C. Del et al. (2021) “Antiplatelet drugs for secondary prevention in patients with ischemic stroke or transient ischemic attack: a systematic review and network meta-analysis,” BMC Neurology, 21(1). Available at: https://doi.org/10.1186/s12883-021-02341-2.
Handayani, R. et al. (2023) “Karakteristik Penderita Stroke Iskemik di Rumah Sakit Ibnu Sina Makassar Tahun 2020-2021,” Fakumi Medical Journal [Preprint].
İlhan, S.Ö. et al. (2022) “Evaluation of irrational drug use of individuals over the age of 18 who applied to a university hospital,” Turkish Journal of Medical Sciences, 52(2), pp. 484–493. Available at: https://doi.org/10.3906/sag-2110-215.
Jannah, A.M., Hardia, L. and Bayu Budiyanto, A. (2023) “Evaluasi Pola Peresepan Obat Anti Hipertensi Di Puskemas,” Jurnal Etnofarmasi, 01(01), pp. 17–21.
KEMENKES (2019) “Pedoman Nasional Pelayanan Kedokteran Tata Laksana Stroke,” in. MENTERI KESEHATAN REPUBLIK INDONESIA.
KEMENKES (2024) Cegah Stroke dengan Aktivitas Fisik. Available at: https://www.kemkes.go.id/id/cegah-stroke-dengan-aktivitas-fisik (Accessed: June 24, 2025).
Kleindorfer, D.O. et al. (2021) “2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association,” Stroke. Wolters Kluwer Health, pp. E364–E467. Available at: https://doi.org/10.1161/STR.0000000000000375.
Kurniasari, D.R. (2017) “Evaluasi Rasionalitas Obat Antiplatelet Pada Pasien Stroke Iskemik Di Instalasi Rawat Inap Rs X Periode 2016,” Naskah Publikasi, pp. 1–17.
Lee, S.W. et al. (2022) “Relationship between metabolic syndrome and follicle-stimulating hormone in postmenopausal women,” Medicine (United States), 101(18), p. E29216. Available at: https://doi.org/10.1097/MD.0000000000029216.
Martinez, R. et al. (2025) “Risk and impact of stroke across 38 countries and territories of the Americas from 1990 to 2021: a population-based trends analysis from the Global Burden of Disease Study 2021,” The Lancet Regional Health - Americas, 43. Available at: https://doi.org/10.1016/j.lana.2025.101017.
Megawati, S., Rahmawati, R. and Fhatonah, N. (2021) “Evaluasi Penggunaan Obat Antiplatelet Pada Pasien Stroke Iskemik Di Instalasi Rawat Inap Rumah Sakit Umum Kabupaten Tangerang Tahun 2019,” Jurnal Farmagazine, 8(1), p. 39. Available at: https://doi.org/10.47653/farm.v8i1.531.
Meza, C.A. et al. (2019) “Endothelial dysfunction: Is there a hyperglycemia-induced imbalance of NOX and NOS?,” International Journal of Molecular Sciences. MDPI AG. Available at: https://doi.org/10.3390/ijms20153775.
Minhas, J.S. et al. (2022) “Oral antiplatelet therapy for acute ischaemic stroke,” Cochrane Database of Systematic Reviews. John Wiley and Sons Ltd. Available at: https://doi.org/10.1002/14651858.CD000029.pub4.
Paciaroni, M. et al. (2019) “Benefits and Risks of Clopidogrel vs. Aspirin Monotherapy after Recent Ischemic Stroke: A Systematic Review and Meta-Analysis,” Cardiovascular Therapeutics. Hindawi Limited. Available at: https://doi.org/10.1155/2019/1607181.
Patrono, C. (2024) “Low-dose aspirin for the prevention of atherosclerotic cardiovascular disease,” European Heart Journal. Oxford University Press, pp. 2362–2376. Available at: https://doi.org/10.1093/eurheartj/ehae324.
Permatasari, D. et al. (2021) “Evaluasi Rasionalitas Penggunaan Obat Neuroprotektif pada Pasien Stroke Iskemik di Rumah Sakit Stroke Nasional Bukittinggi Rationality of Neuroprotective Drug Use in Ischemic Stroke Patients at the Bukittinggi National Stroke Hospital,” Jurnal Farmasi Dan Ilmu Kefarmasian Indonesia, 8(2), p. 162.
Poana, N.L., Wiyono, W.I. and Mpila, D.A. (2020) “Pola Penggunaan Obat Pada Pasien Stroke Hemoragik Di Rsup Prof. Dr. R.D. Kandou Manado Periode Januari-Desember 2018,” Pharmacon, 9(1), p. 90. Available at: https://doi.org/10.35799/pha.9.2020.27469.
Powers, W.J. et al. (2019) “Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke a guideline for healthcare professionals from the American Heart Association/American Stroke Association,” Stroke. Lippincott Williams and Wilkins, pp. E344–E418. Available at: https://doi.org/10.1161/STR.0000000000000211.
Rahayu, G.T. (2023) “Analisis Faktor Risiko Terjadinya Stroke Serta Tipe Stroke,” Faletehan Health Journal, 10(1), pp. 48–95. Available at: www.journal.lppm-stikesfa.ac.id/ojs/index.php/FHJ.
Riedel, K. et al. (2019) “Estrogen determines sex differences in adrenergic vessel tone by regulation of endothelial β-adrenoceptor expression,” American Journal of Physiology - Heart and Circulatory Physiology, 317(2), pp. H243–H254. Available at: https://doi.org/10.1152/ajpheart.00456.2018.
Setiadi, F. et al. (2024) Perbedaan Lama Penurunan Pt Dan Aptt Pasien Stroke Iskemik Yang Diberikan Clopidogrel Di Rs Fatmawati Tahun 2023, Pharmamedica Journal).
World Stroke Organization (2024) Promoting rational use of medicines. Available at: https://www.world-stroke.org/world-stroke-day-campaign/about-stroke/types-of-stroke (Accessed: June 24, 2025).
Xiang, D. et al. (2021) “Protective Effects of Estrogen on Cardiovascular Disease Mediated by Oxidative Stress,” Oxidative Medicine and Cellular Longevity. Hindawi Limited. Available at: https://doi.org/10.1155/2021/5523516.
Zhang, C. et al. (2020) “Follicle-Stimulating Hormone Positively Associates with Metabolic Factors in Perimenopausal Women,” International Journal of Endocrinology, 2020. Available at: https://doi.org/10.1155/2020/7024321.
Zhong, X. et al. (2023) “Immunomodulatory role of estrogen in ischemic stroke: neuroinflammation and effect of sex,” Frontiers in Immunology. Frontiers Media S.A. Available at: https://doi.org/10.3389/fimmu.2023.1164258.
