Transcript Slide 1
ABSTRACT Drug Utilization Study on Ambulatory Rheumatoid Arthritis Patients at Dr. Soetomo Teaching Hospital Surabaya Background: Rheumatoid arthritis (RA) is an autoimmune disease with chronic inflammation, can cause irreversible joint deformities and functional impairment that cannot be cured and that has substantial personal, social and economic cost. The drug effectiveness and potential side effects are important considerations in prescribing drugs for rheumatoid arthritis. Objective: The purpose of this study was to identify the drug utilization profile on ambulatory rheumatoid arthritis patients includes type of drugs, dosages, frequencies and route of administration. Methods: The drug utilization profile on ambulatory rheumatoid arthritis patients was analyzed descriptively by retrospective method. Research sample period was from January 1 st 2006 until May 31st 2007 at the outpatient unit Rheumatology division of Internal Medicine Dr. Soetomo teaching hospital Surabaya. Results: RA patient were 80% female and 20% male, patients age distribution were; adult (>12-65 years old) 94,3% and elderly (>65 years old) 5,7%. Drugs used in RA patients were opioid analgetic tramadol (1 patient), nonopioid analgetic paracetamol (3 patients), NSAIDs; diclofenac Na (24 patients), meloxicam (16 patients); etodolac (2 patients); piroxicam (1 patient), disease modifying antirheumatoid drugs/DMARDs; chloroquine (13 patients), methotrexate (11 patients), sulfasalazine (4 patients), azathioprine (2 patients), corticosteroid; prednisone (23 patients); methylprednisolone (2 patients), H2 receptor antagonist (ranitidine), proton pump inhibitor (omeprazole), antacid and folic acid has been used by rheumatoid arthritis patients to prevent and treated the adverse drugs reactions. More than 90% dose of the drugs that has been given appropriate with the recommended dose, in few case adjustment of the dose related with adverse drugs reactions and drugs interaction is still needed. Drug related problems (DRPs) which occurred in rheumatoid arthritis patients are the adverse drug reactions; gastrointestinal toxicity (13 patients), anaemia (1 patient), stomatitis (2 patients) and increasing SGOT/SGPT (1 patient). Conclusion : Drugs used in RA patients were opioid analgetic (tramadol), nonopioid analgetic (paracetamol), NSAIDs (diclofenac Na, meloxicam, etodolac, piroxicam) to relief the pain and reduce inflammation, disease modifying antirheumatoid drugs/DMARDs (chloroquine, methotrexate, sulfasalazine, azathioprine) to reduce the progression of the disease, corticosteroid (prednisone, methylprednisolone) as bridging therapy and imunosupressant, H2 receptor antagonist (ranitidine), proton pump inhibitor (omeprazole), antacid and folic acid has been used by rheumatoid arthritis patients to prevent and treated the adverse drugs reactions. Keyword : Rheumatoid arthritis (RA), DMARDs, drug utilization study.