Evaluasi Penggunaan Obat pada Pasien Stroke Iskemik di RSD dr. Soebandi Jember

Abstract

Stroke is neurological disorder characterized by dysfunction typically caused by impaired cerebral blood flow. Ischemic stroke results from atherosclerosis, leading to cerebral blood vessel occlusion. Patiens with ischemic stroke require long-term therapeutic management, necessitating rational medication selection and utilization. This study aimed to determine the profiles of ischemic stroke patiens, their treatment regimens, medication therapy appropriateness, and drug related problems among ischemic stroke patiens at dr. Soebandi General Hospital, Jember. Data were collected in January 2025 from medical records of 223 patiens diagnosed with ischemic stroke who met the inclusion criteria. The patiens demographics t dr. Soebandi General Hospital, Jember, showed male predominance (54,70%), primarily affecting adults aged 19-59 years (50,22%), with BPJS health insurance coverage (74,88%), and comorbidities present in (43,94%) of cases. The medication profiles included: antiplatelet therapy with clopidogrel 75 mg (66,36%), antihypertensive therapy with ARB candesartan 16 mg (60,53%), lipid-lowering therapy with atorvastatin 20 mg (48,87%), antidiabetic therapy with metformin 500 mg (4,48%), neuroprotective therapy with citicoline 500 mg (2,69%), and neuropatic pain management with gabapentin 300 mg (9,86%). Comparison with clinical guidelines revealed dosing discrepancies, particularly for neuropatic pain therapy: gabapentin 100 mg once daily in 19 patiens and gabapentin 100 mg twice daily in 7 patiens. Antiallergic therapy included cetirizine 10 mg twice daily in 2 patiens. Drug related problems encompassed moderate drug interactions between aspirin and amlodipine as the most common finding. Subtherapeutic dosing issues were identified with gabapentin 100 mg administered once or twice daily, while supratherapeutic dosing was found with cetirizine 10 mg twice daily.