Perbandingan Regimen Terapi Antipsikotik Berbasis Risperidon Terhadap Sindrom Ekstrapiramidal, Fungsi Kognitif, dan Gangguan Metabolik Pada Pasien Schizophrenia

https://doi.org/10.22146/farmaseutik.v1i1.60346

Hendik Riawan(1*), Cecep Sugeng Kristanto(2), Zullies Ikawati(3)

(1) Magister Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(2) Departemen Ilmu Kedokteran Jiwa, Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan Universitas Gadjah Mada/ RSUP Dr. Sardjito, Yogyakarta
(3) Department of Pharmacology, Faculty of Pharmacy, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Target kerja setiap regimen antipsikotik menimbulkan efek samping berbeda baik digunakan secara tunggal maupun kombinasi. Risperidon tunggal, kombinasi risperidon-klorpromazin dan risperidon-klozapin merupakan 3 besar regimen terapi antipsikotik terbanyak yang digunakan di Instalasi rawat jalan RS Ernaldi Bahar Palembang. Penelitian ini bertujuan untuk mengetahui pengaruh 3 regimen terapi antipsikotik berbasis risperidon terhadap kejadian sindrom ekstrapiramidal (EPS), fungsi kognitif, serta gangguan metabolik. Rancangan penelitian Cohort Prospective pre-post test menggunakan alat bantu kuesioner Extrapyramidal Symptom Rating Scale (ESRS) untuk mengetahui kejadian EPS, Mini Mental State Examination (MMSE) untuk mengetahui perubahan fungsi kognitif serta mengukur Body Mass Index (BMI), kolesterol total, tekanan darah, dan gula darah sewaktu (GDS) untuk mengetahui adanya gangguan metabolik. Pengambilan data dilakukan pada pasien rawat jalan periode Maret–April 2020. Diperoleh sebanyak 361 subyek penelitian, namun akibat pandemi covid-19 maka hanya 180 yang memenuhi kelengkapan data untuk dianalisa dan terdistribusi merata ke dalam 3 regimen terapi antipsikotik yang diteliti. Analisis demografi responden dilakukan secara deskriptif. Uji Kruskal Wallis digunakan untuk mengetahui perbandingan regimen terapi antipsikotik berbasis risperidon terhadap kejadian EPS, sedangkan untuk melihat perburukan fungsi kognitif dan gangguan metabolik digunakan Uji Chi-square. Hasil penelitian menunjukkan terdapat perbedaan yang signifikan munculnya kejadian parkinson (p=0,000) dan distonia (p=0,027). Penggunaan obat antikolinergik yang tidak adekuat merupakan faktor pengganggu yang ikut mempengaruhi secara signifikan terhadap kejadian parkinson (p=0,048). Serta tidak terdapat perbedaan yang signifikan dalam perburukan fungsi kognitif (p=0,465), BMI (p=0,610), kolesterol total (p=0,167), tekanan darah (p=0,327) dan GDS (p=0,218) antar 3 regimen terapi antipsikotik berbasis risperidon.

Keywords


Schizophrenia; efek samping; regimen antipsikotik

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DOI: https://doi.org/10.22146/farmaseutik.v1i1.60346

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