01. No Rekam medik 02. Nama Pasien 03. Jenis Kelamin - Drug Related Problems (Drps): Studi Kesesuaian Dosis Penggunaan Obat Antihipertensi Pada Pasien Gangguan Ginjal Kronik Di RSUP H. Adam Malik Medan Periode September 2013 – Maret 2014

  Lampiran 1. Lembar Pengumpulan data

  01. No Rekam medik

  02. Nama Pasien

  03. Jenis Kelamin

  04. Umur

  05. Berat Badan

  06. Tinggi Badan ฀ Laki-laki .........thn ..............kg ............. cm ฀ Perempuan

  07. Tanggal Masuk Rumah sakit

  08. Tanggal Keluar Rumah sakit

  09. Lama Perawatan

  10. Diagnosa MRS / Diagnosa Kerja

  11. Alasan Masuk Rumah sakit

  12. Alasan Keluar Rumah sakit ฀ Observasi ฀ Tujuan MRS telah selesai ฀ Skreening ฀ Dipindahkan ke RS lain ฀ Diagnostik ฀ Pulang paksa ฀ Terapi initial ฀ Pulang berobat jalan ฀ Terapi komplementeri ฀ Meninggal ฀ Terapi sekunder ฀ ................................ ฀ ...................................... ฀ ................................ ฀ ......................................

  13. DIAGNOSA AKHIR  Utama :  Komplikasi  Sekunder :

  2. Uji Laboratorium Fungsi Ginjal Tgl/ Hasil Pemeriksaan Nilai

  N Normal Parameter Satuan o mg/dl

  1 Ureum <50 mg/dl

  2 Creatinine 0,7-1,20 mg/dl

  3 Urin Acid Lk=3,0 - 7,0 Pr=2,4

• – 6,0

  mEq/L

  4 Na 135

• – 155

  mEq/L

  5 K 3,6 5,5 mEq/L

  6 Cl 96-106

  Lampiran 1. (lanjutan)

3. Keterangan Harian Pemberian Obat

  Tanggal / bulan

  1. Sensor

  2. Kondisi Pasien

  3. BP (mmHg) HR RR Temp (C )

  4. Terapi Hari Ke (15) Jenis Obat

  Nama Dagang Nama Generik (16) Sediaan Dosis

  Rekomendasi (20) Bentuk (17)

  

Kekuatan

(18)

Dosis (19)

  Lampiran 1. (lanjutan)

DATA LENGKAP PASIEN GGK PADA PERIODE SEPTEMBER 2013- MARET 2014

  N L/ UMUR BB TB LAMA JENIS LFG

INISIAL STAGE DOSIS KET.

O P (thn) (Kg) (cm) (Hari) OBAT (ml/dl)

  Lampiran 2. Contoh Perhitungan Penyesuaian Dosis Antihipertensi pada Pasien Gangguan Ginjal Kronik di RSUP H. Adam Malik Medan Periode September 2013

• – Maret 2014 Penderita dengan nomor rekam medik 591121 Jenis kelamin : Laki-laki Umur : 47 tahun Berat badan: 62 kg Kreatinin serum : 19,16 ml/dl

  Mendapat terapi antihipertensi Captopril dosis 3x25 mg Dosis lazim captopril 25-150 mg 2-3 kali/hari.

• Penentuan laju filtrasi glomerulus = 4,179 ml/menit • Penetuan regimen dosis. Dosis captopril untuk penderita dengan LFG < 10 ml/menit adalah 50% dari dosis lazim. Dosis = 50% x 25-150 mg, 2-3 kali/hari.

  = 12,5-75 mg, 2-3 kali/hari. Jadi regimen dosis captopril untuk penderita tersebut menjadi 12,5

• –75 mg, 2-3 kali/hari.

  Lampiran 2. (lanjutan) Penderita dengan nomor rekam medik 588050 Jenis kelamin : Perempuan Umur : 48 tahun Berat badan : 70 kg Kreatinin serum : 2,74 ml/dl Mendapat terapi antihipertensi Captopril dosis 3x25 mg.

  Dosis lazim captopril 25-150 mg 2-3 kali/hari.

• Penentuan laju filtrasi glomerulus = 27,75 ml/ menit • Penetuan regimen dosis. Dosis captopril untuk penderita dengan LFG 10 - 50 ml/menit adalah 75% dari dosis lazim. Dosis = 75% x 25-150 mg, 2-3 kali/hari = 18,75-112,5 mg, 2-3 kali/hari Jadi regimen dosis captopril untuk penderita tersebut menjadi 18,75-112,5

  mg, 2-3 kali/hari

  Lampiran 2. (lanjutan) Penderita dengan nomor rekam medik 590807 Jenis kelamin : Laki-laki .

  Umur : 51 tahun. Kreatinin serum : 2,13 ml/dl. Mendapat terapi antihipertensi bisoprolol dosis 1x1,25 mg. Dosis lazim bisoprolol 2,5-10 mg 1 kali/hari.

• Penentuan laju filtrasi glomerulus.
• Penetuan regimen dosis. Dosis bisoprolol untuk penderita dengan LFG 10 - 50 ml/menit adalah 75% dari dosis lazim. Dosis = 75% x 2,5-10 mg, 1 kali sehari. = 1,875-7,5 mg, 1 kali sehari. Jadi regimen dosis bisoprolol untuk penderita tersebut menjadi 1,875-7,5 mg (1 kali sehari).

  Lampiran 3. Data Lengkap Rekam Medik Pasien Gangguan Ginjal Kronik di

RSUP H. Adam Malik Medan Periode September 2013

• – Maret 2014

  No. Umur BB TB eGFR Jenis NO Insial L/P Stage Scr Dosis Keterangan

  RM (thn) (kg) (cm) (ml/min) Obat 572

  1 GUSE L

  49 78 168

  V 13.61 7.243 Captopril 2x25 mg JAMKESMAS 720

  7.94 4.1378 2x25 mg 575

  2 LM P

  19 23 100

  V Captopril JAMKESMAS 459

  4.1 8.0133 2x12.5 mg 2x25 mg

  Captopril 6 9.3075 3x25 mg

  Furosemid 574

  1x10 mg/ml

  3 TP P

  54 55 160

  V JAMKESMAS Injeksi

  422 2x10 mg

  Nifedipin 5.5 10.153 1x10 mg

  Furosemid 2x40 mg 2x25 mg

  14.03 7.741 Captopril 574

  3x25 mg

  4 SY L

  48 85 165

  V JAMKESMAS 067

  Furosemid 14.06 7.725 2x10 mg/ml

  Injeksi Furosemid

  1x10 mg/ml Injeksi

  Captoptil 3x25 mg 573

  5 TN P

  69 52 150

  V 9.81 4.443 JAMKESMAS 795

  Nifedipin 1x10 mg HCT 1x25 mg

  Amlodipin 1x5 mg 10.44 5.129

  573

  6 SP P

  56 54 160

  V Amlodipin 3x5 mg JAMKESMAS 757

  3.16 16.946 10.44 7.263 Captopril 3x25 mg

  576

  7 AHU L

  56 65 165

  V 7.75 9.784 JAMKESMAS 450

  Nifedipin 1x10 mg 6.89 11.006 3.35 21.193

  574

  8 ZK P

  43 62 155

  IV Captopril 2x18.75 mg

  JAMKESMAS

  350

  3.36

  21.13 2.18 24.528 Captopril 2x18.75 mg 2.52 21.219 HCT 1x25 mg

  Furosemid 572

  9 IRN L

  70 55 165

  IV 3x10 mg/ml JAMKESMAS 472

  Injeksi 2.64 20.254

  3x5 mg Amlodipin

  1x5 mg 13.4 4.902

  576 Furosemid

  10 Mes L

  54 55 155 V 1x10 mg/ml JAMKESMAS 325

  Injeksi 7.16 9.175 7.21 11.519 Furosemid 2x10 mg/ml

  Injeksi 7.76 10.703 3x10 mg/ml

  574 @2ml;Amp

  11 KM L

  48 65 165

  V JAMKESMAS 756

  7.69 10.8 2x100 mg Spironolakto n

  6.31 13.1625 1x100 mg HCT 1x25 mg

  576

  12 TOTA L

  42 60 165

  III 1.39 58.752 Amlodipin 1x5 mg

  JAMKESMAS

  592 Captopril 3x25 mg

  Lampiran 3. (lanjutan)

  4.6

  26.19 2.776 Injeksi

  23.93 3.039 Furosemid 1x10 mg/ml

  JAMKESMAS

  V 27.8 2.675 Captopril 2x25 mg

  52 70 160

  DASI P

  20 585 922

  14.79 Injeksi

  JAMKESMAS

  21 576 384

  V 8.17 8.329 Furosemid 2x10 mg/ml

  53 50 160

  RP P

  19 581 429

  Captopril 3x25 mg

  JAMKESMAS

  V 8.93 6.213 Amlodipin 3x5 mg

  46 50 158

  Amlodipin 2x5 mg

  PBT P

  18 582 863

  JAMKESMAS

  15.18 3.546 3x25 mg 14.77 3.645 Furosemid 1x10 mg/ml 12.87 4.182 Injeksi 2x10 mg/ml 14.78 3.642

  JAMKESMAS

  Captopril 2x12.5 mg

  V 10.3 5.226

  60 57 160

  NA P

  23 579 048

  12.26 6.593 Injeksi 1x10 mg/ml 12.77 6.329 Nifedipin 3x10 mg

  V 6.76 11.957 Furosemid 2x10 mg/ml

  52 55 160

  43 60 165

  SUM L

  22 576 534

  Captopril 3x25 mg

  JAMKESMAS Bisoprolol 1x5 mg

  7.42 Amlodipin 3x5 mg

  7.7

  V

  SAW P

  18.26 3.723 Bisoprolol 1x5 mg 19.02 3.575 Captopril 2x25 mg

  NO No.

  62 60 165

  14 577 238

  14.84

  4.38

  10.62 Injeksi 3x10 mg/ml 4.73 13.742

  6.12

  8.3 7.831 Furosemid

  JAMKESMAS

  V 10.88 5.974 Captopril 3x12.5 mg

  PAI L

  48 66 150

  13 576 896

  Dosis Keterangan

  Jenis Obat

  eGFR (ml/min)

  Stage Scr

  BB (kg) TB (cm)

  Umur (thn)

  RM Insial L/P

  LIB P

  V 10.43 6.872 Furosemid

  JAMKESMAS

  71 45 155

  3.85 Amlodipin 1x5 mg

  17.66

  V

  43 45 150

  NL P

  17 580 020

  JAMKESMAS

  V 3.44 12.536 Captopril 2x12.5 mg

  JBS L

  2x10 mg/ml JAMKESMAS 7.54 9.507 Injeksi 4.19 17.108

  16 581 410

  Nifedipin 3x10 mg 19.13 4.225

  Injeksi 18.06 4.475 Captopril 2x12.5 mg 17.83 4.533

  JAMKESMAS

  Furosemid 2x10 mg/ml

  V 14.2 5.692

  43 60 165

  MN L

  15 579 054

  15.5 3.473

  Lampiran 3. (lanjutan)

  L BB TB eGFR Jenis No. Umur

  NO Inisial / Stage Scr Dosis Keterangan RM (thn)

  P (kg) (cm) (ml/min) Obat

  3x12.5 mg Captopril

  3x25 mg 568

  24 ZUR P

  63 55 155

  V 9.3 5.376

  JAMKESMAS

  517 Furosemid 1x10 mg/ml

  Injeksi 3x10 mg/ml Captopril 3x25 mg

  Furosemid 580

  25 JUH P

  41 58 160

  V 10.14 6.685 1x10 mg/ml

  JAMKESMAS

  554 Injeksi

  Nifedipin 2x10 mg 5.28 15.151 Captopril 3x18.75 mg

  580

  26 RN L

  44 60 155

  IV JAMKESMAS 067

  4.66 17.167 Furosemid 1x40 mg 4.21 12.899 3x75 mg

  Captopril 3x25 mg

  563

  27 TU P

  48 50 160

  V JAMKESMAS 882

  5.85 9.283 Amlodipin 1x5 mg HCT 1x25 mg

  2x12.5 mg Captopril

  12.8 6.235 3x12.5 mg 577

  28 EHS P

  36 65 172

  V Furosemid 2x10 mg/ml JAMKESMAS 359

  Injeksi 1x10 mg/ml 8.9 8.967

  Furosemid 3x40 mg Captopril 2x12.5 mg

  582

  29 MBS P

  56 52 160

  IV 7.07 7,294

  JAMKESMAS

  849 Furosemid 1x40 mg

  576

  30 LEG P

  55 60 165

  V 14.98 4.019 Captopril 2x12.5 mg JAMKESMAS 528

  18.31 2.579 Furosemid 579

  31 ROH P

  60 50 155 V 1x10 mg/ml JAMKESMAS 723

  15.8 2.988 Injeksi

  IV 2.6 22.976 576

  32 AS P

  48 55 155 HCT 1x25 mg JAMKESMAS 709

  2.38 25.099 Furosemid

  3x10 mg/ml 9.64 5.266 Injeksi

  Nifedipin 6x5 mg 576

  33 SUGT P

  54 50 150

  V JAMKESMAS 136

  Captopril 3x50 mg 14.3 3.549 Amlodipin 1x10 mg

  Bisoprolol 1x2.5 mg

  V Furosemid 573

  34 LDPT P

  19 45 150 19.71 3.261 1x10 mg/ml JAMKESMAS 061

  Injeksi Furosemid

  2X40 mg 9.64 5.265

  Captopril 3x50 mg 576

  35 SUGI P

  54 50 150

  V JAMKESMAS 136

  Bisoprolol 1x2.5 mg 8.98 5.653

  Nifedipin 6x5 mg Captpril 3x25 mg

  576

  36 ASH L

  21 48 170

  V 12.33 6.434 BPJS 010

  Amlodipin 2x5 mg

  Lampiran 3. (lanjutan)

  L No. NO Inisial / Umur BB TB Stage eGFR Jenis Dosis Keterangan

  RM Scr P

  (Thn) (kg) (Cm) (ml/min) Captopril 2x25 mg

  576

  37 MTS L

  39 60 160

  V 26.68 3.154 Furosemid BPJS 122

  1x10 mg/ml Injeksi

  9.04

  6.21 Furosemid 588

  38 PP L

  54 47 154 V 2x10 mg/ml BPJS 160

  16.12 3.483 Injeksi Captopril tab

  2x25 mg Scored

  359

  39 TT L

  61 60 160

  V 5.65 11.652 Furosemid BPJS 924

  1x10 mg/ml Injeksi

  @2ml;Amp 12.31 4.289 Amlodipin 3x5 mg

  500

  40 BS P

  54 52 155

  V

  9.31

  5.67 BPJS 333

  Captopril tab 3x25 mg scored

  12.15 4.345 Furosemid 3x40 mg Furosemid

  525

  41 AIPA L

  45 50 150

  IV 2.48 26.601 2x10 mg/ml BPJS 959

  Injeksi @2ml;Amp

  Spironolakton 3x25 mg 11.98 3.453 Furosemid

  584

  42 JUM P

  67 48 155 V 1x10 mg/ml BPJS 504

  Injeksi 4.08 10.139

  @2ml;Amp 584

  43 JUN L

  28 49 115

  V 8.98 8.488 Captopril 2x12.5 mg BPJS 368

  6.39 15.214 Bisoprolol 1x5 mg 588

  44 ARN L 70 100 160

  IV BPJS 152

  1.4 69.445 Captopril 3x18,75 mg Amlodipin 2x5 mg Furosemid 2x10 mg/ml

  588

  45 AZ L

  22 48 150

  V 8.78 8.959 BPJS 767

  Injeksi 4x10 mg/ml 3x10 mg/ml

  12.5 7.455 587

  46 WK L

  30 61 160

  V Captopril 2x25 mg BPJS 486

  14.81 6.293 Amlodipin 1x10 mg

  Captopril 2x50 mg 588

  Captopril tab

  47 AHP L

  51 55 155

  V 8.38 8.113 2x25 mg BPJS 588 scored

  Furosemid 1x10 mg/Vial

  Injeksi 2.77 27.446 Furosemid 3x10 mg/ml

  588

  48 JUL P

  48 70 160

  IV Injeksi 4x10 mg/ml BPJS 050

  2.74 27.747 Captopril 3x25 mg

  3.23 20.833 Furosemid 2x10 mg/ml 588

  Injeksi

  49 SYAM P

  45 60 150

  IV 3x10 mg/ml BPJS 903

  @2ml;Amp

  3.39

  19.85 Furosemid 1x40 mg

  Lampiran 3. (lanjutan) No No.

  Injeksi @2ml;Amp

  31 56 160

  SYA P

  59 590 388

  BPJS HCT 1x25 mg

  V 11.06 5.821 Amlodipin 2x5 mg

  39 54 155

  IBG P

  58 581 818

  BPJS Furosemid 2x10 mg/ml

  Amlodipin 1x10 mg

  V 13.36 7.423 Furosemid 3x40 mg

  55 84 172

  JP L

  57 585 265

  Captopril tab scored 3x12.5 mg

  @2ml;Amp 4x10 mg/ml

  BPJS Injeksi

  V 8.45 6.821 Furosemid 2x10 mg/ml

  V 15.23 5.566

  BPJS 8.71 9.733 2x5 mg

  SUM L

  Furosemid 2x40 mg

  4.58 Furosemid 2x10 mg/ml

  10.2

  5.99 Amlodipin 1x5 mg BPJS

  7.8

  V

  82 58 160

  MYD L

  61 592 262

  19.16 4.1797 Injeksi 2x10 mg/ml

  10.51 8.066 Captopril 1x12.5 mg 8.8 9.633

  Captopril 3x25 mg Furosemid 3x10 mg/ml

  1x5 mg 23.79 3.366

  2x5 mg BPJS

  V 9.9 8.089 Amlodipin

  47 62 165

  GESI L

  60 591 121

  Injeksi

  Furosemid 1x10 mg/ml

  57 50 165

  56 519 690

  RM Inisial

  V 17.21 1.873 Valsartan 1x 80 mg BPJS

  BT L

  52 516 914

  3x25 mg Furosemid 1x40 mg

  BPJS Captopril tab scored

  III 2.16 37.198 Amlodipin 1x 5mg

  51 65 160

  ES L

  51 587 129

  75 42 155

  V 21.36 3.959 Furosemid 3x40 mg BPJS

  DOSI P

  50 577 625

  Dosis Keterangan

  Jenis Obat

  Stage Scr eGFR (ml/ml)

  TB (cm)

  BB (kg)

  Umur (thn)

  L / P

  35 58 155

  53 590 287

  BPJS Propanolol 1x10 mg Spironolakton 1x100 mg

  BPJS 1x5 mg

  II 1.34 74.626 Furosemid 2x40mg

  44 75 165

  MNU L

  55 580 959

  Furosemid 1x40 mg

  Furosemid 1x10 mg/ml Injeksi 2x10 mg/ml

  6.6 13.594 2x25 mg

  Captopril 3x25 mg

  Bisoprolol 1x2.5 mg

  NING P

  IV 4.56 19.676

  64 85 160

  TUBU L

  54 590 189

  1x5 mg Captopril 2x25 mg

  Injeksi Amlodipin

  1x10 mg/ml BPJS

  V 9.66 8.603 Furosemid

  52 80 160

  Injeksi

  Lampiran 3. (lanjutan)

  Injeksi

  69 591 436

  BPJS Furosemid 1x40 mg Valsartan 1x80 mg

  15.5 V 8.6 7.906 HCT 1x25 mg

  60

  44

  EKS P

  68 423 303

  Furosemid 2x10 mg/ml

  51 55 160

  1x1.25 mg 1x2,5 mg

  BPJS Bisoprolol

  V 7.8 10.897 Furosemid 1x40 mg

  38 60 160

  JB L

  67 586 935

  BPJS HCT 1x12.5 mg

  RBB P

  V

  34 52 160

  III 1.36 48.314 Furosemid

  2x20 mg/ml BPJS Injeksi

  V 6.4 6.574 Furosemid

  74 54 160

  ABS P

  71 588 694

  Injeksi BPJS

  2x10 mg/ml BPJS

  57 65 165

  10.05

  WN L

  70 588 030

  Furosemid 1x40 mg 2x40 mg

  3.4 16.997 3x25 mg

  Captopril 3x12.5 mg

  BPJS 5.33 10.842 1x5 mg 4.25 13.597

  5.75 Amlodipin 1x10 mg

  V 14 5.468 Amlodipin 2x10 mg

  ROSI L

  NO No.

  RUK P

  SUG L

  63 590 807

  1x10 mg/ml Injeksi

  Furosemid 1x40 mg Bisoprolol 1x5 mg Furosemid

  BPJS Captopril 3x25 mg

  V 3.16 13.449 Amlodipin 1x5 mg

  68 50 150

  62 588 638

  III 2.13 39.463 Bisoprolol 1x5 mg

  Dosis Keterangan

  Jenis Obat

  Stage Scr eGFR (ml/min)

  TB (cm)

  BB (kg)

  Umur (thn)

  RM Inisial L/P

  51 68 172

  BPJS Furosemid

  66 592 389

  Amlodipin 1x5 mg

  9.28 6.869 Nifedipin 2x10 mg 3x10 mg

  Injeksi 3x10 mg/ml Furosemid 2x40 mg

  Furosemid 1x10 mg/ml 7.89 8.079

  4.07 Captopril 2x25 mg 3x25 mg

  15.66

  Bisoprolol 1x5 mg

  BPJS 1x10 mg

  V 16.79 3.796

  1x10 mg/ml Injeksi

  50 60 160

  LS P

  65 594 316

  BPJS Injeksi 2x10 mg/ml

  V 6.9 14.348 Furosemid 1x10 mg/ml

  41 72 169

  AMT L

  64 594 620

  Captopril 3x12.5 mg

  Lampiran 3. (lanjutan)

  DPN L

  TD L

  81 593 129

  1x10 mg/ml Injeksi

  2x50 mg Furosemid

  BPJS 9.31 7.491

  Captopril 3x12.5 mg

  V 10.77 6.476

  47 54 155

  80 594 797

  V 7.46 7.819

  3x10 mg/ml BPJS Injeksi

  V 8.71 6.489 Furosemid

  56 57 155

  DAR P

  79 595 687

  1x10 mg/ml Injeksi

  Furosemid 1x40 mg Furosemid

  1x10 mg 3.8 18.864

  1x5 mg BPJS

  56 50 160

  Amlodipin 1x5 mg

  48 66 155

  SAI P

  2.59 25.933 Injeksi 2.53 26.548

  2x10 mg/ml BPJS

  IV 3.41 19.697 Furosemid

  47 52 160

  MAR P

  84 592 623

  Injeksi 2x10 mg/ml

  V 5.36 10.902 Furosemid 1x10 mg/ml

  50 55 160

  83 525 936

  BPJS 6.3 9.259 2x5 mg

  7.52 Captopril 2x12.5 mg BPJS

  5.18

  V

  74 50 155

  NU P

  82 593 127

  Injeksi

  Furosemid 3x10 mg/ml

  3.55 16.431 Captopril 2x25 mg

  V 7.93 9.039 Amlodipin

  AIS P

  No No.

  Amlodipin 1x5 mg BPJS

  57 56 160

  TS P

  73 591 564

  14.63

  3.45

  5.28 9.565

  4.57 Captopril tab scored 2x12.5 mg

  11.05

  6.86 7.362

  V 10.41 4.851

  Captopril 3x25 mg BPJS 2.82 19.458 2.67 20.551

  71 62 161

  CG P

  72 461 865

  Jenis Obat Dosis Keterangan

  Stage Scr eGFRS (ml/min)

  TB (cm)

  BB (kg)

  Umur (thn)

  RM Inisial L/P

  IV 3.15 17.419

  74 586 254

  78 587 942

  76 550 449

  BPJS Captopril 2x12.5 mg Furosemid 1x40 mg

  V 8.39 7.294 Amlodipin 1x10 mg

  59 64 166

  AIH P

  77 593 407

  BPJS 1.29 43.287 HCT 1x25 mg

  IV 2.21 25.267 Amlodipin 1x5 mg

  54 55 160

  TP P

  Injeksi

  MAS L

  BPJS Furosemid 1x10 mg/ml

  V 10.7 5.211 Captopril 2x12.5 mg

  67 55 160

  SUGU L

  75 592 291

  16.71 Furosemid 1x40 mg BPJS 5.4 11.882

  3.84

  IV

  63 60 160

  Spironolakto n 3x100 mg

  Lampiran 3. (lanjutan)

  No. Umur BB TB eGFR Jenis No Inisial L/P Stage Scr Dosis Keterangan

  RM (thn) (kg) (cm) (ml/min) Obat Captopril 2x18,75 mg 3 29.445

  Furosemid 594

  85 JISI L

  34 60 160

  IV 2x10 mg/ml BPJS 923

  Injeksi 2.76 32.005

  Spironolakton 1x25 mg Furosemid 1x10 mg/ml

  588

  86 MASI P

  46 57 150

  III 1.35 46.854 BPJS 137

  Injeksi 2x10 mg/ml Captopril 3x12.5 mg

  Furosemid 2x10 mg/ml

  594

  87 HM P

  50 66 150

  V 17.24 4.0675 Injeksi BPJS 715

  3x40 mg Furosemid

  1x40 mg

  Lampiran 4. Data Penggunaan Antihipertensi pada pasien GGK di RSUP H.

  

29

  Association 1.039 1 .308 N of Valid Cases 192

  4 .354 Likelihood Ratio 4.767 4 .312 Linear-by-Linear

  a

  Value df Asymp. Sig. (2- sided) Pearson Chi-Square 4.405

  100.0% 100.0% 100.0% 100.0% 100.0% 100.0% % of Total 45.3% 28.6% 19.8% 5.7% .5% 100.0% Chi-Square Tests

  11 1 192 % within Periode 45.3% 28.6% 19.8% 5.7% .5% 100.0% % within Jenis_OAH

  38

  

55

  87

  66.7% 52.7% 52.6% 63.6% 100.0% 59.9% % of Total 30.2% 15.1% 10.4% 3.6% .5% 59.9% Total Count

  7 1 115 % within Periode 50.4% 25.2% 17.4% 6.1% .9% 100.0% % within Jenis_OAH

  20

  58

  Adam Malik Medan periode September 2013- Maret 2014 dengan Analisis Uji Statistik Chi-square test Case Processing Summary

  33.3% 47.3% 47.4% 36.4% .0% 40.1% % of Total 15.1% 13.5% 9.4% 2.1% .0% 40.1% BPJS Count

  77 % within Periode 37.7% 33.8% 23.4% 5.2% .0% 100.0% % within Jenis_OAH

  4

  18

  

26

  29

  Jamkesmas Count

  II antagonis P e r I o d e

  Bloker Angiotensi

  Jenis_OAH Total Diuretik ACE-I Ca. Antagonis Beta

  Jenis_OAH 192 100.0% .0% 192 100.0% Periode * Jenis_OAH Crosstabulation

  Cases Valid Missing Total N Percent N Percent N Percent Periode *

a. 3 cells (30.0%) have expected count less than 5. The minimum expected count is .40.

H. Adam Malik Medan periode September 2013

• – Maret 2014 dengan Analisis Uji Statistik Chi-square test

  34 % within Periode 100.0% .0% 100.0% % within Kesesuaian_Dosis 54.8% .0% 53.1% Total Count

  64

  2 .310 Likelihood Ratio 3.104 2 .212 Linear-by-Linear Association 1.362 1 .243 N of Valid Cases

  a

  Chi-Square Tests Value df Asymp. Sig. (2- sided) Pearson Chi-Square 2.340

  64 % within Periode 96.9% 1.6% 100.0% % within Kesesuaian_Dosis 100.0% 100.0% 100.0%

  1

  62

  34

  Lampiran 5. Data Kesesuaian Dosis Antihipertensi pada pasien GGK di RSUP

  30 % within Periode 93.3% 3.3% 100.0% % within Kesesuaian_Dosis 45.2% 100.0% 46.9% BPJS Count

  1

  28

  Periode Jamkesmas Count

  Kesesuaian_Dosis Total Sesuai Tidak Sesuai

  64 100.0% Periode * Kesesuaian_Dosis Crosstabulation

  N Percent N Percent N Percent Periode * Kesesuaian_Dosis 64 100.0% .0%

  Case Processing Summary Cases Valid Missing Total

a. 4 cells (66.7%) have expected count less than 5. The minimum expected count is .47.

  Lampiran 6. Daftar Obat Antihipertensi yang Memerlukan Penyesuaian Dosis pada Pasien GGK Penyesuaian dosis berdasarkan

  No Obat Dosis Lazim nilai LFG (mL/menit) >50 10 - 50 <10

  1 ACE inhibitors Benazepril * 10 mg/ hari 100%

  50

  25

• – 75% – 50% (Lotensin) Captopril **

  25 100% 75% 50%

• – 150 mg (Capoten) Enalapril *

  5 75 50%

• – 10 mg/12 jam 100% – 100% (Vasotec) Fosinopril * 10 mg/ hari 100% 100%

  75

• – 100% (Monopril) Lisinopril *

  5 100%

  50

  25

• – 10 mg/ hari – 75% – 50% (Zestril) Quinapril *

  10 100% 75 75%

• – 20 mg/hari – 100% (Accupril) Ramipril *

  5 100%

  50

  25

• – 10 mg daily – 75% – 50% (Altace)

  2 Beta blockers Acebutolol * 400 100% 50%

  30

• – 600 mg – 50% (Sectral) (1
• – 2 x Sehari) Atenolol *

  5 100% 50% 25%

• – 100 mg/ hari (Tenormin)

  Bisoprolol ** 2,5 - 10 mg 100% 75% 50%

  (Zebeta)

  Nadolol * 40 to 80 mg/ hari 100% 50% 25%

  (Corgard)

  3 Diuretics Bumetanide * Tidak perlu — — — (Bumex) penyesuaian

  Furosemide * Tidak perlu — — — (Lasix) penyesuaian Metolazone * Tidak perlu

  — — — (Zaroxolyn) penyesuaian

Spironolactone* Tidak perlu Hindari

— — (Aldactone) penyesuaian Thiazides*

  25 100% 100% Hindari

• – 50 mg/ hari Torsemide * Tidak perlu — — — (Demadex) penyesuaian Triamterene *

  50 100% 100% Hindari

• – 100 mg (Dyrenium) (2 x sehari) Sumber: * Munar dan Singh, 2007
• NKF, 2004

  Lampiran 7. Surat Izin Penelitian dari Dekan Fakultas Farmasi Universitas Sumatera Utara

  Lampiran 8. Surat Izin Penelitian dari RSUP H. Adam Malik Medan Ka. Instalasi Rekam Medik

  Tembusan:

  1. Kepala Bidang Diklit RSUP H. Adam Malik Medan

  2. Pertinggal

  Lampiran 8. (lanjutan) Ka. Instalasi Farmasi

  Tembusan:

  1. Kepala Bidang Diklit RSUP H. Adam Malik Medan

  2. Pertinggal

  Lampiran 9. Surat Keterangan telah Selesai Penelitian di RSUP H. Adam Malik Medan

  : Fakultas Farmasi – Usu Medan