STUDI PENGGUNAAN OBAT PROFILAKSIS STRESS ULCER PADA PASIEN BEDAH SARAF (Penelitian dilakukan di Instalasi Bedah RSUD Dr. Soetomo Surabaya)

Background: Brain injury patients usually prone to stress ulcer. The stress ulcer prophylaxis are very important to monitor, because if a patient does not get proper prophylaxis will cause bleeding more severe and occur mortality. There has not been a research conducted in RSUD Dr. Soetomo about the suitability of treatment with existing guideline. Purpose: To review the type, doses, frequency of usage and identify problems related to drug use, potential and actual interaction between stress ulcer prophylaxis and other therapy in neurosurginal patient. Methodes: A retrospective study using patient medication record. Sampling was done by using a Time Limited Sampling during 1st January 2015 until 31st August 2015 at RSUD Dr. Soetomo with patients of neurosurginal as subject. Result: The total sample of this study were 43 patients. The result showed that 72% of the brain injury patient that use prophylaxis of stress ulcer were female and 28% were male. Result showed that stress ulcer prophylaxis drug use in the case of neurosurginal patients including H2-Antagonist 86%, PPIs 10%, combination of H2-Antagonist and PPIs 12% and the combination of H2-Antagonist, PPIs and sucralfate 2,3%. Patients were also treated with combination therapy. The most combination therapy is H2-Antagonist with proton pomp inhibitor. Stress ulcer prophylaxis doses used in this study are in accordance with the dose in the literature. Drug related problems due to the use of stress ulcer prophylaxis was not found in this study, but there is interaction between stress ulcer prophylaxis and other therapy that used concomitantly. Conclusion: Intravenous H2-Antagonist (ranitidine) is the most widely used stress ulcer prophylaxis in the case of neurosurgical in patients with brain injury. Intravenous ranitidine may be preferred to other stress ulcer prophylaxis because of efficicay, lower cost and lower interaction with other therapies