ABSTRACT. DRUG UTILIZATION STUDY TOWARDS PATIENTS WITH NEPHROTIC SYNDROME AT PEDIATRIC HEALTH DEPARTEMENT Dr. SOETOMO. HOSPITAL SURABAYA. Nephrotic syndrome (NS) is a recurrent chronic disorder characterized by
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DRUG UTILIZATION STUDY TOWARDS PATIENTS WITH NEPHROTIC
SYNDROME AT PEDIATRIC HEALTH DEPARTEMENT Dr. SOETOMO
Nephrotic syndrome (NS) is a recurrent chronic disorder characterized by
massive proteinuria, hypoalbuminemia, edema, and with or without
hyperlipidemia (Alatas et al., 2005). The main drug used in NS is corticosteroid
(prednisone) which is administered by long-term and continuously therapy to get
optimal outcome. The problem is corticosteroid has some possible side effects, one
of them is growth and development disturbance, which is unexpected especially
for children. Therefore, the drug utilization study in this case (NS) is necessary.
The study used retrospective method and descriptive analysis. The
purposes of this study were to describe profile of therapy (kind of drugs, dosage form,
dosage, and route of administration), to analyze the association between laboratory
clinical manifestasion, and to identify drug related problems. The data of the patients
were collected from January 1st 2006 until December 31st 2007. The population were
children with NS who hospitalized in pediatric ward Dr. Soetomo Hospital Surabaya
(n = 41).
The results showed that boys were more dominant (70%) than the girls (30%).
The use of corticosteroid was 98% , immunosuppressive agents such as
cyclophosphamide (12%) and cyclosporine (2%) and other nonspecific measure such
as albumin (63%) to control edema and proteinuria, the other drugs to control
nephrosis complication such as infection, hypovolemia, hypertension and
hypocalcemia. The majority of NS in children was idiopathic (95%), and minimal
change (MCNS) was the most common form of NS (98%). The patients were
classified as steroid-sensitive (85%) and steroid-resistance (15%). A
steroidsensitive patients included infrequent relapser (58%), frequent relapser (20%),
and steroid-dependent (7%). Infection was the most common complication in NS
(39%). Overall, after receiving drug regimentation, patients who experience
remission were 71%, while the rest (29%) still relapsed. The most common drug
related problem was adverse drug reaction (22%). The conclusion was the drugs
utilization of children with NS was appropriate with the guidelines, and some
children had experience side effect of the drugs.
Keywords : Drug Utilization Study, Nephrotic Syndrome, Child, Retrospective,
Corticosteroid, Immunosuppressive, Albumin