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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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Abstract

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

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