Medication Error Tahap Prescribing pada Resep Obat Narkotika di Instalasi Farmasi Salah Satu Rumah Sakit Swasta di Minahasa

Authors

  • Ester Seran Universitas Sam Ratulangi
  • Christi D. Mambo Universitas Sam Ratulangi
  • Angelina S. R. Masengi Universitas Sam Ratulangi

DOI:

https://doi.org/10.35790/ecl.v12i3.55090

Abstract

Abstract: Medication errors can lead to inappropriate use of medication and harm to patients. Medication errors most commonly occur at the prescribing stage. This study aimed to evaluate medication errors during the prescribing stage in terms of the clinical completeness of prescriptions, specifically focusing on drug interactions. This was a retrospective study using secondary data of the Drugs.com and Medscape databases. Data were analyzed univariately. The results showed that the most prescribed narcotic drugs were fentanyl (70%) and codeine (30%). The most interacting types of drugs were fentanyl and ondansetron with a total of 58 events (22.9%) that had major severity according to the Drugs.com database. Meanwhile, according to the Medscape database, the type of drug with the most major interactions was Fentanyl - Propofol with 39 events (15.5%). Based on Drugs.com database, 109 interactions were found with major, 141 moderate, and three unknown severity. Based on Medscape database, there were 85 interactions with major severity, 45 moderate and 123 unknown. In conclusion, interaction between narcotic and non-narcotic drugs especially fentanyl showed high risk potential with major severity. Database of drug interaction is important to achieve safe decision of therapu and to prevent the occurrence of medication error. 

Keywords: medication error; prescribing stage; narcotics; drug interaction

 

Abstrak: Medication error dapat menyebabkan penggunaan obat tidak tepat dan membahayakan pasien. Kesalahan pengobatan yang paling sering terjadi pada tahap prescribing atau penulisan resep obat.. Penelitian ini bertujuan untuk menilai medication error tahap prescribing berupa kelengkapan klinis resep yaitu interaksi obat. Jenis penelitian ialah retrospektif. Data sekunder diperoleh di Instalasi Farmasi salah satu rumah sakit swasta di Minahasa periode Januari – Juni 2023. Analisis data berdasarkan basis data Drugs.com dan Medscape menggunakan metode analisis univariat. Hasil penelitian mendapatkan bahwa jenis obat narkotika yang sering diresepkan ialah fentanyl (70%) dan codeine (30%). Jenis obat yang paling banyak berinteraksi menurut basis data Drugs.com ialah fentanyl dan ondansetron dengan jumlah kejadian sebanyak 58 (22,9%) dan tingkat keparahan major Menurut basis data Medscape jenis obat dengan interaksi major paling banyak ialah fentanyl – propofol sebanyak 39 kejadian (15,5%). Berdasarkan basis data Drugs.com didapatkan 109 interaksi dengan tingkat keparahan major, 141 moderate dan tiga tidak diketahui. Berdasarkan basis data Medscape didapatkan 85 interaksi dengan tingkat keparahan major, 45 moderate dan 123 tidak diketahui. Simpulan penelitian ini ialah interaksi obat narkotika dengan non-narkotika terutama fentanyl menunjukkan potensi risiko tinggi dengan tingkat keparahan major. Penggunaan basis data interaksi obat penting untuk keputusan terapi yang aman dan mencegah kejadian medication error.

Kata kunci: medication error: tahap prescribing; narkotika; interaksi obat

Author Biographies

Ester Seran, Universitas Sam Ratulangi

Program Studi Pendidikan Dokter Fakultas Kedokteran Universitas Sam Ratulangi, Manado, Indonesia

Christi D. Mambo, Universitas Sam Ratulangi

Bagian Farmakologi dan Terapi Fakultas Kedokteran Universitas Sam Ratulangi, Manado, Indonesia

Angelina S. R. Masengi, Universitas Sam Ratulangi

Bagian Farmakologi dan Terapi Fakultas Kedokteran Universitas Sam Ratulangi, Manado, Indonesia

References

WHO. Patient Safety. 2019 [cited 2023 Jul 28]. Available from: https://www.who.int/news-room/fact-sheets/detail/patient-safety

Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie H, Roder De-Wan S, et al. High-quality health systems in the Sustainable Development Goals era: time for a revolution. Lancet Glob Heal 2018;6(11):e1196–e1252. Doi: 10.1016/S2214-109X(18)30386-3

Peraturan Menteri Kesehatan Republik Indonesia Nomor 72 Tahun 2016 Tentang Standar Pelayanan Kefarmasian Di Rumah Sakit. 2016

Tariq RA, Vashisht R, Sinha A, Scherbak Y. Medication dispensing errors and prevention. StatPearls Publishing, 202. Available from: https://pubmed.ncbi.nlm.nih.gov/30085607/

ECAMET. The urgent need to reduce medication errors in hospitals to prevent patient and second victim harm. 2022. Available from: https://www.eaasm.eu/wp-content/uploads/ECAMET-White-Paper-Call-to-Action-March-2022-v3.pdf

Maalangen TV, Citraningtyas G, Wiyono WI. Identifikasi medication error pada resep pasien poli interna di Instalasi Farmasi Rumah Sakit Bhayangkara Tk. III Manado. Pharmacon. 2019;8(2):434–41. Available from: https://ejournal.unsrat.ac.id/index.php/pharmacon/article/view/29310

Kementerian Kesehatan Republik Indonesia. Penanganan obat - obat high alert di fasilitas pelayanan kesehatan. 2022; Available from: https://yankes.kemkes.go.id/view_artikel/172

Drugs.Com. Drug Interactions checker—for drugs, food & alcohol. 2023. Available from: https://www.drugs. com/drug_interactions.html

Mahikhan F, Hashemian M, Dehesh T, Jafari E, Jafari M, Rahimi H-R. Impact of ondansetron on withdrawal signs, fentanyl requirement and pain relief in opioid-addicted patients under general anesthesia. Curr Clin Pharmacol 2019;14(3):232–41. Doi: 10.2174/1574884714666190131122846

Dewi IAPS, Astuti NMW, Sari PMNA. Analisis toksikologi forensik : kasus kematian akibat penggunaan propofol. Indones J Leg Forensic Sci. 2019;9(2):68–75. Available from: http://ojs.unud.ac.id/index.php/ijlfs

Chang J, Yang C. Propofol combined with fentanyl is superior to propofol alone in sedation protocols for painless gastrointestinal endoscopy. J Nanomater 2021;2021. Doi: 10.1155/2021/9955488

Darlong V, Som A, Baidya DK, Pande R, Punj J, Pande A. Effect of varying time intervals between fentanyl and propofol administration on propofol requirement for induction of anaesthesia: randomised controlled trial. Indian J Anaesth 2019;49(4):257–62. Doi: 10.4103/ija.IJA

McLendon K, Preuss CV. Atropine. National Library of Medicine. 2024. Available from: https://pubmed. ncbi.nlm.nih.gov/29262018/

Kim JK, Park JM, Lee CH, Kim DK. Dose fentanyl injection for blunting the hemodynamic response to intubation increase the risk of reflex bradycardia during major abdominal surgery? Korean J Anesthesiol 2012;63(5):402–8. Doi: 10.4097/kjae.2012.63.5.402

Downloads

Published

2024-12-06

How to Cite

Seran, E., Mambo, C. D., & Masengi, A. S. R. (2024). Medication Error Tahap Prescribing pada Resep Obat Narkotika di Instalasi Farmasi Salah Satu Rumah Sakit Swasta di Minahasa . E-CliniC, 12(3), 447–453. https://doi.org/10.35790/ecl.v12i3.55090

Issue

Section

Articles