Abstract

DRUG RELATED PROBLEM ASSOCIATED WITH THE TREATMENT FOR SEVERE ANEMIA WITH KIDNEY TRANSPLANTATION'S HISTORY IN PGI CIKINI HOSPITAL

Aprilita Rina Yanti*, Karmadina Oswanty and Diana Laila

Abstract

Anemia is a condition that develops when blood lacks enough healthy red blood cells or hemoglobin. Hemoglobin is a main part of red blood cells and binds oxygen. Anemia may also be diagnosed where there is decreased oxygen-binding ability of each hemoglobin molecule due to deformity or lack in numerical development as in some other types of hemoglobin (Hb) deficiency. Mr. PA, 72 years old was diagnosed with severe anemia. This diagnosis based on examination of Hb that is very low at 5,29/dL (normal 12-14 g/dL). Patients have had a kidney transplant in 2004 and also had type 2 diabetes , until now he is still using insulin. During hospitalized, he has received 17 types of drugs, those were Claforan (cefotaxime), Folic Acid, Neurobion 5000, Rocer (omeprazole), Imuran (azathioprine), Urdahex (ursodeoksilat acid), Kalmethason (dexamethasone), Actrapid (insulin), Normal Saline 0,9%, Mycostatin (nystatin), Myfortic (mucophenolic acid), Cavit D3, Calcium gluconas, Cefixime, Cetirizine, Codipront, and Heparin. Giving many drugs (polypharmacy) certainly is not recommended, but in this case the treatment according to the patient condition. Based on the result of the clinic secretariat at the ward of K in PGI Cikini Hospital, it could be concluded that there was DRPs (Drug Related Problems) such as drug interaction, adverse drug, improper drug selection, and untreated indications. Adverse Drug Reactions was caused by concomitant administration of immunosuppressant drugs that Imuran, Myfortic and Kalmethason. Use of these drugs may suppress excessive immune responses to facilitate the onset of infection and candidiasis. Using erythropoietininjection is essential for the treatment of cases of severe anemia.

Keywords: Drug Related Problems, severe anemia , kidney transplatation, PGI Cikini Hospital