Dampak Konsumsi Diclofenac terhadap Ulkus Gaster

Roviq Umam Syahroni

doi:10.37287/jppp.v3i3.565

Roviq Umam Syahroni Fakultas Kedokteran, Universitas Lampung

DOI: https://doi.org/10.37287/jppp.v3i3.565

Keywords: diclofenac, NSAIDs, ulkus gaster

Abstract

Diclofenac adalah salah jenis NSAIDs yang paling sering diresepkan. Mekanisme kerja dari diclofenac yaitu dengan menghambat kerja enzim cyclooxygenase (COX) yang menyebabkan terhambatnya produksi prostaglandin. Penghambatan dari prostaglandin dapat mengurangi nyeri dan reaksi inflamasi, namun memiliki efek samping yang bervariasi pada sistem pencernaan khususnya di bagian gaster. Oleh karena itu tujuan dari literature review ini adalah untuk memberikan informasi mengenai hubungan konsumsi diclofenac dengan kejadian ulkus gaster baik pada hewan coba maupun manusia. Sumber referensi dari literature review ini berasal dari jurnal nasional dan internasional meliputi 21 artikel yang diperoleh dengan melakukan literature searching di NCBI dan Google scholar dan dari 2 text book dengan rentang tahun publikasi dari 2009 hingga 2021. Kata kunci yang digunakan dalam proses literature searching ini yaitu “diclofenac”, “NSAIDs”, dan “ulkus gaster” dengan hasil pencarian terdapat 91 artikel kemudian dipilih 21 artikel berdasarkan informasi yang dibutuhkan. Hasil yang didapatkan dari literature review ini mengatakan bahwa diclofenac memiliki peran terjadinya ulkus gaster yang bergantung pada dosis dan lama waktu pemberian.

References

Ahluwalia, A., Hoa, N., Jones, M. K., & Tarnawski, A. S. (2019). NSAID-induced injury of gastric epithelial cells is reversible: roles of mitochondria, AMP kinase, NGF, and PGE2. American journal of physiology. Gastrointestinal and liver physiology, 317(6), G862–G871. https://doi.org/10.1152/ajpgi.00192.2019

Altman, R., Bosch, B., Brune, K., Patrignani, P., & Young, C. (2015). Advances in NSAID development: evolution of diclofenac products using pharmaceutical technology. Drugs, 75(8), 859–877. https://doi.org/10.1007/s40265-015-0392-z

Amrulloh, F. M., & Utami, N. (2016). Hubungan konsumsi OAINS terhadap gastritis. Majority, 5(5), 18-21.

Bindu, S., Mazumder, S., & Bandyopadhyay, U. (2020). Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: A current perspective. Biochemical pharmacology, 180, 114147. https://doi.org/10.1016/j.bcp.2020.114147

Calderon-Ospina, C. A., Nava-Mesa, M. O., & Arbeláez Ariza, C. E. (2020). Effect of Combined Diclofenac and B Vitamins (Thiamine, Pyridoxine, and Cyanocobalamin) for Low Back Pain Management: Systematic Review and Meta-analysis. Pain medicine (Malden, Mass.), 21(4), 766–781. https://doi.org/10.1093/pm/pnz216

Cheng, Y. T., Lu, C. C., & Yen, G. C. (2017). Phytochemicals enhance antioxidant enzyme expression to protect against NSAID-induced oxidative damage of the gastrointestinal mucosa. Mol. Nutr. Food Res., 61(6), 1600659. https://doi.org/10.1002/mnfr.201600659

Galura, G. M., Chavez, L. O., Robles, A., & McCallum, R. (2019). Gastroduodenal Injury: Role of Protective Factors. Current gastroenterology reports, 21(8), 34. https://doi.org/10.1007/s11894-019-0701-x

Kempenich, J. W., & Sirinek, K. R. (2018). Acid Peptic Disease. The Surgical clinics of North America, 98(5), 933–944. https://doi.org/10.1016/j.suc.2018.06.003

Mazumder, S., De, R., Sarkar, S., Siddiqui, A. A., Saha, S. J., Banerjee, C., Iqbal, M. S., Nag, S., Debsharma, S., & Bandyopadhyay, U. (2016). Selective scavenging of intra-mitochondrial superoxide corrects diclofenac-induced mitochondrial dysfunction and gastric injury: A novel gastroprotective mechanism independent of gastric acid suppression. Biochemical pharmacology, 121, 33–51. https://doi.org/10.1016/j.bcp.2016.09.027

McGettigan, P., & Henry, D. (2013). Use of non-steroidal anti-inflammatory drugs that elevate cardiovascular risk: an examination of sales and essential medicines lists in low-, middle-, and high-income countries. PLoS medicine, 10(2), e1001388. https://doi.org/10.1371/journal.pmed.1001388

McNicol, E. D., Ferguson, M. C., & Schumann, R. (2018). Single-dose intravenous diclofenac for acute postoperative pain in adults. The Cochrane database of systematic reviews, 8(8), CD012498. https://doi.org/10.1002/14651858.CD012498.pub2

Niwa, Y., Nakamura, M., Miyahara, R., Ohmiya, N., Watanabe, O., Ando, T., Kawashima, H., Itoh, A., Hirooka, Y., & Goto, H. (2009). Geranylgeranylacetone protects against diclofenac-induced gastric and small intestinal mucosal injuries in healthy subjects: a prospective randomized placebo-controlled double-blind cross-over study. Digestion, 80(4), 260–266. https://doi.org/10.1159/000236032

Nie, W., Xu, P., Hao, C., Chen, Y., Yin, Y., & Wang, L. (2020). Efficacy and safety of over-the-counter analgesics for primary dysmenorrhea: A network meta-analysis. Medicine, 99(19), e19881. https://doi.org/10.1097/MD.0000000000019881

Nuraida, E., Sutiningsih, D., & Hadi, M. (2020). Effectiveness of neem (Azadirachta indica a.juss) bark extract as a gastroprotektor. Jurnal Kedokteran dan Kesehatan Indonesia, 11(2), 150-156. 10.20885/JKKI.Vol11.Iss2.art7

Seo, P. J., Kim, N., Kim, J. H., Lee, B. H., Nam, R. H., Lee, H. S., Park, J. H., Lee, M. K., Chang, H., Jung, H. C., & Song, I. S. (2012). Comparison of Indomethacin, Diclofenac and Aspirin-Induced Gastric Damage according to Age in Rats. Gut and liver, 6(2), 210–217. https://doi.org/10.5009/gnl.2012.6.2.210

Shep, D., Khanwelkar, C., Gade, P., & Karad, S. (2020). Efficacy and safety of combination of curcuminoid complex and diclofenac versus diclofenac in knee osteoarthritis: A randomized trial. Medicine, 99(16), e19723. https://doi.org/10.1097/MD.0000000000019723

Sung, J. J., Kuipers, E. J., & El-Serag, H. B. (2009). Systematic review: the global incidence and prevalence of peptic ulcer disease. Alimentary pharmacology & therapeutics, 29(9), 938–946. https://doi.org/10.1111/j.1365-2036.2009.03960.x

Tarigan, P. (2015). Tukak Gaster. Dalam S. Setiati, I. Alwi, A. Sudoyo, M. Simadibrata, B. Setiyohadi, & A. Syam, Buku Ajar Ilmu Penyakit Dalam (pp. 1783-1793). Jakarta: InternaPublishing.

Traoré, O., Diarra, A. S., Kassogué, O., Abu, T., Maïga, A., & Kanté, M. (2021). The clinical and endoscopic aspects of peptic ulcers secondary to the use of nonsteroidal anti-inflammatory drugs of various origins. The Pan African medical journal, 38, 170. https://doi.org/10.11604/pamj.2021.38.170.17325

Valle, J. D. (2010). Peptic Ulcer Disease and Related Disorder. In D. L. Longo, & A. S. Fauci, Harisson's Gastroenterology and Hepatology (pp. 125-151). New York: McGraw-Hill.

Umegaki, E., Kuramoto, T., Kojima, Y., Nouda, S., Ishida, K., Takeuchi, T., Inoue, T., Tokioka, S., & Higuchi, K. (2014). Geranylgeranylacetone, a gastromucoprotective drug, protects against NSAID-induced esophageal, gastroduodenal and small intestinal mucosal injury in healthy subjects: A prospective randomized study involving a comparison with famotidine. Internal medicine (Tokyo, Japan), 53(4), 283–290. https://doi.org/10.2169/internalmedicine.53.1572

Waranugraha, Y., Putra B. P., & Pratomo, S. B. (2010). Hubungan pola penggunaan OAINS dengan gejala klinis gastropati pada pasien reumatik. Jurnal Kedokteran Brawijaya, 26(2).

Zarghi, A., & Arfaei, S. (2011). Selective COX-2 Inhibitors: A Review of Their Structure-Activity Relationships. Iranian journal of pharmaceutical research : IJPR, 10(4), 655–683.