Dampak Klinis Interaksi Obat antara Clopidogrel dan Inhibitor Pompa Proton : Tinjauan Naratif
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Dual antiplatelet therapy (DAPT), yang terdiri dari aspirin dan antagonis reseptor P2Y12 seperti clopidogrel, merupakan terapi utama pada pasien dengan sindrom koroner akut (SKA). Namun, penggunaannya secara luas dapat meningkatkan risiko perdarahan gastrointestinal. Proton pump inhibitor (PPI) sering digunakan sebagai profilaksis untuk mencegah terjadinya perdarahan. Di sisi lain, PPI diduga dapat menurunkan efektivitas clopidogrel karena adanya interaksi obat secara farmakokinetik. Namun, temuan dari berbagai penelitian mengenai dampak klinis interaksi ini masih tidak konsisten dan kontroversial. Tujuan dari tinjauan naratif ini adalah untuk mengevaluasi efektivitas dan keamanan penggunaan PPI bersamaan dengan clopidogrel. Metode yang digunakan adalah telaah pustaka terhadap artikel-artikel dari jurnal internasional yang membahas interaksi antara PPI dan clopidogrel. Hasil review menunjukkan bahwa beberapa PPI, seperti omeprazole, dapat menghambat enzim CYP2C19 yang berperan dalam aktivasi clopidogrel, sehingga berpotensi menurunkan efektivitasnya. Sebaliknya, beberapa PPI seperti pantoprazole memiliki efek minimal terhadap CYP2C19 dan dianggap lebih aman untuk digunakan bersamaan dengan clopidogrel. Secara keseluruhan, penggunaan PPI dapat menurunkan risiko perdarahan gastrointestinal, namun pemilihan jenis PPI harus disesuaikan untuk meminimalkan interaksi obat yang dapat menurunkan efektivitas clopidogrel.
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