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All Journal BALI MEDICAL JOURNAL (BMJ) MNJ (Malang Neurology Journal) YARSI Medical Journal Cermin Dunia Kedokteran
Jimmy Barus, Jimmy
Departemen Ilmu Penyakit Saraf, Fakultas Kedokteran Unika Atma Jaya
Health Professions Medicine & Pharmacology Neuroscience Public Health

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Journal : Cermin Dunia Kedokteran

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Penatalaksanaan Farmakologis Nyeri pada Lanjut Usia Barus, Jimmy
Cermin Dunia Kedokteran Vol 42, No 3 (2015): Nyeri
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (258.468 KB) | DOI: 10.55175/cdk.v42i3.1027

Abstract

Sejalan dengan meningkatnya populasi lansia maka meningkat pula jumlah kasus nyeri terkait disabilitas dan perubahan degeneratif pada kelompok ini. Penggunaan analgetik pada lansia perlu pertimbangan khusus. Secara umum, asetaminofen/parasetamol merupakan pilihan pertama untuk kasus nyeri muskuloskeletal dengan pemantauan dosis dan efek samping. Jika perlu, COX 2 inhibitor lebih diutamakan untuk menghindari efek gastrointestinal, dan pemberian aspirin bersama PPI untuk mengurangi risiko kardiovaskuler. Penggunaan OAINS sedapat mungkin dibatasi, karena berkaitan dengan efek samping gastrointestinal dan peningkatan risiko gangguan kardiovaskuler. OAINS harus dihindari pada gangguan ginjal. Opioid secara umum dianggap lebih aman, tetapi efek samping harus tetap diperhatikan. Analgetik adjuvan yang dianjurkan adalah antikonvulsan golongan gabapentin dan pregabalin, dan antidepresan golongan SNRI.The increase of elderly population resulted in increasing problem of pain connected to degenerative diseases and disabilities. The use of analgetics among elderly needs special consideration. Acetaminophen/paracetamol is still the first choice for musculoskeletal pain with dose and side effect monitoring. COX2 inhibitor is preferred to avoid gastrointestinal effect, and aspirin in combination with PPI is used to minimize cardiovascular risk. NSAID use is limited as much as possible, because it is associated with gastrointestinal side effects and increased risk of cardiovascular disorders. NSAID should be avoided in renal insufficiency. Opioid is relatively safe but needs monitoring of side effect. Adjuvant analgesics that can be considered are anticonvulsants: gabapentin and pregabalin, and SNRI antidepressant.
Co-Authors A.A. Ketut Agung Cahyawan W Aliza, Sharla Andi Kurnia Bintang, Andi Kurnia Ardianto, Christian Budi Riyanto Wreksoatmodjo, Budi Riyanto Dede Gunawan, Dede Dodik Tugasworo Fritz Sumantri Usman, Fritz Sumantri H. Harsono, H. Mohammad Hasan Machfoed Poppy Kristina Sasmita Putria, Fani Mustika Riza Sulthan, Riza Rusdi Lamsudin, Rusdi Veronika Maria Sidharta Yaputra, Faldi