Kortikosteroid Sistemik: Aspek Farmakologi Dan Penggunaan Klinis Di Bidang Dermatologi
DOI:
https://doi.org/10.33820/mdvi.v45i3.33Abstract
Kortikosteroid sistemik memiliki peranan paling luas di antara semua antiinflamasi dan imunosupresif. Penggunaannya di berbagai bidang kedokteran, termasuk dermatologi, banyak menghasilkan perbaikan klinis yang bermakna. Di sisi lain, pengaruh kortikosteroid terhadap sebagian besar sistem organ, terutama bila diberikan dalam dosis tinggi jangka panjang, berpotensi menghasilkan efek samping serius, meliputi gangguan neuropsikiatrik, kelainan mata, penyakit kardiovaskular, dislipidemia, hiperkoagulabilitas, gangguan gastrointestinal, hiperglikemia, gangguan cairan-elektrolit, kelainan kulit, lipodistrofi, miopati, osteoporosis, infeksi akibat imunosupresi, supresi tumbuh-kembang anak, serta supresi sumbu hipotalamus-hipofisis-adrenal. Optimalisasi penggunaan kortikosteroid berdasarkan sifat farmakologiknya, yakni pemilihan preparat, rejimen dosis, interval serta waktu dan lama pemberian, metode tapering off, potensi interaksi obat, skrining dan pemantauan efek samping serta reaksi hipersensitivitas, juga pemahaman akan fenomena resistensi, kemungkinan timbul dampak buruk dapat dibatasi, sehingga peranan obat ini sebagai pilihan terapi bagi klinisi dapat dipertahankan.Kata kunci: kortikosteroid sistemik, penggunaan klinis, efek samping, farmakologi
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References
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2. Djuanda A. Pengobatan dengan kortikosteroid sistemik dalam bidang dermatovenereologi. Dalam: Djuanda A, Hamzah M, Aisah S, penyunting. Ilmu penyakit kulit dan kelamin. Edisi ke-6. Jakarta: Badan Penerbit FKUI; 2011.h. 339-41.
3. Staa TP, Leufkens HG, Abenhaim L, Begaud B, Zhang B, Cooper C. Use of oral corticosteroids in the United Kingdom. Q J Med. 2000;93:105-11.
4. Gupta P, Bhatia V. Corticosteroid physiology and principles of therapy. Indian J Pediatr.2008;75:1039-44.
5. Waljee AK, Rogers MA, Lin P, Singal AG, Stein JD, Marks RM, dkk. Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study. BMJ. 2017;357:j1415. doi:10.1136/bmj.j1415.
6. Min KH, Rhee C, Jung JY, Suh M. Characteristics of adverse effects when using high dose short term steroid regimen. Korean J Audiol. 2012;16:65-70. doi:10.7874/kja.2012.16.2.65.
7. Ericson-Neilsen W, Kaye AD. Steroids: pharmacology, complications, and practice delivery issues. The Ochsner J. 2014;14:203-7.
8. Listiyawati IT, Sawitri, Agusni I, Prakoeswa CR. Terapi kortikosteroid oral pada pasien baru kusta dengan reaksi tipe 2. Berkala Ilmu Kesehatan Kulit dan Kelamin. 2015;27:48-54.
9. Schimmer BP, Parker KL. Adrenocorticotropic hormone, adrenocortical steroids and their synthetic analogs, inhibitors of the synthesis and actions of adrenocortical hormones. Dalam: Brunton LL, Lazo JS, Parker KL. Goodman and Gilman’s The pharmacological basis of therapeutics. Edisi ke-11. New York: McGraw-Hill, Medical Publishing Division; 2006.h.1587-612.
10. Chrousos GP. Adrenocorticosteroids and adrenocortical antagonists. Dalam: Katzung BG, Masters SB, Trevor AJ. Basic and clinical pharmacology. Edisi ke-12. New York: McGraw-Hill Lange; 2012.h. 697-713.
11. Suherman SK, Ascobat P. Adrenokortikotropin, adrenokortikosteroid, analog sintetik dan antagonisnya. Dalam: Gunawan SG, Setiabudy R, Nafrialdi, Instiaty, penyunting. Farmakologi dan terapi. Edisi ke-6. Jakarta: Badan Penerbit FKUI; 2016. h 507-27.
12. Becker DE. Basic and clinical pharmacology of glucocorticosteroids. Anesth Prog. 2013;60:25-32.
13. Flammer JR, Rogatsky I. Minireview: glucocorticoids in autoimmunity: unexpected targets and mechanisms. Mol Endocrinol. 2011;25:1075-86. doi:10.1210/me.2011-0068.
14. Caplan A, Fett N, Rosenbach M, Werth VP, Micheletti RG. Prevention and management of glucocorticoid-induced side effects: a comprehensive review. J Am Acad Dermatol. 2017;76:1-9. doi:10.1016/j.jaad.2016.01.062.
15. Deshmukh CT. Minimizing side effects of systemic corticosteroids in children. Indian J Dermatol Venereol Leprol. 2007;73:218-21.
16. Eckstein N, Haas B, Hass MD, Pfeifer V. Systemic therapy of cushing’s syndrome. Orphanet J Rare Diseases. 2014;9:1-16. doi:10.1186/s13023-014-0122-8.
17. Fardet L, Kassar A, Cabane J, Flahault A. Corticosteroid-induced adverse events in adults: frequency, screening and prevention. Drug Safety. 2007;30:861-81.
18. Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K. Fitzpatrick’s dermatology in general medicine. Edisi ke-8. New York: The McGraw-Hill Companies; 2012.h.165-2720.
19. Hopkins RL, Leinung MC. Exogenous cushing’s syndrome and glucocorticoid withdrawal. Endocrinol Metab Clin N Am. 2005;34:371-84. doi:10.1016/j.ecl.2005.01.013.
20. Alves C, Robazzi TC, Mendonca M. Withdrawal from glucocorticosteroid therapy: clinical practice recommendations. J Pediatr. 2008;84(3):192-202. doi:10.2223/JPED.1773.
21. Vatti RR, Ali F, Teuber S, Chang C, Gershwin ME. Hypersensitivity reactions to corticosteroids. Clinic Rev Allerg Immunol. 2014;47:26-37. doi:10.1007/s12016-013-8365-z.
22. Nocentini G, Ronchetti S, Bruscoli S, Riccardi C. The clinical pharmacology of past, present, and future glucocorticoids. Spring Int Publis. 2015:43-58. doi:10.1007/978-3-319-16056-6_5.
23. Gross KL, Lu NZ, Cidlowski JA. Molecular mechanisms regulating glucocorticoid sensitivity and resistance. Mol Cell Endocrinol. 2009;300:7-16. doi:10.1016/j.mce.2008.10.001.
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Published
2019-05-09
How to Cite
Siagian, J. N., Ascobat, P., & Menaldi, S. L. (2019). Kortikosteroid Sistemik: Aspek Farmakologi Dan Penggunaan Klinis Di Bidang Dermatologi. Media Dermato-Venereologica Indonesiana, 45(3). https://doi.org/10.33820/mdvi.v45i3.33
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