Case Gastropati Oains
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Transcript of Case Gastropati Oains
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LAPORAN KASUSGastropati OAINS
Oleh : Ade Sesmiza
1110070100146
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Latar ela!a"#$ %erdasar!a" Arthritis Rhe&matism a"d A#i"# 'edi(al I")ormatio" S*stem
+diper!ira!a" se!itar 107,000 pe"derita dira-at
di r&mah sa!it setiap tah&""*a+ !are"a
!ompli!asi sal&ra" (er"a a!iatOAINS+da" se!&ra"#.!&ra"#"*a 16,/00 dia"tara
pe"derita arthritis me"i"##al setiap tah&""*a !are"a
!ompli!asi OAINS di Ameri!a Seri!at,
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Definisi Gastropati OAINS
Gastropati!er&sa!a" epitel ata& e"dotel+ ta"pa i")lamasi
ata& i")lamasi mi"imal pada m&!osa lam&"#
Gastropati OAINS
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Pato)isiolo#i
a!tor a#resi)
a!torde)e"si)
Keadaa"m&!osalam&"#
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a#resi)
e"do#e"
2(l+ pepsi"#aram
emped&
e!so#e"
Oat Al!ohol a!teri
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• I"hiisi sistemi!PG
• I"hiisi (o31• I"hiisi O5
)e! lo!al•
Keasama"OAINS
• 8erpera"#!apdalam epitelm&!osa
Ker&sa!a"
m&!osalam&"#
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Menegakan Diagnosa Gastropati OAINS
Gastropati OAINS
pe"&"9a"#
Pemeri!saa")isi!
a"am"esa
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Pe"atala!sa"aa"
2 e " t i ! a "
p e " ( e t & s
Stop OAINS
# a s t r o p r o
t e ! t o r
A"alo#
prosta#la"di" A"ta#o"isreseptor 2
PPI
; i ! a a d
a
p e r d a r a h a " s
a l & r a "
( e r " aPe"&hi
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Lapora" Kas&s$ Nama : N*, '
$ Um&r : 60th
$ ;e"is !elami" : Peremp&a"
$ Alamat : Pa"i"##aha"
$ Pe!er9aa" : i& r&mah ta"##a$ 8a"##al=9am mas&! : > 9&"i 01/ p&!&l ,0 ?I%
$ R&a"#a" : !e"a"#a
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$ Kel&ha" &tama :$ P&si"#
$ Ri-a*at Pe"*a!it Se!ara"# :
$ p&si"# se9a! sat& mi"##& *a"# lal&$ %A% hitam se9a! sat& mi"##& *a"# lal&
$ Na)s& ma!a" me"&r&"
$ Lemas
$ '&al @
$ '&"tah @.$ N*eri per&t daerah epi#astri&m
$ Sa!it se"di se"di t&"#!ai
$ Ri-a*at pe"*a!it dah&l& :$ Pasie" per"ah me"#alami remati! da" ada ri-a*at memi"&m oat
remati! se9a! leih !&ra"# sat& tah&" *a"# lal&
$ Oat remati! *a"# di!o"s&msi adalah piro3i(am
$ 8ida! ada ri-a*at B'
$ Ri-a*at hiperte"si @
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$ Cital Si#"$ Keadaa" &m&m: sa!it seda"#
$ Kesadara" : (omposme"tis (ooperati)
$ 8e!a"a" darah : 110=60 mm2#
$ Nadi : >>3=me"it
$ re!&e"si "a)as: 03=me"it
$ S&h& : D7+60
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$ Pemeri!saa" )isi! !h&s&s$ Kepala :
$ %e"t&! &lat + "ormo (ephal+ram&t ada p&tih ada hitam+
!&at tida! m&dah di(a&t+ ada l&!a *a"# s&dah
me"#eri"# di !&lit !epala a#ia" o((ipital,$ 'ata :
$ Ko9&"#ti
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$ N*eri tari! @.
$ N*eri !eto! pro(, 'astoide&s @.$ 2id&"# :
$ Normo"asi$ Be
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$ Par& :
$ I : simetris dalam !eadaa" statis da" di"amis
$ P : ta! ada "*eri te!a" lapa"# par&+ )remit&s !a"a" da"
!iri sama$ P : so"or
$ A : &"*i "a)as
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$ 8erapi$ ICB RL > 9am=!ol)
$ I"9e!si e)tria3o" 13#r
$ I"9e!si ra"itidi" 31$ I"9e!si
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Rabu / 10
juni 2015
BAB cair
BAK sering
Pusing (-)
Dada
berdebar (-)
Akral
hangat
Kesadaran
!"#$"s#e
ntis
c""$erati%
&D 110/'0
##g
uhu
*'+'0!
,adi ./i
,a%as
1./i
astr"$ati
A, dan
#elena
Ane#ia
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Ka#is / 11 juni 2015 K"njungtia ane#is
Akral hangat
&idak ada keluhan
Kesadaran
c"#$"s#entis
c""$erati%
&D 130/0 ##g
,adi 0./i
,a%as 1'./i
uhu tidak de#a#
astr"$ati A,
dan #elena
Ane#ia
4u#at / 12 juni 2015 BAB Hitam (-)
Tidak ada keluhan
Kesadaran :
composmentis
cooperatif
TD: 140!0 mmH"
#adi : !0$i
#afas : %0$i
&uhu : tidak demam
'astropati A#& *ek H+ post transfusi
#eurode$ 1$1
,it k "anti ta+let
Kalne$ ta+let in.eksi
transamin stop
/anitidin ta+let
in.eksi ranitidin stop
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abtu / 1* juni
2015
&idak ada
keluhan
Kesadaran
c"#$"s#entis
c""$erati%
&D 130/0
##g
,adi './i
,a%as 1./i
uhu tidak
de#a#
b 11+g/dl
RB! 3+20 .
10'/u6
!& *'+07
astr"$ati
A,
B"leh $ulang
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Pemahasa" !as&s
N*, ' 60 ..a"#sal i"ter"a -a"ita de"#a" !el&ha" p&si"#,
Bari a"am"esa didapat!a" ah-a "*, ' merasa p&si"#
se9a! sat& mi"##& *a"# lal&+ &a"# air esar "*a e-ar"a
hitam de"#a" !o"siste"si (air "am&" ter!ada"# l&ma*a"
padat, Ada m&al da" tida! ada m&"tah seel&m mas&!r&mah sa!it "*, ' me"#el&h!a" "*eri di daerah
epi#astri&m+ "am&" se9a! mi"&m oat "*eri s&dah tida!
ada, N*, ' 9a me"#el&h!a" sa!it se"di se"di t&"#!ai+
da" selama setah&" i"i ia me"#o"s&msi oat remati! 9e"isOAINS *ait& piro3i(am,
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$ Saat mas&! a"#sal i"ter"a -a"ita ditem&!a" ta"da > !ali per me"it+ "a)as 0 !ali per
me"it da" s&h& D7,60 , Pada pemeri!saa" )isi!+
ditem&!a" !o"9&"#ti
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$ N*, ' diterapi de"#a" pemeria" ICB RL 6 9am per !ol)
&"t&! meme"&hi
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Kesimp&la"$ Gastropati OAINS adalah lesi m&!osa *a"# eh&&"#a"
de"#a" pe"##&"aa" OAINS, 'e!a"isme ter9adi"*a
#astropati OAINSerh&&"#a" de"#a" e)e! lo!al *a"#
disea!a" oleh terpera"#!ap"*a OAINS dalam sel epitel
m&!osa #aster da" e)e! sistemi! melal&i pe"#hamata"
O5 *a"# me"*ea!a" si"tesis prosta#la"di"terhamat, Pe"#he"tia" OAINS da" pe"##&"aa" oat
#astroprote!ti) de"#a" mempertima"#!a" resi!o
#astroi"testi"al da" !ardio