DOI: https://doi.org/10.14710/jai.v6i3.9120

Pengaruh Ketorolak dan Parekoksib Terhadap Gambaran Histopatologi Gaster Tikus Wistar

1Rumah Sakit Islam , Indonesia

2Jakarta Utara, Indonesia

3Bagian Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Diponegoro/ RSUP Dr. Kariadi, Indonesia

4 Semarang, Indonesia

5 Bagian Patologi Anatomi, Fakultas Kedokteran, Universitas Diponegoro/ RSUP Dr. Kariadi, Indonesia

View all affiliations
Published: 1 Nov 2014.
Open Access Copyright 2014 JAI (Jurnal Anestesiologi Indonesia)

Citation Format:
Abstract

Latar Belakang : Obat antiinflamasi nonsteroid (OAINS) digunakan sebagai analgetik paska operasi. Berbagai jenis OAINS dapat menghambat sintesis prostaglandin (PG) yang merupakan mediator inflamasi dan mengakibatkan berkurangnya tanda inflamasi.Akan tetapi PG khususnya PGI sebenarnya merupakan zat yang bersifat protektor untuk mukosa saluran cerna atas. Hambatan sintesis PG akan mengurangi ketahanan mukosa, dengan efek berupa lesi akut mukosa gaster bentuk ringan sampai berat. Gastropati OAINS adalah lesi mukosa gaster yang berhubungan dengan terapi OAINS.

Tujuan : Membandingkan gambaran histopatologi gaster antara tikus wistar yang diberikan ketorolak intramuskular dan parekoksib intramuskular.

Metode : Dilakukan penelitian eksperimental laboratorik menggunakan randomized post test control group design pada 21 ekor tikus wistar jantan yang terbagi dalam 3 kelompok yaitu kelompok kontrol (K) tikus wistar yang diberikan luka insisi sepanjang 2 cm dan tidak diberikan injeksi ketorolak maupun parekoksib, Kelompok perlakuan 1 (P1) tikus wistar yang diberikan luka insisi sepanjang 2 cm dan diberikan injeksi ketorolak intramuskuler setara dosis manusia 30 mg tiap 8 jam, kelompok perlakuan 2 (P2) tikus wistar yang diberikan luka insisi sepanjang 2 cm dan diberikan injeksi parekoksib setara dosis manusia 40 mg tiap 12 jam. Pada hari ke 5 dilakukan terminasi dan pada hari ke 6 dilakukan pembuatan blok parafin.

Hasil : Ketorolak 0,54 mg/8 jam selama 5 hari mempengaruhi integritas mukosa lambung tikus wistar lebih buruk dibandingkan dengan parekoksib 0,72 mg /12 jam selama 5 hari (p<0,001)

Kesimpulan : Parecoxib kurang menimbulkan kerusakan mukosa lambung dibandingkan ketorolak.

Fulltext View|Download
Keywords: ketorolak; parekoksib; integritas mukosa lambung

Article Metrics:

Article Info
Section: Original Articles
Language : ID
Recent articles
Perbandingan Penggunaan Triamcinolone Acetonide Dan Gel Larut Air Pada Pipa Endotrakea Terhadap Angka Kejadian Nyeri Tenggorok Perbandingan Penggunaan Triamcinolone Acetonide dan Lidocaine Pada Pipa Endotrakea Terhadap Angka Kejadian Nyeri Tenggorok Pasca Intubasi Pada Anestesi Umum Kadar Serum Substansi P Pada Pemberian Klonidin Sebagai Ajuvan Analgesia Epidural Anestesi Spinal Pada Seksio Sesaria Wanita Dengan Tetralogy Fallot Tidak Terkoreksi Patofisiologi Penyakit Jantung Koroner More recent articles
Most cited articles
Midazolam Intravena Dosis Rendah Tidak Mempengaruhi Nitric Oxide Intraperitoneal Mencit Balb/C Yang Terpapar Lipopolisakarida Patofisiologi Penyakit Jantung Koroner More cited articles
  1. Mccrory CR, Lindahl SGE. Cyclooxygenase Inhibition for post operative analgesia. Anesth analg 2002; 95:169-76
  2. Gajraj NM. Cyclooxygenase 2 inhibitors. Anesth analg 2003; 96: 11720-38
  3. Vane Jr, Booting RM. Mechanism of action of anti-inflammatory drugs. Scan J Rheumatol 1996; 25 suppl 102: 9-21
  4. Vane J, Bakhle Y, Botting R. Cyclooxygenase 1 and 2. Annu Rev Pharmacol Toxicol 1998;38:97-120
  5. Laneuville O, Breuer DK, De Witt DL,et al. Differential inhibition of human prostaglandin endoperoxide H synthases-1 and-2 by nonsteroidal anti inflammatory drugs. J Pharmacol Exp Ther 1994; 271: 927-34
  6. Carabaza A, Cabre F, Rottlan E, et al. Stereoselective inhibitor of inducible cyclooxygenase by chiral nonsteroidal anti-inflammatory drugs. J clin Pharmacol 1996; 36: 36: 505-12
  7. Smith WL, Dewitt DL. Prostaglandin endoperoxide H synthases-1 and -2. Adv Immunol 1996; 62: 167-215
  8. Cheer SM, Goa KL. Parecoxib (Parecoxib Sodium). DRUGS 2001; 61:1133-41
  9. Hawkey CJ. Nonsteroidal anti-inflammatory drugs gastropathy. Gastroenterology 2000; 119:5221-35
  10. Lazzaroni M, Porro GB. Gastrointestinal side effects of traditional non steroid anti inflammatory drugs and new formulations. AP&T 2004; 20:48-58
  11. Harris SI, Stolz RR, Le Comte D, Hubbard RC. Parecoxib sodium demonstrates gastrointestinal safety comparable to placebo in healthy subjects. J Clin Gastroenterol 2004; 38: 575-80
  12. Harris SI, Kuss M, Hubbard RC, Goldstein JL. Upper gastrointestinal safety evaluation of parecoxib sodium, a new parenteral cyclooxygenase2 spesific inhibitor compared with ketorolac, naproxen and placebo. Clin Ther 2001; 23: 1422-8
  13. Laine L, Harper S, Simon T, Bath R, Johanson J, Schwartz H et al. A randomized trial comparing the effect of rofecoxib, a cyclooxygenase-2 spesific inhibitor with that of ibuprofen on the gastroduodenal mucosa of patients with osteoarthritis. Gastroenterology 1999;117:776-83
  14. Deeks JJ, Smith LA, Bradley MD. Efficacy, tolerability and upper gastrointestinal safety of celecoxib for treatment of osteoarthritis and rheumatoid arthritis: systematic review of randomized controlled trials. BMJ 2002; 325: 619
  15. Leite AZ, Sipahi AM, Damiao AO, Garcez AT, Buchpiquel CA, Lopasso FP et al. Effect of selective non steroidal anti-inflammatory inhibitor cyclooxygenase 2 on the small bowel of rats. BRAZ J MED BIOL RES 2004; 37: 333-6
  16. Shigeta J, Takahashi S, Okabe S. Role of cyclooxygenase-2 in the healing of gastric ulcers in rats
  17. Manan C, Pridsoeryanto BP, Daldiyono Estuningsih S, Rahminiwati M. Dyspepsia in nonsteroidal antiinflamatory drug gastropathy. The Indonesia Journal of Gastroenterology Hepatology and Digestive Endoscopy. 2011; 12: 100-103
  18. Warner TD, Giuliano F, VojnovicI, et al. Nonsteroid drug selectivities for cyclooxygenase-1 rather than cyclooxygenase-2 are associated with human gastrointestinal toxicity: a full in vitro analysis. Proc Natl Acad Sci USA 1999; 96: 7563-8
  19. Masferrer JL, Zweifel BS, Manning PT, Hauser SD, Leahy KM, Smith WG, Isakson PC, Seibert K. Selective inhibition of inducible cyclooxygenase 2 in vivo is anti-inflammatory and non ulcerogenic. Proc Natl Acad Sci U S A 1994; 91:3228-3232
  20. Chan Cc, Boyce S, Brideau C, et al. Pharmacology of a selective cyclooxygenase-2 inhibitor, L-745, 337: a novel nonsteroidal anti-inflammatory agent with an ulcerogenic sparring effect in rat and nonhuman primate stomach. J Pharmacol Exp Ther 1995; 274:1531-1537
  21. Langman M, Weil J, Wainwright P, et al. Risk of bleeding peptic ulcer associated with individual nonsteroidal anti-inflammatory drugs. Lancet 1994; 343:1075-8
  22. Gabriel S, Jaakkimainen L, Bombardier C.Risk for serious gastrointestinal complications related to the use of nonsteroidal anti-inflammatory drugs: a meta analysis. Ann Intern Med 1991; 115:787-96
  23. Langenbach R, Morham SG, Tiano HF, Loffin CD, Ghanayem BI Chulada et al. Prostaglandin synthase 1 gene disruption in mice reduces arachidonic acid-induced inflammation and indomethacin-induced gastric ulceration. Cell 1995; 83:483-492
  24. Smith CJ, Zhang Y, Kobold CM, Muhammad J, Zweifel BS, Shaffer A, Thalley JJ, Masferrer JL, Seibert K, Isakson PC. Pharmacological analysis of cyclooxygenase-1 in inflammation. Proc Natl Acad Sci U S A 1998; 95:13313-13318
  25. Gretzer B, Ehrlich K, Maricic N, Lambrecht N, Respondek M, Peskar BM. Selective cyclooxygenase-2 inhibitors and their influenced on the protective effect of a mild irritant in the rat stomach. Br J Pharmacol 1998; 123:927-935
  26. Mizuno H, Sakamoto C, Matsuda K et al. Induction of cyclooxygenase 2 in gastric mucosal lessions and its inhibition by the specific antagonist delays healing in mice. Gastroenterology 1997; 112:387-397
  27. Schmassmann A, Peskar BM, Stettler C, et al. Effects of inhibition of prostaglandin endoperoxide synthase-2 in chronic gastrointestinal ulcer models in rats. Br J Pharmacol 1998; 123:795-804
  28. Jones MK, Wang H, Peskar BM, Levin E, Itani RM, Sarfeh IJ, Tarnawski AS. Inhibition of angiogenesis by non steroidal anti-inflammatory drugs:insight into mechanisms and implications for cancer growth and ulcer healing. Nat MNed 1995;5
  29. Wallace JL, McKnight W, Reuter BK, Vergnolle N. NSAID induced gastric damage in rats: requirement for inhibition of both cyclooxygenase 1 and 2. Gastroenterology 2000; 119:706-14

Last update:

No citation recorded.

Last update: 2024-11-04 09:48:11

No citation recorded.