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Faktor Risiko Pada Pasien Dengan Terapi Rumatan Metadon Dan Antiretroviral: Sebuah Laporan Kasus

  • Sesca Mokalu ,
  • Luh Nyoman Alit Aryani ,
  • Sahat Hamonangan Hariandja ,
  • Ni Made Leni ,

Abstract

Background: The Methadone Maintenance Therapy Program (MMTP) is a government intervention aimed at addressing the adverse effects of the misuse of injectable substances, such as opioids. Methadone, a synthetic opioid agonist, is used to replace opioid dependence. People living with HIV/AIDS (PLWHA) on antiretroviral therapy (ART) are included in this program. They undergo antiretroviral therapy (ART) with the goal of reducing the risk of HIV transmission, preventing the progression of opportunistic infections, improving quality of life, and reducing viral load to undetectable levels. The administration of ART is known to have side effects, such as psychiatric disturbances, and may interfere with methadone dosing in MMTP patients.

Case Presentation: This study presents a case report of a 36-year-old divorced man, currently unemployed, who was brought to Prof. IGNG Ngoerah General Hospital. The patient complained of sadness, severe body pain causing groaning, abdominal cramps accompanied by cold sweats, occasional blank stares, slurred speech, weakness, and inability to engage in activities. These symptoms occurred since the initiation of methadone with ART and persisted despite the patient's regular use of methadone and ART. The patient was treated to improve his general condition, and methadone maintenance was continued with an increased dosage.

Conclusion: PLWHA in MMTP face significant challenges as they undergo two concurrent treatment programs with routine schedules and potential side effects. Methadone should be monitored for possible drug interactions with ARTs, which can lower methadone concentrations and require dose escalation. Methadone treatment programs must ensure that patients receiving concomitant ART have access to medical care so they can be monitored and receive appropriate treatment.

 

Latar Belakang : Program Terapi Rumatan Metadon (PTRM) merupakan langkah intervensi yang diambil pemerintah untuk mengatasai dampak buruk akibat penyalahggunaan NAPZA suntik seperti opioid. Metadon, opioid agonis sintetik, digunakan untuk menggantikan ketergantungan opioid. Orang dengan HIV/AIDS (ODHA) yang menggunakan antiretroviral (ARV) terlibat dalam program ini. Mereka menjalani terapi antiretroviral (ARV) dengan tujuan mengurangi risiko penularan HIV, mencegah perkembangan infeksi oportunistik menjadi lebih parah, meningkatkan kualitas hidup, dan mengurangi jumlah virus dalam darah hingga tidak terdeteksi. Pemberian ARV diketahui juga dapat memberikan efek samping seperti gangguan psikiatri dan memengaruhi dosis metadon pada pasien PTRM.

Presentasi Kasus : Studi ini berupa laporan kasus, laki-laki, 36 tahun, cerai hidup, tidak bekerja, dibawa ke RSUP Prof. IGNG Ngoerah. Pasien mengeluh sedih, tersiksa menahan nyeri seluruh badan hingga menggerang, keram pada area perut disertai keringat dingin, tatapan kadang kosong, bicara tidak jelas, lemas serta tidak bisa beraktivitas. Keluhan dialami sejak awal menggunakan metadon bersama ARV dan berulang walaupun pasien rutin minum metadon dan ARV. Pasien menjalani perawatan untuk perbaikan kondisi medis umum dan terapi rumatan metadon tetap dilanjutkan dengan peningkatan dosis.

Simpulan : Pasien ODHA penasun menghadapi tantangan yang signifikan karena menjalani dua program terapi secara bersamaan dengan rutinitas dan mengalami risiko efek samping. Dosis metadon harus dipantau karena potensi interaksi obat-obatan ARV yang akan menurunkan konsentrasi metadon sehingga membutuhkan peningkatan dosis. Program pengobatan metadon harus memastikan bahwa pasien dengan terapi ARV secara bersamaan memiliki akses untuk perawatan medis yang ketat sehingga pasien dapat dimonitor dan mendapatkan pengobatan yang tepat.

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How to Cite

Mokalu, S., Luh Nyoman Alit Aryani, Sahat Hamonangan Hariandja, & Ni Made Leni. (2023). Faktor Risiko Pada Pasien Dengan Terapi Rumatan Metadon Dan Antiretroviral: Sebuah Laporan Kasus. Intisari Sains Medis, 14(3), 1135–1139. https://doi.org/10.15562/ism.v14i3.1897

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Sesca Mokalu
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Luh Nyoman Alit Aryani
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Sahat Hamonangan Hariandja
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Ni Made Leni
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