Integrasi Misoprostol dalam Daftar Obat Esensial Nasional sebagai Alternatif Penanganan Perdarahan Pasca Persalinan di Wilayah Pedesaan di Indonesia
DOI:
https://doi.org/10.55175/cdk.v47i8.587Keywords:
Indonesia, misoprostol, perdarahan pasca persalinan, wilayah pedesaanAbstract
Di Indonesia, angka kematian ibu akibat perdarahan pasca persalinan (PPP) masih tinggi, terutama di wilayah pedesaan dengan akses terhadap oksitosin sebagai obat lini utama masih sangat terbatas. Misoprostol berpotensi menjadi alternatif oksitosin untuk penanganan PPP di wilayah pedesaan. Telaah literatur manfaat misoprostol menggunakan search engine Google Scholar, PubMed, dan NCBI, dengan kata kunci “misoprostol”, “perdarahan pasca persalinan”, “wilayah dengan sumber daya rendah”, “farmakokinetika”, “farmakodinamika”, dan “Indonesia”. Ditinjau dari aspek Cmax, Tmax, dan AUC, jalur sublingual diduga paling efektif. Penelitian lebih lanjut diperlukan untuk memastikan rute pemberian serta dosis misoprostol yang paling efektif untuk penanganan kasus PPP. Namun, misoprostol belum terdaftar di Daftar Obat Esensial Nasional (DOEN). Ditetapkannya misoprostol dalam DOEN akan memastikan ketersediaannya di fasilitas kesehatan di Indonesia sehingga manajemen PPP di wilayah pedesaan dapat lebih efektif.
In Indonesia, postpartum hemorrhage (PPH) continues to be a leading cause of maternal death, especially in rural areas with limited access to oxytocin as the first-line therapy in PPH management. Misoprostol, a prostaglandin E1 analogue can become an alternative drug for PPH management in rural areas. Literature search was conducted using Google Scholar, PubMed, and NCBI, with keywords including “misoprostol”, “perdarahan pasca persalinan”, “wilayah dengan sumber daya rendah”, “farmakokinetika”, “farmakodinamika”, and “Indonesia”. Evaluation of Cmax, Tmax, and AUC showed that the most effective route of delivery for misoprostol is by sublingual administration. Further research is needed to confirm the most effective delivery route as well as optimal misoprostol dosage for PPH management. However, misoprostol has not been enlisted in Daftar Obat Esensial Nasional (DOEN). Inclusion of misoprostol in DOEN will help ensure its availability in health facilities across Indonesia, towards a more effective management for PPH in rural areas.
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