Profil Penggunaan Obat dan Potensi Interaksi Obat pada Pasien Tuberkulosis Komorbid Diabetes Melitus di Rumah Sakit Pendidikan Universitas Sumatera Utara

Abstract

Background: The treatment of tuberculosis (TB) in patients with diabetes mellitus (DM) requires special attention, as polypharmacy occurs in both diseases, leading to potential interactions between antituberculosis and antidiabetes medications. Objective: To determine the drug usage profile and potential drug interactions in tuberculosis patients with comorbid diabetes. Methods: This study used medical record data of TB and DM patients undergoing outpatient treatment at the educational hospital of Universitas Sumatera Utara (RSP USU). A descriptive research method with retrospective sampling was used. Drugs.com and Lexicomp were used to analyze drug interactions. Results: This research used medical records of 72 TB patients with comorbid DM undergoing outpatient treatment at RSP USU from January to December 2024. The majority of patients were male (73.61%) and aged ≥45 years (76.39%), with 51.39% of patients in the intensive phase and 48.61% in the continuation phase. The drug usage profile shows that the most widely used antituberculosis drugs are fixed-dose combination antituberculosis drugs, namely RHZE (rifampicin, isoniazid, pyrazinamide, and ethambutol) and RH (rifampicin and isoniazid), while for antidiabetes drugs, they are metformin and insulin glargine. Other drugs that are frequently used are vitamin B6, gabapentin, and sucralfate. Based on the analysis of potential drug interactions, all patients (100%) experienced potential interactions. In terms of severity, moderate interactions dominated (75.78%), followed by mayor (21.29%) and minor (2.93%). Meanwhile, based on the mechanism of interaction, pharmacodynamic category (60,74%) was more commonly found compared to pharmacokinetic (25,98%) and pharmacokinetic pharmacodynamic (13,28%). Conclusion: The potential drug interactions that occur in TB patients with comorbid DM are high, thus individual therapy monitoring is essential to improve the effectiveness and safety of the treatment.