Case Report: 60-Year-Old Female with Ischemic Stroke, Type 2 Diabetes Mellitus, and Hypertension

Authors

  • Husnawati Husnawati Program Studi Profesi Apoteker, Sekolah Tinggi Ilmu Farmasi Riau
  • Dita Maulida Andriani Program Studi Profesi Apoteker, Sekolah Tinggi Ilmu Farmasi Riau
  • Famella Yustika Rizki Program Studi Profesi Apoteker, Sekolah Tinggi Ilmu Farmasi Riau
  • Fitri Prima Wanty Program Studi Profesi Apoteker, Sekolah Tinggi Ilmu Farmasi Riau
  • Giacinta Gracesandy Sinaga Program Studi Profesi Apoteker, Sekolah Tinggi Ilmu Farmasi Riau
  • Helvy Rahmi Program Studi Profesi Apoteker, Sekolah Tinggi Ilmu Farmasi Riau
  • Laurentin Leni Anggraini Program Studi Profesi Apoteker, Sekolah Tinggi Ilmu Farmasi Riau
  • Putri Khairani Program Studi Profesi Apoteker, Sekolah Tinggi Ilmu Farmasi Riau
  • Rezkila Sakinah Program Studi Profesi Apoteker, Sekolah Tinggi Ilmu Farmasi Riau
  • Sri Lidya Rasihen Program Studi Profesi Apoteker, Sekolah Tinggi Ilmu Farmasi Riau
  • Wahyudi Wahyudi Program Studi Profesi Apoteker, Sekolah Tinggi Ilmu Farmasi Riau
  • Yori Yunita Sinulinga Program Studi Profesi Apoteker, Sekolah Tinggi Ilmu Farmasi Riau

DOI:

https://doi.org/10.22487/htj.v11i2.1564

Keywords:

Stroke, hypertension, diabetes mellitus, candesartan, KSR

Abstract

Background: Ischemic stroke remains a leading cause of death and disability worldwide, with increasing incidence each year. Patients with comorbidities, such as Type 2 diabetes mellitus (DM), pose additional treatment challenges due to a higher risk of drug-related problems (DRPs), particularly drug interactions. Objective: This study aims to describe pharmaceutical care in female patients diagnosed with ischemic stroke and Type 2 DM, with a focus on identifying and evaluating DRPs. Method: A descriptive case study was conducted. Data were collected through medical records and patient monitoring, focusing on the identification and analysis of potential DRPs in the context of pharmaceutical care. Results: The study found drug interactions as the most prominent DRP. An interaction between potassium slow-release (KSR) and candesartan was identified as requiring monitoring. Additionally, moderate interactions were found between atorvastatin and clopidogrel, as well as atorvastatin and amlodipine. These interactions have the potential to influence therapeutic outcomes. Conclusion: The prescribed medication regimen was generally appropriate for the patient's condition. Nevertheless, the presence of DRPs highlights the importance of regular monitoring and dose adjustments. Optimizing pharmaceutical care through early detection and management of DRPs is essential to ensure treatment safety and effectiveness in patients with complex conditions.

References

Kuriakose D, Xiao Z. Pathophysiology and Treatment of Stroke: Present Status and Future Perspectives. IJMS. 2020;21(20):7609. doi:10.3390/ijms21207609

Agustiawan., Nurhayati. AT. Perbandingan Kadar Gula Darah Pasien Di Instalasi Gawat Darurat Terhadap Tingkat Keparahan Stroke. Healthy Tadulako Journal. 2024;2(3):399-405.

Global, regional and national burden of stroke. a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. Lancet Neurol. 18(5):439-458. doi:10.1016/S1474-4422(19)30034-1.

Goldstein L, Bushnell C, Adams R AE. Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American Heart. Association/American Stroke Association. 2011;42(2):517-584.

Minarti DL, Bintang AK, Akbar M, Aulina S, Bahar A, Idris I. Efek Neuroprotektif Brain-Derived Neurotrophic Factor (BDNF) dengan Tingkat Depresi Pasca Stroke Iskemik: Studi Cross Sectional. HTJ. 2024;10(3):379-386. doi:10.22487/htj.v10i3.1246

Campbell BC V, De Silva DA, Macleod MR, et al. Ischaemic stroke. Nature Reviews Disease Primers. Nature Reviews Disease Primers. 2019;5(1):70-70. doi:https://doi.org/10.1038/s41572-019-0118-8.

Tamburian AG, Ratag BT, Nelwan JE. Hubungan antara Hipertensi, Diabetes Melitus, dan Hiperkolesterolemia dengan Kejadian Stroke Iskemik. Journal of Public Health and Community Medicine. 2020;1(1):27-33.

Agustiawan A, Nurhayati N, Tanjung A. Perbandingan Kadar Gula Darah Pasien di Instalasi Gawat Darurat terhadap Tingkat Keparahan Stroke. HTJ. 2024;10(3):399-405. doi:10.22487/htj.v10i3.1258

Mills KT, Stefanescu A HJ. . The Global Epidemiology Of Hypertension. Nat Rev Nephrol. 2020;16(4):223-237. doi:doi:10.1038/s41581-019-0244-2

Muflihah Rizkawati, Ratna Amalia Fairus, Nurmala Widya Absari. Potensi Tanaman Herbal Bunga Telang (Clitoria Ternatea) Sebagai Alternatif Antihipertensi. Healthy Tadulako Journal. 2023;9(1):43-50.

Ibrahim, Indria Sari, Muhammad Iqbal Fakhruzzaman. Hubungan Aktivitas Fisik, Pola Makan, Dan Merokok Dengan Kejadian Hipertensi Pada Lansia Di Kampung Tua Bakau Serip Tahun 2022. Zona Kedokteran. 2023;13(2):351-352.

Banilai PAS, Sakundarno M. Systematic Review: Faktor-Faktor yang Berhubungan dengan Kejadian Diabetes Melitus (DM) pada Penderita Tuberkulosis (TB). HTJ. 2023;9(2):205-217. doi:10.22487/htj.v9i2.739

Suhartatik S. Faktor-Faktor yang Mempengaruhi Tingkat Kepatuhan Diet Penderita Diabetes Melitus. Healthy Tadulako Journal (Jurnal Kesehatan Tadulako). 2022;8(3):148-156.

Lestari, Zulkamain, St. Aisyah Sijid. Diabetes Melitus: Review Etiologi, Patofisiologi, Gejala, Penyebab, Cara Pemeriksaan, Cara Pengobatan Dan Cara Pencegahan.; 2021.

Priyanto, Nengsih Yulianingsih, Hasim Asyari. Hubungan Pengetahuan Tentang Diabetes Mellitus Dengan Kepatuhan Menjalani Pengobatan Pada Pasien Diabetes Mellitus Di Kecamatan Kertasemaya Tahun 2021Hubungan Pengetahuan Tentang Diabetes Mellitus Dengan Kepatuhan Menjalani Pengobatan Pada Pasien Diabetes. JURNAL JPIKES. 2022;2(1):17-24.

Puti Andalusia Sarigando Banilai, Mateus Sakundarno. Systematic Review:Faktor-Faktor Yang Berhubungan Dengan Kejadian Diabetes Melitus (Dm) Pada Penderita Tuberkulosis (Tb). Healthy Tadulako Journal Jurnal Kesehatan Tadulako. 2023;9(2):205-217.

Dedi, Darwin Syamsul, Resya Tiranda Siregar. Profil Penggunaan Obat Pada Pasien Stroke Iskemik Pada Pasien Di Poli Neurologi. Borneo Nursing Journal (BNJ). 2023;5(1):36-38.

Galindra Y, Sahreni S, Andjellya Z. Hubungan Hiperglikemia reaktif dengan prognostik stroke iskemik di Rumah Sakit Budi Kemuliaan Kota Batam. Jurnal Zona Kedokteran. 2022;12(2):122-128.

Handayani, F., Kusumaningrum, N.S.D., Utami, R.S., Hastuti, Y.D., Suhartini, Widiyastuti, R.H. & Ropyanto CB. Buku Panduan Penatalaksanaan Hipertensi Dan Diabetes Mellitus Untuk Mencegah Stroke. Penerbit Fakultas Kedokteran Universitas Diponegoro Kampus Undip Tembalang Semarang; 2020.

Indonesia KKR. Tatalaksana Stroke. Kementerian Kesehatan RI.

Maida CD, Daidone M, Pacinella G, Norrito RL, Pinto A, Tuttolomondo A. Diabetes and Ischemic Stroke: An Old and New Relationship an Overview of the Close Interaction between These Diseases. IJMS. 2022;23(4):2397. doi:10.3390/ijms23042397

Mosenzon O, Cheng AY, Rabinstein AA, Sacco S. Diabetes and Stroke: What Are the Connections? J Stroke. 2023;25(1):26-38. doi:10.5853/jos.2022.02306

Sarah Rizqiya Zahiya Muharrika Dias Syukriyah, Asra Al Fauzi. Hypertension as a risk factor in stroke: An overview. World J Adv Res Rev. 2024;21(1):2370-2372. doi:10.30574/wjarr.2024.21.1.0204

DiPiro, C. V., Wells, B.G., DiPiro, J.T. & Schwinghammer TL. Pharmacotherapy Handbook,Tenth Edition. Tenth Edit. McGraw-Hill Companies.; 2017.

Mehta A, Mahale R, Buddaraju K, Javali M, Acharya P, Srinivasa R. Efficacy of neuroprotective drugs in acute ischemic stroke: Is it helpful? J Neurosci in Rural Pract. 2019;10(4):56-81.

Ghozy S, Reda A, Varney J, et al. Neuroprotection in Acute Ischemic Stroke: A Battle Against the Biology of Nature. Front Neurol. 2022;13:870141. doi:10.3389/fneur.2022.870141

Paul M, Paul JW, Hinwood M, et al. Clopidogrel Administration Impairs Post-Stroke Learning and Memory Recovery in Mice. IJMS. 2023;24(14):11706. doi:10.3390/ijms241411706

Medscape. Prescription Drug Information, Farmakokinetics and Side Effect. Published online June 2024.

American Pharmacist Association. Drug Information Handbook with International Trade Names Index Ed 28. Lexicomp Inc.; 2019.

Dewi IP, Merry MS. Peranan obat golongan statin. Berkala Ilmiah Kedokteran Duta Wacana. Berkala Ilmiah Kedokteran Duta Wacana. 2017;2(3):3-5.

Downloads

Published

2025-04-30

How to Cite

Husnawati, H., Andriani, D. M., Rizki, F. Y., Wanty, F. P., Sinaga, G. G., Rahmi, H. ., Anggraini, L. L., Khairani, P., Sakinah, R., Rasihen, S. L., Wahyudi, W., & Sinulinga, Y. Y. (2025). Case Report: 60-Year-Old Female with Ischemic Stroke, Type 2 Diabetes Mellitus, and Hypertension. Healthy Tadulako Journal (Jurnal Kesehatan Tadulako), 11(2), 188-194. https://doi.org/10.22487/htj.v11i2.1564

Issue

Vol. 11 No. 2 (2025)

Section

Articles

License

Copyright (c) 2025 Healthy Tadulako Journal (Jurnal Kesehatan Tadulako)

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.