The Multifaceted Nature of Clopidogrel Resistance: Integrating Pharmacodynamic, Pharmacokinetic, and Pharmacogenomic

Andika Yusuf Ramadhan

doi:10.56951/pex51w69

The Multifaceted Nature of Clopidogrel Resistance: Integrating Pharmacodynamic, Pharmacokinetic, and Pharmacogenomic

Penulis

Andika Yusuf Ramadhan Clinical Pharmacology Study Program, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia

DOI:

https://doi.org/10.56951/pex51w69

Kata Kunci:

Resistensi clopidogrel, farmakogenomik, CYP2C19, P2Y12

Abstrak

Clopidogrel adalah obat golongan thienopyridine generasi kedua yang bekerja sebagai agen antiagregasi platelet dan banyak digunakan untuk mengobati penyakit kardiovaskular untuk mencegah pembentukan trombus. Penelitian yang
berkembang di bidang kardiovaskular telah menghasilkan istilah baru, yaitu resistansi clopidogrel, sebuah fenomena yang relevan secara klinis yang ditandai dengan penurunan respons terhadap terapi clopidogrel. Mekanisme resistansi
clopidogrel bersifat multifaktorial dan dapat mencakup penurunan bioavailabilitas clopidogrel karena adanya perubahan farmakokinetika, interaksi farmakokinetika/farmakodinamika (FK/FD) dengan obat lain, dan polimorfisme genetik. Polimorfisme genetik memengaruhi metabolisme prodrug clopidogrel dan menyebabkan konsentrasi subterapeutik
dari metabolit aktif clopidogrel. Selain itu, mutasi pada gen reseptor P2Y12 juga dapat mengubah respons platelet terhadap agonisnya, ADP, sehingga memengaruhi efikasi antagonis. Oleh karena itu, pengujian fungsi platelet dan profil
farmakogenomik merupakan alat yang penting untuk menentukan terapi clopidogrel, terutama dengan dugaan resistansi clopidogrel.

Unduhan

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