Archive for February, 2008

Kadaluwarsa Pangan dan Obat

Tuesday, February 26th, 2008

Oleh : Ibuke Bogi

 

Setiap hari masyarakat moderen dihadapkan pada produk obat dan pangan yang mencantumkan : kadaluwarsa/expired date, atau term lain yang dimaksudkan menjaga keamanan dan kualitas obat dan pangan seperti : self life, use by, best before, display until, dll.

Banyak individu yang sangat perhatian dengan istila-istilah ini saat membeli obat maupun pangan, namun tak jarang ditemukan masyarakat yang terkesan cuek, tidak peduli dengan kode keamanan dan jaminan kualitas tersebut saat mengkonsumsi pangan (sedikit ditemukan ketidak pedulian ini dalam konsumsi obat).

 

SELF LIFE

Self life atau masa berlaku biasanya dicantumkan pada pangan. Self life adalah waktu dimana bahan pangan masih layak dikonsumsi oleh konsumen. Yang ditekankan dalam self life ini adalah kualitas bahan pangan, bukan keamanannya . Kualitas bahan pangan meliputi tekstur, rasa, bau, bentuk, ukuran. Panjang pendeknya self life suatu bahan pangan sangat dipengaruhi oleh panas/temperature, adanya gas, adanya air (pengaruh kelembaban udara/humidity). Sumber penganggu self life ini berasal dari cara produksi bahan, packaging serta cara penyimpanan produk jadi.

Adanya suhu tinggi akan mempercepat berkurangnya self life, karena pada proses kimiawi (bahan pangan pasti memiliki senyawa kimiawi seperti makronutrien, mikronutrien, bahan lain) adanya peningkatan suhu akan meningkatkan energi yang menyebabkan percepatan reaksi kimia perubahan bahan. Pada bahan pangan dan obat yang dipasarkan di Negara dengan temperature sub tropis akan sangat berbeda self life nya bila dibandingkan dengan di Negara tropis.

Berikut perbandingan self life yang dikeluarkan oleh World Food Programme (WFP)

Bahan

Self life di sub tropis

Self life di tropis

Nasi

2-3 tahun

Kurang dari 1 tahun

Kacang

2 tahun

1 tahun

Wheat

2-3 tahun

Kurang dari 2 tahun

Gandum

6-12 bulan

6-8 bulan

Mie instant

2 tahun

1 tahun

Minyak

Lebih dari 1 tahun

1 tahun

Biskuit

18 bulan

6-12 bulan

Ikan dalam kaleng

2 tahun

1 tahun

Teh

2 tahun

1 tahun

Gas dan air sangat mempengaruhi kualitas makronutrien bahan karena terjadinya proses oksidasi maupun konraminasi tumbuhnya mikroorganisme (jamur dan bakteri). Adanya oksigen dan lemak dalam bahan pangan akan menimbulkan proses oksidasi lemak menjadi rancid/tengik. Sedangkan adanya air dan lemak begitu pun akan menyebabkan ketengikan melalui proses hidrolisis lemak. Dalam produksi telah dilakukan upaya memperpanjang self life untuk menghindari rancidity/ketengikan dengan menambahkan antioksidan dan bahan pengawet. Keduanya akan menurunkan self life bahan pangan. Adanya bakteri aerob sejumlah tertentu (coliform 100 CFU/gram,mesofil bakteri 100.000 CFU/gram) masih bisa ditolerir, namun bila ditemukan adanya kenaikan bakteri tersebut self life bahan pangan akan sangat berkurang. Kontaminasi mikroorganisme dihindari dengan merancang kemasan yang sesuai untuk bahan pangan missal dengan kemasan yang divakum udaranya atau yang dikemas dengan bahan pendingin, didistribusikan dalam keadaan dingin, dll.

Dengan kata lain, adanya pengganggu-pengganggu (suhu, cahaya, air) selama proses pembuatan, packaging dan penyimpanan akan menurunkan self life bahan pangan. Oleh karena itu tidak heran bila suatu produk pangan yang diperkirakan akan memiliki self life 12 bulan tetapi karena kesalahan penyimpanan (bisa terjadi baik di industri, di took/outlet maupun di rumah konsumen), maka self life bahan akan berkurang dari 1 tahun. Dapat pula terjadi selama penyimpanan yang dianggap sudah pas, ada sedikit lubang terbuka pada kemasan sehingga memungkinkan masuknya air, udara atau cahaya. Sangat penting untuk selalu memperhatikan kualitas pangan selama dalam penyimpanan seperti yang paling mudah dilakukan adalah jangan pernah mengkonsumsi bahan pangan yang telah berubah warna, rasa, bentuk menjadi lembek, apalagi tumbuh jamur walaupun kemasan belum di buka. Karena berarti kualitas bahan sudah berubah (makro dan mikronutriennya).

Self life ditandai dengan istilah : BEST BEFORE

 

EXPIRED DATE

Jika self life menekankan segi kualitas bahan pangan, maka expired date (ED) menekankan keamanan bahan pangan dan obat. Pada obat secara jelas ditandai dengan tulisan expired date atau ED, atau expired, sedangkan pada pangan dengan USE BY.

Bahan pangan yang dikonsumsi setelah tanggal best beforenya masih mungkin aman, hanya saja kualitasnya telah berubah. Namun bila bahan pangan dikonsumsi setelah melampaui tanggal use by, maka jaminan keamanan bahan pangan telah hilang. Dalam regulasi bahan pangan tidak seketat obat, sehingga masih sering ditemukan barang-barang melebihi tanggal use by diperjual belikan secara terbuka karena biasanya ketidakamanan bahan pangan akan muncul tidak serta merta seperti pada obat, kecuali jika ada kontaminasi mukroorganisme seperti E.coli dan salmonella.

Keamanan bahan pangan dinilai dari parameter ada tidaknya :

  • mikotoksin (toksin berasal dari jamur seperti aflatoksin),dan sianogen/sianida
  • agen penyebab mad cow disease (BSE)
  • bahan polutan organic persisten seperti PCB dan dioksin
  • bahan anorganik berbahaya seperti cadmium, timbal dan merkuri
  • cemaran mikroorganisme E coli dan salmonella.

Bila bahan pangan dikonsumsi sebelum tanggal kadaluwarsanya, dijamin bahan tersebut tidak mengandung bahan-bahan berbahaya di atas.

 

ED PADA OBAT

Waktu kadaluwarsa obat mengindikasikan bahwa obat telah berkurang 10% aktivitasnya. Jadi bukan berarti bila obat telah masuk waktu kadaluwarsanya berarti obat sama sekali telah tidak punya aktivitas atau kemampuan farmakologi. Study untuk menentukan waktu kadaluwarsa obat dilakukan dengan sangat teliti yakni dengan menentukan kadar obat pada keadaan peningkatan temperature terkontrol tiap 10 derajat hingga kadar obat mendekati habis. Pada saat aktivitas/kadar obat telah berkurang 10% itulah ditentukan sebagai t90 yang secara awam diterjemahkan sebagai waktu kadaluwarsa obat.

Pada obat-obat non life saving seperti painkiller, antihistamin, vitamin, antibiotic dengan indeks terapi lebar, obat anti arthritis, dll, obat yang masih sangat dekat dengan waktu kadaluwarsanya masih layak dikonsumsi, asalkan tidak terjadi perubahan konsistensi, bentuk, warna, dan bau obat. Pada obat yang belum melampaui waktu kadaluwarsa yang tercantum dalam kemasan obat, bila ditemukan adanya perubahan bentuk, warna, bahkan bau obat, diharuskan untuk tidak mengkonsumi obat tersebut karena telah terjadi degradasi secara kimiawi obat yang nota bene berasal dari senyawa-senyawa kimia, yang akan menurunkan potensi obat secara bermakna bahkan bisa jadi terjadi kefatalan karena obat telah berubah menjadi toksik. Contoh paling sering terjadi adalah aspirin (aspilet, aspro, dll) yang telah berubah benyek, atau keluar kristal jarum di permukaan obat, walaupun obat masih belum ED, maka tidak boleh dikonsumsi karena kristal jarum asetosal ini akan mengiritasi lambung dengan sangat kuat (berubah bentuk terhidrolisis dari asetosal menjadi asam salilisat yang toksik). Begitu pula antibiotic amoksisilin yang selama penyimpanan berubah benyek karena tidak kuatnya sealed penahan kelembaban, seharusnya tidak dikonsumsi atau diberikan kepada pasien, karena selama penyimpanan telah terjadi masuknya air yang akan menyebabkan cemaran jamur tumbuh subur (antibiotic ini bukan anti jamur), walaupun bila diamati masih jauh dari ED yang tertera di botol obat.

ED obat harus ditaati secara disiplin pada obat-obat yang memiliki indeks terapi sempit seperti teofilin, aminofilin, kinidin, walfarin, digoksin, dll yang merupakan life saving drugs. Pada obat-obat ini, walaupun ED berarti hanya berkurangnya aktivitas/potensi obat sebesar 10%, namun karena obat golongan ini sangat diperlukan untuk pengobatan segera/emergency, dan penurunan 10% sangat bermakna menurunkan potensinya menjadi sama sekali tidak punya manfaat farmakologi, maka sangat tidak benar mengkonsumsi obat golongan ini melampaui ED. Bahkan tenaga medis sangat berhati-hati, lebih baik memilih obat jenis ini yang masih jauh EDnya demi manfaat yang optimal bagi pasien.

Ditilik dari ED, keamanan obat lebih mementingkan manfaat optimal bagi kesembuhan. Bukan melampaui ED berarti obat tidak aman, memunculkan efek samping atau efek toksik. Yang lebih penting ketidak amanan obat disebabkan oleh perubahan konsistensi, bentuk, warna (termasuk kekeruhan pada sediaan steril injeksi atau tetes mata). Jadi obat yang melampaui ED tidak serta merta tidak berkhasiat dan tidak pula pasti memunculkan efek samping.

Contoh ED obat dalam kondisi bervariasi

Obat

ED pada suhu 25

ED pada suhu 35

Amoksisilin caplet

5 tahun

Kurang dari 2,5 tahun

Amoksisilin syrup yang telah dicairkan

14 hari

7 hari

Hidrokortison cream

3 tahun

1 tahun

Insulin vial

30 hari

7 hari

Catatan penting :

Pembahasan self life dan ED di atas adalah pada kondisi kemasan belum dibuka/ belum digunakan produknya.


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