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Clinical Pharmacist’s Role in Optimizing Therapy through Drug-Related Problems Identification Liana Debora; Eni Susanti; Suharjono Suharjono
Indonesian Journal of Clinical Pharmacy Vol 10, No 4 (2021)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15416/ijcp.2021.10.4.303

Abstract

Clinical pharmacists play an important role in a clinical setting as part of a team. Drug-related problem (DRP) is the main part pharmacist should focus on to achieve the optimal therapy for patients. Therefore, this study aimed to investigate the role of clinical pharmacy in a private hospital of West Java, Indonesia, and describe the prevalence of DRPs and several factors associated with the risk of DRPs. The clinical pharmacist's monthly report was obtained from June to August 2020. Furthermore, problems, causes, and types of DRP were identified using PCNE Classification V9.1. Drug classes and other factors related to DRP were also investigated. This was a descriptive study with a retrospective approach to medical records, where 240 DRPs were identified in 157 patients. Approximately 4.45% experienced DRP, especially in ICU at 45.83% and Stroke Unit or SU-IC at 25.42%. The most common DRPs were incomplete drug treatment, drug interaction, and dose adjustment. Antimicrobial, cardiovascular agents, and PPI were the most commonly involved. In the linear regression analysis, length of stay and number of therapy significantly affect DRP. In this study, pharmacists intervented each DRP, with 57% accepted as fully and partially implemented by the physicians. A total of 22% of interventions ended with unknown status due to limited follow-up time. Meanwhile, reviews on medication by clinical pharmacists lead to improvement in drug treatment. The implementation of clinical pharmacy services shows many DRPs to be prevented and increases therapy optimization.Keywords: Clinical pharmacist, drug-related problems, drugs, hospital, intervention Peran Farmasis Klinis dalam Optimalisasi Pengobatan melalui Identifikasi Permasalahan Obat AbstrakFarmasis klinik memiliki peran penting dalam tim di RS terutama dalam mencapai terapi optimal bagi pasien melalui penanganan drug related problems (DRP). Tujuan penelitian ini adalah untuk mengetahui peran farmasis klinik di salah satu RS swasta di Jawa Barat dan faktor risiko terjadinya DRP. Data dari laporan farmasi klinik diambil pada bulan Juni–Agustus 2020. Identifikasi permasalahan, penyebab, jenis DRP dilakukan berdasarkan PCNE Classification V9.1. Golongan obat dan faktor lain yang menyebabkan DRP juga dikaji. Studi ini berupa penelitian deskripsi dengan pendekatan retrospektif berdasarkan rekam medik pasien. Farmasis mengidentifikasi 240 DRP pada 157 pasien rawat inap. Sekitar 4,45% pasien di RS berpotensi mengalami DRP, terutama yang dirawat di ruang perawatan intensif (45,83%) dan unit strok (25,42%). DRP yang paling sering terjadi adalah terapi obat kurang tepat, interaksi obat, dan perlunya penyesuaian dosis. Antimikroba, obat kardiovaskular, dan PPI merupakan obat yang paling sering menyebabkan DRP. Pada analisis statistik menggunakan regresi linier, lama perawatan dan jumlah jenis obat signifikan menyebabkan DRP. Farmasis menyampaikan usulan kepada dokter (>70% kasus). Sebanyak 22% usul berakhir dengan status yang tidak diketahui karena kurangnya waktu untuk follow up usul kepada dokter. Tingkat penerimaan usul yaitu 57%, baik yang diterima sepenuhnya maupun diterima sebagian. Pengkajian pengobatan pasien mendorong beberapa perbaikan terapi obat. Penerapan layanan farmasi klinis dapat mendeteksi dan mencegah DRP sehingga mengoptimalkan pengobatan pasien.   Kata kunci: Drug-related problems, farmasis klinik, intervensi, obat, rumah sakit
Drug Utilization Study of Antibiotics in Bacterial Meningitis (A Retrospective Study in Dr. Soetomo General Hospital, Surabaya, Indonesia) Mareta Rindang Andarsari; Didik Hasmono; Samirah Samirah; Suharjono Suharjono; Dea Ayu Nabilah; Paulus Sugianto
JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA Vol. 4 No. 2 (2017): Jurnal Farmasi dan Ilmu Kefarmasian Indonesia
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (13.691 KB) | DOI: 10.20473/jfiki.v4i22017.80-83

Abstract

Background: Meningitis defined as an inflammation of the meninges, a membrane that surrounds the brain. The inflammation is a result from bacterial infection. Central nervous system infection is a medical emergency because of the progressivity and potentially life-threatening. Antibiotics usage become crucial to reduce morbidity and mortality. Objective: This study was aimed to assess the use of antibiotics, prescribed for patients with bacterial meningitis in Neurology Department of Dr. Soetomo General Hospital Surabaya from January 2010 until June 2015. Methods: Retrospective study using medical record of inpatients obtained from January 1st 2010 until June 30th 2015. The inclusion criteria were inpatients with bacterial meningitis (diagnosed by physician using CT scan data, lumbal puncture and clinical signs and symptoms) and prescribed with antibiotics. Patients with antibiotics therapy less than 3 days and infection other than bacterials were excluded. Results: From 85 patients, male to female ratio was 1.66. Meningitis appear to be mostly occured in productive age, 39 (45.88%) in 15 - 29 years old and 40 (47.06%) in 30 - 60 years old. Number of antibiotics prescribed were 130 prescriptions, as single and combination therapy. The most prescribed antibiotic was cephalosporins (97 prescriptions), dominated by 2 g twice daily ceftriaxone with 86 (66.15%) from overall prescriptions. Followed by metronidazole and fluoroquinolons,11 (8.46%) and 8 (6.15%) respectively. In addition, there were 26 prescriptions of combination therapy, mostly ceftriaxone and metronidazole. Conclusion: Bacterial meningitis are mostly treated using ceftriaxone which is an appropriate drug of choice.
PENINGKATAN KOMPETENSI DAN PENGETAHUAN APOTEKER TERHADAP OBAT OFF LABEL MELALUI WORKSHOP AND TRAINING Suharjono Suharjono; Mahardian Rahmadi; Chrismawan Ardianto; Arina Dery Puspitasari; Dewi Wara Shinta
Jurnal Layanan Masyarakat (Journal of Public Services) Vol. 2 No. 2 (2018): Jurnal Layanan Masyarakat
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (189.917 KB) | DOI: 10.20473/jlm.v2i2.2018.52-55

Abstract

Drug information off label is not widely known and understood by health workers, both doctors and pharmacists. Prescribing drugs off label will also have an impact on ethical rules and drug costs, whether legal and can be covered by insurance. Therefore, there needs to be a continuing education activity for Pharmacists and health professionals to provide information and understanding of participants with the development of drugs off the label. This activity aims to improve the competencies of the participants, as well as understand the legal prescribing rules and as input for insurance and pharmaceutical regulations. The form of activities that will be carried out are workshops and training. The event was held for 2 days, 14-15 October 2018 at Graha Iptekdok, FKUA. There are 10 resource persons with 11 materials divided into 6 workshops, and 1 Micromedex training activity. This activity was attended by 383 participants and 5 invitations. Among the 383 participants, 55% were pharmacists working in hospitals, 30% were pharmacists working in pharmacies, and the rest were pharmacists working in industries, health centers, health services, and pharmacy students. Domicile participants come from various regions, with the largest percentage from Java. Based on the results of the questionnaire evaluation, the average material suitability assessment with participants’ needs was 8 out of 10. On the other hand, the material mastery by the speakers was also very good (8 out of 10). While in terms of the event, the average participant rated very well (7-9 of a scale of 10). A value of 7 is given to the parameters of room facilities. Seeing the enthusiasm of the participants of the Off Label Workshop andTraining in Community and Clinical Settings, the committee plans to follow up by holding a similar event to accommodate potential participants who cannot be accommodated in this event.AbstrakInformasi obat off label belum banyak diketahui dan dipahami oleh para tenaga kesehatan, baik dokter maupun apoteker. Peresepan obat off label juga akan berdampak pada aturan etik dan biaya obat, apakah legal dan bisakah ditanggung oleh asuransi. Oleh sebab itu, perlu adanya suatu kegiatan pendidikan berkelanjutan kepada para Apoteker dan profesi kesehatan untuk memberikan informasi dan pemahaman peserta dengan perkembangan obat off label. Kegiatan ini bertujuan untuk meningkatkan kompetensi para peserta, juga memahami aturan peresepan yang legal dan sebagai masukan untuk asuransi serta peraturan farmasi. Bentuk kegiatan yang akan dilakukan adalah workshop dan training. Acara dilakukan selama 2 hari, 14–15 Oktober 2018 di Graha Iptekdok, FKUA. Terdapat 10 narasumber dengan 11 materi yang dibagi dalam 6 workshop, dan 1 kegiatan pelatihan Micromedex. Kegiatan ini dihadiri oleh 383 peserta dan 5 undangan. Diantara 383 peserta, 55% merupakan apoteker yang bekerja di rumah sakit, 30% adalah apoteker yang bekerja di apotek, dan sisanya adalah apoteker yang bekerja di industri, puskesmas, dinas kesehatan, dan mahasiswa farmasi. Domisili peserta berasal dari berbagai daerah, dengan prosentase terbesar dari Jawa. Berdasarkan hasil evaluasi kuesioner, rata-rata penilaian kesesuaian materi dengan kebutuhan peserta adalah 8 dari skala 10. Selain itu, penguasaan materi oleh narasumber juga sangat baik (8 dari skala 10). Sedangkan dari segi acara, rata-rata peserta menilai sangat baik (7–9 dari skala 10). Nilai 7 diberikan pada parameter fasilitas ruangan. Melihat antusiasme dari peserta off Label Drugs Workshop and Training in Community and Clinical Settings, maka panitia berencana akan melakukan tindak lanjut dengan mengadakan acara yang serupa untuk mengakomodir calon peserta yang tidak dapat tertampung pada acara ini.
Pengaruh Penambahan Fucoidan Pada Omeprazol Terhadap Perbaikan Gejala Dispepsia dan Kualitas Hidup Pada Pasien Dispepsia Fungsional Khaerani Khaerani; Suharjono Suharjono; Bambang Eko Wahyono
PHARMACY: Jurnal Farmasi Indonesia (Pharmaceutical Journal of Indonesia) Jurnal Pharmacy, Vol. 18 No. 01 Juli 2021
Publisher : Pharmacy Faculty, Universitas Muhammadiyah Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/pharmacy.v18i1.7568

Abstract

Dispepsia Fungsional merupakan salah satu gangguan fungsi pada gastrointestinal dan dapat berpengaruh terhadap kualitas hidup pasien. Fucoidan memiliki banyak efek farmakologi, salah satunya sebagai mukoprotektor dan bersifat sebagai anti ulcer pada gastrointestinal yang diduga dapat memperbaiki gejala dispepsia. Tujuan dari penelitian ini yaitu menganalisis efek penambahan fucoidan pada omeprazol terhadap perbaikan gejala dispepsia dan kualitas hidup pasien pada pasien dispepsia fungsional. Hasil yang diperoleh adanya perbaikan gejala dan kualitas hidup sebelum dan setelah menerima penambahan terapi fucoidan dengan nilai p < 0,05. Pada perbandingan perbaikan yang dilakukan pada kedua kelompok tidak terjadi perbaikan yang signifikan secara statistik dengan nilai p > 0,05 untuk beberapa domain kuesioner. Akan tetapi dalam perbaikan gejala klinik yang diobservasi terdapat perbaikan gejala dispepsia dan kualitas hidup yang lebih baik pada penambahan fucoidan.
Molnupiravir - the First Oral Antiviral for COVID-19: A Literature Review Nur Afni; Suharjono Suharjono
Pharmacon: Jurnal Farmasi Indonesia Vol 19, No 1 (2022)
Publisher : Universitas Muhammadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/pharmacon.v19i1.17330

Abstract

The COVID-19 pandemic is still an unresolved global health concern, although half of the world's population has been vaccinated. The pharmaceutical industries are still struggling to develop effective antivirals against SARS-CoV-2. Molnupiravir is a new oral antiviral with antiviral properties by targeting coronavirus RNA. This literature review aims to describe the mechanism of action, efficacy, and safety of molnupiravir based on published preclinical and clinical studies for COVID-19 treatment. Relevant studies were collected by electronic databases, including Google Scholar, PubMed, and Science Direct. The inclusion criteria were preclinical and clinical trials related to molnupiravir as an antiviral for the COVID-19 treatment published in December 2019 to January 2022. Preclinical trials demonstrated therapeutic and prophylactic properties against SARS-CoV-2 in cell culture and animal models. Molnupiravir is currently under the emergency use authorization from the FDA to treat COVID-19. Its potent and broad antiviral activity is demonstrated through a mechanism of error catastrophe that causes coronavirus RNA mutagenesis. The published clinical trials have shown that molnupiravir is well-absorbed, well-tolerated, and has relatively mild side effects such as headache, nausea, and diarrhea with a minimal incidence at a dose of 800 mg twice daily. Time to viral RNA clearance was significantly decreased in patients administered molnupiravir 800 mg compared to those who administered placebo (14 days vs 15 days, P value=0,013). Molnupiravir is a promising oral antiviral that can reduce the incidence of COVID-19 hospitalization or death. Further clinical trials regarding its efficacy for severe symptoms and other clinical aspects such as drug interactions and contraindications are still needed.
Interferons and its use in children with COVID-19: A narrative review Chairunnisa Chairunnisa; Suharjono Suharjono
Jurnal Ilmiah Farmasi Vol. 18 No. 2 (2022): Jurnal Ilmiah Farmasi
Publisher : Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/jif.vol18.iss2.art18

Abstract

Background: All ages, including children, are susceptible to the disease COVID-19. The severity of COVID-19 in children is mild than in adults. One of the recommended antiviral drugs for COVID-19 in children is interferon. Objective: To describe the efficacy and safety of using interferon in children with COVID-19 Method: The article is a narrative study. The main databases in the article search process in this literature review are PubMed and Google Scholar. Results: The articles could potentially be involved in this study were 28 articles. A total of 13 articles included the criteria, 9 articles discussed the use of interferon against respiratory syndrome, 4 articles on interferon in children, and one reference from a literature search. Conclusion: Interferon therapy in COVID-19 in children has a high cure rate but needs to be evaluated in a larger sample of pediatric patients.