Gatot Soegiarto
Allergy & Clinical Immunology Division, Department Of Internal Medicine, Faculty Of Medicine, Universitas Airlangga, Surabaya

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Journal : Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya

Drug Hypersensitivity in Daily Practice Gatot Soegiarto
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 3, No 2 (2019)
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (846.601 KB) | DOI: 10.30651/jqm.v3i2.2781

Abstract

ABSTRACTAdverse drug reactions can affect up to 25% of outpatients and 10–20% of hospitalized patients. They are an important public health issue due to the potential of fatal outcomes. They are increasingly common in daily practice, but ascertaining whether the adverse reaction is a true allergic reaction to the drug is not easy. Drug hypersensitivity encompasses a spectrum of immunologically and non-immunologically-mediated reactions with varying mechanisms and clinical presentations. Factors associated with an increased risk of developing a drug hypersensitivity include patient-related factors, treatment regimen-related factors, and drug-related factors.  Diagnosis of drug hypersensitivity relies on a careful history and physical examination and, in some instances, in vivo and in vitro testing and drug provocation tests. The most effective strategy for the management of drug allergy is avoidance and discontinuation of the offending drug(s). Alternative medications with unrelated chemical structures should be given. Additional therapy is largely supportive which includes nutritional support, fluid replacement, and symptomatic which may include topical corticosteroids, oral antihistamines and, in severe cases, systemic corticosteroids. This article will discuss the classification of adverse reactions to drugs, professional steps that can be taken by a physician in prescribing drugs, minimizing the risk of adverse drug reactions, approach to diagnosis, and managing drug hypersensitivity cases in daily practice.Keywords: drug reaction, drug hypersensitivity, drug allergyCorrespondence to: gatotsby@yahoo.com ABSTRAKReaksi efek samping obat dapat mengenai sekitar 25% pasien rawat jalan dan 10-20% pasien rawat inap. Reaksi efek samping obat adalah masalah kesehatan masyarakat yang penting karena berpotensi fatal. Hal tersebut semakin umum dijumpai dalam praktek sehari-hari, tetapi memastikan apakah reaksi efek samping tersebut adalah reaksi alergi yang sebenarnya terhadap obat itu tidaklah mudah. Hipersensitivitas obat mencakup spektrum reaksi yang dimediasi secara imunologis dan non imunologis dengan berbagai mekanisme dan presentasi klinis. Faktor-faktor yang terkait dengan peningkatan risiko terjadinya hipersensitivitas obat meliputi faktor terkait pasien, faktor terkait regimen pengobatan, dan faktor terkait obat. Diagnosis hipersensitivitas obat bergantung pada anamnesis dan pemeriksaan fisik yang cermat dan, dalam beberapa kasus, tes in vivo dan in vitro dan tes provokasi obat. Strategi yang paling efektif untuk pengelolaan alergi obat adalah penghindaran dan penghentian obat-obatan tersebut. Obat-obatan alternatif dengan struktur kimia yang tidak terkait harus diberikan. Terapi terapi suportif yang mencakup dukungan nutrisi, penggantian cairan, dan gejala yang mungkin termasuk kortikosteroid topikal, antihistamin oral dan, dalam kasus yang parah, kortikosteroid sistemik dapat diberikan. Artikel ini akan membahas klasifikasi reaksi efek samping terhadap obat, langkah profesional yang dapat diambil oleh dokter dalam meresepkan obat, meminimalkan risiko reaksi efek samping obat, pendekatan untuk diagnosis, dan manajemen kasus hipersensitivitas obat dalam praktik sehari-hari.Kata kunci: Reaksi obat, hipersensitivitas obat, alergi obatKorespondensi: gatotsby@yahoo.com
The role of gut microbiota in health and diseases Deasy Fetarayani; Handoko Hariyono; Gatot Soegiarto
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 5, No 1 (2021)
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v5i1.5846

Abstract

ABSTRACTABSTRACTMicrobiota contributes a crucial part in the human hosts' health and actively provides to the emergence of various diseases. The optimal composition of healthy intestinal microbiota varies from person to person. The more various and abundant of the microbiota, the greater their resistance to outside hazards. Colonization of the microbiota in the human body starts after delivery and develops continuously from infant to adult. The largest microbial colony is constructed in the lower part of the adult human digestive tract. The composition of the human intestinal microbiota alters promptly during the beginning of life and is steady. It has been described the close relationship among dysbiosis of the intestinal microbiota with intestinal and non-intestinal diseases. Nevertheless, it is uncertain whether dysbiosis is the culprit of the disease or only as a result of the disease. Human microbiota's role must be investigated more deeply so that later it can be developed for the prevention, diagnosis of disease, and more effective treatment strategies in the future. In this minireview, we will describe the development of the gut microbiota, its interaction with our bodily systems and defense, the multiple causes of dysbiosis, and its impact on several metabolic in inflammatory diseases in humans. With this insight, it is hoped that we can be more cautious about using antibiotics, avoid things that lead to dysbiosis, and handle diseases more holistically, putting the balance of the microbiota into account. Keywords:  human, microbiota, gastrointestinal tract, dysbiosis, health and diseaseCorresponding author: deasyfetarayani@gmail.com