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Systematic Review The Effectiveness of Fibrinolytic Therapy in STEMI Patients Anindya Widyasari Ekasuci; Laksmi Maharani; Dewi Latifatul Ilma
Acta Pharmaciae Indonesia : Acta Pharm Indo Vol 8 No 2 (2020): Acta Pharmaciae Indonesia : Acta Pharm Indo
Publisher : Pharmacy Department, Faculty of Health Sciences, Jenderal Soedirman University, Purwokerto, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.api.2020.8.2.3439

The use of fibrinolytic as a reperfusion therapy for STEMI patients has many benefits, but in its use, it is not yet decided whether fibrinolytic therapy is an effective therapy for STEMI patients. This study aimeds to evaluate and determine the effectiveness of fibrinolytic therapy for STEMI patients through a systematic review method. The selected articles PubMed and Cochrane that fulfilled the keyword search based on PICO (fibrinolytic or thrombolytic, effectiveness or efficacy), and were uploaded from 2010 to 2020 were included in this study. The searching was conducted from 15 May 2020 untill 27 June 2020. From the total of 525 searches displayed, 17 articles were included in the inclusion criteria. Research showed that fibrinolytic with rescue PCI or as adjunctive therapy is an effective therapy in STEMI patients by increasing myocardial perfusion, epicardial flow, ST segment resolution, TIMI score, peak time to troponin reach, and reduce LVEF risk. Fibrinolytic therapy with rescue PCI or as adjunctive therapy is also effective in reducing infarct size and the risk of cardiogenic shock. Fibrinolytic as pharmacoinvasive therapy is an effective therapy for patients with a diagnosis of STEMI.

Faktor-Faktor Yang Berhubungan Dengan Luaran Klinis Asam Valproat Pada Epilepsi Pediatri Dewi Latifatul Ilma; Nialiana Endah Endriastuti; Masita Wulandari Suryoputri
Acta Pharmaciae Indonesia : Acta Pharm Indo Vol 9 No 1 (2021): Acta Pharmaciae Indonesia : Acta Pharm Indo
Publisher : Pharmacy Department, Faculty of Health Sciences, Jenderal Soedirman University, Purwokerto, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.api.2021.9.1.4060

Epilepsi merupakan penyakit kronis dengan prevalensi tinggi pada pediatrik. Salah satu obat anti epilepsi yang banyak diresepkan pada pediatrik adalah asam valproat. Luaran klinis utama pengobatan anti epilepsi adalah tercapainya periode bebas kejang. Tercapainya luaran klinis epilepsi sulit diprediksi karena dipengaruhi oleh banyak faktor. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan luaran klinis pasien epilepsi pediatrik yang menggunakan asam valproat. Pengambilan data dilakukan melalui wawancara kepada orangtua/wali pasien. Epilepsi dikatakan terkontrol jika tercapai periode bebas kejang ≥6 bulan selama menggunakan asam valproat. Analisis data dilakukan dengan uji chi square atau uji Fisher, dilanjutkan dengan uji regresi logistik binomial. Pasien pada penelitian ini berjumlah 39 pasien. Sebagian besar pasien pediatri (64.1%) yang menggunakan terapi asam valproat memiliki epilepsi yang terkontrol, dengan 20 pasien (51.3%) menggunakan monoterapi asam valproat. Faktor yang berhubungan dengan luaran klinis pasien adalah jumlah obat antiepilepsi yang digunakan (p-value <0.05).

Potensi interaksi obat nutrasetikal pada epilepsi anak Nialiana Endah Endriastuti; Masita Wulandari Suryoputri; Dewi Latifatul Ilma; Tunggul Adi Purwonugroho
Acta Pharmaciae Indonesia : Acta Pharm Indo Vol 10 No 1 (2022): Acta Pharmaciae Indonesia : Acta Pharm Indo
Publisher : Pharmacy Department, Faculty of Health Sciences, Jenderal Soedirman University, Purwokerto, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.api.2022.10.1.4352

Background: The trend of using nutraceuticals in Indonesia increases every year. This study aims to describe nutraceuticals consumed in pediatrics with epilepsy as additional antiepileptic therapy and analyze their potential drug interactions. Methods: This research was a cross-sectional study with total sampling method which was carried out in the period of June to July 2020. Inclusion criteria were children with epilepsy aged 0-17 years who were members of the Indonesian Epilepsy Community, had a doctor's diagnosis of epilepsy, received oral antiepileptic medication, and took nutraceutical products/food supplements. Data were analyzed descriptively based on data obtained through electronic data filling sheets and interviews. Results: There were 106 participants from the Indonesian Epilepsy Community in total, with 14 children (13.2 %) using nutraceutical supplements. They were male (n=8; 57.1%), 2-12 years old (n=10; 71.4%), and good nutritional status (n=10; 71.4%). Most nutraceuticals consumed were dietary supplements containing vitamins (n=10; 71.4%). Of the eight potential drug interactions identified, 25% (n=2) were significant interactions, and 75% (n=6) were minor interactions. The potential for major interactions occurred in administering nutraceutical products containing vitamin D with the antiepileptic drug phenytoin and phenobarbital. Conclusion: In this study, nutraceuticals and antiepileptic drugs had a little clinically meaningful interaction effect.

Perkiraan Kadar Seftazidim dalam Darah pada Pasien Pneumonia dengan Gangguan Fungsi Ginjal Dewi Latifatul Ilma; Djoko Wahyono; Ika Puspita Sari
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 9, No 3
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Pneumonia is one of the major causes of mortality due to infection in hospitalized patients. It was frequently found in patients with renal failure. Clinical outcomes of infected patients with renal failure are worse compared to patients without renal failure. The presence of renal impairment affects the pharmacokinetics of the drug. Ceftazidime is one of the most commonly used antibiotics in patients with pneumonia. Approximately, 80-90% of ceftazidime’s total drug fraction is eliminated by kidneys so that the presence of kidney disorders will affect the concentration of ceftazidime in the blood. This study aimed to determine the estimated concentration of ceftazidime in the blood and clinical outcome of pneumonia patients with renal impairment. This study was a retrospective study with descriptive observational design. Data were obtained from patient’s medical record in a hospital in Yogyakarta between January 2013-June 2017 which fulfilled the inclusion criteria, i.e., ≥18 years old patients with complete medical record data, treated in internal medicine ward with diagnosis of pneumonia (HAP/HCAP) who had chronic renal failure, and received ceftazidime for minimum 72 hours or 3 days. The number of research samples were 40 patients. This study showed that 31 patients (77.5%) had achieved estimated ceftazidime concentration in the blood above the minimum inhibitory concentration of 8 μg/ mL. After ceftazidime therapy, 19 patients (47.5%) had improved clinical outcome and 21 patients (52.5%) had not improved clinical outcome.

Analisis Kualitatif Mengenai Peran dan Perilaku Apoteker di Apotek Terkait Penggunaan Telefarmasi Selama Pandemi COVID-19 Anisa Dwi Sasanti; Laksmi Maharani; Nia Kurnia Sholihat; Tunggul Adi Purwonugroho; Ika Mustikaningtias; Dewi Latifatul Ilma
JPSCR: Journal of Pharmaceutical Science and Clinical Research Vol 7, No 2 (2022)
Publisher : Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/jpscr.v7i2.55878

Pandemi coronavirus disease-19 (COVID-19) menyebabkan perubahan pelayanan kesehatan. Upaya mengurangi penyebaran COVID-19 adalah menjaga jarak dan menghindari kerumunan. Pada layanan kesehatan, telefarmasi memberikan akses cepat dan kenyamanan yang baik. Penelitian ini bertujuan mengeksplorasi peran dan perilaku apoteker dalam penggunaan telefarmasi serta faktor-faktor yang mempengaruhi penerapan telefarmasi selama pandemi COVID-19. Penelitian dilakukan menggunakan metode non-eksperimental kualitatif fenomenologis melalui wawancara mendalam. Informan diambil hingga data jenuh dan diperoleh 5 informan. Wawancara dilakukan langsung maupun online. Keabsahan data melalui uji kredibilitas dengan member checking, uji transferabilitas dengan uraian rinci, uji dependabilitas dan uji konfirmabilitas melalui peer debrifing. Hasil wawancara dianalisis secara deskriptif dengan proses berpikir induktif. Peran apoteker dalam telefarmasi selama pandemi COVID-19 adalah memberikan layanan telefarmasi yang profesional, sedangkan perilaku apoteker adalah memanfaatkan telefarmasi untuk memberikan layanan farmasi klinik dan menggunakan media yang bervariasi. Faktor pendukung penerapan telefarmasi selama pandemi adalah kerja sama rekan sejawat dan keluarga pasien, peraturan terkait dukungan telefarmasi, dan pandemi COVID-19; sedangkan faktor penghambatnya adalah teknologi, hambatan finansial pasien, penerimaan pasien terhadap telefarmasi, keterbatasan sumber daya manusia dan waktu.

OFF-LABEL PEDIATRIC DRUG USE IN INDONESIA : A SYSTEMATIC REVIEW Dewi Latifatul Ilma; Nialiana Endah Endriastuti
Jurnal Farmasi Sains dan Praktis Vol 6 No 1 (2020)
Publisher : Universitas Muhammadiyah Magelang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31603/pharmacy.v6i1.3407

The phenomenon of off-label drug use has been widely observed in the pediatric population, including in Indonesia. The major concern arising from the prevalence of off-label drug use is the increased risk of adverse drug reactions. We performed a systematic review to describe and provide insight into off-label pediatric drug use in Indonesia. The articles published using English and Indonesian language was systematically searched in five electronic databases, including Pubmed, Scopus, Google Scholar, Garuda, and Neliti. Key terms used for the search were as follows: "off-label use", "off-label”,"child", "pediatrics", "infant","adolescent", "newborn", "Indonesia". A total of one hundred sixteen studies were initially obtained from an electronic database. Further, after the references were reviewed, ten articles met all the eligibility criteria that were finally selected. The percentage of off-label pediatric drug use was 32.6-89.9%. The off-label categories in the selected studies were age, dosage, contraindication, route of administration, and indication. Among these off-label categories, age was the highest off-label with percentages ranged from 19.8 to 92.9%. Pseudoephedrine hydrochloride and triamcinolone acetonide became the most frequently used drug in that category. Thus we conclude that off-label pediatric drug use is common in Indonesia. Future research should consider the safety of off-label drugs in pediatric, primarily in Indonesia. Clinicians should be aware of off-label drugs in pediatrics and consider the risk-benefit of the drugs when prescribing to children. The authorities need to regulate off-label drug prescribing in pediatrics; therefore, it could improve medication safety and quality.

THE EVALUATION OF ANTI-EPILEPTIC DRUGS DOSAGE IN MALNOURISHED CHILDREN: CASES IN INDONESIAN COMMUNITY OF EPILEPSY Nialiana Endah Endriastuti; Masita Wulandari Suryoputri; Dewi Latifatul Ilma
Jurnal Farmasi Sains dan Praktis Vol 8 No 1 (January-April 2022)
Publisher : Universitas Muhammadiyah Magelang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31603/pharmacy.v8i1.4662

Anti-epileptic drug (AED) has a narrow therapeutic index of drugs that a slight increase in dosage showed toxic effects. The therapeutic response is difficult to predict in malnutrition status because the patient with nutritional deficiency have more complicated problems likes hypoalbuminemia, macronutrient and micronutrients deficiency that affected the levels of AEDs. The nutritional deficiency could be a direct and indirect cause of ineffective AEDs therapy and also recurrent epilepsy. This study aims to describe the use of antiepileptic drugs in Indonesian children with poor nutritional status. The research design was observational studies with cross sectional random sampling to evaluate the AED doses of malnutrition status in children. All information was collected by spreading electronic forms and interviewing the parents by phone. The data were analyzed descriptively. Total of 8 malnourished children mostly included in the range of ages from >2 to 12 years (n=5; 62.50%) with means 3,9±2,7 years. The study showed valproic acid was bigger used in monotherapy (n=5; 62,50%) than polytherapy with carbamazepine or sodium phenytoin and phenobarbital. The means estimation of valproic acid monotherapy concentration in females’ group (n=2; 33,33%) showed sub-therapeutics level were Cssmin 26,09±0,57 mg/L and Cssmax 64,17±1,39 mg/L, also the means in males’ group (n=2; 33,33%) of valproic acid monotherapy were Cssmin 22.07±2,71 mg/L and Cssmax 54.27±6.66 mg/L. All of them included in good clinical outcome of free seizure > 6 months.

Potensi interaksi obat nutrasetikal pada epilepsi anak Nialiana Endah Endriastuti; Masita Wulandari Suryoputri; Dewi Latifatul Ilma; Tunggul Adi Purwonugroho
Acta Pharmaciae Indonesia : Acta Pharm Indo Vol 10 No 1 (2022): Acta Pharmaciae Indonesia : Acta Pharm Indo
Publisher : Pharmacy Department, Faculty of Health Sciences, Jenderal Soedirman University, Purwokerto, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.api.2022.10.1.4352

Background: The trend of using nutraceuticals in Indonesia increases every year. This study aims to describe nutraceuticals consumed in pediatrics with epilepsy as additional antiepileptic therapy and analyze their potential drug interactions. Methods: This research was a cross-sectional study with total sampling method which was carried out in the period of June to July 2020. Inclusion criteria were children with epilepsy aged 0-17 years who were members of the Indonesian Epilepsy Community, had a doctor's diagnosis of epilepsy, received oral antiepileptic medication, and took nutraceutical products/food supplements. Data were analyzed descriptively based on data obtained through electronic data filling sheets and interviews. Results: There were 106 participants from the Indonesian Epilepsy Community in total, with 14 children (13.2 %) using nutraceutical supplements. They were male (n=8; 57.1%), 2-12 years old (n=10; 71.4%), and good nutritional status (n=10; 71.4%). Most nutraceuticals consumed were dietary supplements containing vitamins (n=10; 71.4%). Of the eight potential drug interactions identified, 25% (n=2) were significant interactions, and 75% (n=6) were minor interactions. The potential for major interactions occurred in administering nutraceutical products containing vitamin D with the antiepileptic drug phenytoin and phenobarbital. Conclusion: In this study, nutraceuticals and antiepileptic drugs had a little clinically meaningful interaction effect.

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