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All Journal Folia Medica Indonesiana Jurnal Farmasi Klinik Indonesia INDONESIAN JOURNAL OF PHARMACY JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA Jurnal Pengabdian Pada Masyarakat JFIOnline JURNAL MEDIA KESEHATAN Majalah Farmasetika Indian Journal of Forensic Medicine & Toxicology
Budi Suprapti
Department Of Pharmacy Practice, Faculty Of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
Agriculture, Biological Sciences & Forestry Chemistry Decision Sciences, Operations Research & Management Education Engineering Health Professions Medicine & Pharmacology Public Health Other

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Review of Insulin Therapy In Type 2 Diabetes Mellitus Ambulatory Patients Budi Suprapti; Nia Widyasari; Mahardian Rahmadi; Cahyo Wibisono
Indonesian Journal of Pharmacy Vol 28 No 4, 2017
Publisher : Faculty of Pharmacy Universitas Gadjah Mada, Yogyakarta, Skip Utara, 55281, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1180.322 KB) | DOI: 10.14499/indonesianjpharm28iss4pp221

Abstract

The purposes of this study were to review utilization of insulin therapy in type 2 diabetes mellitus out patients and identify its drug related problems. The data were collected cross-sectionally with purposive sampling method in the period March 2016 until May 2016 in Outpatient Clinic Universitas Airlangga Teaching Hospital Surabaya. The results of 240 patients showed that insulin was used as monotherapy insulin in 2,9% patients; combination 1 insulin & 1-4 OAD in 31,3%; basal bolus therapy 27,9%; combination basal−bolus therapy & 1-3 OAD 43,9%. Based on blood glucose target achievement, only 20,8% of patients achieve the target, 75,1% failed to achieve the target and 4,1%   suffered from hypoglycemia. Drug related problems identified adverse drug reaction of antidiabetic therapy such as hypoglycemia (6.7%), nausea (3.8%), bloating (1.3%), increase of flatulency (2.9%) and inappropriate combination (0,4%). In conclusion insulin therapy was complicated and individually, most of the patients still did not reach the target and there was potential drug related problem in this patients group. So that caring from solid inter-professional health collaboration is needed
BLOOD GLUCOSE TARGET ACHIEVEMENT AND ANTIDIABETES REGIMEN IN TYPE-2 DIABETIC GERIATRIC PATIENTS Budi Suprapti
Indonesian Journal of Pharmacy Vol 25 No 2, 2014
Publisher : Faculty of Pharmacy Universitas Gadjah Mada, Yogyakarta, Skip Utara, 55281, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (626.423 KB) | DOI: 10.14499/indonesianjpharm25iss2pp98

Abstract

Diabetes mellitus (DM) is a leading caused morbidity in geriatric patients. The prevalence of type-2 DM is more than 90% of DM population and increase with age, and half of those patients were geriatric. Blood glucose (BG) control is important for prevention diabetes complications, but attention must be given in geriatric patients due to the increasing susceptibility to risk of hypoglycemia. The aimed of this study was to identify BG achievement in diabetic geriatric patients and its therapeutic management. This study was done in Outpatient Geriatric Clinic, Dr. Soetomo General Hospital Surabaya Indonesia in the period of March to June, 2012. The inclusion criteria were type-2 diabetic geriatric patients with/without diabetic complication that received antidiabetic therapy and had BG data. The results from 165 patients showed that BG target achieved by 53% patients, 41% patients not achieved the target, while 6% patients in risk ofhypoglycemia. Management therapy for patients with achieved BG target was done by (1) continued therapy as before, (2) increasing dosage regimen for patients with BG already in the target but still within the upper limit target or decrease dosage regimen for patients with BG in lower limit target to avoid hypoglycemia, (3) change type of medication for patients who experienced side effects. Meanwhile, from all patients that failed to achieve BG target there were some patients received additional medications and regimen changes, but the rest of those didn’t receive any additional medication or regimen changes, which were many of them eventually became one of the drug-related problems in this patient group. In conclusion, there were still quite large number patients that did not achieve BG target, therapy management changes were made based on BG profile and there were drug related problems related to dosage regimen that needs pharmaceutical care intervention
THE USE OF HYDROXYETHYL STARCH 200/0,5 AS PLASMA SUBTITUTES IS SAFE IN HYPOVOLEMIC PATIENTS AS INDICATED IN CHANGES OF N-ACETYL--GLUCOSAMINIDASE AND CREATININ SERUM PARAMETERS Dewi Wara Shinta; Junaidi Khotib; Eddy Rahardjo; Mahardian Rahmadi; Budi Suprapti
Folia Medica Indonesiana Vol. 51 No. 4 (2015): Oktober - December 2015
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (75.638 KB) | DOI: 10.20473/fmi.v51i4.2852

Abstract

Hydroxyethyl Starch (HES) is a compound that improves intravascular volume effectively and rapidly without causing tissue edema. However, HES also has renal safety profile which is still being debated. Based on clinical experience in Dr. Soetomo Hospital, the frequency of acute renal failure following HES 200/0.5 administration at a dose of less than 20 ml/kg (maximum dose) is very rare. The purpose of this study was to evaluate the effect of HES 200/0.5 at a dose of less than 20 ml/kg in patients undergoing surgery. N-acetyl-b-D-Glucosaminidase (NAG) per urine creatinine ratio and creatinine serum were used as main parameter to assess renal injury. This research was observational and prospective design in patients undergoing elective surgery at Gedung Bedah Pusat Terpadu, Dr. Soetomo Hospital, who requiring resuscitation therapy with HES 200/0.5 and met the inclusion and exclusion criteria. NAG was measured prior to surgery and 12 hours after administration of fluid therapy, while creatinine serum was observed before surgery and 48 hours after resuscitation. This study was conducted for three months, and obtained 50 subjects divided into 2 groups, crystalloid group and HES 200/0.5 group. Demographic and baseline characteristics did not differ between groups, except the total bleeding volume. Total bleeding in HES 200/0.5group was higher than crystalloid group (p <0.0001). The mean volume of fluid received in HES 200/0.5 group was 2042.0 ± 673.9 mL, higher when compared with that of crystalloid group (910.0 ± 592.0 ml). Doses of HES 200/0.5 received was 8.31 ± 4.86 ml/kg. Measurement of the of NAG/creatinine ratio and creatinine serum showed significant increase in both groups, but still within the normal range. In addition, the value of these two parameters did not differ between groups. In conclusion, HES 200/0.5 in a dose of less than 20 ml/kg is safe to use in patients who suffered from hypovolemic hemorrhage, without prior history of renal impairment.
Diabetes Support Groups Improve Patient’s Compliance and Control Blood Glucose Levels Izzah, Zamrotul; Hapsari, Pharmasinta P.; Rahmadi, Mahardian; Budiatin, Aniek S.; Aryani, Toetik; Suprapti, Budi; Ramadiani, Fathia; Shinta, Dewi W.; Andarsari, Mareta R.
Indonesian Journal of Clinical Pharmacy Vol 2, No 3 (2013)
Publisher : Indonesian Journal of Clinical Pharmacy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (562.142 KB)

Abstract

Providing information is not enough to improve diabetic patient’s compliance and achieve goals of therapy. Patient’s good awareness as well as emotional and social supports from family and community may play an important role to improve their compliance and clinical outcomes. Therefore, diabetes support groups were developed and each support group consisted of two pharmacists, two nurses, diabeticpatients and their family members. A total of 70 type 2 diabetic patient’s were enrolled and randomized into support group 1 and support group 2. Patients in the group 1 received information leaflets only, while patients in the group 2 received pharmacist counselling and information leaflets at each meeting. Patient’s awareness of diabetes and compliance with medications were assessed by a short questionnaire at baseline and final follow-up. Blood glucose and cholesterol levels were also evaluated in both groups.At the end of study, the overall patient’s awareness and compliance improved by 61.5%. The random and fasting blood glucose levels decreased over than 30% in the group 2 and around 14% in the group 1. This study reveals that collaboration between health care professionals and community in the diabetes support group might help diabetic patients to increase their knowledge and compliance with the diabetes therapy as well as glycaemic control.Key words: Diabetes, group awareness program, pharmacist, patient counselling Kelompok Dukungan terhadap Diabetes Meningkatkan Kepatuhan dan Kontrol Kadar Glukosa Darah PasienMenyediakan informasi tidak cukup untuk meningkatkan kepatuhan pasien diabetes dan mencapai tujuan terapi. Kesadaran pasien serta dukungan emosional dan sosial dari keluarga dan masyarakat dapat memainkan peran penting untuk meningkatkan kepatuhan dan hasil klinis. Oleh karena itu, kelompok pendukung diabetes dikembangkan dan masing-masing kelompok pendukung terdiri atas dua apoteker, dua perawat, pasien diabetes dan anggota keluarga mereka. Sebanyak 70 pasien diabetes tipe 2 yang terdaftar dan acak ke dalam kelompok dukungan 1 dan kelompok dukungan 2. Pasien dalam kelompok 1 menerima selebaran informasi saja, sedangkan pasien di kelompok 2 menerima konseling dari apoteker dan informasi diabetes pada setiap pertemuan. Kesadaran Pasien diabetes dan kepatuhan dengan obat dinilai oleh kuesioner singkat pada awal dan akhir. Kadar glukosa darah dan koleste-rol juga dievaluasipada kedua kelompok. Pada akhir penelitian, kesadaran dan kepatuhan pasien secara keseluruhan meningkat 61,5%. Kadar glukosa darah acak dan puasa menunjukkan penurunan 30% pada kelompok 2 dansekitar 14 % pada kelompok 1. Penelitian ini mengungkapkan bahwa kolaborasi antara profesional perawatan kesehatan dan masyarakat dalam kelompok pendukung diabetes dapat membantu pasien diabetesuntuk meningkatkan pengetahuan dan kepatuhan mereka dengan terapi diabetes serta kontrol glikemik. Kata kunci: Diabetes, program penyadaran kelompok, apoteker, konseling pasien
EFEKTIVITAS AGONIS RESEPTOR OPIOID KAPPA PADA NYERI AKUT DAN KRONIK Rahmadi, Mahardian; Khotib, Junaidi; Suprapti, Budi; Sjamsiah, Siti
JFIOnline | Print ISSN 1412-1107 | e-ISSN 2355-696X Vol 3, No 1 (2006)
Publisher : Indonesian Research Gateway

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Kappa receptor is one opioid receptor subunit which when activated can stimulate analgesic effect, however with lower dependency risk compare to other opioid receptor subunit. (mu and delta). The objective of this experiment was to examine the effectivity of kappa opioid receptor agonist  in acute and chronic pain (inflammation and neuropathy), in order to find new strategy in pain management. Groups of ICR mice (n = 10) were treated to gain acute and chronic pain model. Acute pain was gain by hot stimulation through hot plate and tail flick. Inflammation model was made by CFA intraplantar injection. Neuropathy pain was induced by binding the sciatic neuron. To examine the pain-blocker effectivity of kappa receptor agonist,  trans-1S,2S]-3,4-dichloro-N-methyl-N-[2-(1-pyrrolidinyl)cyclohexyl]benzeneacetamide(-)U50,488H was inject subcutaneously 3 mg/kg - 20mg/kg body wight. Then hot plate and tail flick were conduct, morphine 10 mg/kg bw use as standard. From results can be concluded that   activation of kappa receptor can induce pain-blocker or analgesic effect as well, against acute or chronic pain, inflammation or neuropathy. ABSTRAK Reseptor kappa merupakan salah satu sub unit reseptor opioid yang jika diaktivasi dapat mempunyai efek analgesik tetapi dengan risiko dependensi yang lebih kecil dari pada sub unit reseptor opioid yang lain (mu dan delta). Penelitian ini bertujuan untuk menentukan efektivitas agonis reseptor opioid kappa pada keadan nyeri akut dan kronik (inflamasi dan neuropati), sehingga diharapkan didapatkan strategi baru dalam penanganan nyeri. Untuk pengujian efektivitas antinyeri dari agonis reseptor kappa, trans-1S,2S]-3,4-dichloro-N-methyl-N-[2-(1-pyrrolidinyl) cyclohexyl]benzeneacetamide   (-)U50,488H diinjeksikan secara subkutan mulai dosis 3 mg/kgbb hingga 20mg/kgbb kemudian dilakukan uji hot plate dan tail flick, sebagai pembanding digunakan morfin 10mg/kgbb. Pegujian dilakukan pada 15, 30, 45, 60, 90 dan 120 menit setelah penginjeksian (-)U50,488H. Aktivitas antinyeri dinyatakan dalam % MPE (maximal possible antinociceptive effect). (-)U50,448H memiliki aktivitas antinyeri sebanding dengan dosis pemberian baik pada keadaan nyeri akut, inflamasi maupun neuropati. Pada dosis 3 mg/kgbb menghasilkan 47% MPE, dosis 5,6 mg/kgbb menghasilkan 76% MPE, dosis 10mg/kgbb menghasilkan 88% MPE dan dosis 20 mg/kgbb menghasilkan 100% MPE. Waktu puncak dicapai pada 15 menit setelah injeksi. Dari penelitian ini dapat disimpulkan bahwa aktivasi reseptor kappa juga dapat memberikan efek anti nyeri, baik pada nyeri akut, inflamasi maupun neuropati.
Efek penambahan parasetamol pada terapi ketorolak terhadap nyeri akut pascaoperasi orthopedi Santoso, Agustinus; Huwae, Thomas Erwin CJ; Idha, Arofa; Suprapti, Budi
JFIOnline | Print ISSN 1412-1107 | e-ISSN 2355-696X Vol 8, No 1 (2016)
Publisher : Indonesian Research Gateway

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

ABSTRACT : The aim of this research is to analyze pain control of paracetamol addition to ketorolac compared with ketorolac alone on patient’s pain response. Ketorolac group (K group) recieved ketorolac 10 mg i.v every 8 hours and Ketorolac and Paracetamol group (KP group) recieved ketorolac 10 mg i.v and paracetamol 1,000 mg orally every 8 hours. Observation of pain intensity with Face Scale at ½ hours before and after administration at the first, the fourth and the seventh analgesics. Observation quality of pain management with QUIPS at ½ hours after administration the seventh analgesics. As the results, paracetamol addition to ketorolac provide better pain control, shown at the mean pain intensity KP group was lower at post to 4, pre to 7 and post to 7 than K group, and the QUIPS results were side effects of paracetamol additional well tolerated, reduce needs for additional analgesics, but no difference at patient satisfactions. These results suggest that paracetamol addition to ketorolac had better pain control than ketorolac alone in patients with orthopedic postoperative acute pain.Keywords : ketorolac, paracetamol, postoperative, face scale, QUIPS ABSTRAK: Penelitian ini bertujuan untuk mengetahui pengendalian nyeri oleh penambahan parasetamol pada ketorolak dibandingkan dengan ketorolak tunggal berdasarkan respon nyeri pasien. Kelompok Ketorolak (Kelompok K) mendapatkan ketorolak 10 mg i.v setiap 8 jam dan kelompok Ketorolak dan Parasetamol (kelompok KP) mendapatkan ketorolak 10 mg i.v dan parasetamol 1000 mg per oral setiap 8 jam. Penilaian intensitas nyeri dengan Face Scale pada 30 menit sebelum (pre) dan sesudah (pasca) pemberian dosis analgesik pertama, ke empat dan ke tujuh. Pengamatan kualitas manajemen nyeri dengan QUIPS pada 30 menit setelah pemberian analgesik dosis ke tujuh. Hasil pengamatan menunjukkan bahwa penambahan parasetamol pada ketorolak memberikan kendali nyeri yang lebih baik, ditunjukkan oleh rerata intensitas nyeri kelompok KP pada pasca dosis ke 4, pre dosis ke 7 dan pasca dosis ke 7 lebih rendah dari kelompok K, serta hasil QUIPS bahwa efek samping penambahan parasetamol dapat ditoleransi, menurunkan kebutuhan analgesik tambahan, namun tidak berbeda pada kepuasan pasien. Hasil diatas menyatakan bahwa penambahan parasetamol pada ketorolak memberikan kendali nyeri lebih baik dari ketorolak tunggal pada pasien nyeri akut pascaoperasi orthopedi. Kata kunci: ketorolak, parasetamol, pascaoperasi, QUIPS  
Paricalcitol For CKD-MBD Associated With Secondary Hyperparathyroidism: A Case Series Focus On TRAP5b, b-ALP, and DKK-1 Suprapti, Budi; Hartono, Frenky; Iqbal, Muhammad; Zuhri, Muhammad Isnaini; Aditiawardana, Aditiawardana
Indonesian Journal of Pharmacy Vol 30 No 1, 2019
Publisher : Faculty of Pharmacy Universitas Gadjah Mada, Yogyakarta, Skip Utara, 55281, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (884.22 KB) | DOI: 10.14499/indonesianjpharm30iss1pp66

Abstract

Chronic kidney disease (CKD) lead to secondary hyperparathyroidism (sHPT) that caused by phosphate retention and hypocalcemia. This condition known as mineral and bone disorder (CKD-MBD). The increase in parathyroid hormone would increase bone turnover that result in an increased risk of bone fractures, and vascular calcification. These will increase the levels of tartrate-resistant acid phosphatase 5b (TRAP5b), and bone-specific alkaline phosphatase (b-ALP), which is a marker of bone turnover, and also dickkopf-related protein 1 (DKK-1), which is an inhibitor of the Wnt pathway. Secondary hyperparathyroidism in CKD also caused by calcitriol deficiency. Paricalcitol is a synthetic calcitrol analogue used to reduce parathyroid hormone (iPTH) with minimal calcemic and phosphatemic activity. Vitamin D receptor activation by paricalcitol will decrease TRAP5b, b-ALP, and DKK-1. In this study we reported 9 cases of CKD-MBD with Hemodialysis (HD) and associated with sHPT. Four of nine cases received 5μg paricalcitol every HD (twice a week) while the others five is not. Level of iPTH, phosphate, calcium, TRAP5b, b-ALP, and DKK-1 were measured before initiation of study and after three months treatment. According to this study, the paricalcol administration suppresses the increase in iPTH level, bone turnover and vascular calcification showed by decreasing or supresses the increase b-ALP, TRAP5b, DKK-1  leves without increasing calcium and phosphate levels.
Analisis Penggunaan Antibiotik pada Pasien Rawat Inap Bedah dengan Menggunakan Defined Daily Dose dan Drug Utilization 90% di Rumah Sakit Universitas Airlangga Novan Y. I. Pratama; Budi Suprapti; Azril O. Ardhiansyah; Dewi W. Shinta
Indonesian Journal of Clinical Pharmacy Vol 8, No 4 (2019)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15416/ijcp.2019.8.4.256

Abstract

Tingkat kematian akibat resistensi terhitung cukup tinggi dan hal ini disebabkan tingginya angka ketidaktepatan dalam terapi antibiotik. Penelitian Antimicrobial Resistance in Indonesia (AMRIN) menunjukkan 42% penggunaan antibiotik terindikasi tidak tepat pada pasien bedah. Penggunaan antibiotik secara bijak merupakan solusi atas masalah resistensi antibiotik. World Health Organization (WHO)dan Kementerian Kesehatan Republik Indonesia merekomendasikan penggunaan metode Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) untuk menilai kuantitas penggunaan antibiotik. Penelitian ini bertujuan untuk mengetahui nilai DDD dan Drug Utilization (DU) 90% dari antibiotik. Penelitian ini merupakan penelitian cross-sectional dengan pengambilan data secara retrospektif yang dilakukan pada November 2016–April 2017 di Rumah Sakit Universitas Airlangga dan data dianalisis menggunakan metode DDD dan DU 90%. Sampel diambil dengan cara total sampling. Sebanyak 463 pasien menjadi sampel pada penelitian ini, dengan 381 pasien mendapatkan antibiotik profilaksis dan 82 pasien mendapatkan antibiotik terapi. Sefazolin merupakan antibiotik profilaksis yang memiliki DDD tertinggi yaitu 69,08/100 operasi dengan lama pemberian sebagian besar dihentikan dalam waktu kurang dari 24 jam post-operasi (82,41%). Antibiotik profilaksis yang masuk segmen DU 90% adalah sefazolin dan seftriakson. Antibiotik terapi yang memiliki DDD tertinggi adalah seftriakson dengan 52,62/100 patient-days dan antibiotik yang masuk segmen DU 90% adalah seftriakson, metronidazol, sefazolin dan meropenem.Kata kunci: Antibiotik, defined daily dose, DU 90%, pasien bedah Analysis of Antibiotic Use in Surgical Inpatients Using Defined Daily Dose and DU 90% at Universitas Airlangga HospitalAbstractAntibiotic resistance is causing high mortality rates throughout the world and resulted from inappropriate use of antibiotics therapy. Antimicrobial Resistance in Indonesia (AMRIN) study showed that there were 42% of inappropriate antibiotic use in surgical patients. Prudent antibiotics use is one of the solution to resolve this problem. Ministry of Health of Indonesia and World Health Organization (WHO) recommend Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) as quantitative evaluation of antibiotics to evaluate the appropriateness of antibiotics use. This study aimed to determine the value of DDD and Drug Utilization (DU) 90% of antibiotics used in surgical patients. This research was conducted using cross-sectional design with retrospective data collection during November 2016–April 2017 at Universitas Airlangga Hospital, and data were analyzed using the DDD method and DU 90%. Sample were collected using total sampling method. A total of 463 patients included as samples in this study, of which 381 patients received prophylactic antibiotic and 82 patients received therapeutic antibiotics. Cefazolin was prophylactic antibiotic with highest DDD of 69.08/100 operations and duration of administration was mostly stopped in less than 24 hours post-operatively (82.41%). Prophylactic antibiotics included in DU 90% segment were cefazoline and ceftriaxone. Therapeutic antibiotic with highest DDD was ceftriaxone with 52.62/100 patient-days. Therapeutic antibiotics included in DU 90% segment were ceftriaxone, metronidazole, cefazolin and meropenem.Keywords: Antibiotic, defined daily dose, DU90%, surgical inpatients
EFEKTIVITAS AGONIS RESEPTOR OPIOID KAPPA PADA NYERI AKUT DAN KRONIK Rahmadi, Mahardian; Khotib, Junaidi; Suprapti, Budi; Sjamsiah, Siti
Jurnal Farmasi Indonesia Vol 3, No 1 (2006)
Publisher : Jurnal Farmasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35617/jfi.v3i1.66

Abstract

Kappa receptor is one opioid receptor subunit which when activated can stimulate analgesic effect, however with lower dependency risk compare to other opioid receptor subunit. (mu and delta). The objective of this experiment was to examine the effectivity of kappa opioid receptor agonist  in acute and chronic pain (inflammation and neuropathy), in order to find new strategy in pain management. Groups of ICR mice (n = 10) were treated to gain acute and chronic pain model. Acute pain was gain by hot stimulation through hot plate and tail flick. Inflammation model was made by CFA intraplantar injection. Neuropathy pain was induced by binding the sciatic neuron. To examine the pain-blocker effectivity of kappa receptor agonist,  trans-1S,2S]-3,4-dichloro-N-methyl-N-[2-(1-pyrrolidinyl)cyclohexyl]benzeneacetamide(-)U50,488H was inject subcutaneously 3 mg/kg - 20mg/kg body wight. Then hot plate and tail flick were conduct, morphine 10 mg/kg bw use as standard. From results can be concluded that   activation of kappa receptor can induce pain-blocker or analgesic effect as well, against acute or chronic pain, inflammation or neuropathy. ABSTRAK Reseptor kappa merupakan salah satu sub unit reseptor opioid yang jika diaktivasi dapat mempunyai efek analgesik tetapi dengan risiko dependensi yang lebih kecil dari pada sub unit reseptor opioid yang lain (mu dan delta). Penelitian ini bertujuan untuk menentukan efektivitas agonis reseptor opioid kappa pada keadan nyeri akut dan kronik (inflamasi dan neuropati), sehingga diharapkan didapatkan strategi baru dalam penanganan nyeri. Untuk pengujian efektivitas antinyeri dari agonis reseptor kappa, trans-1S,2S]-3,4-dichloro-N-methyl-N-[2-(1-pyrrolidinyl) cyclohexyl]benzeneacetamide   (-)U50,488H diinjeksikan secara subkutan mulai dosis 3 mg/kgbb hingga 20mg/kgbb kemudian dilakukan uji hot plate dan tail flick, sebagai pembanding digunakan morfin 10mg/kgbb. Pegujian dilakukan pada 15, 30, 45, 60, 90 dan 120 menit setelah penginjeksian (-)U50,488H. Aktivitas antinyeri dinyatakan dalam % MPE (maximal possible antinociceptive effect). (-)U50,448H memiliki aktivitas antinyeri sebanding dengan dosis pemberian baik pada keadaan nyeri akut, inflamasi maupun neuropati. Pada dosis 3 mg/kgbb menghasilkan 47% MPE, dosis 5,6 mg/kgbb menghasilkan 76% MPE, dosis 10mg/kgbb menghasilkan 88% MPE dan dosis 20 mg/kgbb menghasilkan 100% MPE. Waktu puncak dicapai pada 15 menit setelah injeksi. Dari penelitian ini dapat disimpulkan bahwa aktivasi reseptor kappa juga dapat memberikan efek anti nyeri, baik pada nyeri akut, inflamasi maupun neuropati.
Efek penambahan parasetamol pada terapi ketorolak terhadap nyeri akut pascaoperasi orthopedi Santoso, Agustinus; Huwae, Thomas Erwin CJ; Idha, Arofa; Suprapti, Budi
Jurnal Farmasi Indonesia Vol 8, No 1 (2016)
Publisher : Jurnal Farmasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (658.224 KB) | DOI: 10.35617/jfi.v8i1.224

Abstract

ABSTRACT : The aim of this research is to analyze pain control of paracetamol addition to ketorolac compared with ketorolac alone on patientâ??s pain response. Ketorolac group (K group) recieved ketorolac 10 mg i.v every 8 hours and Ketorolac and Paracetamol group (KP group) recieved ketorolac 10 mg i.v and paracetamol 1,000 mg orally every 8 hours. Observation of pain intensity with Face Scale at ½ hours before and after administration at the first, the fourth and the seventh analgesics. Observation quality of pain management with QUIPS at ½ hours after administration the seventh analgesics. As the results, paracetamol addition to ketorolac provide better pain control, shown at the mean pain intensity KP group was lower at post to 4, pre to 7 and post to 7 than K group, and the QUIPS results were side effects of paracetamol additional well tolerated, reduce needs for additional analgesics, but no difference at patient satisfactions. These results suggest that paracetamol addition to ketorolac had better pain control than ketorolac alone in patients with orthopedic postoperative acute pain.Keywords : ketorolac, paracetamol, postoperative, face scale, QUIPS ABSTRAK: Penelitian ini bertujuan untuk mengetahui pengendalian nyeri oleh penambahan parasetamol pada ketorolak dibandingkan dengan ketorolak tunggal berdasarkan respon nyeri pasien. Kelompok Ketorolak (Kelompok K) mendapatkan ketorolak 10 mg i.v setiap 8 jam dan kelompok Ketorolak dan Parasetamol (kelompok KP) mendapatkan ketorolak 10 mg i.v dan parasetamol 1000 mg per oral setiap 8 jam. Penilaian intensitas nyeri dengan Face Scale pada 30 menit sebelum (pre) dan sesudah (pasca) pemberian dosis analgesik pertama, ke empat dan ke tujuh. Pengamatan kualitas manajemen nyeri dengan QUIPS pada 30 menit setelah pemberian analgesik dosis ke tujuh. Hasil pengamatan menunjukkan bahwa penambahan parasetamol pada ketorolak memberikan kendali nyeri yang lebih baik, ditunjukkan oleh rerata intensitas nyeri kelompok KP pada pasca dosis ke 4, pre dosis ke 7 dan pasca dosis ke 7 lebih rendah dari kelompok K, serta hasil QUIPS bahwa efek samping penambahan parasetamol dapat ditoleransi, menurunkan kebutuhan analgesik tambahan, namun tidak berbeda pada kepuasan pasien. Hasil diatas menyatakan bahwa penambahan parasetamol pada ketorolak memberikan kendali nyeri lebih baik dari ketorolak tunggal pada pasien nyeri akut pascaoperasi orthopedi. Kata kunci: ketorolak, parasetamol, pascaoperasi, QUIPS  
Co-Authors Abdul Rahman Bahmid Aditiawardana Aditiawardana, Aditiawardana Anak Agung Ngurah Putra Riana Prasetya Andarsari, Mareta R. Anggraini Dwi Sensusiati Aniek S. Budiatin Arief Bachtiar Arina Deri Puspita Sari Arina Dery Puspitasari Ayunda Nur Hidayatiningsih Azril O. Ardhiansyah Bayu Dharma Santi Bayu Dharma Shanti Bella Donna Perdana Putra Budiatin, Aniek S. Cahyo Wibisono Chrysnanda Maryska Dewi W. Shinta Dewi W. Shinta Dewi Wara Shinta Didik Hasmono Dwi Hari Susilo Eddy Rahardjo Fathia Ramadiani Hapsari, Pharmasinta P. Hartono, Frenky Hidayati, Movita I Gde Raka Widiana Idha, Arofa Idha, Arofa Junaidi Khotib Khusnul Fitri Hamidah M. Yusuf Assegaf Mahardian Rahmadi Mansur, Mifta Marcha Debby Saraswati Marcha Debby Saraswati Mareta R. Andarsari Mareta Rindang Andarsari Mida Purwiningtyas Mulya Sundari Ni Made Amelia R. Dewi Ni Made Mertaniasih Nia Widyasari Novan Y. I. Pratama Pharmasinta P. Hapsari Pharmasinta Putri Hapsari Prasetya, Anak Agung Ngurah Putra Riana Prastuti Asta Wulaningrum Putranto, J. Nugroho Eko Rahmawati Raising Ramadiani, Fathia Retna Dwi Puspitarini Ria Fitrah Arfiani Santoso, Agustinus Santoso, Agustinus Sarah Puspita Atmaja Shafira Muti Ardiana Shanti, Bayu Dharma Shinta, Dewi W. Sjamsiah, Siti Sjamsiah, Siti Soedarsono Sofiati Diah Baisuni Suharjono Suharjono Suharjono Suharjono Thomas Erwin Christian Junus Huwae Toetik Aryani Tutik Kusmiati UMI FATMAWATI WENNY PUTRI NILAMSARI Yudistira Nurrizky Grahitaning Putra Rohmaana Yulistiani Yulistiani Zamrotul Izzah Zuhri, Muhammad Isnaini