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Jurnal Farmasi Klinik Indonesia

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Published by Universitas Padjadjaran

ISSN : 23375701 EISSN : 2337 5701 DOI : -

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Indonesian Journal of Clinical Pharmacy (IJCP) is a scientific publication on all aspect of clinical pharmacy. It published 4 times a year by Clinical Pharmacy Master Program Universitas Padjadjaran to provide a forum for clinicians, pharmacists, and other healthcare professionals to share best practice, encouraging networking and a more collaborative approach in patient care. Indonesian Journal of Clinical Pharmacy is intended to feature quality research articles in clinical pharmacy to become scientific guide in fields related to clinical pharmacy. It is a peer-reviewed journal and publishes original research articles, review articles, case reports, commentaries, and brief research communications on all aspects of Clinical Pharmacy. It is also a media for publicizing meetings and news relating to advances in Clinical Pharmacy in the regions.

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Efektivitas Pemberian Terapi Cairan Inisial Dibandingkan Terapi Cairan Standar WHO terhadap Lama Perawatan pada Pasien Demam Berdarah di Bangsal Anak Rumah Sakit PKU Muhammadiyah Bantul Asnia Rahmawati; Dyah A. Perwitasari; Nurcholid U. Kurniawan
Indonesian Journal of Clinical Pharmacy Vol 8, No 2 (2019)
Publisher : Universitas Padjadjaran

Demam berdarah dengue (DBD) merupakan penyakit infeksi yang disebabkan oleh virus dengue. Kasus DBD di Kabupaten Bantul pada tahun 2016 berjumlah 1.706 dengan 13 kematian. Salah satu kunci keberhasilan terapi pada pasien DBD adalah menjaga tercukupinya kebutuhan cairan pasien selama fase kritis. Penelitian ini bertujuan untuk mengetahui perbedaan pemberian terapi cairan inisial terhadap perbaikan klinis, laboratoris dan lama rawat inap dibandingkan terapi standar WHO pada pasien dengue fever (DF) dan dengue hemorrhagic fever (DHF) di bangsal anak RS PKU Muhammadiyah Bantul. Penelitian ini dilakukan di bangsal anak RS PKU Muhammadiyah Bantul pada bulan Februari sampai dengan Juni tahun 2018 menggunakan metode eksperimental single blind randomised clinical trial pada dua kelompok yaitu cairan standar WHO (n=24) dan cairan inisial (n=24). Hasil yang diukur yaitu luaran terapi suhu badan, hematokrit, trombosit dan lama rawat inap. Perbedaan antarkelompok dianalisis dengan unpaired t-test dan Mann-Whitney. Berdasarkan hasil penelitian, kedua kelompok tidak menunjukkan perbedaan bermakna terhadap rata-rata suhu badan dan hematokrit (p>0,05), sedangkan kedua kelompok menunjukkan perbedaan yang bermakna terhadap rata-rata peningkatan trombosit dan lama rawat inap (p<0,05). Hal ini menunjukkan bahwa kelompok cairan inisial memiliki rata-rata lama rawat inap lebih cepat 4,00±0,7 hari dibanding kelompok standar WHO yang disertai dengan peningkatan trombosit selama menjalani rawat inap. Simpulan dari penelitian ini adalah pemberian terapi cairan inisial tidak memberikan perbedaan yang signifikan terhadap rata-rata suhu badan dan hematokrit, sedangkan efektivitas antara kedua kelompok menunjukkan perbedaan yang bermakna terhadap rata-rata peningkatan trombosit dan lama rawat inap.Kata kunci: Cairan inisial, demam berdarah dengue, hematokrit, lama rawat inap, suhu badan, trombosit Effectiveness of Initial Fluid Therapy Compared to WHO Standard Therapy on the Length of Stay of Patients with Dengue Fever in Children’s Ward PKU Muhammadiyah Bantul HospitalAbstract Dengue hemorrhagic fever (DHF) is an infectious disease caused by the dengue virus. The number of dengue cases in Bantul Regency in 2016 was 1,706 with 13 deaths. One of the keys to successful therapy in DHF patients is to maintain adequate fluid requirements for patients during the critical phase. This study aimed to determine differences in initial fluid therapy for clinical, laboratory improvement and length of stay compared to WHO standard therapy in dengue fever (DF) and DHF patients in pediatric ward PKU Muhammadiyah Bantul Hospital, Yogyakarta, Indonesia. This research was conducted in the pediatric ward of PKU Muhammadiyah Bantul Hospital in February 2018 to June 2018 using a single blind randomized clinical trial experimental method. Samples were divided into two groups, namely WHO standard fluid (n=24) and initial fluid (n=24). The results measured were body temperature, hematocrit, platelets and length of stay. Differences between groups were analyzed using unpaired t-test and Mann-Whitney. The two groups showed a significant difference toward the increase in platelets and length of stay (p<0.05). This suggests that the initial fluid group had an average length of stay 4.00±0.7 days faster than the WHO standard group which was accompanied by an increase in platelets during hospitalization. In conclusion, the initial fluid therapy did not give a significant difference to the mean body temperature and hematocrit, while the effectiveness between the two groups showed a significant difference toward the increase in platelets and length of stay.Keywords: Body temperature, dengue hemorrhagic fever, hematocrit, initial fluid, length of stay, platelets

Implementasi Antimicrobial Stewardship Program di Kawasan Asia: Sebuah Kajian Sistematis Eko Setiawan; Yosi I. Wibowo; Adji P. Setiadi; Yul'aini Nurpatria; Hernycane Sosilya; Dian K. Wardhani; Menino O. Cotta; Mohd-Hafiz Abdul-Aziz; Jason Roberts
Indonesian Journal of Clinical Pharmacy Vol 8, No 2 (2019)
Publisher : Universitas Padjadjaran

Antimicrobial Stewardship Program (ASP) merupakan salah satu program yang direkomendasikan untuk meningkatkan ketepatan penggunaan antibiotik, khususnya pada setting rumah sakit. Keberhasilan implementasi program tersebut ditentukan oleh banyak faktor, antara lain komunikasi antartenaga kesehatan dan ketersediaan sumber daya manusia maupun sarana-prasarana. Sampai saat ini, bukti penelitian terkait implementasi ASP di Asia khususnya di negara low- dan lower-middle income economies masih terbatas. Tujuan kajian sistematik ini adalah mengidentifikasi jenis strategi ASP yang diimplementasikan di berbagai negara Asia dengan berbagai income status, dan memberikan gambaran dampak dari implementasi ASP terhadap luaran klinis, mikrobiologis, dan finansial. Proses penelusuran pustaka dilakukan dengan menggunakan basis data PUBMED dan kata kunci “antimicrobial stewardship” dan “Asia” yang dikombinasikan dengan Boolean operator yaitu “AND”. Total terdapat 28 penelitian dari sembilan negara diikutsertakan dalam kajian akhir. Belum ditemukan bukti penelitian terpublikasi terkait ASP di Indonesia. Hanya terdapat satu penelitian berasal dari negara lower-middle income economies dan penelitian tersebut dilakukan pada institusi kesehatan tersier. Sebagian besar penelitian, yakni 22, berasal dari negara high-middle income economies, dan 18 dari antaranya dilakukan di rumah sakit tersier atau rumah sakit yang berafiliasi pada institusi pendidikan tinggi. Jenis intervensi ASP yang paling banyak diimplementasikan adalah audit peresepan antibiotik secara prospektif dan disertai dengan pemberian umpan balik, dan penerapannya terbukti dapat menghasilkan luaran yang positif baik secara klinis, mikrobiologis, maupun finansial. Dengan mempertimbangkan dampak positif tersebut, sangat diharapkan agar ASP dapat diimplementasikan pada institusi kesehatan di Indonesia dengan memperhatikan ketersediaan sumber daya dan konteks budaya lokal.Kata kunci: Antibiotik, ketepatan penggunaan, program pengendalian resistensi, resistensi antibiotik The Implementation of Antimicrobial Stewardship Program in Asian Region: A Systematic ReviewAbstractAntimicrobial Stewardship Program (ASP) is one of the recommended programs to optimize the prudent use of antimicrobials, particularly in the hospital settings. The successful ASP implementation is determined by numerous factors, including communication among healthcare workers, and the availability of human resources and facilities. There is limited evidence available regarding the ASP implementation in Asia, particularly in the low- and lower-middle income countries. This systematic review aimed to identify the type of ASP interventions implemented in Asian countries according to the income status and to describe the impact of ASP implementation on the clinical, microbiological, and financial outcomes. The search strategy was undertaken using PUBMED, and the search terms were “antimicrobial stewardship” and “Asia” which were combined with the use of a Boolean operator “AND”. In total, 28 articles from nine countries were included in the final review. No article from Indonesia could be found in this systematic review. There was only an article from a lower-middle income country that was conducted in a tertiary health institution. Most of the articles (22 articles) were from high-middle income countries and 18 of them were conducted either in the tertiary care or university affiliated hospitals. Prospective audit with intervention and feedback was the most frequent ASP used in which positive outcomes on the clinical, microbiological, and financial outcomes have been evidenced. The positive impact of ASP implementation should suggest the needs to initiate the program in the healthcare facilities in Indonesia while taking into account the available resources and the local cultures.Keywords: Antibiotic resistance, antibiotics, prudent use, stewardship program

Comparison of Effects of The Hypoglycemia Management Protocol with 40% Dextrose Concentrated Solution to the Post-Correction Blood Sugar Response through Intravenous Infusion and Intravenous Bolus Yuriani Yuriani; Retnosari Andrajati; Laurentius A. Pramono
Indonesian Journal of Clinical Pharmacy Vol 8, No 2 (2019)
Publisher : Universitas Padjadjaran

Hypoglycemic patients who receive 40% dextrose (D40%) concentrated solution in the correction process need to avoid excessive blood glucose spikes. Administration of D40% was found in two different ways, through intravenous infusion (iv infusion) and intravenous bolus (iv bolus) and the effects of both types of administration were unknown. The purpose of this study was to compare the effect of a hypoglycemia treatment protocol using D40% concentrated solution to the post-correction blood sugar response through iv infusion and iv bolus at two different hospitals with two distinct protocols. This comparative analytical cross-sectional study was conducted retrospectively at St. Carolus Hospital (D40% iv infusion group) and Bella Hospital (D40% iv bolus group). Blood glucose responses, in form of coefficient of variation and degree of overcorrection, were compared between groups. The overall median blood glucose response was 69.5 (3–195) mg/dL for iv infusion group (n=60) and 77 (15–249) mg/dL for iv bolus group (n=62) (p=0.259). The coefficient of variation with iv infusion and iv bolus group were 47.18% and 52.75%, respectively. The median of degree of overcorrection in iv infusion group was lower compared with iv bolus group, 10% (0–138%) versus 23% (0–195%), respectively. Both D40% protocols did not have a significant correlation with the degree of overcorrection (Mann-Whitney test; p=0.099). D40% iv infusion and bolus administration had no effect to the post-correction blood sugar response.Keywords: Blood glucose, dextrose 40%, hypoglycemia, intravenous bolus, intravenous infusion Perbandingan Efek Protokol Manajemen Hipoglikemia dengan Larutan Pekat Dekstrosa 40% secara Intravena Infus dan Intravena Bolus terhadap Respon Gula Darah PascakoreksiAbstrakPasien hipoglikemia yang menerima larutan pekat dekstrosa 40% (D40%) dalam proses koreksinya perlu menghindari lonjakan gula darah yang berlebih. Cara pemberian D40% diberikan dengan dua cara yang berbeda yaitu melalui intravena infus (iv infus) dan intravena bolus (iv bolus), dan efek dari kedua jenis pemberian tersebut belum diketahui. Tujuan dari penelitian ini adalah membandingkan efek protokol manajemen hipoglikemia dengan larutan pekat D40% secara iv infus dan iv bolus terhadap respon gula darah pascakoreksi di dua rumah sakit dengan protokol yang berbeda. Penelitian analitik komparatif secara potong lintang ini dilakukan secara retrospektif di RS St. Carolus (kelompok iv infus D40%) dan RS Bella (kelompok iv bolus D40%). Respon gula darah, dalam bentuk koefisien variasi dan derajat overkoreksi, dibandingkan antara kedua kelompok. Median kenaikan gula darah pada kelompok iv infus D40% 69,5 (3–195) mg/dL (n=60 pasien) dan kelompok iv bolus D40% 77 (15–249) mg/dL (n=62 pasien) (p=0,259). Koefisien variasi dengan iv infus adalah 47,18% dan iv bolus 52,75%. Median derajat overkoreksi iv infus D40% lebih rendah dibandingkan iv bolus D40%, dengan masing-masing 10% (0–138%) dan 23% (0–195%). Kedua cara pemberian D40% tidak memiliki hubungan yang bermakna dengan derajat overkoreksi (uji Mann-Whitney; p=0,099). Pemberian iv infus dan bolus D40% tidak memiliki pengaruh terhadap respon gula darah pascakoreksi.Kata kunci: Dekstrosa 40%, gula darah, hipoglikemia, intravena bolus, intravena infus

Hematologic Toxicities of Chemotherapy in Lung Cancer Patients: A Retrospective Study in Dr. M. Djamil Hospital Padang, Indonesia Yori Yuliandra; Hansen Nasif; Sabrina Ermayanti; Lilik Sulistyowati; Dian A. Juwita
Indonesian Journal of Clinical Pharmacy Vol 8, No 2 (2019)
Publisher : Universitas Padjadjaran

The use of chemotherapeutic agents in the management of cancer is often followed by a range of toxicities to various organ systems. A retrospective study on the hematologic toxicities of chemotherapy in lung cancer patients has been carried out. The study was conducted by a cross-sectional method from medical records of four-year data in 2010–2014 at Dr. M. Djamil Hospital Padang, West Sumatra, Indonesia. Data from medical records of patients diagnosed with lung cancer and underwent chemotherapy, not suffering from primary hematologic diseases, and with normal kidney and liver function prior to chemotherapy were studied. A number of 22 medical records of lung cancer patients which met the criteria with a total of 40 chemotherapy cycles were observed. The study revealed that a combination of carboplatin-paclitaxel was the most common chemotherapy used for the patients (72.7%). The hematologic toxicities comprised anemia, leukopenia, and thrombocytopenia with the severity ranging from grade 1–3. Carboplatin-paclitaxel was the only combination that caused these three toxicities, and the only combination to cause thrombocytopenia as well. Anemia was the major hematologic toxicity experienced by more than half of the patients. The study concludes that there is a reasonably high incidence of hematologic toxicities from chemotherapy among lung cancer patients.Keywords: Anemia, chemotherapy, hematologic toxicity, leukopenia, lung cancer, thrombocytopenia Toksisitas Hematologis Akibat Kemoterapi pada Pasien Kanker Paru: Studi Retrospektif di RSUP Dr. M. Djamil PadangAbstrak Penggunaan obat kemoterapi dalam pengobatan kanker sering disertai dengan toksisitas pada beberapa sistem organ. Kajian retrospektif terhadap toksisitas hematologis akibat kemoterapi pada pasien kanker paru sudah dilaksanakan. Studi ini dilaksanakan dengan metode cross-sectional dari data rekam tahun 2010–2014 di RSUP Dr. M. Djamil Padang, Sumatera Barat. Data pasien yang didiagnosis menderita kanker paru yang menjalani kemoterapi, tidak menderita penyakit hematologis dan gangguan hematopoiesis, serta memiliki fungsi ginjal dan hati yang normal dimasukkan ke dalam kajian. Sejumlah 22 pasien memenuhi kriteria dengan jumlah siklus kemoterapi sebanyak 40. Hasil kajian ini mengungkap bahwa kombinasi karboplatin-paklitaksel merupakan kemoterapi yang paling banyak digunakan (72,2%). Toksisitas hematologis yang terjadi meliputi anemia, leukopenia, dan trombositopenia dengan tingkat keparahan 1–3. Karboplatin-paklitaksel merupakan satu-satunya kombinasi kemoterapi yang menyebabkan ketiga toksisitas hematologis tersebut, sekaligus juga merupakan satu-satunya kombinasi yang menimbulkan trombositopenia. Anemia merupakan toksisitas hematologis yang paling banyak terjadi meliputi lebih dari separuh pasien. Penelitian ini menyimpulkan bahwa terdapat toksisitas hematologis yang cukup tinggi akibat kemoterapi pada pasien kanker paru.Kata kunci: Anemia, kanker paru, kemoterapi, leukopenia, toksisitas hematologis, trombositopenia

Pengaruh Konversi Antibiotik Intravena ke Rute Per-oral terhadap Outcome Ekonomi, Klinis dan Humanis pada Pasien Rawat Inap Laksmi Maharani; Esti D. Utami; Ika Mustikaningtias; Masita W. Suryoputri; Pugud Samodro
Indonesian Journal of Clinical Pharmacy Vol 8, No 2 (2019)
Publisher : Universitas Padjadjaran

Konversi terapi intravena ke rute per-oral dengan memperhatikan perbaikan hemodinamik pasien dalam 48 jam dapat menghemat biaya pengobatan tanpa mengabaikan efektivitas terapi. Penelitian ini bertujuan untuk mengetahui pengaruh intervensi konversi antibiotik intravena ke rute per-oral terhadap outcome klinis berupa lama rawat inap dan konversi angka leukosit pasien; outcome humanis berupa kualitas hidup pasien (WHOQOL-BREF), dan outcome ekonomi berupa biaya antibiotik pasien. Penelitian ini menggunakan desain kuasi-eksperimental dengan kelompok intervensi dan kontrol, single blind, tanpa randomisasi. Subjek penelitian adalah pasien yang mendapatkan antibiotik seftriakson intravena yang dirawat inap di bangsal penyakit dalam RSUD Prof. Dr. Margono Soekarjo, Purwokerto selama bulan September sampai Oktober 2017. Pasien intervensi mendapatkan intervensi berupa konversi antibiotik lebih awal, yaitu 2 hari setelah diberikan antibiotik intravena. Dilakukan perbandingan lama rawat inap, penurunan angka leukosit, biaya antibiotik, dan kualitas hidup pasien antara kelompok kontrol dan intervensi menggunakan analisis statistik Mann-Whitney dan Independent t-test. Hasil penelitian ini menunjukkan bahwa dari 22 subjek yang terbagi dalam 6 pasien intervensi dan 16 pasien kontrol, terjadi penurunan rata-rata lama rawat inap pasien intervensi dibanding kontrol 3,167:5 hari. Rata-rata biaya antibiotik pada kelompok intervensi lebih rendah dibanding kelompok kontrol yaitu Rp73.886,8 dan Rp173.091,125. Rata-rata selisih angka leukosit akhir pada pasien intervensi yaitu 218,33/mm3, sedangkan pada pasien kontrol 2.076.875/mm3. Kualitas hidup yang dicapai pasien lebih tinggi pada pasien kontrol (+6,6875) dibandingkan pasien intervensi (–1,33) walaupun perbedaan tersebut tidak berbeda signifikan (>0,05). Konversi lebih awal seftriakson intravena menjadi sefiksim oral mampu menurunkan lama rawat inap dan menurunkan biaya antibiotik yang dikeluarkan secara signifikan (0,017 dan 0,003).Kata kunci: Konversi antibiotik intravena ke oral, outcome ekonomi klinis dan humanis (ECHO), sefiksim, seftriakson Impact of Intravenous to Oral Antibiotic Switch Therapy towards Economic, Clinical and Humanistic Outcome in InpatientsAbstractAntibiotic conversion from intravenous form to oral form (IV to oral switch) after 48 hours therapy in hemodynamically stable patients can save the cost of treatment without neglecting the effectiveness of therapy. This study aimed to determine the influence of early switch antibiotic from iv to oral on economic clinical humanistic outcome (length of stay in hospital and white blood cell conversion as clinical outcome; quality of life as humanistic outcome using WHOQOL-BREF, and antibiotic cost as economic outcome). This was a quasi-experimental research with control and intervention group, without blinding and randomization. Subjects were inpatients who received ceftriaxone at internal medicine wards of Prof. Dr. Margono Soekarjo hospital for 2 months period from September until October 2017. Intervention group received early antibiotic conversion after 2 days. Length of stay, white blood cell count, quality of life and antibiotic cost were compared between control and intervention groups using Mann-Whitney and Independent t-test. The result showed that from the total of 22 subjects who were divided into intervention group (6 subjects) and control group (16 subjects), there was a decrease in average length of stay of intervention group compared to control (3.167 days and 5 days, respectively). The average of antibiotic cost in intervention group was lower than control group (IDR 73,886.8 and IDR 173,091.125, respectively). The average of white blood cell count in intervention group was 218.33/mm3 while in control group was 2,076,875/mm3. Quality of life of control group was higher (+6,6875) compared to intervention group (–1,33) but was not statistically significant. Early antibiotic switch from ceftriaxone to cefixime could reduce the length of stay and antibiotic cost significantly (0.017 and 0.003).Keywords: Cefixime, ceftriaxone, economic clinical humanistic outcome, intravenous to oral switch therapy antibiotic

Pengaruh Usia Ibu Hamil terhadap Jumlah Sel Punca Hematopoietik dan Very Small Embryonic-like Stem Cell pada Darah Tali Pusat Angliana Chouw; Bayu W. Putera; Cynthia R. Sartika; Ajeng Diantini; Tono Djuwantono; Ahmad Faried; Dwi A. P. Dewi; Julia Riswandani
Indonesian Journal of Clinical Pharmacy Vol 8, No 2 (2019)
Publisher : Universitas Padjadjaran

Darah tali pusat telah banyak digunakan dalam terapi regeneratif. Hal ini disebabkan darah tali pusat mengandung sel punca, yaitu sel punca hematopoietik dan very small embryonic-like stem cell. Keberhasilan terapi regeneratif menggunakan darah tali pusat membutuhkan dosis yang disesuaikan dengan berat badan dan cara pemberian sel punca. Oleh karena itu, dibutuhkan informasi yang dapat memengaruhi jumlah sel punca yang ada pada darah tali pusat. Usia ibu pada saat kehamilan diperkirakan memiliki pengaruh terhadap jumlah sel punca. Penelitian ini dilakukan dengan pendekatan studi potong lintang. Penelitian dilakukan di Laboratorium Prodia StemCell Indonesia pada bulan Desember 2017. Sebanyak 22 sampel yang digunakan dalam penelitian ini merupakan darah tali pusat yang telah disimpan sebelumnya selama lebih dari dua tahun. Deteksi jumlah sel hematopoietik dan very small embryonic-like stem cell dilakukan dengan menggunakan metode flowcytometry. Deteksi sel punca hematopoietik dilakukan dengan menggunakan molekul penanda permukaan CD34+ dan CD45+, sedangkan deteksi very small embryonic-like stem cell dilakukan dengan menggunakan molekul penanda permukaan CD45-, CD34+, dan CD184(CXCR4)+. Pada kelompok usia ibu di atas 30 tahun, rata-rata jumlah sel hematopoietik adalah 63,71±58.419x103 sel/mL dan rata-rata jumlah very small embryonic-like stem cell adalah 7,83±7.060 x103 sel/mL. Uji beda menunjukkan semakin tua usia ibu pada saat kehamilan, jumlah sel punca semakin meningkat, namun tidak ada perbedaan yang signifikan (r=0,0510; p<0,005). Hal ini menunjukkan bahwa usia ibu tidak memengaruhi konsentrasi sel darah tali pusat.Kata kunci: Darah tali pusat, sel hematopoietik, sel punca, very small embryonic-like stem cell Influence of Maternal Age on Hematopoietic Stem Cell and Very Small Embryonic-like Stem Cell Concentration in Umbilical Cord BloodAbstractUmbilical cord blood (UCB) has been used in regenerative medicine due to the stem cell content in the blood. Hematopoietic stem cell and very small embryonic-like stem cell are found in UCB sample. Dosage and route of administration of stem cell need to be determined for the success of regenerative therapy. Therefore, information that can affect the stem cell number is needed. This study used cross-sectional approach, and was conducted at Prodia StemCell Laboratory in December 2017. Twenty-two UCB samples collected from Prodia StemCell Laboratory which had been stored for more than 2 years were thawed to detect the number of stem cell. Flowcytometry method was used to detect the number of hematopoietic stem cell and very small embryonic-like stem cell in UCB sample. Hematopoietic stem cell was detected using antibody CD34+ and CD45+ while very small embryonic-like stem cell was detected using CD45-, CD34+, and CD184(CXCR4)+. The mean cell number of hematopoietic stem cell and very small embryonic-like stem cell in maternal age above 30 years old group were 63.71 ±58.419x103 cell/mL and 7.83±7.060 x103 cell/mL, respectively. There was no significant difference in maternal age group during pregnancy (r=0.0510; p<0.005). In conclusion, the number of cells in umbilical cord blood due to the number of blood cell is not related to maternal age.Keywords: Hematopoeitic stem cell, stem cell, umbilical cord blood, very small embryonic-like stem cell

Pengetahuan Apoteker tentang Obat-Obat Look-alike Sound-alike dan Pengelolaannya di Apotek Kota Yogyakarta Muhammad Muhlis; Resa Andyani; Tika Wulandari; Aulisa A. Sahir
Indonesian Journal of Clinical Pharmacy Vol 8, No 2 (2019)
Publisher : Universitas Padjadjaran

Perkembangan produksi obat yang cukup pesat menyebabkan terdapat beberapa obat yang memiliki bentuk dan nama yang hampir sama, hal ini dapat menyebabkan munculnya medication error berupa kesalahan dalam pemberian obat kepada pasien. Obat yang hampir sama bentuk dan namanya ini dikenal dengan obat-obat look-alike sound-alike (LASA). Penelitian observasional ini bertujuan untuk mengetahui sejauh mana pengetahuan apoteker yang bekerja di apotek Kota Yogyakarta terhadap obat-obat LASA dan apakah apotek tersebut telah melaksanakan penataan obat berdasarkan kaidah obat LASA. Hasil penelitian kemudian diuji menggunakan Chi-Square untuk mengetahui hubungan antara pengetahuan dan pengelolaan obat LASA serta pengelolaan dan kesalahan pengambilan obat LASA. Pengambilan data dilakukan pada bulan September–November 2018. Total sampling adalah apotek di kota Yogyakarta yang bersedia menjadi tempat penelitian dan objek penelitian adalah apoteker yang bekerja di masing-masing apotek dan telah menandatangani informed consent. Dari 136 apotek yang berada di kota Yogyakarta, 66 apotek bersedia menjadi objek penelitian dan mengisi kuesioner dengan benar. Pengetahuan apoteker yang bekerja di apotek Kota Yogyakarta terhadap obat LASA berkategori baik 56% dan kurang baik 44%; pengelolaan obat LASA berkategori baik 41% dan kurang baik 59%; dan pengalaman dalam kesalahan pengambilan obat LASA berkategori pernah 53% dan tidak pernah 47%. Hasil uji Chi-Square menyatakan tidak ada hubungan yang bermakna antara pengetahuan dan pengelolaan obat LASA serta antara pengelolaan dan kesalahan dalam pengambilan obat LASA.Kata kunci: Apotek, apoteker, obat-obat look-alike sound-alike (LASA) Pharmacist Knowledge of Look-alike Sound-alike Drugs and Their Management at Pharmacies in the City of YogyakartaAbstract Drugs production develop rapidly nowadays and many drugs have embodied similar shapes and names which may lead to medication error and difficulty in emergency medication administration. Drugs with similar shapes/physical appearances/packagings and names that have spelling similarities are known as look-alike sound-alike (LASA) medicines. This observational study aimed to determine the extent of the knowledge of pharmacists on LASA drugs at pharmacies in the city of Yogyakarta, and whether the pharmacies have implemented drugs structuring according to the LASA drug rules. The results were analyzed using Chi-Square test to determine the relationship between knowledge and management of LASA drugs, and between the management and errors in taking LASA drugs. Data retrieval was carried out in September-November 2018 with total sampling were pharmacies in the city of Yogyakarta and objects of research were pharmacists who worked at the sampling pharmacies and had signed the informed consent. Of the 136 pharmacies, only 66 pharmacies were willing to become the samples of research. The results showed that pharmacists’ knowledge on LASA drugs categorized as good was 56% and not good was 44%; LASA drugs management categorized as good was 41% and not good was 59%; pharmacists who had experience in errors in taking LASA drugs was 53% and never had was 47%. In conclusion, there was no significant relationship between knowledge and management of LASA drugs, and between management and errors in taking drugs LASA drugs.Keywords: Look-alike sound-alike drugs, pharmacist, pharmacy

Pengaruh Krim Asam Traneksamat terhadap Pembentukan Keriput dan Kadar Matriks Metaloproteinase-1 pada Mencit (Mus Musculus) Jantan Galur Balb/c yang Dipajan Sinar Ultraviolet B Andrew Citrawan; Oki Suwarsa; Hendra Gunawan; Sudigdo Adi; Ronny Lesmana; Achadiyani Achadiyani; Sunaryati S. Adi
Indonesian Journal of Clinical Pharmacy Vol 8, No 2 (2019)
Publisher : Universitas Padjadjaran

Pemberian asam traneksamat (AT) per oral telah terbukti dapat mengurangi keriput yang diinduksi oleh kulit kering pada mencit. Namun, dosis oral yang setara terlalu besar untuk digunakan pada manusia dalam jangka panjang karena dapat menimbulkan toksisitas, sehingga perlu dicari sediaan alternatif lain secara topikal seperti sediaan krim. Penelitian ini bertujuan untuk menganalisis pengaruh pemberian krim AT terhadap pembentukan keriput pada kulit mencit jantan galur Balb/c yang dipajan sinar ultraviolet B (UVB). Penelitian dilakukan terhadap 24 ekor mencit di Laboratorium Farmakologi dan Terapi serta Laboratorium Sentral Universitas Padjadjaran pada bulan Februari hingga Mei 2018. Mencit dibagi secara acak ke dalam empat kelompok, yaitu satu kelompok kontrol (P0) hanya mendapatkan pajanan sinar UVB tanpa krim AT dan tiga kelompok perlakuan (P1, P2, dan P3) mendapat pajanan sinar UVB dan diberikan krim AT dengan konsentrasi masing-masing 3%, 4%, dan 5%. Setelah 10 minggu, dilakukan penilaian kondisi keriput pada kulit punggung mencit berdasarkan metode Bisett, dilanjutkan dengan biopsi kulit punggung mencit untuk pemeriksaan kadar matriks metaloproteinase-1 (MMP-1) dengan teknik western blot (WB). Diperoleh perbedaan nilai rata-rata skor keriput yang bermakna sebesar 2,1±0,105 pada kelompok P0, 1,1±0,167 pada P1 dan P2, serta 1,3±0,211 pada P3 (p=0,005). Diperoleh pula nilai rata-rata kadar MMP-1 yang bermakna, yakni sebesar 0,75±0,08 pada kelompok P0, serta 0,54±0,033, 0,40±0,052, dan 0,54±0,072 pada P1, P2, dan P3 secara berturut-turut (p=0,008). Berdasarkan hasil tersebut, dapat disimpulkan bahwa pemberian krim AT mampu memperlambat pembentukan keriput dan menurunkan kadar MMP-1 pada kulit punggung mencit jantan galur Balb/c yang dipajan sinar UVB.Kata kunci: Keriput, krim asam traneksamat, matriks metaloproteinase-1, sinar ultraviolet B The Effect of Tranexamic Acid Cream on Wrinkle Formation and Matrix Metalloproteinase-1 Levels on Male Balb/c Mice Skin Exposed to Ultraviolet B RadiationsAbstractOral tranexamic acid (TXA) has been proven to ameliorate wrinkle induced by skin dryness in hairless mouse. However, the equal human oral dose is too high and can induce toxicity if used in long term, and study of topical preparations for wrinkle treatment is limited. Therefore, this study was conducted using topical preparations as an alternative for oral treatment to examine the effects of TXA cream in wrinkle formation. Four weeks old of twenty-four male Balb/c mice, divided into four groups, then 3%, 4% and 5% TXA cream were administered on the back skin of mice in each group shortly after ultraviolet B (UVB) exposure, except for control group that only exposed to UVB lights without given any TXA creams. Wrinkle formation and matrix metalloproteinase (MMP-1) level were observed after 10 weeks of treatments. There were significant differences of wrinkle score, with mean value were 2.1±0.105 for control group, 1.1±0.167 for 3% and 4% groups, and 1.3±0.211 for 5% group (p=0.005). There were also significant differences of MMP-1, with mean value were 0.75±0.08 for control group, 0.54±0.033, 0.40±0.052, and 0.54±0.072 for 3%, 4% and 5% group, respectively (p=0.008). Based on significant differences of wrinkle score and MMP-1 level, it can be concluded that administration of TXA cream may able to delay wrinkle formation and reduce the MMP-1 level on the mice skin exposed to ultraviolet B.Keywords: Matrix metalloproteinase-1, tranexamic acid, ultraviolet B, wrinkle

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Rizky Abdulah

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Kota bandung,

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