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The Roots Cause of the Drug Shortage and Expired Drug Problem at Hospital X Ni Putu Udayana Antari; I Gede Wayan Sujarna; Ni Wayan Ratih Purnama Sari; Nurul Fatoni; Ni Luh Damayanti; Ni Made Dharma Shantini Suena
JMMR (Jurnal Medicoeticolegal dan Manajemen Rumah Sakit) Vol. 13 No. 1 (2024): April 2024
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/jmmr.v13i1.46

Abstract

Good drug management in the Hospital Pharmacy Installation is the key to the smooth running of pharmaceutical services. The availability of the necessary drugs at the right time and place affects patient safety and satisfaction. Empty drugs and expired drugs are problems in drug management, mainly Hospital X. Empty drugs result in the replacement of drugs in prescriptions, thus increasing the burden on pharmaceutical services and creating risks for patient safety. Expired drugs cause hospital losses. This study aims to describe the root cause of drug shortages and expired drugs in Hospital X. The research used a qualitative approach to dig deeper into these complex problems—elicitation of data using semi-structured interviews supported by secondary data from the hospital. Data were analyzed using a Fishbone diagram to get a systematic overview of the root causes of problems based on specific domains. The root causes of expired drug problems and empty drug substitution in Hospital X are materials/inputs, methods, people, machinery/equipment, measurement (process evaluation), and the pharmacy facility environment domains.
PENENTUAN NILAI SPF KRIM BUAH JERUK PURUT (CITRUS HYSTRIX DC.) DENGAN SPEKTROFOTOMETRI UV Juliadi, Debby; Shantini Suena, Ni Made Dharma; Astya Putri, Ni Kadek Dita
E-Jurnal Medika Udayana Vol 12 No 9 (2023): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2023.V12.i09.P07

Abstract

Buah jeruk purut mengandung senyawa flavonoid, ?-pinene dan ?-pinene. Senyawa tersebut dapat sebagai tabir surya karena memiliki aktivitas penyerapan sinar UV. Tujuan penelitian ini yaitu untuk mengetahui nilai SPF minyak atsiri dan sediaan krim minyak atsiri buah jeruk purut dan perbedaan nilai SPFnya. Proses ekstraksi buah jeruk purut dilakukan dengan metode destilasi uap air selama 6-7 jam. Ujj kandungan flavonoid minyak atsiri buah jeruk purut dilakukan dengan meneteskan reagen H2SO4, kemudian dilakukan pembuatan sediaan krim dari minyak atsiri buah jeruk purut. Penentuan nilai SPF dilakukan secara in vitro menggunakan instrumen spektrofotometri UV pada panjang gelombang 290-320 nm. Hasil rata-rata nilai SPF minyak atsiri buah jeruk purut yaitu 6.37 termasuk kategori ekstra. Pada basis krim memiliki rata-rata nilai SPF yaitu 5.36 yang menunjukkan bahwa bahan tambahan pada formula krim mempunyai potensi sebagai tabir surya dalam kategori sedang. Krim minyak atsiri buah jeruk purut F1 memiliki rata-rata nilai SPF yaitu 8.72 yang termasuk kategori maksimal. Peningkatan nilai SPF pada formula 1 terjadi karena penambahan minyak atsiri buah jeruk purut dan bahan tambahannya. Kesimpulan dari penelitian ini minyak atsiri dan krim minyak atsiri buah jeruk purut memiliki potensi sebagai tabir surya dilihat dari nilai SPFnya dan terdapat perbedaan bermakna antara nilai SPF minyak atsiri dan sediaan krim minyak atsiri buah jeruk purut.
UJI AKTIVITAS ANTIIFLAMASI GEL EKSTRAK ETANOL BIJI JENITRI (Elaeocarpus serratus L.) PADA MENCIT PUTIH JANTAN (Mus musculus L.) YANG DIINDUKSI KARAGENAN Juliadi, Debby; Suradnyana, I Gede Made; Shantini Suena, Ni Made Dharma
E-Jurnal Medika Udayana Vol 11 No 8 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i8.P04

Abstract

Penelitian ini bertujuan untuk mengetahui aktivitas antiinflamasi gel ekstrak etanol biji jenitri (Elaeocarpus serratus L.) pada mencit putih jantan (Mus musculus L.) yang diinduksi karagenan serta untuk mengetahui dosis optimal gel ekstrak etanol biji jenitri dalam menghambat inflamasi. Metode yang digunakan adalah Paw Udema. Penelitian ini menggunakan 24 ekor mencit putih jantan yang dibagi menjadi 4 kelompok perlakuan. Kelompok 1 diberikan gel tanpa ekstrak, kelompok 2 diberikan natrium diklofenak gel, kelompok 3 dan 4 diberikan gel dengan konsentrasi ekstrak biji jenitri 14mg/20gBB mencit dan 28 mg/20gBB mencit yang diberikan secara topikal. Parameter yang diukur adalah volume peradangan telapak kaki mencit dari jam ke-1 hingga jam ke-6. Hasil penelitian diuji dengan analisis statistik One Way ANOVA dan LSD (Least Significant Difference). Hasil analisis yang didapatkan adalah terdapat perbedaan bermakna antara kelompok kontrol negatif terhadap kelompok kontrol positif dan kelompok perlakuan dan tidak ada perbedaan bermakna antara kelompok kontrol positif dengan kelompok perlakuan. Berdasarkan penelitian ini, dapat disimpulkan bahwa gel ekstrak etanol biji jenitri (Elaeocarpus serratus L.) dengan konsentrasi ekstrak 14 mg/20gBB mencit dan 28 mg/20gBB mencit memiliki aktivitas sebagai antiinflamasi pada mencit putih jantan (Mus musculus L.) yang diinduksi karagenan dan gel ekstrak etanol biji jenitri dengan konsentrasi 28 mg/20gBB mencit memiliki efek sebagai antiinflamasi paling optimal.
Formulasi Masker Peel Off Ekstrak Buah Naga Merah (Hylocereus lemairei Hook.) dan Pati Jagung dengan Variasi Konsentrasi Polyvinyl Alcohol (PVA) Suena, Ni Made Dharma Shantini; Wardani, I Gusti Agung Ayu Kusuma; Antari, Ni Putu Udayana
Jurnal Ilmiah Medicamento Vol 9 No 2 (2023): Jurnal Ilmiah Medicamento
Publisher : Fakultas Farmasi Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36733/medicamento.v9i2.3576

Abstract

Red dragon fruit is rich in nutrients and minerals as well as phytoalbumin and antioxidant compounds such as phenolic compounds and vitamin C. Corn contains vitamins A, B, and E as antioxidants, as well as Thiamin, which can reduce black spots on acne scars and dry out wounds. Peel-off masks are cosmetic preparations for facial care that can form a thin, transparent layer on the surface of the skin and can be peeled off after drying, so they are practical to use. Polyvinyl alcohol (PVA) is a film-forming polymer and can increase viscosity, which in turn plays a role in producing peel-off masks that have good physical quality. This study aims to formulate peel-off masks of red dragon fruit extract (Hylocereus lemairei Hook.) and corn starch with varying concentrations of PVA (F1:2.5%, F2:8.75%, F3:17.5%) in order to have a high-quality good physique. The evaluation of the physical quality of the red dragon fruit and corn starch peel-off masks was organoleptic, homogeneity, pH, spreadability, adhesion, and drying time. The organoleptic preparations (F1-F3) were brownish-orange in color, with a distinctive rose odor, with increased viscosity from F1 to F3, and remained stable for up to 4 weeks of storage. The homogeneity of preparation (F1-F3) was homogeneous and lasted for 4 weeks of storage. The pH value of the preparation on day 1, F1 and F2, had a pH of 4, and F3 had a pH of 4.5. From the 1st to the 4th week, the pH of preparations F1-F3 was 4.5, according to the physiological pH of the skin, 4-8. The spreadability of F1-F3 preparations was in the 5.5-6.5 cm range, according to 5-7 cm provisions. The adhesive power of the F1-F3 preparations was in the range of 5.29-40.1 seconds, which is recommended for more than 1 second. The drying time of F1-F3 preparations was in the range of 20.58-30.45 minutes, according to the provisions of 15-30 minutes. The three red dragon fruit and corn starch peel-off mask formulas (F1, F2, and F3) meet the requirements for good physical quality according to the criteria set and recommended. Increasing the PVA concentration did not affect the pH value and spreadability of the three formulas but increased the adhesiveness value and drying time.
Formulasi serta Uji Aktivitas Antioksidan dan Tabir Surya Krim Ekstrak Aseton Biji Buah Alpukat Suradnyana, I Gede Made; Juliadi, Debby; Suena, Ni Made Dharma Shantini
Jurnal Ilmiah Medicamento Vol 9 No 1 (2023): Jurnal Ilmiah Medicamento
Publisher : Fakultas Farmasi Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36733/medicamento.v9i1.5504

Abstract

The skin often exposed to sunlight and pollution requires treatment with products that protect it from UV radiation and free radicals. Avocado seeds are known to have the potential as a sunscreen and have good antioxidant activity. This study aims to prove the antioxidant and sunscreen activity of acetone avocado seed extract, produce a cream formula that functions as a sunscreen and antioxidant for the skin, and determine the correlation of extract concentration with the activity of avocado seed acetone extract sunscreen cream. Testing of sunscreen and antioxidant activity was carried out in vitro. The results showed that the SPF and IC50 values of the extract were 39.636 and 10.36 ppm, respectively. The SPF value of F1, F2, and F3 creams were 1.859 ± 0.152, 2.941 ± 0.065, and 3.629 ± 0.053, respectively. The SPF value of the three creams was significantly different (p<0.05), and there was a significant (p<0.001) and strong correlation between the concentration of the extract and the SPF value. The IC50 values of formula F1, F2, and F3 were 9.74 ppm, 7.02 ppm, and 6.86 ppm, respectively. Based on these results, it can be concluded that acetone extract from avocado seeds has a high level of sunscreen activity and very strong antioxidant activity. The cream has an SPF value under the category of low protection level and very strong antioxidant activity. A significant and strong correlation exists between the extract's concentration and the cream's SPF value.
Efektivitas Krim Ekstrak Daun Erythrina subumbrans (Hassk.) Merr. terhadap Diameter Luka Bakar Derajat IIA Wardani, I Gusti Agung Ayu Kusuma; Udayani, Ni Nyoman Wahyu; Suena, Ni Made Dharma Shantini
Jurnal Ilmiah Medicamento Vol 10 No 1 (2024): Jurnal Ilmiah Medicamento
Publisher : Fakultas Farmasi Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36733/medicamento.v10i1.8198

Abstract

Burn injuries involve tissue damage caused by heat, including exposure to hot steam, fire, radiation, electricity, hot liquids or fats, electrical currents, and chemical compounds. Dadap Serep leaves (Erythrina subumbrans (Hassk) Merr) are among the plants recorded in Usada Bali, known for treating various types of wounds. This research aimed to assess the effectiveness of ethanol extract cream from Dadap Serep leaves in reducing the diameter of second-degree burns in vivo using white rats as test subjects. Twenty-four rats were randomly divided into four treatment groups: K- (negative control), K+ (positive control), P1 (application of Dadap Serep leaf extract cream 20%), and P2 (application of Dadap Serep leaf extract cream 40%). The cream was topically applied twice daily for 14 days. The burn diameter results were analyzed using SPSS 25 software employing the Tukey Test. Post hoc Tukey testing revealed significant differences between the negative control and positive control groups, treatments 1 and 2, with p-values of 0.001, 0.043, and 0.012, respectively. No significant difference was observed between the positive control group and treatment groups 1 and 2, with p-values of 0.268 and 0.596, respectively. The ethanol extract cream from Dadap Serep leaves proved effective in reducing the diameter of second-degree burns on rat skin. The Dadap Serep leaf extract cream at a concentration of 20% was effective in reducing the diameter of second-degree burns on rat skin.
Analisis Sun Protection Factor (SPF) Stick Ekstrak Daun Nangka (Artocarpus heterophylla Lamk.) 2% secara In Vitro dengan Spektrofotometri UV-Vis Adrianta, Ketut Agus; Berata, Putu Febryana Suryaputri; Suena, Ni Made Dharma Shantini
Jurnal Ilmiah Medicamento Vol 10 No 1 (2024): Jurnal Ilmiah Medicamento
Publisher : Fakultas Farmasi Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36733/medicamento.v10i1.8574

Abstract

Ultraviolet light, especially ultraviolet B (UV-B) light, can cause the formation of free radicals, namely reactive oxygen species (ROS). Jackfruit leaves are rich in phenolic compounds such as flavonoids, have good antioxidant properties, and can act as UV-protectors. Several studies using natural materials have been carried out to determine the protective activity of Jackfruit Leaf Extract (Artocarpus heterophylla Lamk.) as a UV-protector based on the Sun Protection Factor (SPF) value. This research was conducted using the in vitro method using spectrophotometry by first macerating the jackfruit leaves, then concentrating them with a rotary evaporator. The extract obtained was formulated into a stick and then dissolved into several concentrations, namely 2,500 ppm, 5,000 ppm, 7,500 ppm, and 10,000 ppm. The results showed that the SPF value at a concentration of 2,500 ppm was 8.09 (maximum protection), at a concentration of 5,000 ppm was 16.83 (ultra protection), at a concentration of 7,500 ppm was 14.34 (maximum protection), and at a concentration of 10,000 ppm (maximum protection). Based on the results of the study, a 2% stick of jackfruit leaf extract (Artocarpus heterophylla Lamk.) had the highest SPF value, namely 16.83 in the ultra-protection category at a concentration of 5,000 ppm, so it has the potential to be a UV-protector.
Komunikasi dalam pemberian informasi obat Antari, Ni Putu Udayana; Megawati, Fitria; Agustini, Ni Putu Dewi; Mendra, Ni Nyoman Yudianti; Suena, Ni Made Dharma Shantini
Jurnal Inovasi Hasil Pengabdian Masyarakat (JIPEMAS) Vol 7 No 3 (2024)
Publisher : University of Islam Malang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33474/jipemas.v7i3.21897

Abstract

Banyak penelitian menunjukkan terbatasnya informasi yang diberikan kepada pasien saat penyerahan obat di Apotek. Untuk itu perlu diadakan sosialisasi mengenai metode-metode komunikasi yang dapat digunakan untuk memberikan informasi obat agar komunikasi dapat berjalan efektif dan efisien waktu. Pengabdian dilaksanakan menggunakan metode CBPR (Community-Based Participatory Research) dengan melibatkan ApotekKu sebagai salah satu apotek jaringan untuk memberikan pengaruh yang lebih luas bagi masyarakat. Peserta adalah tenaga kefarmasian di seluruh jaringan ApotekKu. Peserta diberikan sosialisasi mengenai pentingnya pemberian informasi obat sesuai dengan standar yang berlaku dan beberapa teknik komunikasi yang dapat diterapkan dalam pelayanan di apotek. Untuk membantu penyampaian informasi kepada pasien, apotek mitra dibantu dengan penyediaan media pemberian informasi obat berupa video dan buku. Sosialisasi dihadiri oleh 100 peserta, analisis pre-test dan post-test peserta sosialisasi menunjukkan adanya peningkatan pengetahuan yang signifikan pada indikator pemberian informasi obat (p-value <0,001) maupun pada indikator teknik komunikasi (p-value = 0,032) menggunakan uji Wilcoxon dengan taraf kepercayaan 95%. Kegiatan pelatihan yang berkesinambungan perlu dilaksanakan untuk melanjutkan materi yang telah disampaikan.
ANALISIS KESESUAIAN BIAYA RIIL PASIEN KEMOTERAPI KANKER SERVIKS DENGAN TARIF INA-CBG’s PADA PASIEN JKN RAWAT INAP DI RSUP SANGLAH DENPASAR TAHUN 2014 Wintariani, Ni Putu; Suwantara, I Putu Tangkas; Suena, Ni Made Dharma Shantini
Jurnal Ilmiah Medicamento Vol 3 No 1 (2017): Jurnal Ilmiah Medicamento
Publisher : Fakultas Farmasi Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36733/medicamento.v3i1.1053

Abstract

Kanker payudara adalah penyakit urutan pertama yang menyerang wanita di Indonesia. Tingginya biaya perawatan dan penggunaan sistem satu tarif Indonesia Case Base Group (INA-CBG) yang saat ini diikuti oleh semua rumah sakit di Indonesia. Tarif yang diputuskan oleh INA-CBG terkadang tidak sesuai dengan biaya sebenarnya yang dikeluarkan rumah sakit sehingga terjadi perbedaan. Penelitian ini bertujuan untuk mengetahui perbedaan biaya riil tanpa kemoterapi dan tarif INA-CBGs, komponen biaya tertinggi dengan biaya riil tanpa kemoterapi, dan untuk mengetahui jumlah biaya riil tanpa kemoterapi yang terkait dengan keteraturan siklus kemoterapi pada pasien rawat inap di serviks. Di Rumah Sakit Umum Sanglah Denpasar pada bulan Januari-Juli 2014. Penelitian ini menggunakan desain analisis deskriptif dengan mengumpulkan data dokumen klaim dan rekam medis penderita kemoterapi kanker payudara di RSUP Sanglah. Diambil secara purposive sampling secara retrospektif dengan desain cross-sectional menurut perspektif rumah sakit; Sampel terdiri dari 161 episode dari 50 pasien. Analisis dilakukan dengan menggunakan satu sampel uji-t untuk mengetahui perbedaan biaya riil dan tarif INA-CBG dan analisis multivariat untuk mengetahui faktor-faktor yang mempengaruhi biaya sebenarnya. Perbedaan antara biaya riil dan tarif paket INA-CBGs pada tingkat keparahan pertama sebesar Rp. 77.021.099 untuk yang pertama, Rp. 40.924.685 untuk yang kedua, dan Rp 248.472.471 untuk kelas ketiga pengobatan; Pada tingkat keparahan kedua sebesar Rp 29.467.328 untuk yang pertama, Rp. 58.917.239 untuk yang kedua, dan Rp 170.277.952 untuk kelas ketiga perawatan, dan pada tingkat keparahan ketiga sebesar Rp 20.903.495 untuk yang pertama, Rp. 19.591.972 untuk yang kedua, dan Rp. 72.467.699 untuk kelas ketiga pengobatan. Faktor-faktor yang mempengaruhi biaya sebenarnya di kelas pertama, kedua, dan kelas ketiga adalah LOS (p = 0.000), prosedur (0.000), dan diagnosis sekunder (p = 0,030). Pola siklus tidak teratur memiliki biaya rata-rata yang nyata tanpa kemoterapi yang lebih rendah daripada yang tidak teratur.
Formulasi dan Uji Stabilitas Krim Ekstrak Aseton Biji Alpukat Suradnyana, I Gede Made; Mendra, Ni Nyoman Yudianti; Juliadi, Debby; Suena, Ni Made Dharma Shantini
Jurnal Ilmiah Medicamento Vol 10 No 2 (2024): Jurnal Ilmiah Medicamento
Publisher : Fakultas Farmasi Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36733/medicamento.v10i2.8728

Abstract

UV radiation can cause skin damage, thus requiring sunscreen and antioxidants for protection. Sunscreen absorbs or reflects UV rays, while antioxidants help increase antioxidant levels in skin tissues. Avocado seeds have potential as sunscreen and antioxidant agents, as the seed extract contains catechin, which can inhibit the enzymes tyrosinase, elastase, hyaluronidase, and collagenase. This study aims to determine the physical and chemical stability and the sunscreen and antioxidant activity of acetone avocado seed extract cream. The research stages included phytochemical screening, determination of total flavonoid content, antioxidant activity of the extract, cream formulation, physical and chemical stability tests, and sunscreen and antioxidant activity stability tests. The results showed that the extract tested positive for flavonoids, tannins, triterpenoids, phenols, and saponins. The extract's total flavonoid content and IC50 were 68.58±0.88 mg QE/100 g and 7.14 µg/ml, respectively. After six months of storage, there were changes in the color and spreadability of the cream. The spreadability significantly decreased from 50.87±3.17 to 35.21±2.09 g.cm/second, the total flavonoid content decreased from 9.16±0.27 to 4.48±0.16 mg QE/100 g, and the antioxidant activity significantly decreased from 7.41 to 18.72 µg/ml. Additionally, there was a significant increase in the SPF value from 1.62±0.01 to 1.87±0.06. Based on these results, the acetone avocado seed extract cream was unstable regarding physical, chemical, sunscreen, and antioxidant activity after six months of storage at room temperature. To improve the stability of the preparation, buffering in an acidic environment, adding antioxidants such as ascorbic acid, and storing at a cool temperature, are recommended.