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PERBANDINGAN EFEKTIVITAS TERAPI DAN BIAYA FILGRASTIM DAN LENOGRASTIM PADA PASIEN KANKER KOLOREKTAL DENGAN REGIMEN KEMOTERAPI FOLFOX Pratama, Jainuri Erik; Ramadhan, Viren; Saharuddin; Pahlavi, Ridlo
Jurnal Ilmiah Farmasi Vol. 20 No. 2 (2024): Jurnal Ilmiah Farmasi
Publisher : Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/jif.vol20.iss2.art10

Background: Granulocyte colony-stimulating factor (GCSF) is a primary regulator of the granulopoiesis process, which mobilizes stem cells from the bone marrow to the blood vessels. Filgrastim and lenograstim are the types of GCSF that have been widely used. Objective: This research aims to study the comparative therapeutic outcomes and cost-effectiveness of filgrastim and lenograstim therapies in colorectal cancer patients undergoing chemotherapy with the FOLFOX regimen.Method: This research was conducted at the pharmacy installation of the Dr. Kariadi Central General Hospital (RSUP Dr. Kariadi) from December 2023 to January 2024. It is observational research with a retrospective pre-posttest cohort study design that evaluates the comparative effectiveness and costs of filgrastim and lenograstim therapies in patients with neutropenia based on an increase in white blood cells (WBC) and absolute neutrophil count (ANC) scores of patients. The data was analyzed using the unpaired comparative analysis method and using the cost-effectiveness analysis (CEA) method to determine the cost-effectiveness. The observations were carried out twice, before and after administering the GCSF therapy. The samples consisted of 25 patients divided into two treatment groups. Results: The average scores of WBC and ANC levels in 15 patients who received filgrastim therapy were 2000 cells/mm3 and 666 cells/mm3. At the same time, the WBC and ANC levels in 10 patients who received lenograstim therapy were 1980 cells/mm3 and 449 cells/mm3. After administering the GCSF therapy, there was a significant increase in WBC and ANC levels (p<0.05) in each group. Still, there was no significant difference in the increase in WBC and ANC between the groups receiving filgrastim and lenograstim (p>0.05). The CEA analysis results showed that an increase of 1 cell/ml of WBC score cost Rp24.2 for filgrastim and Rp347 for lenograstim. In contrast, an increase of 1 cell/ml of ANC score cost Rp111.8 for filgrastim and Rp1572.5 for lenograstim.Conclusion: This research concludes that filgrastim is as effective as lenograstim, yet filgrastim is considered more cost-effective than lenograstim.

Penggunaan DAPT (Dual Antiplatelet) Pada CVA (Cerebrovascular Accident) Trombosis atau Stroke Iskemik dengan Riwayat PJK (Penyakit Jantung Koroner) Putri, Rizky Ayu Artama; Badriah, Rani Nur; Anggraeni, Reta; Pratama, Jainuri Erik; Setiadi, Antonius Adji Prayitno; Herawati, Fauna; Gondokesumo, Marisca Evalina
MAHESA : Malahayati Health Student Journal Vol 4, No 12 (2024): Volume 4 Nomor 12 (2024)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v4i12.16289

ABSTRACT Ischemic stroke is the sudden development of focal neurological deficit due to inadequate blood supply to an area of the brain, which can be thrombotic or embolic. CAD (Coronary Artery Disease) is pathological process characterized by the formation of atherosclerotic plaque followed by rupture, ulceration, or erosion. CAD can take the form of CCS (Chronic Coronary Syndrome). The 2018 AHA/ASA Guidline Antiplatelet Therapy used for ischemic stroke is Aspirin at a dose of 160mg-300mg 1x1. In the 2019 ESC Guidline, CCS patient therapy uses DAPT (Dual antiplatelet). In a 2021 AHA meta-analysis compared with aspirin alone, short-term DAPT within 24 hours after mild-moderate ischemic stroke reduced the risk of recurrent stroke at the expense of a higher risk of major bleeding. Here we present a case of a 76 year old female patient with ischemic stroke and CCS who used DAPT. Complaints of sluggishness, weakness in the left half of the body, acute dysarthria onset on the first day, when waking up. Hemiplegia S 1 week ago onset of waking up and being treated at Mataram Regional Hospital. The patient received the antiplatelet Aspirin 160mg 1x1 a day then switched DAPT (Aspirin 80mg 1x1 and Clopidogrel 75mg 1x1) due to a history of CCS. Keywords: CVA Thrombosis, Ischemic stroke, Aspilet, Clopidogrel, Coronary Artery Disease ABSTRAK Stroke iskemik adalah perkembangan fokal yang tiba-tiba terjadi defisit neurologis akibat suplai oksigen tidak memadai ke suatu area pada otak, dapat bersifat trombotik atau emboli. PJK (Penyakit Jantung Koroner) atau CAD (Coronary Artery Disease) adalah proses patologis ditandai dengan terbentuknya plak aterosklerotik diikuti dengan pecah, ulserasi, atau erosi. PJK dapat berupa penyakit CCS (Chronic Coronary Syndrome). Terapi Antiplatelet Guidline AHA/ASA 2018 yang digunakan pada stroke iskemik adalah Aspirin dosis 160mg-300mg 1x1. Pada Guidline ESC 2019 terapi pasien CCS digunakan DAPT (Dual antiplatelet). Pada meta analisis AHA 2021 dibandingkan dengan aspirin saja, DAPT jangka pendek dalam waktu 24 jam setelah stroke iskemik ringan-sedang mengurangi risiko stroke berulang dengan mengorbankan risiko perdarahan besar yang lebih tinggi. Berikut kami presentasikan sebuah kasus pasien Perempuan 76 tahun dengan Stroke Iskemik dan CCS yang menggunakan DAPT. Keluhann pelo, kelemahan separuh badan kiri, acute disartria onset hari pertama, saat bangun tidur. Hemiplegia S 1 minggu lalu onset bangun tidur di rawat di RSUD Mataram. Pasien menerima antiplatelet Aspirin 160mg 1x1 sehari lalu switch DAPT (Aspirin 80mg 1x1 dan Clopidogrel 75mg 1x1) karena Riwayat CCS. Kata Kunci: CVA trombosis, Ischemic stroke, Aspilet, Clopidogrel, Penyakit Jantung Koroner.

Impaired Liver Function in the Use of Clozapine as an Antipsychotic Aziz, Abdul; Herawati, Fauna; Pratama, Jainuri Erik; Gondokesumo, Marisca Evalina
Journal of Food and Pharmaceutical Sciences Vol 13, No 2 (2025): J.Food.Pharm.Sci
Publisher : Integrated Research and Testing Laboratory (LPPT) Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jfps.20811

Clozapine is an atypical antipsychotic used to treat psychosis, mainly as a second choice for patients with refractory schizophrenia and recommended to manage schizophrenia that does not respond to other therapies. Clozapine is also often associated with elevated transaminase levels without clinical symptoms. In this case, a 45-year-old man, who had been diagnosed with schizophrenia since October 2020, was undergoing treatment with various antipsychotic drugs, including clozapine. About a week before hospitalization, there was a change in the patient's behavior. Due to this condition, the patient was brought to the outpatient psychiatric clinic at Airlangga University Hospital Surabaya, the patient was given clozapine 25 mg therapy at night, but the symptoms experienced were getting worse. The patient was finally taken for hospitalization at Dr. Soetomo Hospital Surabaya. While undergoing treatment at the hospital, the patient was given clozapine 10 mg therapy in the morning and at night, in addition, Olanzapine 10 mg was given intramuscularly if needed. However, on the third day after starting treatment, the patient began complaining of low-grade fever (37.8°C), nausea, and fatigue. Laboratory tests showed an increase in liver enzyme levels. However, several cases of severe liver toxicity due to clozapine use have been reported, and there are no specific guidelines for physicians to prevent or treat this condition. Close monitoring of liver function test (LFT) results is crucial in clozapine therapy, especially in considering the decision to stop treatment early if necessary.

Impaired Liver Function in the Use of Clozapine as an Antipsychotic Aziz, Abdul; Herawati, Fauna; Pratama, Jainuri Erik; Gondokesumo, Marisca Evalina
Journal of Food and Pharmaceutical Sciences Vol 13, No 2 (2025): J.Food.Pharm.Sci
Publisher : Integrated Research and Testing Laboratory (LPPT) Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jfps.20811

Clozapine is an atypical antipsychotic used to treat psychosis, mainly as a second choice for patients with refractory schizophrenia and recommended to manage schizophrenia that does not respond to other therapies. Clozapine is also often associated with elevated transaminase levels without clinical symptoms. In this case, a 45-year-old man, who had been diagnosed with schizophrenia since October 2020, was undergoing treatment with various antipsychotic drugs, including clozapine. About a week before hospitalization, there was a change in the patient's behavior. Due to this condition, the patient was brought to the outpatient psychiatric clinic at Airlangga University Hospital Surabaya, the patient was given clozapine 25 mg therapy at night, but the symptoms experienced were getting worse. The patient was finally taken for hospitalization at Dr. Soetomo Hospital Surabaya. While undergoing treatment at the hospital, the patient was given clozapine 10 mg therapy in the morning and at night, in addition, Olanzapine 10 mg was given intramuscularly if needed. However, on the third day after starting treatment, the patient began complaining of low-grade fever (37.8°C), nausea, and fatigue. Laboratory tests showed an increase in liver enzyme levels. However, several cases of severe liver toxicity due to clozapine use have been reported, and there are no specific guidelines for physicians to prevent or treat this condition. Close monitoring of liver function test (LFT) results is crucial in clozapine therapy, especially in considering the decision to stop treatment early if necessary.

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