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KAJIAN KEAMANAN ANTIHIPERTENSI PASIEN GAGAL GINJAL KRONIK LANJUT USIA DI UNIT HEMODIALISA RSUP DR. SARDJITO YOGYAKARTA Setyaningrum, Ndaru; Pramantara, I Dewa Putu
JFIOnline | Print ISSN 1412-1107 | e-ISSN 2355-696X Vol 9, No 1 (2017): Punica Granatum
Publisher : Indonesian Research Gateway

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

ABSTRACT : The growth of elderly population increase fastest among the other age group. The elderly population been related to decrease renal function and other comorbidity as consequence of aging. The aim of this study is to know how about adverse drug reaction (ADR) and potential interaction of antihypertension drug in chronic kidney disease patient. This is a descriptive study about elderly patient with chronic kidney disease on period October 22th 2012 – January 22th 2013. This study use Naranjo scale to evaluate ADR and Tatro Drug Interactions Fact to evaluate potential drug interaction. There were 38 subjects analized, age < 70 years old (24 patients) and ≥ 70 years old (14 patients); gender men (26 patients) and women (12 patients); duration hemodialysis < 8 months (8 patients) and ≥ 8 months (30 patients); comorbidity DM (23 patients) and non DM (15 patients). There were probable ADR 4 events (10,8%) consist of nifedipine (2 events), lisinoprile (1 event) and captoprile (1 event). There were 14 events (37,8%) potential drug interactions consist of minor interaction (12 events) 32,4% and major interaction (2 events) 5,4%. This study show that there were actual probable ADR 10,8% and potential drug interaction 37,8%.

Status Partisipasi dan Kualitas Hidup Peserta Pos Pelayanan Terpadu Lanjut Usia Dewi, Syamsumin Kurnia; Kusnanto, Hari; Pramantara, I Dewa Putu; Rahayujati, Theodola Baning
Kes Mas: Jurnal Fakultas Kesehatan Masyarakat Vol 11, No 1 (2017): Kes Mas: Jurnal Fakultas Kesehatan Masyarakat
Publisher : Universitas Ahmad Dahlan

Background: Demographic and epidemiologic transition now occurred in the District of Bantul could be followed by decreasing quality of life in elderly. Community elderly care service (CECS) is a primary service for elderly with potential to support increasing quality of life in elderly. Based on previous study, utilization of CECS was high (73.30%) at subdistrict of Bambanglipuro, Bantul. To know the relationship between participation status and quality of life in CECS participants at subdistrict of Bambanglipuro. Method: A cross-sectional study was conducted from April to May 2012. Samples were selected with consecutive sampling technique. Data were collected from 8 CECSs at subdistrict of Bambanglipuro. Quality of life was measured with short form 36 (SF-36) Health Survey, including physical component summary (PCS) and mental component summary (MCS). Data then were analyzed with descriptive and analytic methods using Chi-square test and multiple logistic regression. Results: Of 238 subjects investigated, 186 (78.20%) were good in PCS and 194 (81.50%) were good in MCS. Multivariate analysis showed that active in physical exercise of CECS program, absence of hypertension, and better economic status were related to better PCS (aPR: 5.31, 95%CI: 2.52-11.20; aPR: 3.41, 95%CI: 1.31-5.47; aPR: 2.68; 95%CI: 1.31-5.47) and better MCS (aPR: 3.97, 95%CI: 1.83-8.64; aPR: 3.08, 95%CI: 1.39-6.82; aPR: 6.38; 95%CI: 2.62-15.53). Conclusion: Dominant factors that related to better quality of life in CECS participants were: active in physical exercise program of CECS, absence of hypertension and better economic status.

ANALISIS FAKTOR YANG MEMPENGARUHI KEPATUHAN PENGAMBILAN OBAT PESERTA PROGRAM RUJUK BALIK DI BANDAR LAMPUNG Setyaningrum, Ndaru; Pramantara, I Dewa Putu
Jurnal Farmasi Indonesia Vol 9, No 1 (2017)
Publisher : Jurnal Farmasi Indonesia

ABSTRACT : Program (Program Rujuk Balik = PRB) through a health care program for the participants of the National Health Insurance with chronic diseases. Barriers to success of therapeutic treatment for patients with chronic diseases is non-adherenceÂ related to the patient's treatment regimen. Taking medication adherence for patients with chronic illness is the first adherence can be assessed on how a person decides to get medicines for themselves. Analyzing factors affecting medication adherence taking participants PRB is important, cause non-adherence adverse effects appear in the treatment.Â Participants adherence taking the drug on a PRB can be obtained from the data prescription claims to calculate the medication possession ratio (MPR), which MPR â?¥ 80% declared adherence. Data obtained fromÂ prescription claim by participants PRB forÂ September 2015 until December 2015 in Bandar Lampung. Sample case study 82 people with diabetes. The calculation result MPR explains that 62.2% of respondents declared adherence taking medication, while 37.8% of respondents declared non-adherence. The results of theÂ logistic regression analysis, stating that there are influences together of factors respondents' knowledge, respondents belief, attitudes of personnel pharmacy services, pharmacy facilities, cost, availability of medication PRB, family support, and accessibility affect to respondent adherence ofÂ taking medication. However, factors that significantly influence medication adherence refer the decision back is knowledge of respondents with sig = 0,028 (sig <0.05), belief of respondents with sig = 0,003 (sig <0.05), and accessibility sig = 0,044 (sig < 0.05) significantly affect to adherence Â of taking medication.

KAJIAN KEAMANAN ANTIHIPERTENSI PASIEN GAGAL GINJAL KRONIK LANJUT USIA DI UNIT HEMODIALISA RSUP DR. SARDJITO YOGYAKARTA Setyaningrum, Ndaru; Pramantara, I Dewa Putu
Jurnal Farmasi Indonesia Vol 9, No 1 (2017)
Publisher : Jurnal Farmasi Indonesia

ABSTRACT : The growth of elderly population increase fastest among the other age group. The elderly population been related to decrease renal function and other comorbidity as consequence of aging. The aim of this study is to know how about adverse drug reaction (ADR) and potential interaction of antihypertension drug in chronic kidney disease patient. This is a descriptive study about elderly patient with chronic kidney disease on period October 22th 2012 â?? January 22th 2013. This study use Naranjo scale to evaluate ADR and Tatro Drug Interactions Fact to evaluate potential drug interaction. There were 38 subjects analized, age < 70 years old (24 patients) and â?¥ 70 years old (14 patients); gender men (26 patients) and women (12 patients); duration hemodialysis < 8 months (8 patients) and â?¥ 8 months (30 patients); comorbidity DM (23 patients) and non DM (15 patients). There were probable ADR 4 events (10,8%) consist of nifedipine (2 events), lisinoprile (1 event) and captoprile (1 event). There were 14 events (37,8%) potential drug interactions consist of minor interaction (12 events) 32,4% and major interaction (2 events) 5,4%. This study show that there were actual probable ADR 10,8% and potential drug interaction 37,8%.Â Â

PROBLEM PEMILIHAN OBAT PADA PASIEN RAWAT INAP GERIATRI DI RSUP DR. SARDJITO YOGYAKARTA Rahmawati, Fita; Ellykusuma, Nany Yusuf; Pramantara, I Dewa Putu; Sulaiman, Syed Azhar Syed
Jurnal Farmasi Indonesia Vol 4, No 1 (2008)
Publisher : Jurnal Farmasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35617/jfi.v4i1.5

Old age is associated with chronic diseases and disabilities, which in turn require multiple medications. This often complicate diagnosed and appropriate drug therapy. The aim of the study was to determine types and number of inappropriate drug in geriatric patients in Bougenville Ward Dr. Sardjito Hospital Yogyakarta. Research type is descriptive. Data taken prospectively during two period, January to February 2006 and Agust to October 2006. The study was conducted in 100 geriatric patients hospitalized with inclusion criteria 65 years old and above and admission into Bougainville ward (interne department) RSUP Dr. Sardjito Hospital, Yogyakarta. Data collecting was conducted through medical record then adjustment of inappropriate drug of choice was identified by pharmacist-physician discussion. Evaluation of the data was carried out descriptively. The result of the study showed that inappropriate drug of choice occurred in 48 cases. This problem include more effective drug available 12 cases, contraindication present 15 cases, dosage form inappropriate 2 cases, condition refractory to drug 1 case, drug not indicated (unsafe) for condition 9 cases, patient received unnecessary multiple drug combination 9 cases. The finding of our study support pharmacist in collaboration between physician-pharmacist-nurse can effectively reduce incidence of Drug Related Problems in geriatric patient. ABSTRAK Penelitian ini bertujuan untuk mengetahui jumlah dan persentase Drug-Related Problems (DRPs) yang terjadi pada pasien geriatri di Bangsal Bougenville IRNA I RSUP Dr. Sardjito Yogyakarta. Penelitian bersifat deskriptif, pengambilan data dilakukan secara prospektif pada 100 pasien dengan kriteria pasien berumur lebih dari 60 tahun dan menjalani rawat inap di bangsal Bougenville IRNA I bagian Penyakit Dalam RSUP Dr. Sardjito. Data diambil pada 2 periode waktu yaitu bulan Januari â?? Februari 2006 dan bulan Agustus-Oktober 2006. Identifikasi Drug Related Problem (DRP) terkait dengan pemilihan obat yang tidak tepat dilakukan melalui diskusi dengan klinisi. Analisis data selanjutnya dilakukan secara deskriptif. Hasil penelitian menunjukkan bahwa problem pemilihan obat yang tidak tepat terjadi sejumlah 48 kasus. Problem ini meliputi obat yang diterima pasien bukan merupakan obat yang paling tepat 12 kasus, pasien menerima kombinasi obat yang tidak diperlukan sebanyak 9 kasus, obat dikontraindikasikan pemakaiannya untuk pasien sejumlah 15 kasus, obat tidak aman bagi kondisi pasien 9 kasus, bentuk sediaan tidak tepat 2 kasus, obat yang digunakan sudah merupakan obat yang paling tepat namun pada kasus tersebut tidak efektif sejumlah 1 kasus. Untuk mengurangi kejadian Drug-Related Problems (DRPs) pada pasien geriatri diperlukan peningkatan peran aktif farmasis serta kerja sama diantara tenaga medis dalam memberikan pelayanan kesehatan.

PROBLEM PEMILIHAN OBAT PADA PASIEN RAWAT INAP GERIATRI DI RSUP DR. SARDJITO YOGYAKARTA Rahmawati, Fita; Ellykusuma, Nany Yusuf; Pramantara, I Dewa Putu; Sulaiman, Syed Azhar Syed
Jurnal Farmasi Indonesia Vol 4, No 1 (2008)
Publisher : Jurnal Farmasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35617/jfi.v4i1.6

Old age is associated with chronic diseases and disabilities, which in turn require multiple medications. This often complicate diagnosed and appropriate drug therapy. The aim of the study was to determine types and number of inappropriate drug in geriatric patients in Bougenville Ward Dr. Sardjito Hospital Yogyakarta. Research type is descriptive. Data taken prospectively during two period, January to February 2006 and Agust to October 2006. The study was conducted in 100 geriatric patients hospitalized with inclusion criteria 65 years old and above and admission into Bougainville ward (interne department) RSUP Dr. Sardjito Hospital, Yogyakarta. Data collecting was conducted through medical record then adjustment of inappropriate drug of choice was identified by pharmacist-physician discussion. Evaluation of the data was carried out descriptively. The result of the study showed that inappropriate drug of choice occurred in 48 cases. This problem include more effective drug available 12 cases, contraindication present 15 cases, dosage form inappropriate 2 cases, condition refractory to drug 1 case, drug not indicated (unsafe) for condition 9 cases, patient received unnecessary multiple drug combination 9 cases. The finding of our study support pharmacist in collaboration between physician-pharmacist-nurse can effectively reduce incidence of Drug Related Problems in geriatric patient. ABSTRAK Penelitian ini bertujuan untuk mengetahui jumlah dan persentase Drug-Related Problems (DRPs) yang terjadi pada pasien geriatri di Bangsal Bougenville IRNA I RSUP Dr. Sardjito Yogyakarta. Penelitian bersifat deskriptif, pengambilan data dilakukan secara prospektif pada 100 pasien dengan kriteria pasien berumur lebih dari 60 tahun dan menjalani rawat inap di bangsal Bougenville IRNA I bagian Penyakit Dalam RSUP Dr. Sardjito. Data diambil pada 2 periode waktu yaitu bulan Januari â?? Februari 2006 dan bulan Agustus-Oktober 2006. Identifikasi Drug Related Problem (DRP) terkait dengan pemilihan obat yang tidak tepat dilakukan melalui diskusi dengan klinisi. Analisis data selanjutnya dilakukan secara deskriptif. Hasil penelitian menunjukkan bahwa problem pemilihan obat yang tidak tepat terjadi sejumlah 48 kasus. Problem ini meliputi obat yang diterima pasien bukan merupakan obat yang paling tepat 12 kasus, pasien menerima kombinasi obat yang tidak diperlukan sebanyak 9 kasus, obat dikontraindikasikan pemakaiannya untuk pasien sejumlah 15 kasus, obat tidak aman bagi kondisi pasien 9 kasus, bentuk sediaan tidak tepat 2 kasus, obat yang digunakan sudah merupakan obat yang paling tepat namun pada kasus tersebut tidak efektif sejumlah 1 kasus. Untuk mengurangi kejadian Drug-Related Problems (DRPs) pada pasien geriatri diperlukan peningkatan peran aktif farmasis serta kerja sama diantara tenaga medis dalam memberikan pelayanan kesehatan.

Plateletcrit as Risk Factor of Major Adverse Cardiac Event in Elderly Patient with Acute Coronary Syndrome Kathrine, Anita Septiana Maria; Pramantara, I Dewa Putu; Hartopo, Anggoro Budi
Acta Interna The Journal of Internal Medicine Vol 12, No 1 (2023): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.98161

Background. The morbidity and mortality of patients with acute coronary syndrome (ACS) are very high so it is important to do risk factor stratification. Several studies found that plateletcrit plays an important role in predicting mortality in STEMI patients and that it had a significant correlation as a predictor of a coronary slow flow phenomenon correlated with a worse cardiovascular outcome. The aging process is associated with altered platelet activity and a higher rate of vascular disease. The effect of aging on thrombotic function is not fully understood yet, so further research is needed. It is hypothesized that high plateletcrit increases the risk of major cardiovascular events (MACE) in elderly acute coronary syndrome (ACS) patients treated in intensive cardiac care unit (ICCU).Objective. To determine the role of plateletcrit as a risk factor for major cardiovascular events in elderly acute coronary syndrome patients.Method. We collected samples of elderly patients who experienced ACS in the period January 2016 - December 2019, recorded plateletcrit data and whether there were MACE incidents or not. The data were processed in SPSS to find a cut off of plateletcrit values which are a risk factor for the occurrence of MACE in elderly patients at Dr. Sardjito Hospital.Result. A total of 174 study subjects consisted of 58 MACE and 116 non-MACE groups, the results showed that platelecrit ≥0.35 increased the risk of MACE with a p value of 0.046 and OR 5.49.Conclusion. Plateletcrit is statistically significant to the incidence of MACE in elderly coronary syndrome patients who are treated in intensive cardiac are units.

Efektivitas H2-Receptor Antagonist dan Proton Pump Inhibitor sebagai Profilaksis Stress Ulcer pada Pasien dengan Ventilator Mekanik Saroh, Muya; Nugroho, Agung Endro; Pramantara, I Dewa Putu
Majalah Farmaseutik Vol 20, No 2 (2024)
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/farmaseutik.v20i2.88994

Pasien kritis lebih berisiko mengalami stress ulcer yang dikarenakan oleh perubahan perfusi mukosa lambung, penurunan faktor pelindung mukosa dan peningkatan asam lambung, sehingga menyebabkan risiko perdarahan saluran pencernaan bagian atas. Pemberian profilaksis stress ulcer direkomendasikan pada pasien yang memiliki faktor risiko terjadinya perdarahan stress ulcer, terutama pasien dengan penggunaan ventilator mekanis. Penelitian ini bertujuan untuk mengetahui perbandingan efikasi PPI dan H2RA sebagai profilaksis stress ulcer pada pasien dengan penggunaan ventilator mekanis.Pada studi kohort retrospektif ini, data diperoleh dari rekam medis pasien ICU dengan penggunaan ventilator mekanis di RSUD Kabupaten Temanggung dari bulan Juni 2021 hingga Mei 2023. Sebanyak 153 pasien menenuhi kriteria inklusi yang terbagi menjadi 81 pasien pada kelompok H2RA dan 72 pasien pada kelompok PPI. Efikasi profilaksis stress ulcer dinilai berdasarkan kejadian perdarahan saluran pencernaan, dikatakan memiliki efikasi yang baik jika tidak terjadi perdarahan. Kejadian perdarahan saluran cerna pada kelompok H2RA adalah 19 (23,5%) dan kelompok PPI adalah 15 (20,8%). Secara statistik tidak terdapat perbedaan efikasi profilaksis stress ulcer H2RA dan PPI dalam mencegah kejadian perdarahan saluran cerna bagian atas pada pasien dengan penggunaan ventilator mekanis (RR 1,126; 95% CI 0,619-2,047; p=0,697).

The Impact of Health Education Training on Knowledge of Prevention and Control of Hypertension among Youth Group Fitriadi, Yogi; Fajri, Imam Khoirul; Pramantara, I Dewa Putu
Review of Primary Care Practice and Education Vol 7, No 2 (2024): July
Publisher : Faculty of Medicine, Public Health, and Nursing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/rpcpe.100855

Introduction: Hypertension is a serious issue that can lead to various complications if not prevented and managed, starting from adolescence and young adulthood. Education on non-communicable diseases related to hypertension has been limited in schools, with little focus on community settings. This study aims to examine the impact of health education for adolescents and young adults on changes in knowledge and behavioral practices for the prevention and control of hypertension. Methods: This study employs a quasi-experimental design with pretest and posttest without a control group. Subjects were obtained through purposive sampling, resulting in a total of 32 respondents. Demographic characteristics and Kirkpatrick Level I evaluations were analyzed univariately. The comparison of knowledge scores before and after the intervention was analyzed bivariate, taking data normality into account. Results: After receiving health education for adolescents and young adults, there was a significant increase in knowledge scores regarding hypertension prevention and control before and after the intervention (p<0.001). The evaluation of the training program yielded very good scores, with the highest percentage from the facilitator evaluations. Conclusion: There was an increase in knowledge scores related to hypertension prevention and control among adolescents and young adults after receiving health education interventions from health professionals.

Drug-Drug Interactions (DDIs) in Elderly Hypertensive Inpatients Titami, Arina; Wiedyaningsih, Chairun; Pramantara, I Dewa Putu
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 15, No 1
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpf.101799

Background: The prevalence of hypertension is higher among the elderly population. Elderly patients are considered a high-risk population for Drug-Drug Interactions (DDIs) due to multi-morbidity-related polypharmacy, age-related physiological changes, as well as pharmacokinetic and pharmacodynamic changes.Objectives: This study conducted a drug use survey in the inpatient department of the Academic Hospital of Universitas Gadjah Mada Yogyakarta to assess Drug-drug interactions (DDIs) in individual prescriptions for elderly hypertensive patients.Methods: This research employs an observational study design with a retrospective cohort approach. This study was conducted at the Academic Hospital of Universitas Gadjah Mada Yogyakarta in January-December, 2021. The inclusion criteria for this study included patients diagnosed with hypertension, aged 60 years or older and those hospitalized. Ethical approval for this research was granted by the Faculty of Medicine, Public Health and Nursing Research Ethics Commission at Universitas Gadjah Mada, Yogyakarta under approval number KE-FK-0500-EC-2022.Results: 120 prescriptions from 120 patients were collected from the medical records maintained by the Academic Hospital of Universitas Gadjah Mada Yogyakarta. This study identified 66 cases of Drug-Drug Interactions (DDIs), mainly due to drug interactions comprising 8 interactions unrelated to hypertension, and 58 related to hypertension. Three actual drug interaction events resulted in increased blood pressure, while the others were potential drug interactions.Conclusion: From this study, it can be concluded that elderly patients are considered a natural high-risk population for DDIs. Each patient should be assessed individually based on their prescriptions, although in many cases, DDIs are unavoidable.Keywords: Drug-Drug Interactions; Elderly; Hypertension; Inpatients

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