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Drug-Related Problems in Patients with Liver Failure: An Analysis of Pharmacokinetic Interactions and Dosing Inappropriateness A Literature Review Nasution, Izza Aulia Rizqika; Reza Laila Najmi; Resi Rizki Banjarani; Sari Rahmadhani; Restu Anisa Puteri
The Journal Of Pharmacy Vol. 3 No. 2 (2026): Journal Of Pharmacy UMRI
Publisher : LPPM, Universitas Muhammadiyah Riau

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Abstract

Drug-related problems represent a major challenge in the pharmacotherapeutic management of patients with liver failure due to significant pharmacokinetic alterations, polypharmacy, and inappropriate dosing. Hepatic dysfunction affects drug absorption, distribution, metabolism, and elimination, thereby increasing the risk of adverse drug reactions, clinically significant drug–drug interactions, and therapeutic failure. This review aimed to summarize current evidence on the determinants of DRPs in patients with liver failure, focusing on pharmacokinetic changes, dose individualization, polypharmacy, and medication safety. A comprehensive literature review was conducted using PubMed, Embase, and the Cochrane Library to identify peer-reviewed studies published between 2015-2026. Keywords included liver failure, liver cirrhosis, drug-related problems, pharmacokinetics, dose adjustment, polypharmacy, and hepatic impairment. Eligible studies evaluated pharmacokinetic alterations, prescribing practices, medication safety, or clinical outcomes in adults with chronic liver disease. The findings consistently showed a high prevalence of DRPs in this population. Approximately one-quarter of commonly used medications required dose adjustment due to altered systemic exposure, while polypharmacy affected nearly one-third of patients and exceeded 50% in several cohorts. Inappropriate prescribing, inadequate dose individualization, and limited use of pharmacokinetic modeling were identified as major contributors to adverse drug reactions, hepatotoxicity, and clinically relevant drug–drug interactions. Additionally, reliance on conventional liver disease classification systems without integrating dynamic hepatic function markers often resulted in suboptimal therapy. Overall, pharmacokinetic alterations, polypharmacy, and inappropriate prescribing are key determinants of DRPs in patients with liver failure, underscoring the importance of individualized dosing, comprehensive medication review, pharmacokinetic modeling, and multidisciplinary pharmaceutical care to improve medication safety.
Integrasi Pengolahan Sampah Rumah Tangga (3R) dan Literasi Keuangan Bank Sampah pada Kader PKK RW 01 Padangsari Sari Rahmadhani; Tri Sumiyanti
JURNAL PENGABDIAN MASYARAKAT AKADEMISI Vol. 4 No. 3 (2026): JULI : JURNAL PENGABDIAN MASYARAKAT AKADEMISI
Publisher : CV. ALIM'SPUBLISHING

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59024/jpma.v4i3.2472

Abstract

Household waste management in urban areas requires an integrated approach that simultaneously addresses environmental preservation and socio-economic governance. This community service program aims to enhance the capacity of Family Welfare Empowerment (PKK) cadres in RW 01 Padangsari, Banyumanik District, Semarang City, in integrated household waste management through the 3R principles and micro-financial literacy. The service method applied Participatory Action Learning and Community Empowerment involving 32 cadres and RT representatives through five structured stages: needs assessment, 3R conceptual and practical training, waste bank financial literacy workshop, RT environmental ambassadors organizing, and comprehensive evaluation. The program resulted in a substantial cognitive improvement in 3R mastery and waste segregation, the practical adoption of odor-free kitchen composters (1:1 soil ratio), and the implementation of a standardized cash inflow-outflow ledger for neighborhood waste bank management guided by financial experts. The establishment of 5 neighborhood environmental ambassadors guarantees the sustainability of circular economy practices and transparent fund management at the household level.
Co-Authors - Astohar - Dhian AMS Abdullah Abdullah Abdullah Abdullah Adhitya Yoga Prasetya Agustinus Jaha Dili Amini, Rahmi Anastasia Wea Andi Kartika Anisa Kusumawardani Anisa, Fitri Arkanuddin Nur Arona Jaya Telaumbanua Astillero, Marlon Rael Astohar Astohar Astohar Astohar Ausgaria Ega Benediktus Ardie Reho Bhandari, Rahul Bone, Esra Eban Br Haloho, Yesicha Windi Yani Chanwut Thongkamkaew Christiani, Aqnisa DHIAN ANDANARINI MINAR SAVITRI Dian Kurniasari Dian Kurniasari Dili, Agustinus Jaha Diovany Tirtana Endamora Fatlina Z Hari, Dewi Gulyla Hasan Abdul Rozak Heri Susanto Husnunnisa Indira Djanuarti Indrasmitha, Gustyana Indriyani, Rahayu Irawan Yuswono Irfan, Nawwar Ita Nur Rahmawati Jaeni Jaeni Kase, Ratna Khazanah Nurain Nurdin Khazanah Nurain Nurdin Kikiana, Marsia Laila, Nazil Rizki Lubis, Nursyafni Lusi Indriani Mabruri, Dzikhaq Miftakhurniyati, Miftakhurniyati Muhamad Saufi Che Rusuli Mulyani Mulyani Nasution, Izza Aulia Rizqika Nico Irawan Ningly, Ira Ningrum, Dina Dwi Noor Salim Noveri Rahmawati Novtafia Endri Nur, Arkanuddin Nurdina Putri Olo, Andriana Paskah A Sinaga Praptitorini, Mirna Dyah Putri Tri Hartini Putri, Nurdina Rahayu Indriyani Rahmawati, Ita Nur Rahul Bhandari RATNA SARI Resi Rizki Banjarani Restu Anisa Puteri Restu Anisa Putri Reza laila Najmi Rizky Rindiana Rosita Rosita Rusli, Muhamad Saufi Che Shobandiyah, Siti Shobandiyah, Siti Siti Helmyati Siti Niqmatun Jannah Sugiharti Sugiharti Sugiharti Sugiharti Taswan, Taswan Tri Sumiyanti Wery, Artiany Yanto, Dwi Zati Rizka Fadhila