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Survei Pengetahuan Dokter Spesialis terhadap Penggunaan Opiat pada Tatalaksana Nyeri Kanker di Rumah Sakit Pemerintah, Jakarta, 2017 INDRAYANI, LENNY; SETIABUDY, RIANTO; SOETIKNO, VIVIAN; IRAWAN, COSPHIADY
Indonesian Journal of Cancer Vol 11, No 4 (2017): October- December 2017
Publisher : Indonesian Journal of Cancer

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Treatment of cancer pain often requires opioids, and morphine is a gold standard in the management of severe cancer pain. Inadequate knowledge of cancer pain management causes opioid usage is not optimal. Indonesia is one of the countries with very low opioid consumption. The purpose of this study was to find out the physicianâs knowledge about the management of cancer pain in choosing opioid, administration, doses, side effects, addiction and factors of opioid that barrier in pain management. This cross-sectional study was conducted in General Hospital Jakarta and a Private Hospital in Tangerang. Inclusion criteria were medical specialist who treating cancer pain. This study used questionnaires that filled out by respondents and confidential. Score of adequate knowledge was â¥ 70, and to assess the relationship between knowledge of opioid use with specialization analyzed by Chi-square test and Fisherâs exact if Chi-square requirement is not fulfilled. Statistical analysis was performed by SPSS version 20. From a total of 146 distributed questionnaires, we received 103 questionnaires (70,5%). In this study, the majority of respondents (69,9%) had inadequate knowledge. The highest rate (70,55) was found in the choosing opioid section, while the lowest rate (49,5) was found in the opioid side effects section. There is no significant relationship between physician knowledge on opioid usage and specialization (P= 0,355). Government regulation is major obstacle to opioid use, followed by lack of training, drug availability and knowledge of side effectsÂ ABSTRAK Penatalaksanaan nyeri kanker sering kali membutuhkan opiat dengan morfin sebagai gold standard menurut panduan WHO analgesic step ladder . Pengetahuan penalaksanaan nyeri kanker yang kurang menyebabkan penggunaan opiat yang tidak optimal. Indonesia merupakan salah satu negara dengan konsumsi opiat yang sangat rendah. Tujuan studi ini adalah untuk mengetahui pengetahuan dokter mengenai penanganan nyeri kanker dalam pemilihan opiat, cara pemberian, dosis, efek samping, dan adanya adiksi, serta faktor-faktor yang menjadi penghambat pada penanganan nyeri kanker. Desain penelitian ini merupakan survei potong lintang ( cross sectional ) yang dilakukan terhadap dokter spesialis yang menangani nyeri kanker di Rumah Sakit Umum Pemerintah Jakarta dan salah satu rumah sakit swasta di Tangerang. Penelitian ini menggunakan kuesioner yang diisi responden dan bersifat rahasia. Pengetahuan dianggap baik bila nilai â¥ 70. Sedangkan untuk menilai hubungan antara pengetahuan tentang penggunaan opiat dengan bidang spesialisasi dokter dianalisis dengan uji Chi-square . Hasil statistik dianalisis dengan menggunakan SPSS versi 20. Dari total 146 kuesioner yang didistribusikan, didapatkan 103 kuesioner (70,5%) yang direspons. Pada penelitian ini, mayoritas responden (69,9%) mempunyai pengetahuan yang tidak adekuat. Rerata tertinggi didapatkan pada bagian pemilihan opiat 70,55; sedangkan rerata terendah didapatkan pada bagian efek samping opiat, yaitu 47,56. Tidak terdapat hubungan bermakna antara pengetahuan dokter tentang penggunaan opiat dengan bidang spesialisasi (P= KORESPONDENSI: Lenny Indrayani Departemen Farmakologi dan Terapeutik, Universitas Indonesia. Email: lenny3ma@gmail.com Indonesian Journal of Cancer Vol. 11, No. 4 October - December 2017160 0,355). Regulasi pemerintah merupakan penghambat utama pada penggunaan opiat, disusul dengan kurangnya pelatihan, ketersediaan obat dan pengetahuan tentang efek samping.

Evaluation of Kidney Injury Molecule-1 (KIM-1) and Neutrophil Gelatinase-Associated Lipocalin (NGAL) Urinary Levels for Detecting Kidney Dysfunction in Patients With Nasopharyngeal Cancer Treated With Cisplatin-Based Treatment Rejeki, Marliana Sri; Arozal, Wawaimuli; Setiabudy, Rianto; Atmakusuma, Djumhana
Indonesian Journal of Cancer Vol 12, No 2 (2018): April-June
Publisher : National Cancer Center - Dharmais Cancer Hospital

Background: Cisplatin has a potency of causing nephrotoxicity. Serum BUN and creatinine levels have been well-known for detecting kidney dysfunction; while KIM-1 and NGAL urine levels are relatively new measurements. The study was aimed to evaluate urinary KIM-1 and NGAL level to detect kidney dysfunction in patients with advanced stage NPC who received cisplatin-based chemotherapy.Methods: The study was a cohort-prospective study with 3 subject groups, i.e. patients who had never received and who had received 75-100 mg/m2 cisplatin-based chemotherapy as well as those who had never received 40 mg/m2 cisplatin-based chemotherapy. The levels of urinary KIM-1, NGAL and serum level of BUN and creatinine were measured before and after receiving cisplatin. Statistical analyses were ANOVA, Pearson, Spearman, Kolmogorov-Smirnov test and SPSS version 22.0.Result: There was a significant difference of delta BUN level (p=0.0001) and delta urinary NGAL level (p = 0.025) before and after treatment in all three groups; while delta KIM-1 level showed no significant difference in all three groups (p=0.275). Cisplatin may cause accumulated nephrotoxicity, which has dose-dependent manner.Conclusion: Measuring urinary NGAL level can detect an early stage of kidney dysfunction; however, it still cannot replace the role of BUN. Measurement of urinary KIM-1 level cannot detect kidney dysfunction.

The Role of Melatonin in Improving Hypoxia in Malignant Tumor: A Mini-Review Kartini, Diani; Taher, Akmal; Panigoro, Sonar S.; Setiabudy, Rianto; Jusman, Sri W; Haryana, Sofia M; Abdullah, Murdani; Rustamadji, Primariadewi
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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KADAR 2,3-DINOR-6-KETO-PROSTAGLANDIN-F1 DALAM URIN WANITA PASCAMENOPAUSE ALAMI DAN PRAMENOPAUSE YANG MINUM ASPIRIN 100 MG Arieselia, Zita; Setiawati, Arini; Setiabudy, Rianto; Baziad, Ali
Bahasa Indonesia Vol 10 No 2 (2011): Damianus Journal of Medicine
Publisher : Atma Jaya Catholic University of Indonesia

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Background: The prevalence of cardiovascular diseases in women increases sharply after menopause. In postmenopausal women, thromboxane production increases while prostacyclin production decreases. Low dose aspirin (75- 150 mg) has long been known as an antiplatelet aggregator. Aspirin reduces the production of both thromboxane (potent thrombocyte aggregator and vasoconstrictor) and prostacyclin (anti thrombocyte aggregator and potent vasodilator).Methods: The present study was an open-label clinical trial with 2 parallel groups. One group consisted of 15 premenopausal women (age > 40 years) while the other group 15 postmenopausal women (for 3 - 5 years). Twenty-four hours urine was collected from each subject before and after aspirin 100 mg daily for 7 days. The concentration of prostacyclin was measured as its metabolite (2,3-dinor-6-keto-prostaglandin-F1) in urine using EIA (Enzyme Immunoassay). Thromboxane as its urinary metabolites (11-dehidrotromboksan-B2) was also measured in these same urine samples in the previous study.Results: Previous study showed that aspirin significantly reduced thromboxane in both groups, with significantly larger percentage reduction in postmenopausal women compared to premenopausal women. Results of the present study showed that aspirin reduced prostacyclin significantly in both premenopausal women (mean difference = 78.44 ng/g creatinine; p = 0.001) and postmenopausal women (mean difference = 35.71 ng/g creatinine; p <0.001), but the percentage reduction between the groups was not significantly different (46,26% vs. 40,94%; p = 0,574). The decrease in thromboxane and prostacyclin should be compared (as the decrease in the ratio of 11-dehidrotromboksan-B2 / 2,3-dinor-6-keto-prostaglandin-F1) to assess aspirin efficacy as an antithrombotic. Calculation of the ratio of 11-dehidro-tromboksanB2 / 2,3-dinor-6-keto-prostaglandin-F1 before aspirin consumption was much higher in postmenopausal women compared to that in premenopausal women (4.09 vs. 1.13; p = 0.001). The decrease in 11-dehidro-tromboksan-B2 / 2,3- dinor-6-keto-prostaglandin-F1? ratio by aspirin was found much larger in postmenopausal women compared to that in premenopausal women (1.91 vs.0.17; p = 0.022).Conclusions: It was concluded that aspirin reduced prostacyclin significantly in each group with nonsignificant percentage reduction between groups, but reduced the 11-dehidro-tromboksan-B2/2,3-dinor-6-keto-prostaglandin-F1? ratio much larger in post-menopausal women compared to that in premenopausal women.

Implikasi Klinis Variasi Jumlah Copy Gen CYP2D6 Gayatri, Anggi; Ascobat, Purwantyastuti; Setiabudy, Rianto
Generics: Journal of Research in Pharmacy Vol 3, No 2 (2023): Generics: Journal of Research in Pharmacy, Volume 3, Edisi 2, 2023
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/halal.v%vi%i.19085

Enzim CYP2D6 adalah salah satu varian sitokrom P450 (CYP450) yang berperan dalam metabolisme obat di hati. Isoform ini berperan dalam memetabolisme 25% obat yang saat ini beredar di pasaran. Aktivitas CYP450 dapat dipengaruhi oleh berbagai faktor seperti usia, jenis kelamin, fungsi organ pemetabolisme, jenis dan derajat penyakit, serta variasi genetik. Salah satu faktor penentu aktivitas CYP2D6 adalah sifat gene CYP2D6 yang sangat polimorfik. Faktor penentu polimorfisme gen CYP2D6 adalah mutasi pada nukleotida tunggal (single nucleotide polymorphisms (SNPs)) dan variasi jumlah copy (copy number variation (CNV)) gen CYP2D6. Kejadian mutasi gen dan variasi jumlah copy gen CYP2D6 dapat meningkatkan atau menurunkan aktivitas enzim CYP2D6 yang selanjutnya dapat menurunkan atau meningkatkan efikasi obat yang merupakan substrat CYP2D6 ataupun dapat menimbulkan toksisitas obat. Berbagai penelitian telah dilakukan untuk mengevaluasi hubungan mutase SNPs gen CYP2D6 dengan efek obat. Dalam tinjauan kali ini akan dibahas mengenai pengaruh variasi jumlah copy (copy number variation) gen CYP2D6 terhadap efek terapi ataupun efek samping obat.

Implikasi Klinis Variasi Jumlah Copy Gen CYP2D6 Gayatri, Anggi; Ascobat, Purwantyastuti; Setiabudy, Rianto
Generics: Journal of Research in Pharmacy Vol 3, No 2 (2023): Generics: Journal of Research in Pharmacy, Volume 3, Edisi 2, 2023
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/halal.v%vi%i.19085

Enzim CYP2D6 adalah salah satu varian sitokrom P450 (CYP450) yang berperan dalam metabolisme obat di hati. Isoform ini berperan dalam memetabolisme 25% obat yang saat ini beredar di pasaran. Aktivitas CYP450 dapat dipengaruhi oleh berbagai faktor seperti usia, jenis kelamin, fungsi organ pemetabolisme, jenis dan derajat penyakit, serta variasi genetik. Salah satu faktor penentu aktivitas CYP2D6 adalah sifat gene CYP2D6 yang sangat polimorfik. Faktor penentu polimorfisme gen CYP2D6 adalah mutasi pada nukleotida tunggal (single nucleotide polymorphisms (SNPs)) dan variasi jumlah copy (copy number variation (CNV)) gen CYP2D6. Kejadian mutasi gen dan variasi jumlah copy gen CYP2D6 dapat meningkatkan atau menurunkan aktivitas enzim CYP2D6 yang selanjutnya dapat menurunkan atau meningkatkan efikasi obat yang merupakan substrat CYP2D6 ataupun dapat menimbulkan toksisitas obat. Berbagai penelitian telah dilakukan untuk mengevaluasi hubungan mutase SNPs gen CYP2D6 dengan efek obat. Dalam tinjauan kali ini akan dibahas mengenai pengaruh variasi jumlah copy (copy number variation) gen CYP2D6 terhadap efek terapi ataupun efek samping obat.

Effects of Physalis angulata extracts on bleomycin-induced rat: analysis on lung inflammation and fibrosis Wibowo, Suryo Anggoro Kusumo; Rumende, Cleopas Martin; Isbagio, Harry; Setiyono, Agus; Setiabudy, Rianto; Rachmadi, Lisnawati; Kertia, Nyoman
Medical Journal of Indonesia Online First
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257875

BACKGROUND Scleroderma is an immune-mediated connective tissue disease, with interstitial lung disease as one of its manifestations. Physalis angulata (P. angulata) or ciplukan has shown potential in treating fibrosis, but its role in preventing lung inflammation and fibrosis remains unknown. This study aimed to evaluate the effect of P. angulata extract in a bleomycin (BLM)-induced scleroderma rat. METHODS Sprague-Dawley rats were divided into 6 groups. For lung inflammation prevention, 3 groups received: (1) BLM only, (2) BLM+50 mg/kgBW P. angulata, and (3) BLM+100 mg/kgBW P. angulata. After 14 days, rats were sacrificed and bronchoalveolar lavage (BAL) leukocyte count, interleukin-6 (IL-6) levels, and lung injury score were assessed. For fibrosis prevention, another 3 groups received the same interventions and were sacrificed after 51 days. Fibrosis score, fibrosis area, hydroxyproline, transforming growth factor-beta (TGF-β), and matrix metalloproteinase-13 (MMP-13) levels were analyzed. BLM was administered subcutaneously, while P. angulata was given orally for 14 days. IL-6, TGF-β, and MMP-13 were measured by ELISA and hydroxyproline by colorimetric method. Mean differences and p-values were calculated using appropriate statistical tests. RESULTS P. angulata extract did not prevent lung inflammation, as there were no differences in BAL leukocyte count (p = 0.126), IL-6 levels (p = 0.173), or lung injury scores (p = 0.397) between the BLM-only group and those receiving P. angulata. The extract also did not prevent lung fibrosis, with no differences in fibrosis scores (p = 0.173), fibrosis area (p = 0.359), hydroxyproline (p = 0.295), TGF-β (p = 0.374), or MMP-13 (p = 0.088) levels among groups. CONCLUSIONS P. angulata extract did not prevent the development of lung inflammation or fibrosis.

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