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Systematic Review The Effectiveness of Fibrinolytic Therapy in STEMI Patients Anindya Widyasari Ekasuci; Laksmi Maharani; Dewi Latifatul Ilma
Acta Pharmaciae Indonesia : Acta Pharm Indo Vol 8 No 2 (2020): Acta Pharmaciae Indonesia : Acta Pharm Indo
Publisher : Pharmacy Department, Faculty of Health Sciences, Jenderal Soedirman University, Purwokerto, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.api.2020.8.2.3439

The use of fibrinolytic as a reperfusion therapy for STEMI patients has many benefits, but in its use, it is not yet decided whether fibrinolytic therapy is an effective therapy for STEMI patients. This study aimeds to evaluate and determine the effectiveness of fibrinolytic therapy for STEMI patients through a systematic review method. The selected articles PubMed and Cochrane that fulfilled the keyword search based on PICO (fibrinolytic or thrombolytic, effectiveness or efficacy), and were uploaded from 2010 to 2020 were included in this study. The searching was conducted from 15 May 2020 untill 27 June 2020. From the total of 525 searches displayed, 17 articles were included in the inclusion criteria. Research showed that fibrinolytic with rescue PCI or as adjunctive therapy is an effective therapy in STEMI patients by increasing myocardial perfusion, epicardial flow, ST segment resolution, TIMI score, peak time to troponin reach, and reduce LVEF risk. Fibrinolytic therapy with rescue PCI or as adjunctive therapy is also effective in reducing infarct size and the risk of cardiogenic shock. Fibrinolytic as pharmacoinvasive therapy is an effective therapy for patients with a diagnosis of STEMI.

Pemantauan Kadar Obat Antiepilepsi secara Farmakokinetika Terhadap Clinical Outcome pada Pasien Pediatrik Masita W. Suryoputri; Nialiana E. Endriastuti; Dewi L. Ilma
Indonesian Journal of Clinical Pharmacy Vol 10, No 4 (2021)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15416/ijcp.2021.10.4.272

Tingginya prevalensi penggunaan obat antiepilepsi pada pediatrik akan meningkatkan risiko timbulnya efek samping dan efek toksik, sehingga perlu adanya pemantauan kadar obat. Pemantauan kadar obat dapat dilakukan secara farmakokinetika dengan menghitung kadar obat dalam darah berdasarkan dosis dan frekuensi terapi yang diberikan pada responden. Penelitian ini bertujuan untuk mengetahui kadar obat antiepilepsi secara farmakokinetika dan mengetahui hubungan kadar obat terhadap clinical outcome. Penelitian ini dilakukan dengan rancangan deskriptif observasional. Pengumpulan data responden dilakukan di Komunitas Epilepsi Indonesia selama bulan Juni–Juli 2020 secara daring dan wawancara melalui telepon. Hasil penelitian ini menunjukkan bahwa dari 11 responden yang menggunakan fenitoin, hanya 1 responden (9,09%) berada di dalam rentang terapi (10–20 mg/L) dan 10 responden (90,91%) di luar rentang terapi (<10 mg/L); dari 15 reponden yang menggunakan fenobarbital, 9 responden (57,14%) berada di dalam rentang terapi (15–40 mg/L) dan 6 responden (42,86%) di luar rentang terapi (<15 mg/L dan >40 mg/L); dari 23 responden yang menggunakan asam valproat secara monoterapi, 7 responden (30,44%) berada di dalam rentang terapi (50–100 mg/L) dan 16 responden (69,56%) di luar rentang terapi (<50 mg/L dan >100 mg/L), dan dari 24 responden yang menggunakan asam valproat secara politerapi, 18 responden (75%) berada di dalam rentang terapi (50–100 mg/L) dan 6 responden (25%) di luar rentang terapi (<50 mg/L dan >100 mg/L). Tidak terdapat hubungan yang signifikan (p>0,05) antara kadar obat dengan clinical outcome yang diperoleh pada responden yang menggunakan terapi asam valproat baik monoterapi maupun politerapi. Simpulan pada penelitian ini adalah dari responden yang menggunakan obat antiepilepsi, sebanyak 38 responden (52,05%) dari antaranya memiliki kadar tidak sesuai kisaran terapi dan 35 responden (47,95%) dari antaranya memiliki kadar obat sesuai kisaran terapi. Perlu dilakukan pemantauan kadar obat antiepilepsi secara langsung terhadap responden yang memiliki kadar obat tidak sesuai kisaran terapi untuk menghindari efek toksik dan meningkatkan clinical outcome yang diinginkan.Kata kunci: Antiepilepsi, clinical outcome, pemantauan kadar obat Effects of Antiepileptic Drug Levels on Clinical Outcomes in Pediatric Patients Using Pharmacokinetics ApproachAbstractThe high prevalence of antiepileptic drug use in pediatrics increases the risk of side and toxic effects; therefore, it is necessary to monitor drug levels. Therapeutic drug monitoring is conducted through pharmacokinetics by calculating blood drug levels based on respondents' dose and frequency of therapy. This study aimed to determine the pharmacokinetics of antiepileptic drug levels and the correlation with clinical outcomes using descriptive observational design. Furthermore, the Indonesian Epilepsy Community collected respondents' data from June to July 2020 through online and telephone interviews. Out of the 11 respondents that recieved phenytoin, only 1 (9.09%) was in the therapeutic range (10–20 mg/L), while 10 (90.91%) were outside the therapeutic range (<10mg/L). From the 14 respondents that received phenobarbital, 8 (57.14%) were in the therapeutic range (15–40 mg/L), and 6 (42.86%) were outside the therapeutic range (<15 mg/L and >40 mg/L). From the 47 respondents that received valproic acid, 23 were administered through monotherapy, 7 (30.44%) were in the therapeutic range (50–100 mg/L), and 16 (69.56%) were outside the therapeutic range (<50 mg/L and >100mg/L). Out of the 24 respondents that received valproic acid as monotherapy, 18 (75%) were in the therapeutic range (50–100 mg/L), and 6 (25%) were outside the therapeutic range (<50 mg/L and >100mg/L). The results showed that there was no significant relationship (p>0.05) between drug levels and clinical outcome in respondents treated with either monotherapy or polytherapy of valproic acid. In conclusion, a total of 38 respondents (52.05%) had drugs levels outside the therapeutic range, while 35 (47.95%) had drug levels in the therapeutic range. Furthermore, respondents with drug levels outside the therapeutic range require direct monitoring of antiepileptic drug levels to avoid toxic effects and improve clinical outcomes. Keywords: Antiepileptic, drug levels monitoring, clinical outcome

Faktor-Faktor Yang Berhubungan Dengan Luaran Klinis Asam Valproat Pada Epilepsi Pediatri Dewi Latifatul Ilma; Nialiana Endah Endriastuti; Masita Wulandari Suryoputri
Acta Pharmaciae Indonesia : Acta Pharm Indo Vol 9 No 1 (2021): Acta Pharmaciae Indonesia : Acta Pharm Indo
Publisher : Pharmacy Department, Faculty of Health Sciences, Jenderal Soedirman University, Purwokerto, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.api.2021.9.1.4060

Epilepsi merupakan penyakit kronis dengan prevalensi tinggi pada pediatrik. Salah satu obat anti epilepsi yang banyak diresepkan pada pediatrik adalah asam valproat. Luaran klinis utama pengobatan anti epilepsi adalah tercapainya periode bebas kejang. Tercapainya luaran klinis epilepsi sulit diprediksi karena dipengaruhi oleh banyak faktor. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan luaran klinis pasien epilepsi pediatrik yang menggunakan asam valproat. Pengambilan data dilakukan melalui wawancara kepada orangtua/wali pasien. Epilepsi dikatakan terkontrol jika tercapai periode bebas kejang ≥6 bulan selama menggunakan asam valproat. Analisis data dilakukan dengan uji chi square atau uji Fisher, dilanjutkan dengan uji regresi logistik binomial. Pasien pada penelitian ini berjumlah 39 pasien. Sebagian besar pasien pediatri (64.1%) yang menggunakan terapi asam valproat memiliki epilepsi yang terkontrol, dengan 20 pasien (51.3%) menggunakan monoterapi asam valproat. Faktor yang berhubungan dengan luaran klinis pasien adalah jumlah obat antiepilepsi yang digunakan (p-value <0.05).

Potensi interaksi obat nutrasetikal pada epilepsi anak Nialiana Endah Endriastuti; Masita Wulandari Suryoputri; Dewi Latifatul Ilma; Tunggul Adi Purwonugroho
Acta Pharmaciae Indonesia : Acta Pharm Indo Vol 10 No 1 (2022): Acta Pharmaciae Indonesia : Acta Pharm Indo
Publisher : Pharmacy Department, Faculty of Health Sciences, Jenderal Soedirman University, Purwokerto, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.api.2022.10.1.4352

Background: The trend of using nutraceuticals in Indonesia increases every year. This study aims to describe nutraceuticals consumed in pediatrics with epilepsy as additional antiepileptic therapy and analyze their potential drug interactions. Methods: This research was a cross-sectional study with total sampling method which was carried out in the period of June to July 2020. Inclusion criteria were children with epilepsy aged 0-17 years who were members of the Indonesian Epilepsy Community, had a doctor's diagnosis of epilepsy, received oral antiepileptic medication, and took nutraceutical products/food supplements. Data were analyzed descriptively based on data obtained through electronic data filling sheets and interviews. Results: There were 106 participants from the Indonesian Epilepsy Community in total, with 14 children (13.2 %) using nutraceutical supplements. They were male (n=8; 57.1%), 2-12 years old (n=10; 71.4%), and good nutritional status (n=10; 71.4%). Most nutraceuticals consumed were dietary supplements containing vitamins (n=10; 71.4%). Of the eight potential drug interactions identified, 25% (n=2) were significant interactions, and 75% (n=6) were minor interactions. The potential for major interactions occurred in administering nutraceutical products containing vitamin D with the antiepileptic drug phenytoin and phenobarbital. Conclusion: In this study, nutraceuticals and antiepileptic drugs had a little clinically meaningful interaction effect.

Perkiraan Kadar Seftazidim dalam Darah pada Pasien Pneumonia dengan Gangguan Fungsi Ginjal Dewi Latifatul Ilma; Djoko Wahyono; Ika Puspita Sari
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 9, No 3
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Pneumonia is one of the major causes of mortality due to infection in hospitalized patients. It was frequently found in patients with renal failure. Clinical outcomes of infected patients with renal failure are worse compared to patients without renal failure. The presence of renal impairment affects the pharmacokinetics of the drug. Ceftazidime is one of the most commonly used antibiotics in patients with pneumonia. Approximately, 80-90% of ceftazidime’s total drug fraction is eliminated by kidneys so that the presence of kidney disorders will affect the concentration of ceftazidime in the blood. This study aimed to determine the estimated concentration of ceftazidime in the blood and clinical outcome of pneumonia patients with renal impairment. This study was a retrospective study with descriptive observational design. Data were obtained from patient’s medical record in a hospital in Yogyakarta between January 2013-June 2017 which fulfilled the inclusion criteria, i.e., ≥18 years old patients with complete medical record data, treated in internal medicine ward with diagnosis of pneumonia (HAP/HCAP) who had chronic renal failure, and received ceftazidime for minimum 72 hours or 3 days. The number of research samples were 40 patients. This study showed that 31 patients (77.5%) had achieved estimated ceftazidime concentration in the blood above the minimum inhibitory concentration of 8 μg/ mL. After ceftazidime therapy, 19 patients (47.5%) had improved clinical outcome and 21 patients (52.5%) had not improved clinical outcome.

OFF-LABEL PEDIATRIC DRUG USE IN INDONESIA : A SYSTEMATIC REVIEW Dewi Latifatul Ilma; Nialiana Endah Endriastuti
Jurnal Farmasi Sains dan Praktis Vol 6 No 1 (2020)
Publisher : Universitas Muhammadiyah Magelang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31603/pharmacy.v6i1.3407

The phenomenon of off-label drug use has been widely observed in the pediatric population, including in Indonesia. The major concern arising from the prevalence of off-label drug use is the increased risk of adverse drug reactions. We performed a systematic review to describe and provide insight into off-label pediatric drug use in Indonesia. The articles published using English and Indonesian language was systematically searched in five electronic databases, including Pubmed, Scopus, Google Scholar, Garuda, and Neliti. Key terms used for the search were as follows: "off-label use", "off-label”,"child", "pediatrics", "infant","adolescent", "newborn", "Indonesia". A total of one hundred sixteen studies were initially obtained from an electronic database. Further, after the references were reviewed, ten articles met all the eligibility criteria that were finally selected. The percentage of off-label pediatric drug use was 32.6-89.9%. The off-label categories in the selected studies were age, dosage, contraindication, route of administration, and indication. Among these off-label categories, age was the highest off-label with percentages ranged from 19.8 to 92.9%. Pseudoephedrine hydrochloride and triamcinolone acetonide became the most frequently used drug in that category. Thus we conclude that off-label pediatric drug use is common in Indonesia. Future research should consider the safety of off-label drugs in pediatric, primarily in Indonesia. Clinicians should be aware of off-label drugs in pediatrics and consider the risk-benefit of the drugs when prescribing to children. The authorities need to regulate off-label drug prescribing in pediatrics; therefore, it could improve medication safety and quality.

THE EVALUATION OF ANTI-EPILEPTIC DRUGS DOSAGE IN MALNOURISHED CHILDREN: CASES IN INDONESIAN COMMUNITY OF EPILEPSY Nialiana Endah Endriastuti; Masita Wulandari Suryoputri; Dewi Latifatul Ilma
Jurnal Farmasi Sains dan Praktis Vol 8 No 1 (January-April 2022)
Publisher : Universitas Muhammadiyah Magelang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31603/pharmacy.v8i1.4662

Anti-epileptic drug (AED) has a narrow therapeutic index of drugs that a slight increase in dosage showed toxic effects. The therapeutic response is difficult to predict in malnutrition status because the patient with nutritional deficiency have more complicated problems likes hypoalbuminemia, macronutrient and micronutrients deficiency that affected the levels of AEDs. The nutritional deficiency could be a direct and indirect cause of ineffective AEDs therapy and also recurrent epilepsy. This study aims to describe the use of antiepileptic drugs in Indonesian children with poor nutritional status. The research design was observational studies with cross sectional random sampling to evaluate the AED doses of malnutrition status in children. All information was collected by spreading electronic forms and interviewing the parents by phone. The data were analyzed descriptively. Total of 8 malnourished children mostly included in the range of ages from >2 to 12 years (n=5; 62.50%) with means 3,9±2,7 years. The study showed valproic acid was bigger used in monotherapy (n=5; 62,50%) than polytherapy with carbamazepine or sodium phenytoin and phenobarbital. The means estimation of valproic acid monotherapy concentration in females’ group (n=2; 33,33%) showed sub-therapeutics level were Cssmin 26,09±0,57 mg/L and Cssmax 64,17±1,39 mg/L, also the means in males’ group (n=2; 33,33%) of valproic acid monotherapy were Cssmin 22.07±2,71 mg/L and Cssmax 54.27±6.66 mg/L. All of them included in good clinical outcome of free seizure > 6 months.

Potensi interaksi obat nutrasetikal pada epilepsi anak Endriastuti, Nialiana Endah; Suryoputri, Masita Wulandari; Ilma, Dewi Latifatul; Purwonugroho, Tunggul Adi
Acta Pharmaciae Indonesia Vol 10 No 1 (2022): Acta Pharmaciae Indonesia : Acta Pharm Indo
Publisher : Pharmacy Department, Faculty of Health Sciences, Jenderal Soedirman University, Purwokerto, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.api.2022.10.1.4352

Background: The trend of using nutraceuticals in Indonesia increases every year. This study aims to describe nutraceuticals consumed in pediatrics with epilepsy as additional antiepileptic therapy and analyze their potential drug interactions. Methods: This research was a cross-sectional study with total sampling method which was carried out in the period of June to July 2020. Inclusion criteria were children with epilepsy aged 0-17 years who were members of the Indonesian Epilepsy Community, had a doctor's diagnosis of epilepsy, received oral antiepileptic medication, and took nutraceutical products/food supplements. Data were analyzed descriptively based on data obtained through electronic data filling sheets and interviews. Results: There were 106 participants from the Indonesian Epilepsy Community in total, with 14 children (13.2 %) using nutraceutical supplements. They were male (n=8; 57.1%), 2-12 years old (n=10; 71.4%), and good nutritional status (n=10; 71.4%). Most nutraceuticals consumed were dietary supplements containing vitamins (n=10; 71.4%). Of the eight potential drug interactions identified, 25% (n=2) were significant interactions, and 75% (n=6) were minor interactions. The potential for major interactions occurred in administering nutraceutical products containing vitamin D with the antiepileptic drug phenytoin and phenobarbital. Conclusion: In this study, nutraceuticals and antiepileptic drugs had a little clinically meaningful interaction effect.

Pengaruh Keterampilan Komunikasi Apoteker di Banyumas Terhadap Tingkat Kepercayaan dan Loyalitas Masyarakat Baturraden Sartana, Btari Asa; Pratiwi, Hening; Ilma, Dewi Latifatul Ilma
Pharmaceutical Journal of Indonesia Vol. 8 No. 2 (2023)
Publisher : Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.pji.2023.008.02.8

Keterampilan komunikasi apoteker dibutuhkan dalam pelayanan kefarmasian karena dapat meningkatkan kualitas pelayanan dengan membangun hubungan baik dengan pasien. Hubungan baik ini dapat membangun kepercayaan dan loyalitas pasien kepada apoteker. Penelitian ini bertujuan untuk mengetahui pengaruh keterampilan komunikasi secara langsung terhadap loyalitas atau tidak langsung dengan harus mendapatkan kepercayaan pasien terlebih dahulu. Penelitian ini menggunakan desain cross sectional. Pengambilan data dilakukan pada Juli 2021 - Agustus 2021 di Kecamatan Baturraden dengan teknik purposive sampling pada responden dengan kriteria berusia 18-55 tahun dan mendapat pelayanan kefarmasian oleh apoteker di apotek Kebupaten Banyumas dalam 3 bulan terakhir. Sebanyak 106 data responden dianalisis secara deskriptif, uji asumsi klasik, dan analisis jalur yang disertai uji sobel untuk mengetahui pengaruh antar variabel. Keterampilan komunikasi Apoteker di Banyumas dinilai cukup baik (76,41%). Tingkat kepercayaan dan loyalitas masyarakat Baturraden dinilai sedang (66,98%; 71,7%). Keterampilan komunikasi apoteker berpengaruh positif dan signifikan secara tidak langsung terhadap loyalitas melalui kepercayaan sebagai variabel intervening (β = 0,647; 0,607; p-value <0,001; z score = 4,611). Namun tidak signifikan secara langsung terhadap tingkat loyalitas (β = 0,049; p-value = 0,626).

Qualitative analysis of Indonesian hospital pharmacist’s perceptions of their roles and behaviour during the covid-19 pandemic Prasetyaningrum, Dina Ayu; Purwonugroho, Tunggul Adi; Mustikaningtia, Ika; Ilma, Dewi Latifatul; Sholihat, Nia Kurnia; Maharani, Laksmi
Academic Hospital Journal Vol 6, No 2 (2024)
Publisher : Rumah Sakit Akademik Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ahj.v6i2.100052

AbstractBackground: Pharmacists are health workers who play an important role in dealing with COVID-19 pandemic problems. This study explored the hospital pharmacist's perception of their roles and behaviours and the influence factors during the COVID-19 pandemic period.Material and Methods: The research was conducted using phenomenological qualitative methods through in-depth online interviews using an online meetings platform. Informants were taken until the data was saturated. Credibility tests by member checking, dependability, and confirmability tests were performed to ensure data validity. The results of the interviews then were analyzed by thematic analysis.Results: Eight informants were included with 5 emerging themes revealed from this study. The theme consists of the pharmacist's high commitment to his important role as a team member of the healthcare provider in providing the best service by adapting their services, ensuring rational therapy for COVID-19 patients, and maintaining the availability of medicines, medical devices, and consumable medical materials. Furthermore, pharmacists described some innovation strategies, like drug delivery for outpatients and telepharmacy services. The supporting factors for pharmacists in their services were interprofessional collaboration between pharmacists and other healthcare providers. Support from colleagues, hospital management, government, donations and technology were also revealed as positive factors. The barrier factors included uncertain pandemic conditions, pharmacists who were exposed to the virus and the mental health condition of healthcare professionals during the pandemic.Conclusion: Pharmacists have a strong commitment to playing a crucial part in the healthcare team in offering the most treatment possible and providing management work. They created some innovative initiatives to tackle the COVID-19 burden. Supportive and barrier factors that affect pharmacist performance during pandemics were also disclosed and examined in this paper.Keywords:

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