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All Journal Pharmaciana: Jurnal Kefarmasian JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA Jurnal Penelitian Kesehatan Suara Forikes Belitung Nursing Journal JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) JSFK (Jurnal Sains Farmasi & Klinis) Jurnal Respirologi Indonesia Jurnal Ilmu Kefarmasian Indonesia Indonesian Journal of Cancer Eduvest - Journal of Universal Studies Jurnal Farmasi Indonesia Holistik Jurnal Kesehatan Jurnal Info Kesehatan Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Nadia Farhanah Syafhan
Division Of Clinical Pharmacy, Faculty Of Pharmacy, Universitas Indonesia, Depok 16424, West Java, Indonesia | Universitas Indonesia Hospital, Jl. Prof. DR. Bahder Djohan, Pondok Cina, Beji, Depok, West Java 16424, Indonesia
Aerospace Engineering Biochemistry, Genetics & Molecular Biology Chemistry Computer Science & IT Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Other

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Literature Review on the Appropriateness of Medication Prescription in Chronic Kidney Disease Patients: Focus on Antibiotic Use Oktamauri, Ariesa; Syafhan, Nadia Farhanah; Sari, Santi Purna
Eduvest - Journal of Universal Studies Vol. 5 No. 3 (2025): Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v5i3.44784

Abstract

Chronic Kidney Disease (CKD) significantly impacts pharmacokinetics and pharmacodynamics, altering drug metabolism and excretion, thus increasing the risk of drug toxicity. CKD patients are more susceptible to infections, which contribute to significant morbidity and mortality. This underscores the importance of appropriate antimicrobials used in this population. This literature review explores recent findings on medication prescribing practices, dose adjustments, and factors affecting appropriateness, especially in antibiotic use for CKD patients. A comprehensive literature search was conducted using six databases to identify studies published from 2015 to 2024. Twenty-six studies were included. This literature review found that prevalence of inappropriate prescriptions in CKD patients ranges widely between 10% to 77.1% and from 30% to 34,9% specifically for antibiotic, with higher rates observed in outpatient settings compared to hospital environments. Antibiotics, antidiabetic agents, antihypertensive, nutraceuticals, and electrolytes are frequently inappropriately prescribed. Factors influencing inappropriate prescription include comorbidity, severity level of kidney disorder, age, and polypharmacy. The antibiotics most commonly prescribed inappropriately include cefazolin, meropenem, oral sulfamethoxazole-trimethoprim, nebulised colistin, vancomycin, and piperacillin-tazobactam. This study emphasizes the mixed and limited evidence regarding the clinical outcomes of antibiotics dose adjustments in CKD patients. While some studies suggest that antibiotics dose adjustments improve therapeutic outcomes and reduce adverse events, others show no significant impact. Further research is needed to understand the impact of this intervention, as these outcomes may be influenced by various factors. Enhanced education and collaboration between healthcare providers are critical to improving the accuracy of antibiotic prescriptions and ensuring patient safety in CKD management.
Efektivitas intervensi apoteker terhadap optimalisasi terapi opioid dan manajemen nyeri pada pasien kanker: A literature review Budiastuti, Rizky Farmasita; Sari, Santi Purna; Andrajati, Retnosari; Syafhan, Nadia Farhanah
Holistik Jurnal Kesehatan Vol. 19 No. 5 (2025): Volume 19 Nomor 5
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i5.872

Abstract

Background: Cancer pain remains a significant clinical challenge, with a high prevalence across various disease stages. Opioids are the mainstay for moderate to severe pain management but carry risks of dependence, tolerance, and serious side effects, necessitating careful supervision. Purpose: To review the effectiveness of pharmacist interventions in managing opioid use among cancer pain patients. Method: A literature search was conducted using two approaches: keyword-based searches through electronic databases (Google Scholar and Scopus) and the snowballing technique. Keywords included "cancer pain," "opioid," "pharmacist intervention," and "breakthrough pain," combined with Boolean operators. After identifying primary articles, backward and forward snowballing was performed to find additional relevant studies. All articles were screened based on predefined inclusion and exclusion criteria. Results: The review demonstrates that pharmacist interventions can improve pain control by up to 40%, reduce opioid-related side effects such as constipation by up to 50%, and enhance patient adherence to therapy. In Indonesia, however, barriers such as limited access to strong opioids, low patient education levels, and minimal pharmacist involvement in multidisciplinary teams remain significant challenges. Conclusion: Pharmacists play a strategic role in cancer pain management, particularly in optimizing pain control, minimizing opioid dependence, and managing adverse effects. Their active involvement in multidisciplinary teams enhances patients' quality of life and reduces inappropriate opioid use. Strengthening policies, providing continuous professional development, and conducting context-specific research are essential to optimize pharmacist contributions in Indonesia.   Keywords: Cancer Pain; Opioids; Pain Management; Pharmacist Intervention.   Pendahuluan: Nyeri kanker merupakan tantangan klinis utama dengan prevalensi tinggi pada berbagai tahap penyakit kanker, dan opioid menjadi terapi lini utama untuk nyeri sedang hingga berat. Namun, penggunaannya memiliki risiko ketergantungan, toleransi, serta efek samping serius, sehingga diperlukan pengawasan ketat. Tujuan: Untuk meninjau literatur terkait efektivitas intervensi apoteker dalam pengelolaan penggunaan opioid pada pasien nyeri kanker. Metode: Pencarian literatur dilakukan dengan dua pendekatan, yaitu pencarian menggunakan kata kunci melalui basis data elektronik (Google scholar dan Scopus) serta teknik snowballing. Kata kunci yang digunakan meliputi: "cancer pain", "opioid", "pharmacist intervention", dan "breakthrough pain", yang dikombinasikan menggunakan operator Boolean. Setelah diperoleh artikel utama, dilakukan teknik snowballing secara backward dan forward untuk menemukan studi relevan. Semua artikel yang diperoleh diseleksi berdasarkan kriteria inklusi dan eksklusi. Hasil: Tinjauan menunjukkan bahwa intervensi apoteker dapat meningkatkan efektivitas terapi nyeri hingga 40%, menurunkan kejadian konstipasi sebagai efek samping hingga 50%, serta meningkatkan kepatuhan pasien terhadap regimen terapi. Namun, di Indonesia, implementasi peran apoteker masih menghadapi hambatan seperti keterbatasan akses opioid kuat, kurangnya edukasi pasien, dan rendahnya keterlibatan apoteker dalam tim multidisiplin. Simpulan: Dari tinjauan ini menunjukan bahwa intervensi apoteker terbukti memiliki kontribusi strategis dalam pengelolaan nyeri kanker, khususnya melalui pengendalian nyeri yang lebih efektif, pencegahan ketergantungan opioid, dan manajemen efek samping yang lebih terstruktur. Keterlibatan apoteker dalam tim multidisiplin dapat meningkatkan kualitas hidup pasien dan menurunkan risiko penggunaan opioid yang tidak tepat. Namun, untuk mengoptimalkan peran ini, diperlukan dukungan kebijakan, pelatihan berkelanjutan, serta riset lebih lanjut dalam konteks lokal untuk menjawab tantangan implementasi di Indonesia.   Kata Kunci: Intervensi Apoteker; Nyeri Kanker; Opioid; Pengelolaan Nyeri.
Cognitive Function in Type 2 Diabetes Mellitus Patients Taking Metformin and Metformin-Sulfonylurea Rachman, Abu; Sauriasari, Rani; Syafhan, Nadia Farhanah; Prawiroharjo, Pukovisa; Risni, Hindun Wilda
Kesmas Vol. 17, No. 4
Publisher : UI Scholars Hub

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

Abstract

The most prescribed antidiabetic drugs in Indonesian primary health care are metformin or a combination of metformin and sulfonylurea. Studies on metformin have shown various impacts on cognitive decline in patients with type 2 diabetes mellitus, whereas sulfonylurea has been shown to reduce this impact. This study aimed to compare the impacts of metformin and metformin-sulfonylurea on cognitive function and determine what factors affected it. This cross-sectional study was conducted at Pasar Minggu Primary Health Care involving 142 type 2 diabetes mellitus patients taking metformin or metformin-sulfonylurea for > 6 months and aged > 36 years. Cognitive function was assessed using the validated Montreal Cognitive Assessment Indonesian version. The effects of metformin and metformin-sulfonylurea on cognitive decline showed no significant difference, even after controlling for covariates (aOR = 1.096; 95% CI = 0.523–2.297; p-value = 0.808). Multivariate analysis showed age (OR = 4.131; 95% CI = 1.271–13.428; p-value = 0.018) and education (OR = 2.746; 95% CI = 1.196–6.305; p-value = 0.017) affected cognitive function. Since a lower education and older age are likely to cause cognitive decline, health professionals are encouraged to work with public health experts to address these risk factors for cognitive function.
Co-Authors Abu Rachman Adil khan, Muhammad Aditya Wirawan Adityo Susilo, Adityo Afina Nur Fauziyyah AGUSDINI BANUN SAPTANINGSIH Aldora, Ghea Shafa Amarila Malik Andi Utari Prasetya Ningrum Andrajati, Retnosari Ariesa Oktamauri Azizahwati Bambang Karsono Bambang Wispriyono Chairunnisa, Dian Fitri Deli Marteka Delila Eliza DENNI JOKO PURWANTO, DENNI JOKO Dinda Bestari Sutantoputri Djuria, Rachmawati Felani Eliza, Delila Elsa Vera Denida Purba Farmasita Budiastuti, Rizky Fauzi, Muhamad Andhika Habibie, Taufan Harun Hadijah Tahir Hadiwati, Rangkay Hindun Wilda Risni Hindun Wilda Risni Imaniar, Rania Imanuel Sianipar Ingrid Faustine July Kamila, Shinta Kartika Citra Dewi Permata Sari Kartika Citra Dewi Permata Sari Kusumawardani, Larasati Arrum Meiliani Shara Suria L MUTIARA JEANY RAHAYU PERTIWI Nadhila Hasna Hanifah Nasution, Izza Aulia Rizqika Nisa Maria Noor, Sidra Prasetyaningrum, Marchen Pukovisa Prawiroharjo Pukovisa Prawiroharjo, Pukovisa Purnama Putri, Raden Jacinda Yasmin Rachman, Abu Rachmawati Felani Djuria Rani Sauriasari Rani Sauriasari Rani Sauriasari, Rani Retnosari Andrajati Retnosari Andrajati Retnosari Andrajati Retnosari Andrajati Retnosari Andrajati Retnosari Andrajati Risni, Hindun Wilda Salsabila, Azzahra Fahira Santi Purna Sari Sri Wulandah Fitriani Sri Wulandah Fitriani Sri Wulandah Fitriani, Sri Wulandah Vriona Ade Maenkar Wahono, Dwi Edi Yahdiana Harahap