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Olaparib As Therapy For Metastatic-Castration Resistant Prostate Cancer : Systematic Review And Meta Analysis Putra Gunawan, I Made Rian; Herawati, Fauna; Kirtishanti, Aguslina
Jurnal Farmasi Sains dan Terapan (Journal of Pharmacy Science and Practice) Vol 11, No 1 (2024): February
Publisher : Jurnal Farmasi Sains dan Terapan (Journal of Pharmacy Science and Practice)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jfst.v11i1.5284

Abstract

Prostate cancer is the second most prevalent cancer in men with approximately 1.4 million men worldwide. The main therapy for prostate cancer is androgen deprivation therapy (ADT), but patients who have received ADT may experience a condition of castration resistant prostate cancer (CRPC). More than 84% of patients have metastasized when diagnosed with CRPC (mCRPC) and median survival about 36 months. The Food & Drugs Association (FDA) has approved a new therapy for mCRPC patients, an example is olaparib. The purpose of this systematic review and meta analysis is to assess effectiveness (overall survival) and safety of olaparib in mCRPC. This research is using randomized control trial’s (RCT) article. The literature search process was carried out using the PubMed database. The quality of inclusion was assessed using the Critical Appraisal Skill Program (CASP) checklist and journal reputation. The results of the meta-analysis on the effectiveness of olaparib has showed that there was no significant difference in the patient's overall survival rate (RR=0. 81; 95% CI=0.58-1.13). The results of the meta analysis on the safety level of olaparib has showed a significant difference, seen from the side effects such as anemia (RR=3.47; 95% CI=2.59-4.65), nausea (RR=2.05; 95% CI=1.62-2.60) and fatigue (RR=1.32; 95% CI=1.10-1.59). The conclusion is olaparib as mCRPC therapy does not show significant effectiveness in improving overall survival in mCRPC. In addition, the low safety level of olaparib in mCRPC patients were seen from side effects such as anemia, nausea and fatigue
Management of Stage-4 HIV with Cerebral Toxoplasmosis Coinfection and SIADH Complication Laksono, Pandu; Oktavia, Erlin; Putri, Hidayati Adi; Herawati, Fauna
Majalah Kedokteran Bandung Vol 56, No 3 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.3355

Abstract

HIV/AIDS stage 4 is the stage where the HIV/AIDS patients have low immunity protection against infections, which can led to coinfections and complications. This case report presented an evaluation of the diagnosis and treatment of an HIV/AIDS stage 4 patient with cerebral toxoplasmosis coinfection and SIADH complications. A man (47 years, 35 kg), married with two children, complaining of weakness, nausea, vomiting, weight loss, and low appetite. Sodium level were measured, showing a 117 mg/dL level that continued to decrease throughout the patient's treatment. Five days later, the patient lost his consciousness with a GCS score of 224, indicating severe brain injury, and was diagnosed with cerebral toxoplasmosis based on the result of head CT-SCAN with contrast. On day 6, the patient was tested positive for HIV and diagnosed with stage 4 with an absolute CD4 count of 4 cells/μl. Therapy was provided by giving pyrimethamine-clindamycin therapy for cerebral toxoplasmosis, followed by Tenofovir, Lamivudine, and Evafirenz as antiretroviral therapy. Treatment for hyponatremia was done by administration of 3% NaCl and tolvaptan. The patient started experiencing an improvement in consciousness after the 10th day of medication, and sodium levels fluctuated throughout the treatments. Patient was discharged after 15 days with clinical improvements.
Analysis of Prophylactic Antibiotic Administration in BPJS-Covered Patients Undergoing Caesarean Section at Husada Utama Hospital, Surabaya Alfarendra, Muhammad Daffa; Indrayanti, Mufida; Yulia, Rika; Herawati, Fauna
Journal of Maternal and Child Health Vol. 9 No. 4 (2024)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejmch.2024.09.04.11

Abstract

Background: Considering the importance of the rational use of antibiotics to prevent the develop­ment of antibiotic resistance, especially in surgical patients who are at risk of developing Surgical Site Infections (SSI). A study will be conducted to evaluate the use of antibiotics in caesarean section patients at Husada Utama Hospital Surabaya. Subjects and Method: This study uses a descriptive observational research design with a retrospective data collection approach on patients who underwent either emergency or elective caesarean section (CS) on January – may 2024 at Husada Utama Hospital Surabaya. The variables in this study are the antibiotic use patterns of CS patients, which include the type of antibiotics used, the antibiotic dosage, the duration of antibiotic administration, the amount of antibiotic use measured by the DDD/100 bed days method and DU90%, the appropriateness of antibiotic use according to the national formulary and hospital antibiotic guidelines, the response time for CS surgery, and the risk of developing surgical site infection (SSI). The sample for this study consisted of patients who underwent either emergency or elective CS surgery at the Husada Utama Hospital Surabaya from January to May 2024. Results: From January to May 2024, 69 samples were analysed. These included 65 patients undergoing elective caesarean sections and 4 patients undergoing emergency caesarean sections with a response time of <30 minutes. The antibiotics used were cefazolin 2 g and ceftriaxone 1 g, administered intravenously over 30-60 minutes. Antibiotic consumption was measured using the DDD/100 bed days method and DU 90% segment. The amount of cefazolin used was 26.50 DDD/100 bed days and the amount of ceftriaxone used was 0.96 DDD/100 bed days. Cefazolin was the most commonly used antibiotic in all types of surgery, accounting for 95.65% of the DU 90% segment. Antibiotic use 95.65% was in accordance with PPAB guidelines and Ministry of Health regulations in terms of type, dosage and route of administration. There were no surgical site infections during the study period. Conclusion: Ninety five percent of antibiotic use in caesarean section patients in the hospital is in accordance with the type of antibiotic recommended in the antibiotic use guidelines, which is cefazolin. The use of the broad-spectrum antibiotic ceftriaxone is 0.96 DDD/100 bed days. The programme to control antimicrobial resistance in the obstetrics and gynaecology unit, especially regarding the prophylactic use of antibiotics, is effective.
Optimalisasi Clinical Pathway “Penggunaan Antibiotik” dalam Praktik Kolaborasi Interprofesional Manajemen Perawatan Pasien Bedah Ortopedi di Surabaya Irawati, Adinda; Herawati, Fauna; Wiyono, Heru; Yulia, Rika
MPI (Media Pharmaceutica Indonesiana) Vol. 4 No. 1 (2022): JUNE
Publisher : Fakultas Farmasi, Universitas Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24123/mpi.v4i1.4559

Abstract

Praktik kolaborasi antar profesi kesehatan (interprofessional collaborative practice, IPC) dari berbagai latar belakang profesi yang berbeda menggunakan clinical pathway (CP) atau alur klinis disepakati oleh Profesional Pemberi Asuhan (PPA) sangat diperlukan untuk memberikan kualitas pelayanan yang terbaik. Penerapan CP penggunaan antibiotik pada pasien bedah dapat menjadi model, mengingat penggunaan antibiotik profilaksis bedah yang tidak tepat dapat meningkatkan risiko terjadinya Infeksi Luka Operasi (ILO) dan resistensi obat. Telah dilakukan penelitian yang bertujuan untuk mengetahui persepsi tenaga kesehatan dalam praktik kolaborasi interprofesional manajemen perawatan pasien bedah ortopedi sebelum dan sesudah intervensi CP terintegrasi, dan profil penggunaan antibiotik. Penelitian ini merupakan penelitian eksperimen kuasi (quasi-experiment) dengan rancangan one group pretest-posttest design menggunakan kuesioner Collaborative Practice Assessment Tool (CPAT). Lima puluh dua kuesioner diberikan kepada semua tenaga kesehatan (dokter, perawat, dan apoteker) yang berinteraksi dalam pengisian CP (tidak ada data gugur). Nilai persepsi tenaga kesehatan tentang praktik kolaborasi sesudah intervensi (212,17) lebih tinggi daripada sebelum intervensi (173,63); sedangkan nilai DDD/100 bed-days pre-intervensi lebih rendah daripada pos-intervensi. Namun kedua perbedaan tersebut tidak bermakna secara statistik.
Profil Kualitas dan Kuantitas Penggunaan Antibiotik Profilaksis pada Pre, On, dan Pos Bedah di Rumah Sakit Provinsi (RSP) NTB Massey, Firdaus Kabiru; Yulia, Rika; Muliani, Nurlina; Herawati, Fauna
JSFK (Jurnal Sains Farmasi & Klinis) Vol 8 No 1 (2021): J Sains Farm Klin 8(1), April 2021
Publisher : Fakultas Farmasi Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jsfk.8.1.43-52.2021

Abstract

Penelitian ini bertujuan untuk mengetahui profil kuantitas penggunaan antibiotik berdasarkan metode DDD/100 patient-days dan kualitas penggunaan antibiotik berdasarkan persentase kesesuaian (indikasi, waktu pemberian, durasi, dosis, dan rute pemberian) terhadap ASHP, PPAB, dan Formularium Rumah Sakit, serta profil Infeksi Daerah Operasi (IDO) pada pasien bedah di RSP NTB periode Januari-Juni 2019. Metode penelitian menggunakan desain penelitian deskriptif dengan pengambilan data secara retrospektif terhadap data rekam medik sampel penelitian. Subyek penelitian adalah pasien bedah periode Januari-Juni 2019 yang memenuhi kriteria inklusi, yaitu sebanyak 323 sampel penelitian. Hasil yang diperoleh dari penelitian ini yaitu kuantitas penggunaan antibiotik periode Januari-Juni 2019 di dominasi oleh antibiotik ceftriaxone (J01DD04) dengan nilai total DDD/100 patient-days pada pre operasi yaitu 77,655, on operasi 87,31, dan post operasi 93,65. Kesesuaian pemilihan antibiotik profilaksis berdasarkan guideline ASHP sebesar 1,9%, PPAB 15,5%, dan Formularium RSP NTB 100%, sedangkan kesesuaian durasi, waktu pemberian, dosis, dan rute pemberian berdasarkan ASHP berturut-turut yaitu 19,2%, 42,7%, 1,5%, dan 100%. Sampel penelitian yang mengalami IDO yaitu 2 dari 323 sampel (0,62%) dengan hasil pertumbuhan bakteri yaitu Proteus sp., Staphylococcus aureus, S. epidermidis, dan E.coli. Uji sensitivitas keseluruhan bakteri penyebab IDO ditemukan masih sensitif terhadap antibiotik seperti chloramphenicol, amoxicillin-clavulanic acid, vancomycin, cefoxitin, dan oxacillin
Kajian Literatur: Efektivitas Antibiotik Golongan Beta-Laktam pada Pasien Lansia dengan Pneumonia Komunitas Wijaya, Afelia Mettania; Herawati, Fauna; Yulia, Rika
JSFK (Jurnal Sains Farmasi & Klinis) Vol 8 No 2 (2021): J Sains Farm Klin 8(2), Agustus 2021
Publisher : Fakultas Farmasi Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jsfk.8.2.80-92.2021

Abstract

Antibiotik golongan beta-laktam memiliki efektivitas yang baik pada pasien dewasa. Lansia dan dewasa memiliki perbedaan baik fisik maupun psikis yang mengakibatkan efektivitas dan rekomendasi jenis antibiotik juga mengalami perbedaan. Penelitian ini bertujuan untuk memberikan informasi terkait efektivitas serta rekomendasi antibiotik golongan beta-laktam pada pasien lansia dengan Pneumonia Komunitas. Penelitian ini merupakan kajian literatur yang menggunakan artikel dengan beberapa desain studi. Kualitas jurnal dinilai dengan Critical Appraisal Skills Programme (CASP) checklist dan reputasi jurnal. Didapatkan 9 artikel memenuhi kriteria dan berkualitas baik. Berdasarkan hasil sintesis, antibiotik golongan beta-laktam yang sering digunakan untuk mengatasi pneumonia komunitas pada lansia adalah Ceftriaxone, ertapenem, ampicillin/sulbactam, biapenem, dan Imipenem/cilastatin. Efektivitas antibiotik beta-laktam pada lansia dengan pneumonia komunitas ditentukan oleh 3 kriteria, yaitu clinical efficacy, microbiological efficacy, dan treatment duration. Secara keseluruhan, antibiotik golongan beta-laktam yang dapat menjadi rekomendasi dan memiliki efektivitas terbaik dalam mengatasi pneumonia komunitas pada lansia adalah Cefepime. Kemudian ertapenem dan biapenem pada rekomendasi kedua, serta Meropenem pada rekomendasi ketiga. Penelitian ini masih memiliki kelemahan karena informasi yang terbatas mengenai topik, beberapa artikel dengan resiko bias sedang, dan beberapa artikel hasil pencarian yang menggunakan artikel diluar bahasa inggris.
Persepsi Tenaga Kesehatan terhadap Praktik Kolaborasi Interprofesional dalam Terapi Antibiotik pada Bedah Ortopedi Viani, Ella; Yulia, Rika; Herawati, Fauna
JSFK (Jurnal Sains Farmasi & Klinis) Vol 8 No 3 (2021): J Sains Farm Klin 8(3), Desember 2021
Publisher : Fakultas Farmasi Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jsfk.8.3.296-302.2021

Abstract

Kolaborasi interprofesional (Interprofessional Collaborative/IPC) menjadi strategi untuk menjawab kebutuhan akan pelayanan kesehatan yang terpadu. Dalam terapi antibiotik, praktik IPC yang efektif dapat meningkatkan ketepatan peresepan dan penggunaan antibiotik yang berdampak pada penurunan kejadian resistensi antibiotik. Agar tercipta praktik IPC yang efektif, perlu dilakukan identifikasi permasalahan yang ada dari persepsi tenaga kesehatan yang terlibat dalam IPC. Penelitian ini bertujuan menilai persepsi tenaga kesehatan terhadap praktik IPC dalam terapi antibiotik di unit bedah ortopedi. Penelitian ini merupakan penelitian observasional dengan pendekatan cross-sectional. Persepsi tenaga kesehatan dinilai menggunakan kuesioner Collaborative Practice Assessment Tool (CPAT) yang terdiri dari 8 domain dengan total 53 item pernyataan. Penelitian melibatkan 47 responden tenaga kesehatan di unit bedah ortopedi. Hasil penelitian menunjukkan terdapat perbedaan persepsi yang signifikan antara perawat dan tenaga kefarmasian terhadap domain hambatan tim dalam kolaborasi. Pada domain kepemimpinan terdapat perbedaan yang siginifikan antara tenaga kefarmasian dan dokter. Penelitian ini menyimpulkan secara umum, tenaga kesehatan menilai praktik IPC sudah berjalan dengan baik  (76,47% dari skor maksimum CPAT).Perawat menilai otonomi mereka dalam IPC masih terbatas ( 52% dari skor maksimum domain hambatan tim dalam kolaborasi), serta tenaga kefarmasian menilai masih adanya dominasi tenaga kesehatan lain dalam praktik IPC  (72% dari skor maksimum domain kepemimpinan)
Penggunaan DAPT (Dual Antiplatelet) Pada CVA (Cerebrovascular Accident) Trombosis atau Stroke Iskemik dengan Riwayat PJK (Penyakit Jantung Koroner) Putri, Rizky Ayu Artama; Badriah, Rani Nur; Anggraeni, Reta; Pratama, Jainuri Erik; Setiadi, Antonius Adji Prayitno; Herawati, Fauna; Gondokesumo, Marisca Evalina
MAHESA : Malahayati Health Student Journal Vol 4, No 12 (2024): Volume 4 Nomor 12 (2024)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v4i12.16289

Abstract

ABSTRACT Ischemic stroke is the sudden development of focal neurological deficit due to inadequate blood supply to an area of the brain, which can be thrombotic or embolic. CAD (Coronary Artery Disease) is pathological process characterized by the formation of atherosclerotic plaque followed by rupture, ulceration, or erosion. CAD can take the form of CCS (Chronic Coronary Syndrome). The 2018 AHA/ASA Guidline Antiplatelet Therapy used for ischemic stroke is Aspirin at a dose of 160mg-300mg 1x1. In the 2019 ESC Guidline, CCS patient therapy uses DAPT (Dual antiplatelet). In a 2021 AHA meta-analysis compared with aspirin alone, short-term DAPT within 24 hours after mild-moderate ischemic stroke reduced the risk of recurrent stroke at the expense of a higher risk of major bleeding. Here we present a case of a 76 year old female patient with ischemic stroke and CCS who used DAPT. Complaints of sluggishness, weakness in the left half of the body, acute dysarthria onset on the first day, when waking up. Hemiplegia S 1 week ago onset of waking up and being treated at Mataram Regional Hospital. The patient received the antiplatelet Aspirin 160mg 1x1 a day then switched DAPT (Aspirin 80mg 1x1 and Clopidogrel 75mg 1x1) due to a history of CCS. Keywords: CVA Thrombosis, Ischemic stroke, Aspilet, Clopidogrel, Coronary Artery Disease  ABSTRAK Stroke iskemik adalah perkembangan fokal yang tiba-tiba terjadi defisit neurologis akibat suplai oksigen tidak memadai ke suatu area pada otak, dapat bersifat trombotik atau emboli. PJK (Penyakit Jantung Koroner) atau CAD (Coronary Artery Disease) adalah proses patologis ditandai dengan terbentuknya plak aterosklerotik diikuti dengan pecah, ulserasi, atau erosi. PJK dapat berupa penyakit CCS (Chronic Coronary Syndrome). Terapi Antiplatelet Guidline AHA/ASA 2018 yang digunakan pada stroke iskemik adalah Aspirin dosis 160mg-300mg 1x1. Pada Guidline ESC 2019 terapi pasien CCS digunakan DAPT (Dual antiplatelet). Pada meta analisis AHA 2021 dibandingkan dengan aspirin saja, DAPT jangka pendek dalam waktu 24 jam setelah stroke iskemik ringan-sedang mengurangi risiko stroke berulang dengan mengorbankan risiko perdarahan besar yang lebih tinggi. Berikut kami presentasikan sebuah kasus pasien Perempuan 76 tahun dengan Stroke Iskemik dan CCS yang menggunakan DAPT. Keluhann pelo, kelemahan separuh badan kiri, acute disartria onset hari pertama, saat bangun tidur. Hemiplegia S 1 minggu lalu onset bangun tidur di rawat di RSUD Mataram. Pasien menerima antiplatelet Aspirin 160mg 1x1 sehari lalu switch DAPT (Aspirin 80mg 1x1 dan Clopidogrel 75mg 1x1) karena Riwayat CCS.  Kata Kunci: CVA trombosis, Ischemic stroke, Aspilet, Clopidogrel, Penyakit Jantung Koroner.
Efek Samping Agranulositosis Imbas Metamizole: Kajian Pustaka Pribadi, Ezra Immanuelly; Marzuki, Jefman Efendi; Herawati, Fauna
MPI (Media Pharmaceutica Indonesiana) Vol. 7 No. 1 (2025): JUNE
Publisher : Fakultas Farmasi, Universitas Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24123/mpi.v7i1.7300

Abstract

Agranulositosis merupakan kondisi yang jarang terjadi, namun dapat berpotensi fatal dan menyebabkan kematian apabila tidak ditindaklanjuti secara tepat dan cepat. Insidensi agranulositosis yaitu 6,2 juta kasus/penduduk/tahun. Agranulositosis imbas obat dapat disebabkan oleh analgesik antipiretik metamizole, dimana aksesibilitas metamizole mudah di Indonesia. Tujuan penulisan artikel ini adalah untuk memaparkan kejadian agranulositosis imbas metamizole. Tinjauan pustaka dilakukan dengan pencarian artikel melalui basis data Pubmed dan Google Scholar. Berdasarkan eksplorasi literatur, beberapa faktor risiko yang mempengaruhi kejadian agranulositosis adalah jenis kelamin, usia lanjut, infeksi virus dan durasi penggunaan yang lebih lama. Oleh karena itu, diperlukan pertimbangan mengenai manfaat dan risiko penggunaan metamizole. Agranulocytosis is a rare but potentially fatal condition that can lead to death if not promptly and appropriately managed. The incidence of agranulocytosis is estimated at 6.2 cases per million population per year. Drug-induced agranulocytosis can be triggered by the use of the analgesic and antipyretic agent metamizole, which remains widely accessible in Indonesia. This article aims to present findings related to agranulocytosis induced by metamizole. This literature review was conducted through article searches in the PubMed and Google Scholar databases. Based on the reviewed literature, several risk factors influencing the occurrence of agranulocytosis include female gender, older age, viral infections, and prolonged duration of metamizole use. Therefore, careful consideration of the benefits and risks of metamizole use is essential in clinical practice. Submitted: 24-01-2025, Revised: 19-05-2025, Accepted: 26-05-2025, Published regularly: June 2025
Impaired Liver Function in the Use of Clozapine as an Antipsychotic Aziz, Abdul; Herawati, Fauna; Pratama, Jainuri Erik; Gondokesumo, Marisca Evalina
Journal of Food and Pharmaceutical Sciences Vol 13, No 2 (2025): J.Food.Pharm.Sci
Publisher : Integrated Research and Testing Laboratory (LPPT) Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jfps.20811

Abstract

Clozapine is an atypical antipsychotic used to treat psychosis, mainly as a second choice for patients with refractory schizophrenia and recommended to manage schizophrenia that does not respond to other therapies. Clozapine is also often associated with elevated transaminase levels without clinical symptoms. In this case, a 45-year-old man, who had been diagnosed with schizophrenia since October 2020, was undergoing treatment with various antipsychotic drugs, including clozapine. About a week before hospitalization, there was a change in the patient's behavior. Due to this condition, the patient was brought to the outpatient psychiatric clinic at Airlangga University Hospital Surabaya, the patient was given clozapine 25 mg therapy at night, but the symptoms experienced were getting worse. The patient was finally taken for hospitalization at Dr. Soetomo Hospital Surabaya. While undergoing treatment at the hospital, the patient was given clozapine 10 mg therapy in the morning and at night, in addition, Olanzapine 10 mg was given intramuscularly if needed. However, on the third day after starting treatment, the patient began complaining of low-grade fever (37.8°C), nausea, and fatigue. Laboratory tests showed an increase in liver enzyme levels. However, several cases of severe liver toxicity due to clozapine use have been reported, and there are no specific guidelines for physicians to prevent or treat this condition. Close monitoring of liver function test (LFT) results is crucial in clozapine therapy, especially in considering the decision to stop treatment early if necessary.