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All Journal Viva Medika: Jurnal Kesehatan, Kebidanan dan Keperawatan Jurnal Kefarmasian AKFARINDO Archives of The Medicine and Case Reports CERATA
Khamdiyah Indah Kurniasih
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Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Social Sciences

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Comparative Effectiveness of Single Versus Combination Antihypertensive Therapy in PROLANIS Hypertension Patients: A Retrospective Study in Purbalingga Regency Khamdiyah Indah Kurniasih; Nanang Munif Yasin; Utami, Pri Iswati
Archives of The Medicine and Case Reports Vol. 5 No. 4 (2024): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v5i4.625

Abstract

The PROLANIS program in Indonesia aims to manage chronic diseases like hypertension. While combination antihypertensive therapy is recommended for many patients, evidence on its effectiveness in the PROLANIS setting remains limited. This study investigated the comparative effectiveness of single versus combination antihypertensive therapy in achieving blood pressure control among PROLANIS hypertension patients in Purbalingga Regency. A retrospective cohort study was conducted using data from PROLANIS hypertension patients in Purbalingga Regency from January-December 2023. Patients were categorized into two groups: those receiving single antihypertensive therapy and those receiving combination therapy. The primary outcome was the proportion of patients achieving blood pressure control (<140/90 mmHg). Secondary outcomes included changes in blood pressure, medication adherence, and adverse events. Multivariable logistic regression was used to adjust for potential confounders. A total of 1,250 patients were included, with 680 receiving single therapy and 570 receiving combination therapy. The proportion of patients achieving blood pressure control was significantly higher in the combination therapy group (65%) compared to the single therapy group (52%) (adjusted odds ratio [OR] 1.72, 95% confidence interval [CI] 1.35-2.20). Combination therapy was also associated with greater reductions in systolic and diastolic blood pressure. No significant differences were observed in medication adherence or adverse events between the two groups. Combination antihypertensive therapy is more effective than single therapy in achieving blood pressure control among PROLANIS hypertension patients in Purbalingga Regency. These findings support the use of combination therapy as the preferred approach for managing hypertension in this population.
Impact of mRNA COVID-19 Vaccines on Blood Pressure in Hypertensive Patients: A Retrospective Observational Study Raysyifa, Mugi Rahma; Khamdiyah Indah Kurniasih; Siti Setianingsih
Archives of The Medicine and Case Reports Vol. 5 No. 4 (2024): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v5i4.628

Abstract

The COVID-19 pandemic necessitated rapid vaccine development, with mRNA vaccines (Moderna or Pfizer) emerging as frontrunners. While effective, concerns arose regarding their impact on blood pressure (BP), particularly in hypertensive individuals, a population already at increased cardiovascular risk. The study aimed to investigate the effects of mRNA COVID-19 vaccines on BP in hypertensive patients. A retrospective observational study was conducted at the Mrebet Community Health Center. Data from hypertensive patients receiving the second dose of either Moderna or Pfizer vaccine were analyzed. Pre- and post-vaccination BP readings, patient demographics, medication profiles, and hypertension severity were assessed. Statistical analysis was performed to evaluate changes in BP and identify potential associations. The study included 33 hypertensive patients (mean age: 55.2 years, 84.8% female). The majority (84.8%) received the Moderna vaccine. Pre- and post-vaccination BP readings showed a slight increase in systolic BP (133 mmHg to 137 mmHg) and a minor decrease in diastolic BP (85 mmHg to 84 mmHg). Statistical analysis revealed a significant association between vaccination and changes in diastolic BP (p < 0.05), but not systolic BP (p > 0.05). In conclusion, mRNA COVID-19 vaccines may have a modest impact on BP in hypertensive patients, particularly on diastolic BP. The clinical significance of these changes warrants further investigation. Close monitoring of BP in hypertensive individuals post-vaccination is recommended.
ANALISIS PENGGUNAAN ANTIBIOTIK PASIEN DEMAM TIFOID DI RSUD dr. R. GOETENG TAROENADIBRATA PURBALINGGA TAHUN 2022 MENGGUNAKAN METODE ATC/DDD DAN DU 90% Alifia Kurniati; Sunarti; Khamdiyah Indah Kurniasih
Jurnal Kefarmasian Akfarindo Vol 9 No 1 (2024)
Publisher : Akademi Farmasi Indonesia Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37089/jofar.vi0.283

Abstract

Demam tifoid termasuk salah satu permasalahan kesehatan yang signifikan terutama di negara-negara berkembang, salah satunya indonesia. Penggunaan antibiotik secara berlebihan dapat membahayakan pasien dan menimbulkan resistensi obat terhadap bakteri. Upaya untuk mengetahui kuantitas pemakaian antibiotik perlu dilakukan menggunakan metode kuantitatif yseperti metode ATC (Anatomic Therapeutic Chemical) dan DDD (Defined Daily Dose) serta DU 90% (Drug Utilization). Penelitian ini dilakukan untuk menilai penggunaan antibiotik pada pasien dewasa yang menderita demam tifoid sesuai ATC/DDD dan DU 90% yang dirawat di RSUD dr. R. Goeteng Taroenadibrata Purbalingga tahun 2022. Jenis penelitian ini yaitu deskriptif melalui pengumpulan data retrospektif berdasarkan rekam medis, pengumpulan sampel dengan metode purposive sampling berjumlah 302 sampel. Data yang dikumpulkan meliputi nomor rekam medis, lama rawat inap, identitas pasien, diagnosis, dan profil pengobatan (nama antibiotik, jumlah antibiotik, cara pemberian, aturan pakai, dosis obat). Organisasi Kesehatan Dunia (WHO) menerapkan ATC (Anatomical Therapeutic Chemical) dan DDD (Defined Daily Dose) sebagai standar global dalam penelitian tentang penggunaan obat. Salah satu contoh penggunaannya adalah dalam mengukur pemakaian antibiotik dengan metode ATC/DDD. Hasil penelitian menunjukkan total nilai DDD yaitu 120,31 DDD/100 patient days dengan 1210 hari total rawat inap. Antibiotik dengan nilai DDD tertinggi per 100 hari pasien hingga terendah yaitu cefixime (63,26), ceftriaxon (45,62), ciprofloxacin p.o (5,33), ciprofloxacin i.v (0,91), amoxicillin p.o (1,4), amoxicillin i.v (0,21), cefotaxime (0,41) dan azithromycin (3.17). Antibiotik yang termasuk dalam kategori DU 90% yaitu cefixime (52,58) serta ceftriaxon (37,92%).
Drug Utilization Analysis in Stroke Patients at Cilacap Regional Public Hospital Using the ATC/DDD Method and DU 90% Argi Asih; Sunarti; Khamdiyah Indah Kurniasih
Viva Medika Vol 17 No 1 (2024)
Publisher : Universitas Harapan Bangsa Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35960/vm.v17i1.1353

Abstract

Stroke is a serious medical condition in which the blood supply to the brain is disrupted, leading to the death of brain cells. The use of stroke medications aims to prevent and treat thromboembolism, and the increased use of stroke medications reflects the high global morbidity and mortality rates. This study aims to describe the utilization of drugs for stroke in patients treated at Cilacap Regional Public Hospital in 2022. The research method used was a descriptive study with a retrospective approach, referring to medical record data. A total of 167 samples were taken by purposive sampling, and the samples were evaluated using the ATC/DDD method and DU 90%. The results showed that the highest DDD/100 bed days value was for oral Acetylsalicylic Acid at 128124.19, and the lowest DDD/100 bed days value was for intravenous Phytomenadione at 6.73. The stroke medication included in the DU 90% was the ischemic stroke drug, oral Acetylsalicylic Acid, with a DU% value of 97.61%. The stroke medications in the 10% segment were the ischemic stroke drugs, namely oral Clopidogrel, oral Cilostazol, and oral Warfarin, as well as the hemorrhagic stroke drugs, intravenous Tranexamic Acid and intravenous Phytomenadione. The DDD per 100 bed days value for stroke medications exceeded the WHO's appropriateness criteria.
Analisis Rasionalitas Penggunaan Antiplatelet Aspirin Dan Clopidrogel Sebagai Monoterapi Pada Pasien Stroke Iskemik Muktiono, Ridho Dwi; Khamdiyah Indah Kurniasih; Silma Kaaffah
CERATA Jurnal Ilmu Farmasi Vol 16 No 2 (2025): Cerata Jurnal Ilmu Farmasi
Publisher : Universitas Muhammadiyah Klaten

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61902/cerata.v16i2.2053

Abstract

Stroke termasuk faktor utama disabilitas dan kematian nomor dua di dunia. Antiplatelet yaitu pengobatan untuk stroke iskemik dilakukan dengan memberi obat anti-agregasi platelet yang bertujuan untuk menghambat penggumpalan trombosit, sehingga mencegah terbentuknya trombus yang sering terjadi pada sistem arteri. Aspirin dan clopidogrel termasuk agen antiplatelet yang direkomendasikan oleh kementerian kesehatan melalui Pedoman Nasional Pelayanan Kedokteran Tata Laksana Stroke Tahun 2019. Tujuan penelitian ini supaya tahu rasionalitas pemakaian antiplatelet aspirin dan clopidrogel sebagai monoterapi pada pasien Rawat inap stroke iskemik di RSUD Prof. Dr. Margono Soekarjo. Penelitian ini yakni deskriptif kuantitatif dengan pendekatan secara retsrospektif dengan memakai data sekunder yaitu rekam medis pasien di RSUD Prof. Dr. Margono. Hasil penelitian dari total 100 pasien stroke iskemik mayoritas laki laki banyaknya 60 pasien (60%) dan wanita banyaknya 40 pasien (40%). Usia pasien mayoritas 56 – 65 tahun banyaknya 41 pasien (41%). Pemakaian obat antiplatelet yang paling banyak dipakai yaitu clopidogrel banyaknya 83%. Evaluasi rasionalitas sesuai tepat pasien 100%, tepat obat 83%, tepat dosis 100%, dan tepat interval 100%.
Co-Authors Alifia Kurniati Argi Asih Muktiono, Ridho Dwi Nanang Munif Yasin Pri Iswati Utami Raysyifa, Mugi Rahma Silma Kaaffah Siti Setianingsih Sunarti