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Interaksi Obat-Herbal dengan Agen Hormon dalam Terapi Kanker: Tinjauan Mekanisme dan Implikasi Klinis Zulqifli, Iqbal; Hikmah, Nurul; Shella, Tasya Permata; Azizah, Nabilla Faoziyyah; Apriani, Risa Dwi; Putri, Mukarromah Dita; Hilmi , Indah Laily
Journal of Pharmaceutical and Sciences JPS Volume 8 Nomor 4 (2025)
Publisher : Fakultas Farmasi Universitas Tjut Nyak Dhien

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36490/journal-jps.com.v8i4.1073

Abstract

Hormone therapy is the cornerstone of treatment for hormone-dependent cancers, such as breast and prostate cancer. On the other hand, the high rate of herbal medicine use as complementary treatment in cancer patients has the potential to cause herbal drug interactions (HDIs), which can affect the efficacy and safety of the primary therapy. This study aims to identify and categorize drug-herbal interactions (DHIs) in cancer hormone therapy based on pharmacokinetic mechanisms (including CYP450 enzyme and drug transporter modulation) and pharmacodynamic mechanisms (including hormone receptor and signaling pathway modulation), as well as to conclude their clinical implications. A systematic review was conducted following the PRISMA-ScR guidelines. A literature search was performed in the PubMed, Scopus, ScienceDirect, Frontiers, and Google Scholar databases for relevant in silico, in vitro, and in vivo studies published between 2015 and 2025. Analysis showed that HDI can be categorized into two main groups. First, pharmacokinetic interactions that occur through the modulation of cytochrome P450 (CYP) enzymes and drug transporters, such as the reduction in the bioavailability of tamoxifen by Hedyotis diffusa. Second, pharmacodynamic interactions at hormone receptors, such as the synergistic effect between Boswellia serrata and enzalutamide. The nature of interactions varies greatly, from antagonistic to synergistic, depending on the specific herbal-drug pair. These findings emphasize the importance of clinical vigilance, such as open communication with patients, dose adjustments, therapeutic monitoring, and interprofessional collaboration. These measures are necessary to reduce the risk of HDI and improve the efficacy of cancer therapy.
Evaluasi Bukti dari Uji Klinis tentang Interaksi Antibiotik dan Antasida: Suatu Tinjauan Sistematis Literatur Al Qindy, Wildan Hidayah; Nurdin, Fitri Oktaviani; Khaerunisa, Aulia; Putri, Meisya Diffa Amalia; Hilmi, Indah Laily; Putri, Mukarromah Dita
Journal of Pharmaceutical and Sciences JPS Volume 8 Nomor 4 (2025)
Publisher : Fakultas Farmasi Universitas Tjut Nyak Dhien

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36490/journal-jps.com.v8i4.1093

Abstract

Drug interactions between antibiotics and antacids represent an important clinical issue that can affect therapeutic efficacy and increase the risk of treatment failure. The concurrent use of these drug classes frequently occurs in clinical practice, particularly in patients receiving antibiotic therapy who also present with gastrointestinal complaints. This systematic literature review aims to evaluate the clinical trial evidence regarding antibiotic–antacid interactions, focusing on pharmacokinetic and pharmacodynamic mechanisms, clinical implications, and current research limitations. Relevant articles were identified through PubMed, Google Scholar, and other scientific databases using standardized keywords. Literature selection followed the PRISMA guidelines to ensure the quality and relevance of included studies. The analysis revealed that antacids and proton pump inhibitors (PPIs) can significantly reduce the bioavailability of antibiotics, especially fluoroquinolones and tetracyclines, through chelation with metal ions and by increasing gastric pH, thereby impairing drug absorption. Concomitant use of antibiotics and PPIs was also associated with a higher risk of Clostridioides difficile infection (CDI), particularly in elderly or comorbid patients. Conversely, newer acid-suppressing agents such as vonoprazan demonstrated good efficacy in Helicobacter pylori eradication regimens without compromising antibiotic activity. Despite these findings, most studies were retrospective, with limited sample sizes and specific populations. Therefore, large-scale prospective clinical trials are needed to strengthen the evidence base. A comprehensive understanding of antibiotic–antacid interactions is essential to support rational, safe, and effective prescribing practices in clinical settings.
Keamanan Kontrimoksazol pada Wanita Hamil: Safety of Cotrimoxazole in Pregnant Woman: a Narrative Review Putri, Mukarromah Dita; Yasin, Nanang Munif; Puspitasari, Ika
Jurnal Surya Medika (JSM) Vol. 10 No. 2 (2024): Jurnal Surya Medika (JSM)
Publisher : Institute for Research and Community Services Universitas Muhammadiyah Palangkaraya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33084/jsm.v10i2.5816

Abstract

Latar Belakang : Pada wanita hamil, kondisi imunitas dapat berubah yang dipengaruhi oleh hormon kehamilan. Fluktuasi hormonal dan perubahan pada sistem kekebalan tubuh adalah penyebab utama pada peningkatan kerentanan tubuh terhadap infeksi. Kotrimoksazol adalah antibiotik yang terdiri dari trimethoprim dan sulfametoksazol yang bisa digunakan untuk mengatasi infeksi saluran kemih, selulitis, demam tifoid pada anak, disentri basiler dan infeksi kolera. Secara luas kotrimoksazol banyak digunakan sebagai profilaksis untuk pasien yang terinfeksi HIV untuk melindungi dari infeksi oportunistik. Tujuan: Penelusuran dan pembahasan artikel ini bertujuan untuk memaparkan keamanan kotrimoksazol pada wanita hamil. Metode: Artikel ini merupakan tinjauan naratif. Penelusuran artikel dilakukan secara elektronik melalui database BioMed Central, PubMed, ScienceDirect, Scopus, Clinical Key, dan Springer Link yang diterbitkan tahun 2003-2023 dengan artikel yang masuk kriteria inklusi sebanyak 4 artikel. Hasil: Terdapat 4 artikel yang membahas keamanan penggunaan kotrimoksazol pada kehamilan yang memenuhi kriteria inklusi. Kesimpulan: Kotrimoksazol dapat digunakan pada masa kehamilan dengan memberikan terapi tambahan asam folat untuk mencegah kejadian tidak diinginkan pada janin.
Pengaruh Berbagai Bentuk Intervensi Apoteker terhadap Kepatuhan Pengobatan dan Kualitas Hidup Pasien Rawat Jalan Skizofrenia : Narrative Review Sambada, Annisa; Putri, Mukarromah Dita; Mulyati, Noviani Ayu
Journal of Pharmaceutical and Sciences JPS Volume 8 Nomor 4 (2025)
Publisher : Fakultas Farmasi Universitas Tjut Nyak Dhien

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36490/journal-jps.com.v8i4.1204

Abstract

Schizophrenia is a global issue with a significant increase in recurrence, affecting approximately 23 million people or 1 in every 345 individuals worldwide, with recurrence rates increasing from 28% in 2019 to 54% in 2021[2]. This narrative review examined the literature from 2015–2024 from PubMed and Google Scholar with inclusion criteria of pharmacist interventions in outpatient schizophrenia patients, the use of assessment instruments such as MARS, PANSS, and WHOQOL-BREF, and the reporting of quantitative outcomes related to adherence and quality of life. Seven studies that met the criteria showed that pharmacist counseling can significantly improve medication adherence. In the Si-Care model, adherence rates increased from 77.38% to 97.57% (an increase of 20.19%; p = 0.000). Higher effectiveness was seen in longer-duration interventions, interactive methods such as home visits, and implementation involving collaboration with psychiatrists, which also supported improvements in quality of life. However, variations in study design resulted in diverse findings, and single-session interventions tended to be less optimal than ongoing support. Without counseling, adherence rates remained low, at around 65%. Overall, the available evidence confirms the benefits of pharmacist counseling, but further research is needed to standardize intervention models and evaluate the long-term impact on outpatients with schizophrenia.
Interaksi Obat Pada Pasien Geriatri: Kajian Berbasis Evidence Tentang Kombinasi Antihipertensi dan Obat Non Steroidal Anti-Inflammatory Alya, Rahma; Khuriyah, Khuriyah; Ananda, Meisya Dwi; Putra, Hasan Etanov; Adzkia, Muhammad Adit; Putri, Mukarromah Dita; Hilmi, Indah Laily
Journal of Pharmaceutical and Sciences JPS Volume 9 Nomor 1 (2026)
Publisher : Fakultas Farmasi Universitas Tjut Nyak Dhien

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36490/journal-jps.com.v9i1.1182

Abstract

The number of elderly individuals continues to increase globally, accompanied by a high prevalence of chronic diseases, particularly hypertension and musculoskeletal disorders. This condition makes geriatric patients vulnerable to polypharmacy, which increases the risk of drug interactions, one of which is between antihypertensives and non-steroidal anti-inflammatory drugs (NSAIDs). Such interactions can potentially reduce therapy effectiveness, cause electrolyte disturbances, and lead to acute kidney injury (AKI). This study aims to comprehensively examine the interaction between antihypertensives and NSAIDs in geriatric patients and its impact on therapy safety. The method used is a literature review by selecting national and international articles published between 2015 and 2025, written in either Indonesian or English, specifically investigating interactions between antihypertensives (β-blockers, ACE inhibitors, ARBs, diuretics, and CCBs) and NSAIDs. The review results indicate that most interactions are pharmacodynamic, involving either antagonism or negative synergism. NSAIDs can reduce the effectiveness of antihypertensive therapy through mechanisms such as sodium retention, afferent arteriolar vasoconstriction, and decreased renal perfusion. In certain combinations, such as the triple whammy phenomenon (NSAIDs, diuretics, and RAAS inhibitors), the risk of AKI and hyperkalemia increases significantly. This risk is higher in geriatric patients with decreased kidney function, comorbidities, and concurrent use of multiple drugs. In conclusion, the interaction between antihypertensives and NSAIDs in the elderly population is an important clinical issue. Therefore, close monitoring of kidney function and electrolytes, using the lowest effective dose for the shortest possible duration, and patient education to avoid self-medication are necessary to ensure therapy safety.
Interaksi Warfarin dan Aspirin terhadap Risiko Perdarahan pada Pasien Penderita Penyakit Kardiovaskular Subekti, Firli Reisya; Nurhafidah, Zahra; Saputri, Jasmine Rahma; Adhwa'a Kaylla; Shadrina, Jahra Almas; Maharani, Puteri Rahma; Putri, Mukarromah Dita; Sudarjat, Hadi; Hilmi, Indah Laily
Journal of Pharmaceutical and Sciences JPS Volume 9 Nomor 1 (2026)
Publisher : Fakultas Farmasi Universitas Tjut Nyak Dhien

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36490/journal-jps.com.v9i1.1196

Abstract

Background: Cardiovascular disease (CVD) remains a leading cause of global morbidity and mortality; therefore, antithrombotic therapy such as warfarin and aspirin plays a crucial role in preventing thromboembolic events. The combination of these two agents provides a synergistic effect in inhibiting thrombus formation but significantly increases the risk of bleeding. Objective: To evaluate the impact of concominant ose of warfarin and aspirin on bleeding risk and its clinical benefits in patients with CVD. Methods: A systematic literature search was conducted using Google Scholar and Pubmed, with eligible studies analyzed. Result: The concomitant use of warfarin and aspirin increases the incidence of major bleeding without providing additional benefits in preventing stroke or myocardial infarction. Moreover, poor anticoagulation control further exacerbates this risk. Conclusion: The combination of warfarin and aspirin should be reserved only for patients with strong clinical indications, while warfarin monotherapy is safer for those with stable conditions. These findings emphasize the importance of individualized therapy evaluation and optimal INR monitoring to balance therapeutic benefits and bleeding risks.