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Pertimbangan Interaksi Obat dalam Memilih Obat Psikofarmaka pada Pasien HIV dengan Gangguan Mood: Evidence Based Case Report Putri, Frilya Rachma; Indiastari, Dewi; Surya, Michael; Hanum, Anisa Syahfitri
Majalah Kedokteran Indonesia Vol 73 No 4 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.4-2023-1059

Abstract

Introduction: Mood disorders are one of the most common mental disorders in HIV patients. When used for HIV patients with mood disorders, psychiatric drugs might interact with ARVs. The selection of psychiatric drugs for HIV patients needs to be adjusted to avoid side effects due to adverse drug interactions. Objective: To discuss the interactions between psychiatric drugs and HIV ARVs as a consideration for treatment options.Methods: A literature search was conducted through PubMed and Scopus using keywords with the Boolean operator concept. Selected literature reviews a collection of drug interactions between psychiatric drugs for mood disorders and antiretrovirals used for HIV patients.Results: Out of 88 literatures works obtained, 3 of which reviewed the interactions of various psychiatric drugs with antiretrovirals in HIV patients. Psychopharmaceutical and antiretroviral interactions are related to their metabolism by the Cytochrome P450 (CYP450) enzyme. Psychopharmaceutical and antiretrovirals that are metabolized by the same isoenzyme will cause changes in blood plasma levels which then leads to risks of causing side effects.Conclusion: Although there is no ideal drug option for treating mood disorders in HIV patients, SSRIs are still the first choice because of their fewer interactions with antiretrovirals. The antiretrovirals that interacts the most with psychopharmaceutical are those belonging to PI group. It is recommended to avoid drug combinations that cause a lot of interactions and reduce the treatment benefits.
Terapi Perilaku Kognitif pada Pasien COVID-19 Newly Diagnosed dengan Insomnia karena Gangguan Penyesuaian: Laporan Kasus Surya, Michael; Purnama, Dharmawan Ardi
Majalah Kedokteran Indonesia Vol 72 No 6 (2022): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.72.6-2022-881

Abstract

Background: COVID-19 patients are reported suffering from anxiety, depression, and stress which culminates in the form of insomnia, and becomes a typical comorbid in hospitalized patients. Sedative-hypnotic drugs usually used to treat insomnia may not provide a viable solution as it has inhibitory effects on the respiratory system. Previous research suggested that one-week Cognitive Behavioral Therapy improved sleep latency, night sleep time, and sleep efficiency of COVID-19 patients with insomnia. Case: A case of 53-year-old female patient with moderate symptoms of COVID-19 suffered from sleeping problems was diagnosed with insomnia due to adjustment disorder. She was given medication for three days and was scheduled for one hour of cognitive behavioral therapy intervention everyday. CBT intervention also included scheduling a regular daily activity and sleep hygiene programme. Result: There was no improvement from medication administered to help in relieving the insomnia symptoms. However, the patient was more able to sleep well on the sixth day of treatment, after five daily sessions of CBT, which was three days after stopping the medication. Conclusion: These results confirmed the effectiveness of daily CBT in improving the patient’s sleep quality and efficiency after one week, as suggested by previous studies.