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IDENTIFIKASI PROBLEMA OBAT DALAM PHARMACEUTICAL CARE Yulistiani, .; Suharjono, .; Hasmono, Didik; Khotib, Junaidi; Sumarno, .; Rahmadi, Mahardian; Sidharta, Bambang
JFIOnline | Print ISSN 1412-1107 | e-ISSN 2355-696X Vol 4, No 1 (2008)
Publisher : Indonesian Research Gateway

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Pharmaceutical care is a colaborative process which goal is to prevent, identify, and solve the drug problem. Pharmacists is the one who responsible to pharmaceutical care, to assure the safety and effectiveness of drug use. This works was aimed to identify and analyze drug problems happened during pharmaceutical care. Data was collected from Dr. Syaiful Anwar Hospital Malang, from 1 Januari until 31 August 2006. This was a prospective study (n=138) with descriptive analysis. From the results it can be concluded that drug problems happened during pharmaceutical care in Dr. Syaiful Anwar Hospital Malang consist of: Drug Adverse Reaction (non-elergy side effect 15.22% and toxic effect 3.62%), error in drug choice (untreated indication 18.12%, unappropriate drug to indication 11.59%, unclear drug use 4.35%, unappropriate drug duplication 1.45%), contraindication 0.72%, dosing problem (overtherapy dose 22.46%, overlength therapy 2.90%, subtherapy dose 0.72%), drug interaction (potential interaction 138 cases, manifested interaction 8 cases), and others (patient uncontentment 10.14% and patient unproper care about his/her own disease/therapy 4.35%). ABSTRAKPharmaceutical care merupakan proses kolaboratif yang bertujuan untuk mencegah, mengidentifikasi, dan menyelesaikan problema obat. Dalam pelaksanaan, pharmaceutical care merupakan tanggung jawab profesional farmasis untuk menjamin penggunaan obat yang aman dan efektif dalam meningkatkan kualitas hidup pasien. Penelitian ini bertujuan untuk mengidentifikasi dan menganalisa problema obat yang terjadi dalam pharmaceutical care. Penelitian dilakukan di Rumah Sakit Umum Dr. Syaiful Anwar Malang periode 1 Januari s/d 31 Agustus 2006, merupakan penelitian observasional-data prospektif (n=138) dengan analisis deskriptif. Dari hasil penelitian dapat disimpulkan bahwa macam problema obat yang terjadi meliputi : Reaksi obat yang tidak dikehendaki terdiri dari: efek samping non alergi (15,22%), efek toksik (3,62%); pemilihan obat terdiri dari: obat tidak diresepkan tetapi indikasi jelas (18,12%), obat tidak sesuai indikasi (11,59%), indikasi penggunaan obat tidak jelas (4,35%),duplikasi obat tidak sesuai (1,45%), Kontraindikasi (0,72%); pemberian dosis terdiri dari: dosis terlalu tinggi (22,46%), durasi terapi terlalu panjang (2,90%), dosis terlalu rendah (0,72%); interaksi obat terdiri dari: interaksi potensial 138 kejadian (n=138), manifestasi interaksi (8 kasus); dan problema lain (ketidakpuasan pasien terhadap terapi yang diberikan (10,14%) dan kurangnya perhatian/kesadaran pasien terhadap kondisi/ penyakitnya (4,35%).

Effects of Probiotics and Vitamin B Supplementation on IFN-γ and IL-12 Levels During Intensive Phase Treatment of Tuberculosis Budi Suprapti; Suharjono Suharjono; Rahmawati Raising; Yulistiani Yulistiani; Zamrotul Izzah; Wenny Putri Nilamsari; Prastuti Asta Wulaningrum; Arief Bachtiar
Indonesian Journal of Pharmacy Vol 29 No 2, 2018
Publisher : Faculty of Pharmacy Universitas Gadjah Mada, Yogyakarta, Skip Utara, 55281, Indonesia

Tuberculosis is an acute infectious disease that primarily affects the lungs. Probiotics supplementation can increase the number and activity of NK cell in peripheral blood by modulation of IL-12, thus increasing IFN-γ production by Th1 response. Vitamin B1 acts on macrophages and affects neutrophil motility. Vitamin B6 is associated with the release of cytokines and the responsiveness of NK cells, while vitamin B12 affects to lymphocytes, Tcell proliferation, CD4+ ratios, and NK cell activity. To analyze the effects of probiotics and vitamin B1, B6, B12 supplementation on IFN-γ and IL-12 levels during intensive phase of antituberculosis treatment. The study was pre-post test randomised control by time series. The control group was TB patients with standard therapy of antituberculosis and vitamin B6, while the intervention group was TB patients receiving therapy plus once daily probiotics and vitamin B1, B6, B12supplementation during the intensive phase. Blood samples were withdrawn at baseline, one month, and two months after therapy to measure plasma IFN-γ and IL-12 levels using the ELISA method. Twenty two patients were divided equally into two groups. There was a tendency to greater increase of IFN-γ in the first month of the intervention group, followed by a significant decline after two-month therapy (p < 0.05). In both groups there was a rise in IL-12 levels after one month followed by a decrease in the second month (p > 0.05). However, the percentage was higher in the supplementation group. Adding probiotics and vitamins B1, B6, B12 could improve immune response through IL-12 and IFN-γ modulation during intensive phase therapy.

Analysis of Methyldopa Therapy on sFlt-1 Antiangiogenic Levels in Patients with Severe Preeclampsia Teri Wina Herwati; Yulistiani Yulistiani; Eddy Zarkaty M
Folia Medica Indonesiana Vol. 54 No. 1 (2018): March
Publisher : Faculty of Medicine, Universitas Airlangga

Methyldopa is the first-line drugs to treat hypertension in pregnancy. It can decrease blood pressure in preeclampsia by affecting a2-adrenoreceptors in central nervous system. However, it could also act by decreasing production of sFlt-1 antiangiogenic protein levels involved in the pathophysiology of hypertention in preeclampsia. The purpose of this study was to analyze methyldopa therapy on sFlt-1 antiangiogenic levels in the plasma of pregnant women with severe preeclampsia at the Obstetric Departement, Haji Hospital, Surabaya. This was a prospective study with observational cross-section study design. The sFlt-1 angiogenic levels were observed before and after (48 hours) methyldopa administration in severe preeclampsia patient with or without complications in the period of August to October 2016. Patient received methyldopa 250 mg or 500 mg, three times a day for clinical indications according a standard protocol. The study was approved by the ethical committee of Haji Hospital, Surabaya. There were 19 patients with preeclampsia who met the inclusion criteria, showed a decrease in the levels of sFlt-1 before and 48 hours after methyldopa therapy. Levels of sFlt-1 before methyldopa therapy in a dose of 250 mg was 10.15±10.00 (2.55-34.70) ng/ml and after therapy 8,37±9,20 (0.72-9.20) ng/ml, with a percentage decrease 17.54%. sFlt-1 levels before methyldopa therapy in a dose of 500 mg was 8.05±7.07 (2.55-20.76) ng/ml, after therapy 4.50±2.90 (2.19-9.95) ng/ml, with a percentage decrease 44.16%. Methyldopa therapy could decrease sFlt-1 levels of antiangiogenic factor in patients with severe preeclampsia.

Children with Standard Risk Acute Lymphoblastic Leukemia in Induction And Consolidation Phase Adinugraha Amarullah; Didik Hasmono; IGD Ugrasena; Yulistiani Yulistiani
Folia Medica Indonesiana Vol. 54 No. 1 (2018): March
Publisher : Faculty of Medicine, Universitas Airlangga

Prednisone has an important role in the therapy of patient with standard risk ALL. Patients with standard risk ALL receiving high dose prednisone as therapy and supraphysiology dose of prednisone are expected to cause suppression in HPA-axis (Hypothalamic Pituitary Adrenal axis). This suppression could reduce immune system in children with ALL and increase infection risk because reduction of cortisol level. In Indonesia, we did not find study about the incident of adrenal suppression after high dose prednisone therapy, especially in induction to consolidation phase ALL patient. The aim of this study was to analyze adrenal suppression after high dose prednisone therapy on children with standard risk acute lymphoblastic leukemia in induction and consolidation phase. This study has received a certificate of Ethical Clearance No. 588/Panke.KKE/X/2016, a longitudinal observational, prospective, non-randomized trial involving children with ALL who received prednisone for 49 days during the induction phase. We collected and compared laboratory result of cortisol level in children with ALL and received prednisone therapy during induction to consolidation phase. Sample was taken at week 0,4,5,6,7,8,10,12 in the course of ALL chemotheraphy Indonesian protocol year 2013. Serum was examined using methods CLIA ADVIA Centaur® XP. Between June 2016 – January 2017, 13 patients (8 males, 5 females) were included in this study. Decrease of cortisol level after prednisone therapy occured in week-10 as much as 53% compared with week-0 (p=0.027). Cortisol level increased 64% of week-12 compared with week-10 (p=0.003). In conclusion, high dose prednisone is not significant to causing adrenal suppression in induction phase of ALL patients, and the reducing cortisol level is reversible.

Analysis of High Dose and Long-Term Prednisone Therapy on Trap 5B Level Change in Children with Steroid Sensitive Nephrotic Syndrome Dessy Surya Setyani; Mariyatul Qibtiyah; Ninik Asmaningsih; Yulistiani Yulistiani
Folia Medica Indonesiana Vol. 54 No. 2 (2018): June
Publisher : Faculty of Medicine, Universitas Airlangga

Nephrotic syndrome is a condition which is characterized by protein leakage from the blood to the urine through glomeruli. It leads to hypoproteinemia and generalised oedema. Patients with nephrotic syndrome need high dose and long term glucocorticoid such as prednisone. High dose and long term glucocorticoid can increase bone resorption. Biological marker is a valuable tool to evaluate efficacy of therapy. TRAP 5B is a sensitive biological marker for bone resorption because it reflects the number of osteoclasts. TRAP 5B is not affected by renal dysfunction and food. It also has a low diurnal variation than other bone resorption marker. The aim of this study was to analyze the changes of TRAP 5B levels at induction and alternate phase in children with steroid sensitive nephrotic syndrome. This observational prospective study was conducted from May to October 2016. Venous blood samples obtained at 08.00-10.00 am. TRAP5B levels were measured before and after induction phase and after alternate phase using ELISA. Fifteen patients were included in this study (60% boys). Majority of their age was 6 - <12 years and 40% were dependent steroid NS. TRAP 5B serum levels in induction phase increased by 37.41%±56.22%. In alternate phase, TRAP 5B serum levels increased by 28.75%±66.55% compared to the induction phase. However, the level change of both phases were not significant. As a conclusion, TRAP 5B levels increased in induction and alternate phase after high dose and long-term prednisone treatment in nephrotic syndrome.

Analysis of Prophylactic Antibiotics Usage in Caesarean Section Delivery Binti Muzayyanah; Yulistiani Yulistiani; Didik Hasmono; Nuraida Wisudani
Folia Medica Indonesiana Vol. 54 No. 3 (2018): September
Publisher : Faculty of Medicine, Universitas Airlangga

Caesarean section is the delivery through a surgical incision in the abdomen and uterus with various risks, such as Surgical Site Infection (SSI) which either occurs rapidly (24-48 hours postoperatively) or delayed. To reduce the risk of various post-cesarean section infections, prophylactic antibiotics are given. The administration of prophylactic antibiotics with recommended regimens, such as in developed countries as in the United States and Europe, with first generation of cephalosporins has not been applied in Dr. Iskak Hospital, Tulungagung. This hospital still used other types of antibiotics, such as cefotaxime or ceftriaxone. In addition, for several reasons, prophylactic antibiotics were continued with other antibiotics to reduce the risk of delayed infection. This study was designed to analyze the effectiveness of prophylactic antibiotics as recommended in cesarean section. This was a prospective observational study with consecutive sampling type, examined 41 mothers with cesarean section at the Department of Obstretics and Gynecology, Dr. Iskak Hospital, Tulungagung, Indonesia. This study was conducted from May to July, 2017. The results of the study showed that the effectiveness of prophylactic antibiotic use was 98% based on the clinical parameters and maternal laboratory outcome, which showed that SIRS was in normal category. Whereas, there was one mother (2%) who had SSI on day 10 postoperatively.

Drug Review : Oksitosin dan Misoprostol Pada Postpartum Hemorrhage (PPH) Aghnia Fuadatul Inayah; Yulistiani Yulistiani; Ayu Ratnasari; Rahmadhani Tyas Angganawati; Agus Sulistyono
Farmasains : Jurnal Ilmiah Ilmu Kefarmasian Vol. 9 No. 1 (2022)
Publisher : Universitas Muhammadiyah Prof. DR. HAMKA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22236/farmasains.v9i1.5350

Postpartum Hemorrhage (PPH) merupakan penyebab yang sangat penting dari mortalitas dan morbiditas ibu di seluruh dunia. Seluruh pedoman merekomendasikan oksitosin intramuskular sebagai pengobatan uterotonik lini pertama untuk semua perempuan yang melahirkan pada persalinan trimester ketiga. Pengobatan ini untuk pencegahan PPH karena kemanjuran dan keamanannya, sementara misoprostol digunakan sebagai alternatif dalam kondisi di mana oksitosin tidak tersedia atau di daerah di mana pasien tidak memiliki akses ke perawatan yang terampil. Tujuan penelitian ini untuk membandingkan penggunaan oksitosin dan misoprostol berdasarkan dosis, dan aspek farmasi yang berupa bentuk sediaan, pemberian, stabilitas/penyimpanan dan efek samping umum yang terjadi pada pasien PPH. Studi ini merupakan narrative review yang dilakukan penelusuran pustaka melalui Google Scholar, Pubmed dan Science Direct. Hasil review menunjukkan profilaksis oksitosin mengurangi kehilangan darah dan kejadian PPH tanpa hasil yang merugikan. Penggunaan oksitosin dengan Uniject juga memberikan keuntungan pada penghematan biaya. Akan tetapi, penggunaan oksitosin harus diberikan oleh tenaga profesional. Pengunaan misoprostol adalah alternatif yang efektif untuk pengobatan PPH primer. Namun, penggunaan misoprostol dikaitkan dengan beberapa efek samping sehingga diberikan apabila ketersediaan oksitosin terbatas. Dengan demikian, dapat disimpulkan pemberian oksitosin lebih diutamakan untuk PPH karena dari efek samping lebih minimal dibandingkan misoprostol.

Drug Review : Oksitosin dan Misoprostol Pada Postpartum Hemorrhage (PPH) Aghnia Fuadatul Inayah; Yulistiani Yulistiani; Ayu Ratnasari; Rahmadhani Tyas Angganawati; Agus Sulistyono
Farmasains : Jurnal Ilmiah Ilmu Kefarmasian Vol. 9 No. 1 (2022)
Publisher : Universitas Muhammadiyah Prof. DR. HAMKA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22236/farmasains.v9i1.5350

Postpartum Hemorrhage (PPH) merupakan penyebab yang sangat penting dari mortalitas dan morbiditas ibu di seluruh dunia. Seluruh pedoman merekomendasikan oksitosin intramuskular sebagai pengobatan uterotonik lini pertama untuk semua perempuan yang melahirkan pada persalinan trimester ketiga. Tujuan penelitian ini untuk membandingkan penggunaan oksitosin dan misoprostol berdasarkan dosis, dan aspek farmasi yang berupa bentuk sediaan, pemberian, stabilitas/penyimpanan dan efek samping umum yang terjadi pada pasien PPH. Studi ini merupakan narrative review yang dilakukan penelusuran pustaka melalui Google Scholar, Pubmed dan Science Direct. Dari hasil pencarian, diperoleh sebanyak 5855 jurnal dan terpilih 40 jurnal yang memenuhi kriteria inklusi. Kriteria inklusi yaitu memenuhi kaidah introduction, method results and discussion dan terbit selama 10 tahun terakhir. Jurnal yang tidak dapat diakses secara lengkap dieksklusi dan diperoleh sebanyak 23 jurnal. Hasil review menunjukkan profilaksis oksitosin mengurangi kehilangan darah dan kejadian PPH tanpa hasil yang merugikan. Penggunaan oksitosin dengan Uniject juga memberikan keuntungan pada penghematan biaya. Akan tetapi, penggunaan oksitosin harus diberikan oleh tenaga profesional. Dengan demikian, dapat disimpulkan pemberian oksitosin lebih diutamakan untuk PPH karena dari efek samping lebih minimal dibandingkan misoprostol.

UJI STABILITAS SEDIAAN AMPISILLIN SULBAKTAM SETELAH REKONSTITUSI I Gede Edy Sagitha; Suharjono Suharjono; Yulistiani Yulistiani; Isnaeni Isnaeni
Pharma Xplore : Jurnal Sains dan Ilmu Farmasi Vol 8 No 1 (2023): Pharma Xplore : Jurnal Sains dan Ilmu Farmasi
Publisher : Fakultas Farmasi Universitas Buana Perjuangan Karawang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36805/jpx.v8i1.4333

Repeated use of antibiotic ampicillin sulbactam after reconstitution, therefore in storage various many factor can affect it stability such as type of solvent used, storage temperature and storage time. Objective of study is to analyze the chemical stability product of ampicillin sulbactam in repeated use with the parameters of the solvent and storage temperature Sample products were weighed and reconstituted using WFI and NS solvents, diluted ad 20 ppm and put into sterile vials. Then stored at room temperature (25-30 ° C) and refrigerator temperature (4-8 ° C). Storage is carried out for 24 hours which is divided into 4 -time series, namely 0, 1, 4 and 24 hours. Each time series is microbiological tested and after 18 hours incubation the inhibition zone is observed and its diameter measured using calipers. Result of study is at 0th hour showed a significant difference in different solvents. Samples dissolved with NS solvents have a greater inhibition zone than those dissolved using WFI. This happens because there is a primary salt effect that occurs with the influence of electrolytes (salt) or variations in the strength of ions can affect the coefficient of activity that affects the reaction rate. From the statistical analysis at the 1st and 4th hours, the storage temperature that provides significant result, storage in the refrigerator produces better results compared to storage at room temperature. At 24 hours the temperature and solvent did not give the significant result on the stability of the sulbactam ampicillin sample. Conclusion is NS solvents give better results than WFI solvents. Samples are more stable if stored in a refrigerator. After 4 hours based on the above study the sample no longer meets the requirements of Indonesian Pharmacopoeia 5th edition

The Effect of Corticosteroid Administration on Maternal Outcomes in Patients with Hellp Syndrome Yulistiani Yulistiani; Rana Rana
Eduvest - Journal of Universal Studies Vol. 4 No. 6 (2024): Journal Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v4i6.1480

HELLP syndrome is a hemolysis syndrome with microangiopathic blood smears, increased liver enzymes, and low platelets in pregnant and postpartum patients. HELLP syndrome may be a complication or progression of severe preeclampsia. The death rate due to HELLP syndrome is relatively high. The use of corticosteroids is expected to increase platelet counts, reduce LDH values, and reduce liver function parameters to speed up the duration of healing and reduce mortality. Corticosteroids inhibit endothelial activation, reduce vascular endothelial injury, increase hepatic blood flow, prevent thrombotic microvascular hemolysis, and reduce platelet consumption. Objective: To evaluate the effectiveness of corticosteroids in patients with HELLP syndrome. Method: This research was conducted using a literature review method by searching articles from Google Scholar, PubMed, and Science Direct. Results: Administration of corticosteroids can increase platelet counts, reduce AST/ALT values, and reduce the need for blood product transfusions. Conclusion: Corticosteroids effectively increase platelet counts in patients with HELLP syndrome.

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