Dimo Pratama
Program Studi S1 Farmasi, STIKes Mitra Keluarga, Bekasi, Jawa Barat, Indonesia

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Potensi Interaksi Obat di Ruang Rawat Intensif: Sebuah Studi Observasional di Salah Satu Rumah Sakit Kota Bandung Ivan S. Pradipta; Dimo Pratama; Hanifahzin Khatami; Julisiana Sanggelorang
Indonesian Journal of Clinical Pharmacy Vol 11, No 1 (2022)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15416/ijcp.2022.11.1.41

Abstract

Ruang rawat intensif atau Intensive Care Unit (ICU) rumah sakit berperan dalam menangani pasien yang membutuhkan penanganan intensif. Perlunya intervensi pasien yang komprehensif dan cepat berpotensi menyebabkan kejadian interaksi obat dengan obat yang dapat menyebabkan reaksi obat yang tidak dikehendaki. Penelitian ini bertujuan untuk mendeskripsikan potensi kejadian interaksi antara obat dengan obat yang digunakan di ruang ICU salah satu rumah sakit di Kota Bandung. Studi observasional deskriptif ini dilakukan di salah satu rumah sakit Kota Bandung pada bulan Maret 2021. Penggunaan obat di ruang ICU diamati melalui laporan penggunaan obat ruang ICU rumah sakit dan potensi kejadian interaksi obat dengan obat diidentifikasi melalui instrumen software drug interaction checker. Proses validasi dilakukan dengan menganalisis hasil interaksi dengan literatur interaksi obat dan instrumen drug interaction checker lainnya. Terdapat 21 jenis obat yang paling sering digunakan di lokasi penelitian. Analisis dengan menggunakan instrumen dan literatur interaksi obat menunjukkan terdapat 22 pasangan interaksi obat dengan obat yang berpotensi terjadi. Interaksi obat tersebut meliputi tiga interaksi obat dengan tingkat keparahan mayor, yaitu interaksi obat deksametason-levofloksasin; fenitoin-nikardipin; fenitoin-nimodipin, sedangkan sisanya merupakan interaksi obat dengan tingkat keparahan moderat. Potensi interaksi obat dengan obat yang terjadi umumnya berdampak pada tekanan darah dan sistem saraf. Tingginya potensi kejadian interaksi obat dengan obat perlu menjadi perhatian bagi para tenaga kesehatan dalam pemilihan obat di ICU. Studi lanjutan diperlukan untuk menganalisis potensi penggunaan obat lainnya yang dapat menekan efek interaksi obat sehingga diharapkan dapat mencegah terjadinya reaksi obat yang tidak dikehendaki di ICU.Kata kunci: Drug related problems, ICU, interaksi obat-obat Potential Drug-Drug Interaction in the Intensive Care Unit: An Observational Study at a Hospital in BandungAbstractThe hospital’s Intensive Care Unit (ICU) is at the forefront of treating emergency patients requiring intensive care. The comprehensive, fast, and accurate medication in the unit causes the incidence of drug-drug interactions (DDI’s) and can lead to therapeutic failures in patients. Therefore, this study aimed to describe potential (DDIs) in the ICU of a hospital in Bandung. A descriptive observational study was performed in a hospital in Bandung from 1st to 31st March 2021. The drug use report observed the use of medics in the ICU. Furthermore, the potential DDI’s were identified using a drug interaction checker. It was validated using the textbook and another reputable checker. There are twenty-one types of drugs commonly used in the study setting, and the analysis showed twenty-two potential DDI’s. The interaction consists of three significant DDI’s, including dexamethasone-levofloxacin, phenytoin-nicardipine, and phenytoin-nimodipine, while the others are moderate. The majority of them generally affect the blood pressure and nervous system. Health care providers should observe the high incidence of DDI’s when selecting and monitoring drugs in the ICU. Further study is needed to explore the potential of other drugs that can minimize the interaction effect. Therefore, it is expected to improve ICU patients’ safety in adverse drug reaction situations.Keywords: Drug-drug interactions, drug-related problems, ICU
Association of IMPDH1 and IMPDH2 gene polymorphisms with efficacy and toxicity of mycophenolic acid treatment in renal transplant patients: a narrative review Pratama, Dimo; Ikawati, Zullies; Hermawan, Adam
Indonesian Journal of Pharmacology and Therapy Vol 6 No 3 (2025)
Publisher : Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada and Indonesian Pharmacologist Association or Ikatan Farmakologi Indonesia (IKAFARI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijpther.20875

Abstract

Immunosuppressive regimen treatment in renal transplant recipients is necessary to prevent acute rejection from the body’s immune system. Mycophenolic acid (MPA), commonly prescribed for renal transplant recipients, exists in two formulations: mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS). Both drugs act by inhibiting inosine-5’-monophosphate dehydrogenase (IMPDH), an enzyme that is responsible for the guanosine nucleotide synthesis pathway of T and B lymphocytes. IMPDH exists in two isoforms, IMPDH1 and IMPDH2, encoded by IMPDH1 and IMPDH2 gene, respectively. Polymorphisms in these genes may alter the enzyme activity, potentially influencing MPA pharmacodynamics and leading to variations in therapeutic responses among renal transplant patients taking MPA. A systematic literature search was performed using Scopus, PubMed, and Web of Science with the Boolean search strategy: “IMPDH AND Polymorphism* AND Mycophenol* AND ((Renal OR Kidney) Transplant* OR Graft*)”. The articles yielded from this literature search were screened, resulting in 15 articles that were included in this review. Some studies reported the association between the IMPDH1 or IMPDH2 polymorphism and acute rejection, while others found no significant correlation. Regarding toxicity, leukopenia was linked to IMPDH1 SNPs (rs2278293, rs2278294), although the results were inconsistent. Most of the studies found no significant association between IMPDH2 SNPs and leukopenia incidence.
Association of IMPDH1 and IMPDH2 gene polymorphisms with efficacy and toxicity of mycophenolic acid treatment in renal transplant patients: a narrative review Pratama, Dimo; Ikawati, Zullies; Hermawan, Adam
Indonesian Journal of Pharmacology and Therapy Vol 6 No 3 (2025)
Publisher : Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada and Indonesian Pharmacologist Association or Ikatan Farmakologi Indonesia (IKAFARI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijpther.20875

Abstract

Immunosuppressive regimen treatment in renal transplant recipients is necessary to prevent acute rejection from the body’s immune system. Mycophenolic acid (MPA), commonly prescribed for renal transplant recipients, exists in two formulations: mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS). Both drugs act by inhibiting inosine-5’-monophosphate dehydrogenase (IMPDH), an enzyme that is responsible for the guanosine nucleotide synthesis pathway of T and B lymphocytes. IMPDH exists in two isoforms, IMPDH1 and IMPDH2, encoded by IMPDH1 and IMPDH2 gene, respectively. Polymorphisms in these genes may alter the enzyme activity, potentially influencing MPA pharmacodynamics and leading to variations in therapeutic responses among renal transplant patients taking MPA. A systematic literature search was performed using Scopus, PubMed, and Web of Science with the Boolean search strategy: “IMPDH AND Polymorphism* AND Mycophenol* AND ((Renal OR Kidney) Transplant* OR Graft*)”. The articles yielded from this literature search were screened, resulting in 15 articles that were included in this review. Some studies reported the association between the IMPDH1 or IMPDH2 polymorphism and acute rejection, while others found no significant correlation. Regarding toxicity, leukopenia was linked to IMPDH1 SNPs (rs2278293, rs2278294), although the results were inconsistent. Most of the studies found no significant association between IMPDH2 SNPs and leukopenia incidence.
Maintenance Immunosuppressive Prescribing Patterns in Kidney Transplant Recipients at an Indonesian Tertiary Referral Hospital: A Retrospective Cross-Sectional Study Dimo Pratama; Aqmarina Tamimi; Yulia Wardhani
Archives of The Medicine and Case Reports Vol. 7 No. 3 (2026): Archives of The Medicine and Case Reports
Publisher : HM Publisher in collaboration with CMHC Research Center

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v7i3.925

Abstract

Kidney transplantation is the optimal kidney replacement therapy for end-stage kidney disease, but graft survival depends on lifelong maintenance immunosuppression. Indonesian data on how these medicines are actually prescribed remain scarce. Retrospective cross-sectional drug-utilisation study of 53 maintenance immunosuppressant prescriptions dispensed to kidney transplant recipients at a tertiary referral hospital in Yogyakarta, Indonesia, between 2017 and 2024. Proportions were estimated with Wilson 95% confidence intervals (CI); within-class preference with exact binomial tests; associations with Fisher exact tests; prescribing concentration with diversity indices and bootstrap CIs; and frequencies were benchmarked against published French, Korean and Indonesian reference proportions using Holm-adjusted exact binomial tests, reported as absolute differences and prevalence ratios. Reporting followed STROBE. Recipients were mostly aged 18–49 years (73.6%) and male (64.2%). Tacrolimus was the only calcineurin inhibitor prescribed (100.0%; 95% CI 93.2–100.0), and mycophenolic acid the only antiproliferative agent. Methylprednisolone was the preferred corticosteroid (69.8%; 56.5–80.5; p = 0.002) and enteric-coated mycophenolate sodium the preferred formulation (77.4%; 64.5–86.5; p < 0.001). The modal regimen was tacrolimus plus methylprednisolone plus mycophenolate sodium (56.6%; 43.3–69.0). Tacrolimus and mycophenolic acid use exceeded a French national cohort (+8.7 and +9.5 percentage points; Holm-adjusted p = 0.040 and 0.034), whereas corticosteroid maintenance did not differ significantly (96.2% versus 88.1%; p = 0.086). Prescribing was highly concentrated (Herfindahl–Hirschman Index 3,799). In conclusion, maintenance prescribing was exceptionlessly tacrolimus- and mycophenolate-based, exceeding even high-volume European practice, and reproduced an independent Indonesian series almost exactly. Corticosteroid maintenance was near-universal, identifying corticosteroid minimisation and therapeutic drug monitoring capacity as priority targets.
UJI EVALUASI DAN AKTIVITAS SALEP EKSTRAK DAUN BINAHONG (ANREDERA CORDIFOLIA), MINYAK ATSIRI LEMON, DAN MINYAK CALENDULA TERHADAP PENYEMBUHAN LUKA SAYAT Anisa Rachmita Arianti; Maya Uzia Beandrade; Intan Kurnia Putri; Dimo Pratama
SEHAT : Jurnal Kesehatan Terpadu Vol. 5 No. 4 (2026)
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/s-jkt.v5i4.61673

Abstract

Meningkatnya minat masyarakat terhadap produk perawatan tubuh berbahan alami mendorong pengembangan sabun cair natural yang tidak hanya aman digunakan, tetapi juga memiliki mutu fisik yang baik dan diterima oleh konsumen. Kombinasi minyak atsiri jeruk nipis (Citrus aurantifolia) dan kemangi (Ocimum basilicum) dipilih karena memiliki aktivitas antibakteri, antiseptik, serta memberikan aroma yang menyegarkan. Penelitian ini bertujuan untuk mengevaluasi tingkat penerimaan konsumen terhadap sabun cair natural yang diformulasikan dengan kombinasi kedua minyak atsiri tersebut melalui uji hedonik serta menganalisis stabilitas fisik sediaan selama penyimpanan. Penelitian menggunakan rancangan eksperimental dengan beberapa variasi formula. Penilaian hedonik dilakukan oleh panelis berdasarkan parameter warna, aroma, tekstur, dan tingkat kesukaan secara keseluruhan. Evaluasi stabilitas fisik meliputi pengamatan organoleptik, pengukuran pH, viskositas, tinggi busa, serta uji iritasi kulit. Data hasil pengujian dianalisis menggunakan One Way ANOVA pada tingkat kepercayaan 95% untuk mengetahui perbedaan antarformula. Hasil penelitian diharapkan menunjukkan bahwa formula sabun cair natural dengan kombinasi minyak atsiri jeruk nipis dan kemangi memiliki karakteristik fisik yang stabil, tidak menimbulkan iritasi, serta memperoleh tingkat penerimaan yang baik berdasarkan uji hedonik. Dengan demikian, formulasi yang dikembangkan berpotensi menjadi produk kosmetik berbahan alami yang memenuhi aspek mutu, keamanan, dan preferensi konsumen sehingga layak untuk dikembangkan lebih lanjut sebagai sabun cair natural.
EVALUASI PENGGUNAAN ANTIBIOTIK PADA PASIEN RAWAT INAP DENGAN DIAGNOSIS DEMAM TIFOID 2025 Imay Nur Andani; Anisa Rachmita Arianti; Dimo Pratama; Embriana Dinar Pramestyani
Jurnal Kesehatan Tambusai Vol. 7 No. 3 (2026): SEPTEMBER 2026
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jkt.v7i3.60768

Abstract

Demam tifoid merupakan penyakit infeksi sistemik yang disebabkan oleh bakteri Salmonella typhi dan masih menjadi salah satu masalah kesehatan di Indonesia. WHO melaporkan sekitar 9 juta kasus demam tifoid dengan lebih dari 100.000 kematian setiap tahun. Pengobatan demam tifoid umumnya menggunakan antibiotik, tetapi penggunaannya perlu diperhatikan untuk memastikan kesesuaian dengan pedoman terapi serta mencegah penggunaan yang tidak tepat. Penelitian ini bertujuan untuk menganalisis pola penggunaan dan ketepatan penggunaan antibiotik pada pasien demam tifoid di RS X. Penelitian ini merupakan penelitian kuantitatif dengan desain deskriptif dan pendekatan retrospektif. Pengambilan sampel dilakukan menggunakan teknik purposive sampling dengan sumber data berupa rekam medis pasien rawat inap yang terdiagnosis demam tifoid pada periode Januari–Desember 2025. Variabel penelitian meliputi usia, jenis kelamin, penyakit penyerta, golongan antibiotik, jenis antibiotik, ketepatan diagnosis, ketepatan obat, dan ketepatan dosis. Hasil penelitian menunjukkan bahwa kelompok usia 18–65 tahun merupakan kelompok terbanyak, yaitu 47 pasien (63,5%). Pasien perempuan sebanyak 40 pasien (54%) dan laki-laki sebanyak 34 pasien (46%). Sebanyak 40 pasien (54%) memiliki penyakit penyerta. Antibiotik yang paling banyak digunakan adalah seftriakson sebanyak 56 pasien (75,7%). Evaluasi ketepatan penggunaan antibiotik menunjukkan tepat diagnosis sebanyak 72 pasien (97%), tepat obat sebanyak 72 pasien (97%), dan tepat dosis sebanyak 69 pasien (93%). Penggunaan antibiotik pada pasien demam tifoid di RS X secara umum telah sesuai dengan pedoman pengobatan.