Thendi Abdul Arief
Universitas Gadjah Mada

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Ketidaksesuaian Penggunaan Proton Pump Inhibitors (PPIs) pada Lanjut Usia dan Interaksi Obat: Kajian Naratif Thendi Abdul Arief; Nabila Risti Rachmadi; Hanum Hasifah Fahriah; Agung Endro Nugroho
Jurnal Ilmiah Medicamento Vol 12 No 1 (2026): Jurnal Ilmiah Medicamento (In progress)
Publisher : Fakultas Farmasi Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36733/medicamento.v12i1.11519

Abstract

Background: PPIs are highly effective for treating gastrointestinal disorders, including dyspepsia, peptic ulcer disease, gastritis, and gastroesophageal reflux disease (GERD). Furthermore, for the prophylaxis of NSAIDs and to mitigate gastrointestinal bleeding in patients receiving glucocorticoids, antiplatelet agents, or anticoagulants, particularly in the elderly population. The prescribing of PPIs among elderly patients remains a widespread issue that can lead to inappropriate use, hospital admission, or discharge. Additionally, the inappropriate use of PPIs can lead to possible drug-drug interactions.Objective: This narrative review aims to comprehensively assess inappropriateness associated with PPIs use in the elderly population and drug-drug interactions.Methods: Studies published from 2014 to 2024 were identified through a comprehensive search of multiple databases, including PubMed, Google Scholar, and ScienceDirect.Results: Long-term dangers such as infections and nutritional deficits are increased by inappropriate usage, which is defined by unwarranted commencement and lengthy duration. Simultaneously, PPIs present significant DDI hazards through modulating the absorption of pH-dependent medications and blocking cytochrome P450 enzymes, particularly CYP2C19. These risks are made worse by the prevalence of polypharmacy and aging-related deterioration of renal and hepatic function.Conclusion: In clinical practice, these findings call for systematic drug reviews and organized deprescribing programs to detect and manage high-risk combos. Implementing PPI stewardship programs in hospital and community settings is highly advised at the policy and systems level to enhance pharmaceutical safety in this susceptible population and to encourage evidence-based, guideline-concordant prescription.
Understanding the Safety Profile of Imatinib in Asian Chronic Myeloid Leukemia Patients: A Systematic Review Niky Budiarti; Zullies Ikawati; Arief Nurrochmad; Thendi Abdul Arief
Jurnal Ilmiah Medicamento Vol 12 No 1 (2026): Jurnal Ilmiah Medicamento (In progress)
Publisher : Fakultas Farmasi Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36733/medicamento.v12i1.13296

Abstract

Background: The treatment of chronic myeloid leukemia has advanced substantially since the introduction of tyrosine kinase inhibitors, particularly imatinib. However, adverse events associated with imatinib may affect adherence and quality of life, highlighting the importance of understanding safety outcomes across populations.Objective: This systematic review aimed to synthesize evidence on hematologic and non-hematologic adverse events associated with imatinib use among chronic myeloid leukemia patients in Asia.Methods: A systematic literature search was conducted in PubMed, Scopus, and ScienceDirect for studies published between January 2020 and July 2025. Eligible studies were synthesized narratively due to methodological heterogeneity. Adverse events were extracted as reported and graded using standardized toxicity criteria, and causality assessment was applied when available. Study quality was evaluated using established critical appraisal tools. Five studies from India, China, and Taiwan met the inclusion criteria.Results: The most frequent hematologic adverse event was anemia, followed by neutropenia and thrombocytopenia. Common non-hematologic adverse events included gastrointestinal symptoms, peripheral or periorbital edema, muscle cramps, and hyperpigmentation, with regional variations. Most events were mild to moderate (grades 1–2), while severe fluid retention, including pleural and pericardial effusions, was reported in isolated cases. No studies reported permanent discontinuation of imatinib due to adverse events.Conclusion: This review summarizes imatinib-related adverse events among chronic myeloid leukemia patients from selected Asian regions—East and South Asia, specifically India, China, and Taiwan—showing predominantly mild to moderate toxicities and providing practice-informed insights for clinical monitoring. However, the absence of data from other Asian regions precludes generalization to the entire Asian continent.