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INDONESIA
Jurnal Farmasi Klinik Indonesia
Published by Universitas Padjadjaran
ISSN : 23375701     EISSN : 2337 5701     DOI : -
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Indonesian Journal of Clinical Pharmacy (IJCP) is a scientific publication on all aspect of clinical pharmacy. It published 4 times a year by Clinical Pharmacy Master Program Universitas Padjadjaran to provide a forum for clinicians, pharmacists, and other healthcare professionals to share best practice, encouraging networking and a more collaborative approach in patient care. Indonesian Journal of Clinical Pharmacy is intended to feature quality research articles in clinical pharmacy to become scientific guide in fields related to clinical pharmacy. It is a peer-reviewed journal and publishes original research articles, review articles, case reports, commentaries, and brief research communications on all aspects of Clinical Pharmacy. It is also a media for publicizing meetings and news relating to advances in Clinical Pharmacy in the regions.
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Search results for , issue "Vol 2, No 2 (2013)" : 10 Documents clear
Effect of Attapulgite on the Oral Bioavailability of Ciprofloxacin Izzah, Zamrotul; Gratia, Veronica; Aryani, Toetik; Suharjono, Suharjono
Indonesian Journal of Clinical Pharmacy Vol 2, No 2 (2013)
Publisher : Indonesian Journal of Clinical Pharmacy

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Abstract

As a result, this drug-drug interaction may reduce ciprofloxacin bioavailability. This study was aimed to determine the effect of attapulgite on the bioavailability of a single orally-administered ciprofloxacin. Six New Zealand white rabbits received each of the following treatments in a randomized, three-way crossover sequence, separated by a 7-day washout period: (i) ciprofloxacin (23 mg/kgBW) alone; (ii) ciprofloxacin (23 mg/kgBW) given simultaneously with attapulgite (28 mg/kgBW); (iii) ciprofloxacin(23 mg/kgBW) given 2 hours after attapulgite (28 mg/kgBW). Blood samples (1 mL) were collected from the marginal ear vein up to 240 minutes postdose. The plasma concentrations of ciprofloxacin were determined by a validated high-performance liquid chromatography method. The maximum concentration and oral bioavailability (AUC0-240 min) of ciprofloxacin were significantly decreased by 49% and 32% when administered concomitantly with attapulgite (p<0.001). Attapulgite appeared to have no significant effect on the bioavailability of ciprofloxacin when administered 2 hours before ciprofloxacin. In conclusion, the oral bioavailability of ciprofloxacin is markedly reduced when administered concomitantly with attapulgite. This drug-drug interaction may decrease clinical efficacy and promote microbial resistance to ciprofloxacin. However, the interaction could be minimized by separating the adminsitration of these drugs at least 2 hours.Key words: Attapulgite, bioavailability, ciprofloxacin, drug-drug interactionPengaruh Atapulgit pada Ketersediaan Hayati Siprofloksasin OralKemampuan absorpsi atapulgit dapat menghambat absorpsi siprofloksasin pada pemberian per oral. Sebagai hasilnya, interaksi obat-obat ini dapat menurunkan ketersediaan hayati siprofloksasin. Penelitian ini bertujuan untuk  mendeterminasi efek atapulgit pada ketersediaan hayati obat siprofloksasin yang diberikan secara oral. Sebanyak 7 kelinci putih Selandia Baru menerima perlakuan secara random dengan desain three-way crossover sequence, yang dipisahkan dengan periode washout 7 hari. (i) siprofloksasin (23 mg/kgBB); (ii) siprofloksasin (23 mg/kgBB) diberikan secara simultan dengan atapulgit (28 mg/kgBB); (iii) siprofloksasin (23 mg/kgBB) diberikan 2 jam setelah pemberian atapulgit (28 mg/kgBB. Sampel darah (1 mL) dikumpulkan pada marginal ear vein setelah 240 menit pemberian obat. Konsentrasi siprofloksasin plasma dihitung dengan metode kromatografi cair kinerja tinggi tervalidasi. Konsentrasi maksimum dan ketersediaan hayati oral (AUC0-240 min) siprofloksasin secara signifikan berkurang 49% dan 32% ketika dikombinasikan bersamaan dengan atapulgit (p< 0,001). Atapulgit tidak memiliki pengaruh signifikan pada ketersediaan hayati ketika diberikan 2 jam sebelum siprofloksasin. Ketersediaan hayati siprofloksasin berkurang secara signifikan ketika diberikan bersamaan dengan pemberian atapulgit. Interaksi obat dengan obat ini dapat mengurangi efikasi obat dan meningkatkan resistensi mikrob terhadap siprofloksasin. Namun, interaksi dapat dikurangi dengan pemberian obat pada jarak waktu minimal 2 jam.Kata kunci: Atapulgit, interaksi obat dengan obat, ketersediaan hayati, siprofloksasin
Pengaruh Pemakaian Kontrasepsi terhadap Peningkatan Tekanan Darah Wanita di Puskesmas Wonogiri Sujono, Tanti A.; Milawati, Alfiana; Hakim, Arif R.
Indonesian Journal of Clinical Pharmacy Vol 2, No 2 (2013)
Publisher : Indonesian Journal of Clinical Pharmacy

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Abstract

Tujuan penelitian ini adalah untuk mengetahui pengaruh pemakaian kontrasepsi hormonal (suntik dan pil) terhadap peningkatan tekanan darah wanita akseptor KB di Puskesmas Wonogiri Kabupaten Wonogiri. Penelitian ini merupakan penelitian noneksperimental (observasional) dengan desain cross sectional. Cara pengambilan sampel secara purposive sampling terhadap akseptor KB yang datang ke Puskesmas Wonogiri I dan II untuk melakukan KB. Data dikumpulkan dari 29 akseptor KB suntik, 22akseptor KB pil, dan 34 akseptor KB IUD (kontrasepsi nonhormonal sebagai kontrol). Data diambil dari kartu status peserta KB, selain itu juga pemberian kuisioner dan wawancara langsung dengan akseptor KB. Data kemudian dianalisis berdasarkan rasio prevalensi terjadinya peningkatan tekanan darah. Hasil perhitungan Rasio Prevalensi (RP>1), hal ini menunjukkan bahwa kontrasepsi hormonal KB suntik danKB pil sebagai faktor resiko terjadinya peningkatan tekanan darah pada akseptor KB hormonal berturut-turut sebesar 2,93 dan 3,61 kali dibanding kontrasepsi IUD (nonhormonal). Hal ini menunjukkan bahwa KB hormonal yang mengandung kombinasi estrogen dan progesteron menyebabkan peningkatan tekanan darah walaupun masih dalam rentang tekanan darah yang normal (<140 mmHg).Kata kunci: Kontrasepsi hormonal, kontrasepsi suntik dan pil, tekanan darah Effect of Contraceptive Agents to Women Blood Pressure in Wonogiri Community Health CentersThe purpose of this study to determine the effect of the use of hormonal contraceptives (injections and pills) against increasing of blood pressure on women KB acceptors at the Wonogiri public health center in Wonogiri regency. This research is non-experimental (observational) with cross sectional design. Thesampling with purposive sampling to acceptors who come to the public health center Wonogiri I and II to conduct KB. Data were collected from 29 acceptors injection, 22 acceptors pill and 34 acceptors IUD (nonhormonal contraception as a control). The data were taken from the acceptors status card, questionnairesand direct interviews with them. The data were analyzed the prevalence ratio of the increase in blood pressure. The result calculation of Prevalence Ratio (PR>1), it indicated that the hormonal contraceptive (injection and pill) as a risk factor the occurence of increased blood pressure at hormonal KB acceptors, about 2,93 and 3,61 times consecutively compared to IUD. This suggests that hormonal contraseptive containing a combination of estrogen and progesterone causes an increase in blood pressure,although still within the normal range of blood pressure (<140 mmHg).Key words: Hormonal contraception, contraception injection and pill, blood pressure
Pengaruh Kontaminasi Mikroba terhadap Kualitas Obat Antituberkulosis Racikan di Bandung Kautsar, Angga P.; Kusuma, Sri A. F.; Kurniawati, Kartini; Ab. Razak, Syahidah Binti
Indonesian Journal of Clinical Pharmacy Vol 2, No 2 (2013)
Publisher : Indonesian Journal of Clinical Pharmacy

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Abstract

Berdasarkan profil tuberkulosis (TBC) Indonesia dari World Health Organization (WHO), total kasus baru penyakit TBC pada tahun 2011 adalah 313.601 kasus dan 8,9% melibatkan anak-anak di bawah 15 tahun. Tingkat kesembuhan TBC pada anak dipengaruhi terutama oleh kualitas pengobatan Obat Anti Tuberkulosis (OAT) yang diberikan. Pertimbangan pemberian obat dalam bentuk racikan tersebut karena perhitungan dosis dapat disesuaikan dengan berat badan dan umur anak secara lebih tepat. Tujuanpenelitian ini adalah mengukur pengaruh kontaminasi mikroba terhadap kualitas OAT racikan guna meningkatkan efek terapi yang diharapkan dan mencegah kegagalan pengobatan TBC. Uji kontaminasi mikroba menggunakan Metode Angka Lempeng Total (ALT). Hasil uji menunjukkan kondisi kadar kontaminasi mikroba seluruhnya dalam kategori memenuhi syarat. Kualitas obat racik menunjukkan 82% masuk dalam kategori cukup baik, dan 18% masuk dalam kategori baik. Kata kunci: Tuberkulosis, proses peracikan, Metode Angka Lempeng TotalEffect of Microbes Contamination in Quality of Compounding Antitubeculosis Drugs in BandungBased on The Indonesia’s TBC profile from WHO, total of TBC new cases in year 2011 is 313.601 cases and 8.9% involve children under age of 15. TBC cure rate for pediatric patient was influenced primarily by the quality of antituberculosis medicine given. Consideration of drug delivery in the form of compoundedmedicine because the dose can be calculated and adjust base on weight and age of the pediatric patient. The qualities of compounded medicine need to be monitored in order to increase the expected therapeutic effect and to prevent TBC treatment failure. Survey has been carried out in the level of microbecontaminations test using Total Plate Count Method (TPC). From the TPC test, all of the microbe contaminations tests (100%) show qualified levels of contaminations. Both of the results, the qualitiesof compounded medicine shows 82% categorize as good and 18% as very good.Key words: Tuberculosis, compounding processes, Total Plate Count Method
Analisis Efektivitas Biaya Penggunaan Antibiotik Pasien Sepsis di Rumah Sakit di Bandung Rahayu, Cherry; Purwanti, Okky S.; Sinuraya, Rano K.; Destiani, Dika P.
Indonesian Journal of Clinical Pharmacy Vol 2, No 2 (2013)
Publisher : Indonesian Journal of Clinical Pharmacy

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Abstract

Tujuan penelitian ini adalah untuk mengetahui kelompok kombinasi antibiotik empirik yang paling efektif secara biaya (cost effectiveness) yang digunakan pada sepsis sumber infeksi pernapasan yang dirawat di salah satu rumah sakit di kota Bandung periode tahun 2010–2012. Penelitian merupakan studi analisis observasional dengan pengumpulan data secara retrospektif. Data diambil dari rekam medis pasien rawat inap sepsis sumber infeksi pernapasan dan mendapat terapi antibiotik empirik sefotaksimmetronidazol dan sefotaksim-eritromisin. Komponen biaya yang dikumpulkan meliputi biaya antibiotik empirik, biaya tindakan, biaya penunjang, biaya rawat inap, dan biaya administrasi. Hasil Incremental Cost Effectiveness Ratio (ICER) menunjukkan rasio nilai biaya langsung terhadap pasien yang selamat sebesar Rp 3.301.090,00 untuk kombinasi sefotaksim- metronidazol yang dibandingkan dengan antibiotik empirik lain, sedangkan perbandingan kombinasi sefotaksim-eritromisin dengan antibiotik lain terhadap biaya dan pasien yang selamat sebesar Rp 2.227.366,89. Dapat disimpulkan bahwa kombinasi antibiotik sefotaksim-eritromisin lebih efektif secara biaya dibanding kombinasi sefotaksim-metronidazol.Kata kunci: Antibiotik empirik, cost effectiveness, farmakoekonomi, sepsis Cost Effectiveness Analysis of Antibiotic Used among Sepsis Patients in Hospital in BandungThe aim of this study was to determine the antibiotic combination group that were the most effective in cost (cost effectiveness) used as sepsis with respiratory infections treatment at one of hospital in Bandung. Observational study was conducted by retrospective data. Data were collected from medical record from inpatients sepsis with respiratory infection and received empirical therapy cefotaximemetronidazole or cefotaxime-erythromycin. Direct medical cost is collected from empirical antibiotic costs, costs of medical treatment, medical expenses, hospitalization costs, and administrative costs. The results of Incremental Cost Effectiveness Ratio (ICER) showed that ratio of direct medical cost and survived patients is 3.301.090,00 IDR for cefotaxime-metronidazole that compared to other empirical antibiotic, and 2.227.366,89 IDR for cefotaxime-erythromycin. It can be conclude that the combination of cefotaxime-erythromycin is more cost effective than cefotaxime-metronidazole.Key words: Empirical therapy, cost effectiveness, pharmacoeconomic, sepsis
Peresepan Obat-obat Off-Label pada Pasien Anak Usia 0 Hingga 2 Tahun di Apotek Kota Bandung Pratiwi, Ami A.; Khairinnisa, Miski A.; Alfian, Sofa D.; Priyadi, Akhmad; Pradipta, Ivan S.; Abdulah, Rizky
Indonesian Journal of Clinical Pharmacy Vol 2, No 2 (2013)
Publisher : Indonesian Journal of Clinical Pharmacy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (305.032 KB)

Abstract

Obat off-label merupakan obat yang diresepkan tetapi tidak sesuai dengan informasi resmi obat seperti indikasi obat yang tidak sesuai dengan yang dinyatakan oleh izin edar serta dosis, umur pasien, dan rute pemberian yang tidak sesuai. Penelitian ini dilakukan untuk mengetahui persentase jumlah resep pasien dokter spesialis anak yang mengandung obat off-label pada pasien anak usia 0 hingga 2 tahun di Apotek Kota Bandung serta mengetahui pola penggunaannya melalui studi observasional dengan pengambilan data secara retrospektif. Identifikasi obat yang diresepkan termasuk kategori off-label atau tidak berdasarkan Pediatric Dosage Handbook 2007, Drug Information Handbook (DIH) 2012, British National Formulary (BNF) 2009, MIMS USA 2013, MIMS Indonesia 2013, dan ISO 2012–2013. Berdasarkan hasil penelitian diperoleh 542 lembar resep off-label (19,77%) dari 2741 total lembar resep, serta sebanyak 699 (7,89%) item obat off-label dari 8861 obat, dengan persentase kategori off-label usia 70,53%, off-label dosis 19,74% dan off-label kontraindikasi 9,73%. Penelitian ini menunjukkan bahwa potensi peresepan obat off-label di apotek di Kota Bandung pada tahun 2012 tinggi sehingga perlu pemilihan obat yang tepat serta pengawasan dalam penggunaan obat pada anak.Kata kunci: Obat off-label, pediatri, peresepan, Bandung The Prescription of Off-Label Drugs towards 0–2 Years Old Pediatric Patients in Community Pharmacy in Bandung CityOff-label drug is a drug which is not prescribed in accordance with official drug information, including patient age, drug indications didn’t match with the marketing authorization, dosage and route ofadministration are not appropriate. This study was conducted to determine the percentage of patients pediatrician who prescribed with containing drugs off-label in pediatric patients aged 0 to 2 years at pharmacy in Bandung and determine the pattern of use through an observational study with retrospective data collection. Identification of medications that are prescribed off-label category or not based on the Pediatric Dosage Handbook 2007, Drug Information Handbook (DIH) in 2012, the British NationalFormulary (BNF) in 2009, MIMS USA 2013, MIMS Indonesia in 2013, and ISO 2012–2013. Based on the results obtained 542 pieces of off-label prescriptions (19.77%) of the 2741 total pieces recipes, as well as 699 (7.89%) of off-label drug items from 8861 drug, the percentage of off-label age category 70.53%, off-label doses of 19.74% and off-label contraindication 9.73%. The results of this study indicate that the uses of off-label drugs for children is high at Pharmacy in Bandung. This study is expected to be basicconsideration in examining the efficacy and safety in off-label drug uses for children aged 0 to 2 years.Key words: Off-label drug, pediatric, prescription, Bandung
Pengaruh Pemakaian Kontrasepsi terhadap Peningkatan Tekanan Darah Wanita di Puskesmas Wonogiri Tanti A. Sujono; Alfiana Milawati; Arif R. Hakim
Indonesian Journal of Clinical Pharmacy Vol 2, No 2 (2013)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (594.187 KB)

Abstract

Tujuan penelitian ini adalah untuk mengetahui pengaruh pemakaian kontrasepsi hormonal (suntik dan pil) terhadap peningkatan tekanan darah wanita akseptor KB di Puskesmas Wonogiri Kabupaten Wonogiri. Penelitian ini merupakan penelitian noneksperimental (observasional) dengan desain cross sectional. Cara pengambilan sampel secara purposive sampling terhadap akseptor KB yang datang ke Puskesmas Wonogiri I dan II untuk melakukan KB. Data dikumpulkan dari 29 akseptor KB suntik, 22akseptor KB pil, dan 34 akseptor KB IUD (kontrasepsi nonhormonal sebagai kontrol). Data diambil dari kartu status peserta KB, selain itu juga pemberian kuisioner dan wawancara langsung dengan akseptor KB. Data kemudian dianalisis berdasarkan rasio prevalensi terjadinya peningkatan tekanan darah. Hasil perhitungan Rasio Prevalensi (RP>1), hal ini menunjukkan bahwa kontrasepsi hormonal KB suntik danKB pil sebagai faktor resiko terjadinya peningkatan tekanan darah pada akseptor KB hormonal berturut-turut sebesar 2,93 dan 3,61 kali dibanding kontrasepsi IUD (nonhormonal). Hal ini menunjukkan bahwa KB hormonal yang mengandung kombinasi estrogen dan progesteron menyebabkan peningkatan tekanan darah walaupun masih dalam rentang tekanan darah yang normal (<140 mmHg).Kata kunci: Kontrasepsi hormonal, kontrasepsi suntik dan pil, tekanan darah Effect of Contraceptive Agents to Women Blood Pressure in Wonogiri Community Health CentersThe purpose of this study to determine the effect of the use of hormonal contraceptives (injections and pills) against increasing of blood pressure on women KB acceptors at the Wonogiri public health center in Wonogiri regency. This research is non-experimental (observational) with cross sectional design. Thesampling with purposive sampling to acceptors who come to the public health center Wonogiri I and II to conduct KB. Data were collected from 29 acceptors injection, 22 acceptors pill and 34 acceptors IUD (nonhormonal contraception as a control). The data were taken from the acceptors status card, questionnairesand direct interviews with them. The data were analyzed the prevalence ratio of the increase in blood pressure. The result calculation of Prevalence Ratio (PR>1), it indicated that the hormonal contraceptive (injection and pill) as a risk factor the occurence of increased blood pressure at hormonal KB acceptors, about 2,93 and 3,61 times consecutively compared to IUD. This suggests that hormonal contraseptive containing a combination of estrogen and progesterone causes an increase in blood pressure,although still within the normal range of blood pressure (<140 mmHg).Key words: Hormonal contraception, contraception injection and pill, blood pressure
Pengaruh Kontaminasi Mikroba terhadap Kualitas Obat Antituberkulosis Racikan di Bandung Angga P. Kautsar; Sri A. F. Kusuma; Kartini Kurniawati; Syahidah Binti Ab. Razak
Indonesian Journal of Clinical Pharmacy Vol 2, No 2 (2013)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (569.635 KB)

Abstract

Berdasarkan profil tuberkulosis (TBC) Indonesia dari World Health Organization (WHO), total kasus baru penyakit TBC pada tahun 2011 adalah 313.601 kasus dan 8,9% melibatkan anak-anak di bawah 15 tahun. Tingkat kesembuhan TBC pada anak dipengaruhi terutama oleh kualitas pengobatan Obat Anti Tuberkulosis (OAT) yang diberikan. Pertimbangan pemberian obat dalam bentuk racikan tersebut karena perhitungan dosis dapat disesuaikan dengan berat badan dan umur anak secara lebih tepat. Tujuanpenelitian ini adalah mengukur pengaruh kontaminasi mikroba terhadap kualitas OAT racikan guna meningkatkan efek terapi yang diharapkan dan mencegah kegagalan pengobatan TBC. Uji kontaminasi mikroba menggunakan Metode Angka Lempeng Total (ALT). Hasil uji menunjukkan kondisi kadar kontaminasi mikroba seluruhnya dalam kategori memenuhi syarat. Kualitas obat racik menunjukkan 82% masuk dalam kategori cukup baik, dan 18% masuk dalam kategori baik. Kata kunci: Tuberkulosis, proses peracikan, Metode Angka Lempeng TotalEffect of Microbes Contamination in Quality of Compounding Antitubeculosis Drugs in BandungBased on The Indonesia’s TBC profile from WHO, total of TBC new cases in year 2011 is 313.601 cases and 8.9% involve children under age of 15. TBC cure rate for pediatric patient was influenced primarily by the quality of antituberculosis medicine given. Consideration of drug delivery in the form of compoundedmedicine because the dose can be calculated and adjust base on weight and age of the pediatric patient. The qualities of compounded medicine need to be monitored in order to increase the expected therapeutic effect and to prevent TBC treatment failure. Survey has been carried out in the level of microbecontaminations test using Total Plate Count Method (TPC). From the TPC test, all of the microbe contaminations tests (100%) show qualified levels of contaminations. Both of the results, the qualitiesof compounded medicine shows 82% categorize as good and 18% as very good.Key words: Tuberculosis, compounding processes, Total Plate Count Method
Analisis Efektivitas Biaya Penggunaan Antibiotik Pasien Sepsis di Rumah Sakit di Bandung Cherry Rahayu; Okky S. Purwanti; Rano K. Sinuraya; Dika P. Destiani
Indonesian Journal of Clinical Pharmacy Vol 2, No 2 (2013)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (597.835 KB)

Abstract

Tujuan penelitian ini adalah untuk mengetahui kelompok kombinasi antibiotik empirik yang paling efektif secara biaya (cost effectiveness) yang digunakan pada sepsis sumber infeksi pernapasan yang dirawat di salah satu rumah sakit di kota Bandung periode tahun 2010–2012. Penelitian merupakan studi analisis observasional dengan pengumpulan data secara retrospektif. Data diambil dari rekam medis pasien rawat inap sepsis sumber infeksi pernapasan dan mendapat terapi antibiotik empirik sefotaksimmetronidazol dan sefotaksim-eritromisin. Komponen biaya yang dikumpulkan meliputi biaya antibiotik empirik, biaya tindakan, biaya penunjang, biaya rawat inap, dan biaya administrasi. Hasil Incremental Cost Effectiveness Ratio (ICER) menunjukkan rasio nilai biaya langsung terhadap pasien yang selamat sebesar Rp 3.301.090,00 untuk kombinasi sefotaksim- metronidazol yang dibandingkan dengan antibiotik empirik lain, sedangkan perbandingan kombinasi sefotaksim-eritromisin dengan antibiotik lain terhadap biaya dan pasien yang selamat sebesar Rp 2.227.366,89. Dapat disimpulkan bahwa kombinasi antibiotik sefotaksim-eritromisin lebih efektif secara biaya dibanding kombinasi sefotaksim-metronidazol.Kata kunci: Antibiotik empirik, cost effectiveness, farmakoekonomi, sepsis Cost Effectiveness Analysis of Antibiotic Used among Sepsis Patients in Hospital in BandungThe aim of this study was to determine the antibiotic combination group that were the most effective in cost (cost effectiveness) used as sepsis with respiratory infections treatment at one of hospital in Bandung. Observational study was conducted by retrospective data. Data were collected from medical record from inpatients sepsis with respiratory infection and received empirical therapy cefotaximemetronidazole or cefotaxime-erythromycin. Direct medical cost is collected from empirical antibiotic costs, costs of medical treatment, medical expenses, hospitalization costs, and administrative costs. The results of Incremental Cost Effectiveness Ratio (ICER) showed that ratio of direct medical cost and survived patients is 3.301.090,00 IDR for cefotaxime-metronidazole that compared to other empirical antibiotic, and 2.227.366,89 IDR for cefotaxime-erythromycin. It can be conclude that the combination of cefotaxime-erythromycin is more cost effective than cefotaxime-metronidazole.Key words: Empirical therapy, cost effectiveness, pharmacoeconomic, sepsis
Peresepan Obat-obat Off-Label pada Pasien Anak Usia 0 Hingga 2 Tahun di Apotek Kota Bandung Ami A. Pratiwi; Miski A. Khairinnisa; Sofa D. Alfian; Akhmad Priyadi; Ivan S. Pradipta; Rizky Abdulah
Indonesian Journal of Clinical Pharmacy Vol 2, No 2 (2013)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (305.032 KB)

Abstract

Obat off-label merupakan obat yang diresepkan tetapi tidak sesuai dengan informasi resmi obat seperti indikasi obat yang tidak sesuai dengan yang dinyatakan oleh izin edar serta dosis, umur pasien, dan rute pemberian yang tidak sesuai. Penelitian ini dilakukan untuk mengetahui persentase jumlah resep pasien dokter spesialis anak yang mengandung obat off-label pada pasien anak usia 0 hingga 2 tahun di Apotek Kota Bandung serta mengetahui pola penggunaannya melalui studi observasional dengan pengambilan data secara retrospektif. Identifikasi obat yang diresepkan termasuk kategori off-label atau tidak berdasarkan Pediatric Dosage Handbook 2007, Drug Information Handbook (DIH) 2012, British National Formulary (BNF) 2009, MIMS USA 2013, MIMS Indonesia 2013, dan ISO 2012–2013. Berdasarkan hasil penelitian diperoleh 542 lembar resep off-label (19,77%) dari 2741 total lembar resep, serta sebanyak 699 (7,89%) item obat off-label dari 8861 obat, dengan persentase kategori off-label usia 70,53%, off-label dosis 19,74% dan off-label kontraindikasi 9,73%. Penelitian ini menunjukkan bahwa potensi peresepan obat off-label di apotek di Kota Bandung pada tahun 2012 tinggi sehingga perlu pemilihan obat yang tepat serta pengawasan dalam penggunaan obat pada anak.Kata kunci: Obat off-label, pediatri, peresepan, Bandung The Prescription of Off-Label Drugs towards 0–2 Years Old Pediatric Patients in Community Pharmacy in Bandung CityOff-label drug is a drug which is not prescribed in accordance with official drug information, including patient age, drug indications didn’t match with the marketing authorization, dosage and route ofadministration are not appropriate. This study was conducted to determine the percentage of patients pediatrician who prescribed with containing drugs off-label in pediatric patients aged 0 to 2 years at pharmacy in Bandung and determine the pattern of use through an observational study with retrospective data collection. Identification of medications that are prescribed off-label category or not based on the Pediatric Dosage Handbook 2007, Drug Information Handbook (DIH) in 2012, the British NationalFormulary (BNF) in 2009, MIMS USA 2013, MIMS Indonesia in 2013, and ISO 2012–2013. Based on the results obtained 542 pieces of off-label prescriptions (19.77%) of the 2741 total pieces recipes, as well as 699 (7.89%) of off-label drug items from 8861 drug, the percentage of off-label age category 70.53%, off-label doses of 19.74% and off-label contraindication 9.73%. The results of this study indicate that the uses of off-label drugs for children is high at Pharmacy in Bandung. This study is expected to be basicconsideration in examining the efficacy and safety in off-label drug uses for children aged 0 to 2 years.Key words: Off-label drug, pediatric, prescription, Bandung
Effect of Attapulgite on the Oral Bioavailability of Ciprofloxacin Zamrotul Izzah; Veronica Gratia; Toetik Aryani; Suharjono Suharjono
Indonesian Journal of Clinical Pharmacy Vol 2, No 2 (2013)
Publisher : Universitas Padjadjaran

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Abstract

As a result, this drug-drug interaction may reduce ciprofloxacin bioavailability. This study was aimed to determine the effect of attapulgite on the bioavailability of a single orally-administered ciprofloxacin. Six New Zealand white rabbits received each of the following treatments in a randomized, three-way crossover sequence, separated by a 7-day washout period: (i) ciprofloxacin (23 mg/kgBW) alone; (ii) ciprofloxacin (23 mg/kgBW) given simultaneously with attapulgite (28 mg/kgBW); (iii) ciprofloxacin(23 mg/kgBW) given 2 hours after attapulgite (28 mg/kgBW). Blood samples (1 mL) were collected from the marginal ear vein up to 240 minutes postdose. The plasma concentrations of ciprofloxacin were determined by a validated high-performance liquid chromatography method. The maximum concentration and oral bioavailability (AUC0-240 min) of ciprofloxacin were significantly decreased by 49% and 32% when administered concomitantly with attapulgite (p<0.001). Attapulgite appeared to have no significant effect on the bioavailability of ciprofloxacin when administered 2 hours before ciprofloxacin. In conclusion, the oral bioavailability of ciprofloxacin is markedly reduced when administered concomitantly with attapulgite. This drug-drug interaction may decrease clinical efficacy and promote microbial resistance to ciprofloxacin. However, the interaction could be minimized by separating the adminsitration of these drugs at least 2 hours.Key words: Attapulgite, bioavailability, ciprofloxacin, drug-drug interactionPengaruh Atapulgit pada Ketersediaan Hayati Siprofloksasin OralKemampuan absorpsi atapulgit dapat menghambat absorpsi siprofloksasin pada pemberian per oral. Sebagai hasilnya, interaksi obat-obat ini dapat menurunkan ketersediaan hayati siprofloksasin. Penelitian ini bertujuan untuk  mendeterminasi efek atapulgit pada ketersediaan hayati obat siprofloksasin yang diberikan secara oral. Sebanyak 7 kelinci putih Selandia Baru menerima perlakuan secara random dengan desain three-way crossover sequence, yang dipisahkan dengan periode washout 7 hari. (i) siprofloksasin (23 mg/kgBB); (ii) siprofloksasin (23 mg/kgBB) diberikan secara simultan dengan atapulgit (28 mg/kgBB); (iii) siprofloksasin (23 mg/kgBB) diberikan 2 jam setelah pemberian atapulgit (28 mg/kgBB. Sampel darah (1 mL) dikumpulkan pada marginal ear vein setelah 240 menit pemberian obat. Konsentrasi siprofloksasin plasma dihitung dengan metode kromatografi cair kinerja tinggi tervalidasi. Konsentrasi maksimum dan ketersediaan hayati oral (AUC0-240 min) siprofloksasin secara signifikan berkurang 49% dan 32% ketika dikombinasikan bersamaan dengan atapulgit (p< 0,001). Atapulgit tidak memiliki pengaruh signifikan pada ketersediaan hayati ketika diberikan 2 jam sebelum siprofloksasin. Ketersediaan hayati siprofloksasin berkurang secara signifikan ketika diberikan bersamaan dengan pemberian atapulgit. Interaksi obat dengan obat ini dapat mengurangi efikasi obat dan meningkatkan resistensi mikrob terhadap siprofloksasin. Namun, interaksi dapat dikurangi dengan pemberian obat pada jarak waktu minimal 2 jam.Kata kunci: Atapulgit, interaksi obat dengan obat, ketersediaan hayati, siprofloksasin

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