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Jurnal Farmasi Klinik Indonesia

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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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Revitalisasi Manajemen Sediaan Farmasi sebagai Upaya Peningkatan Kepuasan Pelanggan Rawat Jalan pada Salah Satu Rumah Sakit Swasta di Kota Bandung Nabilla Nabilla; Emma Surahman
Indonesian Journal of Clinical Pharmacy Vol 4, No 1 (2015)
Publisher : Universitas Padjadjaran

waktu yang tepat. Oleh karena itu, rumah sakit membutuhkan sistem manajemen farmasi yang baik. Penelitian ini bertujuan untuk menganalisis tingkat kepuasan pelanggan dan merevitalisasi manajemen sediaan farmasi di Rumah Sakit (RS) A untuk meningkatkan kepuasan pelanggan. Jenis penelitian yang digunakan adalah mixed method dengan pendekatan potong lintang. Penelitian kuantitatif menggunakan metode survei dengan kuesioner yang dianalisis dengan Partial Least Square (PLS). Hasil penelitian menunjukkan tanggapan karyawan IFRS terhadap manajemen sediaan farmasi di RS A berada pada kategori sangat baik (88,7%) dan tanggapan pelanggan terhadap manajemen sediaan farmasi di RS A pada kategori puas (75,1%). Pendekatan kualitatif menggunakan metode wawancara kepada kepala IFRS serta kepala unit pelayanan farmasi rawat jalan dan gudang farmasi. Manajemen sediaan farmasi di rumah sakit A sudah sesuai dengan standar yang telah ditetapkan pemerintah, akan tetapi masih perlu perbaikan di setiap kegiatan manajemen sediaan farmasi. Oleh karena itu, revitalisasi manajemen sediaan farmasi diperlukan sebagai upaya peningkatan kepuasan pelanggan.Kata kunci: Kepuasan pelanggan, manajemen sediaan farmasi, revitalisasiRevitalization of Pharmaceutical Supply Management as an Effort to Increase Outpatient Customer Satisfaction in One of Private Hospital in BandungHospital pharmacies are required to provide appropriate pharmaceutical preparation. Therefore, hospital needs good pharmacy management system. The aims of this study was to analyze customer satisfaction and revitalization of pharmaceutical management in hospital A to improve customer satisfaction. This study was used cross sectional study with quantitative and qualitative approaches. Quantitative approach used survey method with questionnaires and data was analyzed by Partial Least Square (PLS). The results showed that the response to the IFRS employees of pharmaceutical management in hospital A had a very good categories (88.7%) and customer responses to pharmaceutical supply management in hospital A in the category satisfied (75.1%). A qualitative approach using interviews with the head of the hospital pharmacy as well as the head unit of the outpatient pharmacy services and pharmacy warehouse. Pharmaceutical management in hospital A is appropriate to the standards by the government, but still needs improvement in pharmaceutical management. Therefore, revitalization of pharmaceutical management is needed as an effort to increase customer satisfaction.Key words: Customer satisfaction, pharmaceutical management, revitalization

Studi Pendahuluan Polimorfisme Genetik Gen CYP1A2*1F pada Pasien Asma dan Nonasma di Indonesia Doddy de Queljoe; Mariana Wahjudi; Muhammad Erdiansyah; Rivan V. Suryadinata; Amelia Lorensia
Indonesian Journal of Clinical Pharmacy Vol 4, No 1 (2015)
Publisher : Universitas Padjadjaran

Polimorfisme genetik CYP1A2 berkaitan dengan metabolisme teofilin sehingga dapat memengaruhi kadar obat dalam darah serta berpengaruh terhadap kejadian adverse drug reaction (ADR) dan outcome klinis terapi asma. Frekuensi polimorfisme CYP1A2 diketahui bervariasi antar etnis. Diduga populasi Indonesia memiliki frekuensi varian gen CYP1A2*1F yang tinggi. Penelitian ini bertujuan untuk mengetahui profil polimorfisme gen CYP1A2*1F pada sampel nonasma dan asma di Indonesia dengan populasi lain berdasarkan literatur. Pengambilan data dilakukan pada Januari–Juni 2014. Sampel darah diperoleh dari 29 orang nonasma dan 16 pasien asma. Setelah dilakukan ekstraksi DNA genomik kemudian ditentukan polimorfisme gen CYP1A2*1F dengan metode PCR-RFLP. Hasil penelitian ini menunjukkan bahwa polimorfisme gen CYP1A2*1F pada sampel nonasma adalah 10,35% (3/29) untuk C/C, 37,93% (11/29) untuk C/A dan 51,72% (15/29) untuk A/A. Pada penderita asma frekuensi distribusi genotip C/A sebesar 81,25% (13/16) dan A/A sebesar 18,75% (3/16). Tidak terdapat perbedaan signifikan (p=0,276) frekuensi alel antara sampel nonasma dan pasien asma. Frekuensi gen CYP1A2*1F pada populasi Indonesia lebih besar dibandingkan dengan populasi Mesir, Jepang, dan Inggris akan tetapi lebih rendah dibandingkan dengan Malaysia. Oleh karena itu, dapat disimpulkan tidak terdapat perbedaan frekuensi.Kata kunci: Asma, CYP1A2*1F, polimorfisme genetikPilot Study on Genetic Polymorphisms CYP1A2*1F on Asthma Patients and Nonasthma in IndonesiaGenetic polymorphisms of CYP1A2 is related to the theophylline metabolism that may affect drug levels in the blood, which can also affect incidence of adverse drug reaction (ADR) and clinical outcomes of asthma therapy. The frequency of CYP1A2 polymorphism is known to vary among ethnic. Allegedly the Indonesian population has high frequency of gene variants of CYP1A2*1F. This study aims to determine the profile of CYP1A2*1F gene polymorphism in a sample of nonasthma and asthma in Indonesia with other populations based on the literature. Data were taken on January–June 2014. Blood samples were obtained from 29 nonasthma samples and 16 patients with asthma. After extraction of genomic DNA, CYP1A2*1F gene polymorphisms determined by PCR-RFLP. The results of this study indicate that the CYP1A2*1F gene polymorphism in nonasthma samples was 10.35% (3/29) for C/C, 37.93% (11/29) for the C/A, and 51.72% (15/29) for A/A. The asthmatics genotype have a frequency distribution of C/A genotype of 81.25% (13/16) and A/A of 18.75% (3/16). There was no significant difference (p=0.276) allele frequencies between samples of nonasthma and asthma patients. The frequency of CYP1A2*1F gene in Indonesian population is higher than the population of Egypt, Japan, and UK, but lower compared to Malaysia. It can be concluded that there is no difference in frequency.Keywords: Asthma, CYP1A2*1F, genetic polymorphisms

Rasionalitas Penggunaan Antibiotik di Salah Satu Rumah Sakit Umum di Bandung Tahun 2010 Mally G. Sholih; Ahmad Muhtadi; Siti Saidah
Indonesian Journal of Clinical Pharmacy Vol 4, No 1 (2015)
Publisher : Universitas Padjadjaran

Penggunaan antibiotik yang tidak tepat karena intensitas penggunaan antibiotik yang relatif tinggi dapat menimbulkan berbagai permasalahan dan ancaman global bagi kesehatan terutama resistensi bakteri terhadap antibiotik. Penelitian ini bertujuan untuk menetapkan jumlah dan pola penggunaan antibiotik pada pasien di salah satu rumah sakit pemerintah di Kota Bandung. Metode penelitian dilakukan secara deskriptif dengan pengambilan data secara retrosfektif. Data penggunaan antibiotik pada tahun 2010 diperoleh dari rekapitulasi pengeluaran instalasi farmasi dari bulan Januari–Desember 2010. Pengambilan data dilakukan dari bulan Juni–Juli 2011 di salah satu rumah sakit umum pemerintah tipe B. Data yang diperoleh kemudian diolah dan diklasifikasikan. Pengolahan data penggunaan antibiotik dilakukan dengan metode ATC/DDD dan segmen DU 90%. Hasil penelitian penggunaan antibiotik pada tahun 2010 adalah 95719,01 DDD. Antibiotik yang masuk pada segmen DU 90% ada 5 golongan (penisilin, sefalosporin, kuinolon, makrolida dan sulfonamida). Pola penggunaan antibiotik pada caturwulan ke-1 yang memenuhi segmen DU 90% yaitu penisilin, sefalosforin, kuinolon, dan makrolida. Pada caturwulan ke-2 dan caturwulan ke-3 ada lima golongan antibiotik yang masuk dalam segmen DU 90% yaitu penisilin, sefalosforin, kuinolon, makrolida, dan sulfonamida. Penelitian menyimpulkan bahwa pada caturwulan ke-1 hingga caturwulan ke-3 terjadi peningkatan persentase penggunaan dan jumlah golongan antibiotik yang masuk ke dalam segmen DU 90%.Kata kunci: Antibiotik, ATC/DDD, segmen DU 90%Rationality Antibiotic Use at One of Public Hospital in Bandung 2010The inappropriate antibiotic use was caused by using of high relatively the antibiotic so that have caused global threat and health problems especially antibiotic resistance. The objective of this study is to determine quantity and pattern of patient antibiotic use at one of hospital in Bandung. The study method was utilized descriptively and was obtained retrospectively. The antibiotic use data on 2010 was obtained from pharmacy department recapitulation on January–December 2010. Data was taking on January–December 2011 at one of type B hospital in Bandung. The data was processed and classified. The antibiotic use data has processed using ATC/DDD method and DU 90 % segment. The result showed that antibiotic use on 2010 was 95719,01 DDD. There were 5 groups of antibiotic class in DU90% segment (penicillin, cephalosporin, quinolone, macrolide, and sulphonamide) . The antibiotics use pattern in the first quarter in DU 90% segment werepenicillin, cephalosporin, quinolone, and macrolide. There were 5 groups within second and third quarter in DU90% were penicillin, cephalosporin, quinolone, macrolideand sulphonamide. It can be concluded that the antibiotic use in first to third quarter have decreased percentage and number antibiotic groups in DU90% segment.Key words: Antibiotics, ATC/DDD, DU90% segment

A Prospective Study of Adverse Drug Reactions in 1 Month–12 Years Old Pediatric Patients Asawari Raut; Vijay Kalrao; Roja Rani; Ravi Kumar
Indonesian Journal of Clinical Pharmacy Vol 4, No 1 (2015)
Publisher : Universitas Padjadjaran

Adequate controlled clinical trials in pediatric population, especially in oncology and vaccinations are still insufficient due to ethical considerations. Certain conditions in children in general and in Indian children in particular, suggested the need for Adverse Drug Reaction (ADR) monitoring. Thus this study was aimed to investigate the incidence of ADRs in pediatric populations. A prospective spontaneous reporting study was conducted over a period of six months from October 2012 to March 2013 in pediatric inpatients ward of Bharati Hospital in Pune. Reported ADRs were assessed for its causality by using WHO causality assessment scale, and its severity by using Hart wig Severity Scale. A total of 107 suspected ADRs were reported and evaluated from 54 patients, showing an overall incidence of 4.75%. Incidence rate of ADRs during hospitalization was 4.13%, while ADRs induced hospitalization was 0.62%. The gastrointestinal system (48.59%) was the most affected, and antibiotics was the most common the drug class associated to ADRs. In term of causality, 55.14% of the reactions were classified as possible, while in term of severity, 64.49% were classified as moderate. Most patients (60.75%) recovered from the incidence. Although the prevalence and severity of ADRs in pediatrics populations is reported to be higher than those of in adults, the incidence of ADRs in our study was only 4.75% which is lower than those of reported in adults, this may due to the spontaneous reporting system that used in this study.Keywords: Adverse drug reaction, causality, prospective spontaneous reporting system, severity Studi Prospektif Reaksi Obat yang Merugikan pada Pasien Anak 1 Bulan–12 TahunUji klinik pada anak khususnya onkologi dan vaksinasi masih kurang memadai karena pertimbangan aspek etik. Kondisi tertentu pada anak secara umum dan khususnya di India memerlukan pemantauan Rekasi Obat yang Merugikan (ROM). Penelitian ini bertujuan untuk mengetahui insidensi ROM pada pasien anak. Studi pelaporan spontan prospektif dilakukan selama enam bulan pada Oktober 2012–Maret 2013 di bangsal anak Rumah Sakit Bharati di Pune. ROM yang dilaporkan dinilai kausalitasnya dengan WHO causality assessment dan keparahan dengan skala Wig Hart Severity. Sebanyak 107 suspek ROM dilaporkan dan dievaluasi dari 54 pasien menunjukkan insidensi sebesar 4,75%. Tingkat kejadian ROM selama rawat inap sebesar 4,13% sementara ROM yang menyebabkan pasien dirawat inap sebesar 0,61%. Sistem pencernaan (48,5%) paling sering dilaporkan dan antibiotik sebagai obat yang berasosiasi dengan ROM. Berdasarkan kausalitas, 55,14% reaksi obat diklasifikasikan possible (55,14%) sementara dalam aspek kepaharahan, 64,49% diklasifikasikan moderat. Mayoritas pasien sembuh dari ROM (60,75%). Prevalensi dan keparahan ROM pada anak dilaporkan lebih tinggi dibandingkan dewasa, akan tetapi insiden ROM pada penelitian ini hanya 4,75% yang lebih rendah daripada yang dilaporkan pada orang dewasa, dimungkinkan karena penelitian ini merupakan sistem pelaporan spontan.Kata kunci: Causality, keparahan, reaksi obat yang merugikan, sistem pelaporan spontan prospektif

Penggunaan Suplemen Herbal sebagai Upaya Swamedikasi di Kota Bandung Dika P. Destiani; Auliya A. Suwantika
Indonesian Journal of Clinical Pharmacy Vol 4, No 1 (2015)
Publisher : Universitas Padjadjaran

Swamedikasi menggunakan suplemen herbal di Indonesia belum terdokumentasi karena sebagian besar masyarakat yang mengonsumsinya tidak berkonsultasi dengan tenaga kesehatan. Penelitian retrospektif observasional ini dilakukan di salah satu pusat pelayanan kesehatan di Bandung pada tahun 2014 denganpengambilan data dari data penjualan suplemen herbal. Penjualan swamedikasi suplemen atau vitamin selama tahun 2014 mencapai 30.163 item dengan swamedikasi suplemen herbal untuk penyakit kronik dan degeneratif sebanyak 1.277 item. Berdasarkan kategori terapi, suplemen herbal yang paling banyak dikonsumsi adalah suplemen herbal untuk indikasi hiperlipidemia dengan kandungan bawang putih, lecithin, dan spirulina. Dari hasil penelitian ini dapat dilihat tingginya angka penggunaan swamedikasi suplemen herbal, akan tetapi tidak diketahui apakah masyarakat sudah memperoleh informasi yang benar dari apoteker mengenai cara penggunaannya.Kata kunci: Bandung, herbal, observasional, suplemen, swamedikasiThe Use of Herbal Supplements as One of Self Medications in BandungThe use of herbal supplements as one of self medications in Indonesia has not yet been well-documented since many people used these supplements in absence of medical consultation with pharmacist. This retrospective observational study was conducted at one of healthcare service centers in Bandung. Data related to the sale of herbal supplements during 2014 period was collected and analyzed. We found that 30.163 items of herbal supplements were sold in 2014. Approximately 1.277 sold items were specific supplements for chronic and degenerative diseases. Based on the category of therapy, the most sold item was a herbal supplement for hyperlipidemia with three major ingredients: garlic, lecithin, and spirulina. Despite the huge number of the use of herbal supplements in Indonesia, medical information from pharmacist about the use of herbal supplements is still scarce.Key words: Bandung, herbal, observation, self medication, supplement

Resistensi Aspirin pada Pasien Penyakit Jantung Koroner dengan Hipertensi Ema P. Yunita; Bambang S. Zulkarnain; Muhammad Aminuddin
Indonesian Journal of Clinical Pharmacy Vol 4, No 1 (2015)
Publisher : Universitas Padjadjaran

Aspirin adalah terapi antiplatelet standar untuk penyakit jantung dan pembuluh darah. Aspirin dapat memberikan efek antiplatelet melalui asetilasi siklooksigenase di platelet sehingga menimbulkan hambatan pembentukan platelet yang permanen. Namun, aktivitas antiplatelet pada setiap individu dapat bervariasi. Penelitian di luar Indonesia memperkirakan sekitar 5 sampai 45% dari populasi tidak memperoleh efek antiplatelet yang adekuat dari aspirin. Penelitian tentang resistensi aspirin belum pernah dilakukan di RS Indonesia. Penelitian ini dilakukan untuk melihat prevalensi resistensi aspirin dan mengetahui faktor-faktor yang dapat memengaruhi resistensi aspirin pada pasien penyakit jantung koroner dengan komorbid hipertensi menggunakan metode agregasi platelet optik. Penelitian ini menggunakan studi potong lintang dengan melibatkan 43 pasien di Rumah Sakit Dr. Soetomo Surabaya selama bulan Juni 2012. Hasil penelitian menunjukkan tidak diperoleh pasien dengan resistensi aspirin dan hanya dua (4,7%) pasien termasuk aspirin semirespon. Respon pasien penyakit jantung coroner (PJK) dengan komorbid hipertensi terhadap aspirin sebagai antiplatelet masih bagus. Diperlukan penelitian serupa dengan sampel yang lebih besar pada pasien PJK disertai dua atau lebih komorbid. Selain itu, diperlukan penelitian lanjutan untuk mengetahui genotipe diantara pasien yang memberikan respon bagus dan pasien yang memberikan respon kurang terhadap aspirin.Kata kunci: Agregasi platelet, hipertensi, penyakit jantung koroner, resistensi aspirinAspirin Resistance in Coronary Artery Disease with Hypertensive PatientsAspirin is gold standard for antiplatelet therapy in cardiovascular treatment today. It exerts its antiplatelet effect by acetylation of the platelet cyclooxygenase, resulting in an irreversible inhibition of plateletdependent thromboxane formation. However, aspirin has been shown to have variable antiplatelet activity in individual patients. Previous studies estimated that 5% to 45% of population do not achieve an adequate antiplatelet effect from aspirin. Studies about aspirin resistance have never been done in Indonesian hospitals. This study was initiated to investigate the prevalence of aspirin resistance and influencing factors of aspirin resistance in coronary artery disease with hypertensive patients by using an established method of optical platelet aggregation. Fourty three patients were involved in this study. The sampling of this cross sectional study was conducted at Dr. Soetomo Hospital Surabaya in June 2012. Of the patients studied, there were no aspirin resistant and only 2 (4.7%) were aspirin semiresponders. It can be concluded that coronary artery disease patients with hypertension to aspirin as antiplatelet agent were good. Similar research is needed to be conducted with more sample sizes in coronary artery diseasepatients with two or more comorbid. In addition, further research is needed to determine genotyping between good or poor patient’s respond to aspirin.Keywords: Aspirin resistance, coronary artery disease, hypertensive, platelet aggregation

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Rizky Abdulah

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r.abdulah@unpad.ac.id

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Kota bandung,

Jawa barat

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