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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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Search results for , issue "Vol 4, No 3 (2015)" : 16 Documents clear

Monitoring Penggunaan Antibiotik dengan Metode ATC/DDD dan DU90% di RSUD Abepura Jayapura, Indonesia Hasrianna Hasrianna; Nurul Annisa; Tiana Milanda; Ivan S. Pradipta; Rizky Abdulah
Indonesian Journal of Clinical Pharmacy Vol 4, No 3 (2015)
Publisher : Universitas Padjadjaran

Tingginya penggunaan antibiotik akan meningkatkan potensi penggunaannya yang tidak rasional dan berdamPak pada tingkat mortalitas, biaya, dan resistensi khususnya dalam lingkungan rumah sakit. Studi observasi dengan data retrospektif telah dilakukan untuk mengevaluasi penggunaan antibiotik dari April 2013–Maret 2014 menggunakan metode ATC/DDD dan DU 90%. Hasil penelitian menunjukkan antibiotik yang masuk ke dalam segmen DU 90% pada periode I adalah kotrikmoksazol 480 mg tablet(40,34 DDD/kunjungan) dan amoksisilin 500 mg tablet (4,53 DDD/kunjungan), periode II adalah sefiksim sirup kering (0,68 DDD/kunjungan), amoksisilin 500 mg tablet (0,41 DDD/kunjungan), siproflokasain 500 mg tablet (0,31 DDD/kunjungan), doksisiklin 100 mg (0,26 DDD/kunjungan), sefiksim 100 mg kapsul (0,15 DDD/kunjungan), sefadroksil 500 mg kapsul (0,12 DDD/kunjungan),seftriakson 1 gr injeksi (0,08 DDD/kunjungan), dan periode III adalah kotrimoksazol 480 mg tablet (74,85 DDD/kunjungan). Tingginya penggunaan antibiotik setiap kunjungan pada penggunaan kotrimoksasol merupakan sebuah tanda ketidakrasionalan dalam penggunaan antibiotik. Diperlukan studi kualititaf untuk mengetahui pola ketidakrasionalan dalam penggunaan antibiotik pada rumah sakit tersebut danmengembangkan model intervensi yang tepat.Kata kunci: Antibiotik, ATC/DDD, DU 90%, rumah sakitMonitoring Use of Antibiotics with ATC/DDD and DU90% Method in Abepura Hospital Jayapura, IndonesiaThe high use of antibiotics will increase its irrational use, affect the mortality rates, costs and resistance, especially in a hospital. We conducted an observational study with retrospective data to evaluate the use of antibiotics from April 2013–March 2014 using the ATC/DDD and DU90% methods. The results showed the antibiotic included DU 90% segment in the first 4 months period were cotrimoxazole tablets 480 mg (40.34 DDD per encounter) and amoxicillin tablets 500 mg (4.53 DDD per encounter), in the second period were cefixime dry syrup (0.68 DDD per encounter), amoxicillin tablets 500 mg (0.41 DDD per encounter), ciprofloxacin tablets 500 mg (0.31 DDD per encounter), doxycycline tablets 100 mg (0.26 DDD per encounter), cefixime tablets 100 mg capsules (0.15 DDD per encounter), cefadroxil tablets 500 mg capsule (0.12 DDD per encounter), ceftriaxone injection 1 g (0.08 DDD per encounter), and during the third period was cotrimoxazole tablets 480 mg (74.85 DDD per encounter). The data showed that cotrimoxazole has the highest rate of utilization per visit which is a signal for irrational use. Qualitative study is needed to describe irrational use of antibiotics in the hospital and to find the appropriate intervention model.Key words: Antibiotics, ATC/DDD, DU 90%, hospital

Korelasi Faktor Usia, Cara Minum, dan Dosis Obat Metformin terhadap Risiko Efek Samping pada Penderita Diabetes Melitus Tipe 2 Magdarita Riwu; Anas Subarnas; Keri Lestari
Indonesian Journal of Clinical Pharmacy Vol 4, No 3 (2015)
Publisher : Universitas Padjadjaran

Metformin merupakan obat antidiabetes oral yang umumnya direkomendasikan sebagai pengobatan lini pertama pada diabetes melitus tipe 2 apabila kadar glukosa darah tidak terkontrol dengan modifikasi gaya hidup. Pada penggunaan metformin sebagai kontrol glikemia sering terjadi reaksi obat yang merugikan (ROM) berupa gangguan gastrointestinal seperti diare, mual, dan perut kembung. Penelitian ini bertujuan untuk menganalisis korelasi faktor usia, cara minum, dan dosis metformin terhadap risiko efek samping gangguan gastrointestinal pada penderita rawat jalan BPJS Kesehatan yang baru terdiagnosis diabetes melitus tipe 2 di RSAU Dr. M. Salamun Bandung. Penelitian ini adalah analitik observasional dengan desain potong lintang. Data dikumpulkan dari bagian poliklinik penyakit dalam, rekam medis, dan form check penderita yang mendapat pengobatan dengan metformin yang dilakukan sejak April–Juni 2014. Jumlah penderita yang memenuhi kriteria penelitian sebanyak 65 orang dengan rentang usia rata-rata 48 tahun. Keluhan efek samping yang dialami penderita berupa kembung (58,46%) dan mual (41,54%). Cara minum dan dosis metformin berkorelasi terhadap risiko efek samping berupa mual dan kembung pada penderita diabetes melitus tipe 2 (p<0,05) sedangkan faktor usia tidak berkorelasi (p>0,05). Penggunaan metformin dianjurkan sesudah makan dan dengan dosis awal rendah yang dititrasi perlahan untuk mengurangi dan menghindari terjadinya efek samping mual dan perut kembung pada penderita diabetes melitus tipe 2.Kata kunci: Diabetes melitus tipe 2, efek samping, metforminThe Correlation of Age Factor, Administration, and Metformin Dose Against Risk of Side Effect on Type 2 Diabetes MellitusMetformin is an antidiabetic oral medicine commonly recommended as first line treatment on type 2 diabetes mellitus. Metformin can caused drug related problems (DRPs) such as gastrointestinal disorders, e.g. diarrhea, nausea, and flatulence. This study aimed to analyze correlation profiles on age, administration, and metformin dosage factors against risk of gastrointestinal disorders among newlydiagnosed diabetic outpatients of National Health Insurance in RSAU Dr. M. Salamun Bandung. This study was an analytic observational study with a cross sectional method. The study was carried out in the internal medicine outpatient clinic and data were extracted from patients medical records from April to June 2014. Metformin-treated patients were interviewed using a form check. The number of patients were 65 with the median rate was 48 years old. Side effect reported were flatulence (58.46%) and nausea (41.54%). Administration and metformin dosage factors were correlated to the risk of side effects such as nausea and flatulence on type 2 diabetes mellitus (p<0.05), while age was not correlated (p>0.05). The administration of metformin is recommended after meals and with a lower initial dose titrated slowly to reduce and avoid the side effects of nausea and flatulence in patients with type 2 diabetes mellitus.Keywords: Metformin, side effect, type 2 diabetes mellitus

Penggunaan Obat yang Berpotensi Tidak Tepat pada Populasi Geriatri di Kota Bandung Rizky Abdulah; Melisa I. Barliana
Indonesian Journal of Clinical Pharmacy Vol 4, No 3 (2015)
Publisher : Universitas Padjadjaran

Analisis penggunaan penggunaan obat yang berpotensi tidak tepat pada populasi geriatri penting dilakukan untuk mengidentifikasi strategi manajemen risiko di populasi tersebut. Analisis ini masih sedikit dilakukan di negara-negara Asia, terutama di Indonesia. Penelitian ini dilakukan untuk mengestimasi prevalensi penggunaan obat yang berpotensi tidak tepat pada pasien geriatri di Kota Bandung, dengan melakukan studi potong lintang secara retrospektif pada 11 apotek. Prevalensi penggunaan obat yang berpotensitidak tepat dianalisis menggunakan kriteria eksplisit Beers dan McLeod dengan seting komunitas untuk populasi geriatri. Dengan menggunakan kriteria tersebut, ditemukan bahwa dari total 1.445 resep untuk pasien geriatri yang masuk ke dalam kriteria inklusi pada studi ini, terdapat 203 (14%) resep mengandung Paling tidak 1 pengobatan yang tidak tepat. Selain itu dari total 3.808 obat yang diresepkan, terdapat 218 obat (5.7%) tidak tepat untuk digunakan pada populasi geriatri. Studi ini merupakan studi pertama tentang penggunaan penggunaan obat yang berpotensi tidak tepat untuk pasien geriatri di Indonesia, sehingga hasil penelitian ini diharapkan dapat bermanfaat untuk meningkatkan kewaspadaan regulator dan tenaga profesional kesehatan tentang penggunaan penggunaan obat yang berpotensi tidak tepat populasi geriatri.Kata Kunci: Evaluasi penggunaan obat, geriatri, IndonesiaPotentially Inappropriate Medication Use for Geriatric Population in Bandung CityAnalysis of potentially inappropriate medication in geriatric population is important to identify specific target risk-management strategies. This, however, is rarely conducted in Asian countries, especially in Indonesia. Thus this study was conducted to estimate the prevalence of potentially inappropriate medication use among geriatric patients in Bandung City, Indonesia. In this study, we conducted a retrospective cross sectional study at 11 selected community pharmacies. Prevalence of potentially inappropriate medication use was documented using Beers and McLeod criterias for geriatrics in community setting. Combining all 3 sets of criteria for potentially inappropriate medication, we found that from total of 1.445 prescriptions for geriatric patients that match to the research inclusion criteria, 203 (14%) prescription contain at least 1 inappropriate medication. Furthermore, from total of 3.808medicines prescribed, 218 (5.7%) was inappropriate for geriatric used. To our knowledge, this is the first study on the prevalence of inappropriate medication for geriatric population in Indonesia. The result of this study should increase the awareness of regulators and healthcare professionals about potentially inappropriate medications in geriatric population.Keywords: Drug use evaluation, geriatric, Indonesia

Pengaruh Pemberian Umpan Balik Tekanan Darah kepada Dokter terhadap Perubahan Biaya Terapi Pasien Hipertensi Rita Suhadi; Jarir At Thobari; Bambang Irawan; Iwan Dwiprahasto
Indonesian Journal of Clinical Pharmacy Vol 4, No 3 (2015)
Publisher : Universitas Padjadjaran

Suatu penelitian intervensi analitik telah dilakukan dengan tujuan untuk mengevaluasi cost-effectiveness terapi pasien rawat jalan hipertensi di empat rumah sakit (RS) di Kota Yogyakarta. Penelitian dilakukan dengan metode grafik scatter-plot; aksis-X dan aksis-Y menunjukkan selisih tekanan darah (TD) dan biaya antar kelompok. Pemberian umpan balik TD diberikan kepada dokter spesialis perlakuan sebanyak empat kali setelah informed consent, sementara dokter kontrol menjalani terapi secara alamiah. Pasien dari dokter subjek >18tahun, menerima antihipertensi, Askes *, ≥4 kali kunjungan, dan ≥1 kali TD sistolik (TDS) ≥140mmHg diikutkan penelitian. Data terapi, TD, dan biaya terapi pasien dikumpulkan selama 8 bulan secara prospektif sejak intervensi pertama dari catatan medik pasien dan klaim pembayaran RS kepada Askes. Seluruh biaya terkait hipertensi dan kardiovaskular dengan perspektif RS diikutkan analisis. Data diperoleh dari rekam medik dan klaim biaya terapi oleh RS kepada PT. Askes. Hipotesis: proporsi pasien di kuadran kanan grafik mencapai ≥90%. Kuadran kanan menunjukkan TDS perlakuan lebih baik. Hasil penelitian menunjukkan pasien perlakuan (n=379) dan kontrol (n=266) tidak berbeda bermakna untuk umur, jender, TD, dan jumlah antihipertensi. Pasien perlakuan memiliki TD diastolik lebih baik, biaya antihipertensi per kunjungan lebih tinggi (p<0,05) tetapi sama untuk obat kardiovaskular serta biaya total (p>0,05). Proporsi pasien kuadran kanan sebesar 56,2%. Analisis subgrup pada perempuan, tanpa umur 80–90tahun, TDS final≤160mmHg, rerata TDS ≤150mmHg, dan antihipertensi 1–3 item diperoleh proporsi kuadran kanan 66,9% tetapi belum mencapai 90%. Pemberian umpan balik TD kepada dokter meningkatkan proporsi pasien di kuadran kanan meskipun belum mencapai proporsi yang diharapkan.*Askes pada saat sekarang ini sudah berubah menjadi Jaminan Kesehatan Nasional oleh BPJSKata kunci: Biaya terapi, cost-effectiveness, hipertensi, umpan balik tekanan darah kepadadokterThe Effect of Blood Pressure Feedback Intervention to Doctors on the Change of the Hypertensive Patient Therapy CostAn analytical intervention study has been done with the aim to evaluate the therapy cost-effectiveness among the hypertensive ambulatory patients at four hospitals in Yogyakarta city. The study was done with the scatter-plot method; x-axis and y-axis were for the difference of blood pressure and therapy cost between groups respectively. Blood pressure feedback intervention was delivered monthly for four times to the specialists in the intervention group since the informed-consent approval. The control specialists preceded the natural practice. The included patients were the specialist’s subjects with the following criteria: >18 years, “Askes” -insured, ≥4 visits, and ≥1 visit with systolic blood pressure (SBP) ≥140mmHg. The medication profile, BP level, and therapy cost profile were collected prospectively for eight months since the first intervention from medical record and the hospital claim to Askes. All hypertensive and cardiovascular therapy cost with the hospital perspective were included in the analysis. Hypothesis: the patient proportion in the right quadrants of the graph reached ≥90%. The right quadrantsof graph indicated lower mean SBP of intervention group. The result showed that the intervention (n=379) and control (n=266) groups were similar for age, gender, BP, and items of antihypertensive medicine. The intervention group had only improved diastolic BP and higher antihypertensive medicine cost (p<0.05), but similar for cardiovascular medicine and the total therapy cost (p>0.05). Patients in the right quadrant were 56.2%. Sub-group analysis for female only, without 80–90 years, final SBP ≤160mmHg, and mean ≤150mmHg, and 1–3 antihypertensive items resulted 66.9% of right-quadrant patients but it was lower than 90%. Feedback intervention improved the proportion of patients in the right-quadrants of the graph though it was lower than the expected proportion.Keywords: Blood pressure feedback to physicians, cost effectiveness analysis, cost of therapy, hypertension

The Renal Toxicity of Welding Fumes in Heavy Equipment Manufacturer Workers Mulyana Mulyana; Nuri P. Adi; Meily Kurniawidjaja Kurniawidjaja; Vani N. Pratami; Andi Wijaya; Irawan Yusuf
Indonesian Journal of Clinical Pharmacy Vol 4, No 3 (2015)
Publisher : Universitas Padjadjaran

Exposure to welding fumes in the workplace has been associated with decreasing renal function. We studied renal function parameters in men workers from heavy equipment manufacturer exposed to welding fumes. This study aimed to evaluate renal function status among worker exposed to welding fumes. A case-control design, random study, was conducted among welder (35 subjects) and nonwelder (35 subjects) with more than 1 years experience in the same job task in a heavy equipment manufacturer. All subjects were completed physical examination, informed consent, questionnaire and laboratory tests. Renal function was easured as creatinine serum using enzimatic method. Urinary heavy metals level was analyzed using inductively coupled plasma mass spectrometry. Comparisson analysis between group was performed to determined median level for each variable. Linear regressionmodel was developed to predict renal function function parameter status urinary heavy metals level as variable. This study showed there were higher creatinine serum, chromium, iron, manganese and nickel in welder than non welder(p<0.05). After multivariate analysis, urinary nickel is a predictor for renal function status among welder. Exposure to welding fumes was significantly correlated with renal function status in welder. Nickel is the predictive variable for renal function. Although statistically significant but in clinical field needs carefully interpreting data.Keyword: Nickel, renal function, welder, welding fumesToksisitas Renal Uap Las pada Pekerja Industri Alat BeratPajanan uap las di tempat kerja telah dihubungkan dengan penurunan fungsi ginjal. Dalam penelitian ini, kami menguji status fungsi ginjal pada pekerja pria yang terpajan uap las di industri alat berat. Penelitian ini mengevaluasi status fungsi ginjal pada pekerja terpajan uap las, dengan desain kontrol kasus, acak, dilakukan pada 35 subjek pengelas dan 35 bukan pengelas yang telah bekerja paling tidak 1 tahun dengan jenis pekerjaan yang sama di industri alat berat. Seluruh subjek telah melakukan pemeriksaan fisik,pengisian form kesediaan setelah penjelasan, kuesioner, dan pemeriksaan laboratorium. Pemeriksaan kadar kreatinin dilakukan dengan metode enzimatik. Pemeriksaan kadar logam berat dalam urin dengan inductively copled plasma mass spectrometry. Dilakukan analisis perbandingan untuk membedakan nilai median antar kelompok. Dilakukan juga analisis multivariat untuk menentukan variabel prediksi. Hasil penelitian memperlihatkan bahwa status fungsi ginjal pada pekerja las lebih rendah dibandingkan dengan bukan pengelas. Nikel urin merupakan variabel prediksi yang bermakna terhadap penurunan fungsi ginjal. Walaupun secara statistik diketahui bermakna, namun dalam penggunaan klinis harus dilakukan interpretasi dengan hati-hati.Kata kunci: Fungsi ginjal, nikel, pengelas, uap las

Kualitas Hidup Pasien Kanker Payudara dengan Terapi Kombinasi Fluorouracil, Doxorubicin, dan Cyclofosfamide Dewi D. Agustini; Emma Surahman; Rizky Abdulah
Indonesian Journal of Clinical Pharmacy Vol 4, No 3 (2015)
Publisher : Universitas Padjadjaran

Pengobatan pada kanker payudara dengan kemoterapi kombinasi Fluorouracil, Doxorubicin, dan Cyclofosfamide (FAC) menimbulkan perbedaan kualitas hidup pasien yang penting untuk diketahui karena dapat menunjang keefektifan pengobatan. Tujuan penelitian ini adalah untuk mengukur perbedaan dan mengetahui dimensi yang memengaruhi kualitas hidup pasien kanker payudara dari setiap siklus kemoterapi di RS Hasan Sadikin Bandung. Jenis penelitian ini adalah observasional analitik dengan pedekatan potong lintang. Sebanyak 200 pasien kanker payudara dipilih secara purposive dan dipisahkan berdasarkan siklus terapi. Penilaian kualitas hidup dilakukan secara multidimensional menggunakan instrumen EORTC QLQ (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire) C30 dan BR23. Analisis data dihitung menggunakan uji t independen dan regresi linier berganda. Hasil penelitian menunjukkan terdapat perbedaan kualitas hidup yang sangat signifikan antara skala fungsi QLQ-C30 baseline dengan terapi ke-5, skala gejala QLQ-C30 baseline dengan terapi ke-5, skala fungsi QLQ-BR23 baseline dengan terapi ke-1, 2, 3, 4, dan 5, skala gejala QLQ-BR23 baseline dengan terapi ke-4, kemudian perbedaan signifikan antara skala gejala QLQ-BR23 baseline denganterapi ke-1, 3, dan 5. Dimensi yang berpengaruh signifikan terhadap kualitas hidup adalah fungsi sosial, mual dan muntah, gangguan pernapasan, gangguan tidur, dan kesulitan keuangan.Kata kunci: BR23, EORTC QLQ C30, kanker payudara, kualitas hidupQuality of Life Patients with Breast Cancer Therapy Combination Fluorouracil, Doxorubicin, and CyclofosfamideTreatment of breast cancer with combination chemotherapy Florouracil, doxorubicin, and Cyclofosfamide (FAC) lead to differences in the quality of life of patients is important to know because it can support the effectiveness of patient treatment. The aim of the study was to measure the difference and know the dimensions that affect the quality of life of breast cancer patients from each cycle of chemotherapy in Hasan Sadikin Hospital. This research is an observational analytic cross sectional approach. A sample of 200 breast cancer patients who were selected purposively and separated based on cycles of therapy. Assessment of quality of life of patients is done using a multidimensional instrument EORTC QLQ (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire) C30 and BR23. Data analysis was calculated using independent t test and linear regression. The results showed that there are differences in quality of life is very significant between QLQ-C30 functioning scale baseline with treatment 5, the QLQ-C30 symptom scale baseline therapy 5th, QLQ-BR23 function scale baseline with therapy 1st, 2nd, 3rd, 4th, and 5th, QLQ-BR23 symptoms scale baseline with therapy 4th, then a significant difference between scale symptoms of QLQ-BR23 baseline therapy with the 1st, 3rd, and 5th. Dimensions have a significant effect on quality of life is a social function, nausea and vomiting, dyspnea, sleep disorders and financial difficulties.Key words: BR23, breast cancer, EORTC QLQ C30, quality of life

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Rizky Abdulah

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Kota bandung,

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