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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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Metformin Enhances Anti-proliferative Effect of Cisplatin in Cervical Cancer Cell Line Ratih D. Yudhani; Riza N. Pesik; Dono Indarto
Indonesian Journal of Clinical Pharmacy Vol 5, No 2 (2016)
Publisher : Universitas Padjadjaran

Cervival cancer is one of the top rank of gynecological malignancy in the world, leading to high morbidity and mortality rates. Cisplatin is a chemotherapeutic agent that is generally used to treat cervical cancer but the use of this drug is limited because of serious side effects. Metformin, a diabetic drug, decreases not only blood glucose levels but also cell viability of some cancer cells. The aim of this study was to investigate the anti-proliferative effect of combination metformin and cisplatin in HeLa cells (cervical cancer cell line). Anti-proliferative effect of these combined drugs was analized using MTT assay, combination index assay and HeLa cell morphology. Inhibitory concentration (IC50) of cisplatin and metformin was determined before performing combination index assay. Administration of 10 mM metformin showed inhibition of HeLa cell proliferation and it reached 50% inhibition of cell proliferation at 60 mM. Whilst, cisplatin showed a stronger anti-proliferative effect with initial inhibition dose at 12 μM and IC50 dose at 44 μM. Combination of 30 mM metformin and 5 μM cisplatin indicated the strongest anti-proliferative effect on HeLa cell. In conclusion, metformin may become a promising drug for treatment of cervical cancer in future which enhances anti-proliferative effect of cisplatin.Key words: Anti-proliferative effect, combination index, cervical cancer, cisplatin, metformin Peningkatan Efek Anti-poliferatif Cisplatin oleh Metformin pada Cell Line Kanker Serviks Kanker serviks merupakan salah satu keganasan ginekologi tertinggi di dunia, dengan tingkat morbiditas dan mortalitas yang tinggi. Cisplatin merupakan obat kemoterapi yang umum digunakan untuk terapi kanker serviks, namun penggunaannya relatif terbatas karena menyebabkan beberapa efek samping yang serius. Metformin merupakan obat anti diabetik yang mampu menurunkan kadar glukosa darah dan juga mampu menurunkan viabilitas beberapa jenis sel kanker. Penelitian ini bertujuan untuk mengetahui efek anti-proliferasi kombinasi metformin dan cisplatin pada sel HeLa (cell line kanker serviks). Efek anti-proliferasi kombinasi kedua senyawa tersebut dianalisis melalui MTT assay, combination index assay dan morfologi sel HeLa. Nilai inhibitory concentration (IC50) metformin dan cisplatin pada sel HeLa ditentukan lebih dahulu sebelum melakukan combination index assay. Pemberian metformin 10 mM mulai menunjukkan penghambatan proliferasi sel HeLa dan penghambatan proliferasi sel mencapai 50% pada dosis 60 mM. Cisplatin menunjukkan efek anti-proliferasi yang lebih kuat dengan dosis awal penghambatan sebesar 12 μM dan IC50 sebesar 44 μM. Kombinasi antara metformin 30 mM dan cisplatin 5 μM memperlihatkan efek anti-proliferatif terkuat pada sel HeLa. Sebagai kesimpulan, metformin kemungkinan menjadi obat yang menjanjikan untuk terapi kanker serviks di masa mendatang dengan cara meningkatkan efek anti-proliferasi cisplatin.Kata kunci: Cisplatin, combination index, efek anti-proliferatif, kanker serviks, metformin

Analisis Minimalisasi Biaya Penggunaan Antibiotik Meropenem dan Ceftazidime pada Terapi Febrile Neutropenia Rizky Abdulah; Raine D. Kumamba; Rano K. Sinuraya; Cherry Rahayu; Melisa I. Barliana
Indonesian Journal of Clinical Pharmacy Vol 5, No 2 (2016)
Publisher : Universitas Padjadjaran

Antibiotik dibutuhkan sebagai salah satu terapi dalam menunjang keberhasilan terapi febrile neutropenia. Beragamnya alternatif terapi antibiotik, menjadikan studi farmakoekonomi diperlukan agar didapatkan terapi yang efektif dan efisien. Tujuan penelitian ini adalah untuk mengetahui antibiotik yang lebih efisien dari segi biaya, yang digunakan dalam terapi febrile neutropenia di salah satu rumah sakit rujukan di kota Bandung selama periode 2011–2013. Penelitian ini merupakan studi observasi analisis, dengan pengambilan data secara retrospektif yang dilakukan pada bulan Februari 2014, melalui data rekam medis pasien rawat inap febrile neutropenia yang mendapatkan terapi antibiotik meropenem atau ceftazidime. Hasil penelitian menunjukkan bahwa walaupun secara statistik tidak menunjukkan perbedaan bermakna, rata-rata total biaya terapi menggunakan antibiotik meropenem adalah sebesar Rp11.094.147, sedangkan rata-rata biaya total perawatan kelompok antibiotik ceftazidime sebesar Rp7.082.523. Hasil penelitian ini diharapkan dapat membantu tenaga profesional kesehatan dalam manajemen terapi febrile neutropenia.Kata kunci: Ceftazidime, farmakoekonomi, febrile neutropenia, meropenemCost Minimization Analysis of the Use of Meropenem and Ceftazidime in Febrile Neutropenia Therapy Use of antibiotics is required in febrile neutropenia therapy. The variety choice on the use of antibiotics has increased the role of pharmacoeconomics study to determine the most effective and efficient antibiotic in a specific area. The purpose of this study was to investigate the lowest cost antibiotic between meropenem and ceftazidime that were used as one of febrile neutropenia treatments at one of referral hospitals in West Java province during 2011–2013. This study was a retrospective, observational and analytical study that was performed on February 2014 by collecting medical record data related to febrile neutropenia inpatient who received meropenem or ceftazidime therapy. The result showed that although it was not statistically significant, the total cost for ceftazidime therapy was IDR7,082,523, which was lower than meropenem therapy (IDR11,094,147). Hopefully, this result can assist the health professionals in the management of febrile neutropenia therapy.Keywords: Ceftazidime, febrile neutropenia, meropenem, pharmacoeconomics

Polimorfisme Gen γ-Aminobutyric Acid Type A Receptor Subunit α-6 (GABRA6) dan Gangguan Kecemasan Melisa I. Barliana; Carissa P. Purabaya; Sri A. F. Kusuma; Rizky Abdulah
Indonesian Journal of Clinical Pharmacy Vol 5, No 2 (2016)
Publisher : Universitas Padjadjaran

Gangguan kecemasan sering terjadi karena pengaruh lingkungan dan juga dipengaruhi oleh variasi genetik. Gamma-aminobutyric acid type A receptors Subunit α-6 (GABRA6) adalah reseptor dari Gamma-aminobutyric acid type A (GABA). Single Nucleotide Polymorphism (SNP) gen GABRA6 pada posisi rs3219151 (T1521C) mempengaruhi respon seseorang terhadap stres. Tujuan penelitian ini adalah identifikasi genotipe gen GABRA6 pada populasi di Kota Bandung serta korelasinya dengan kondisi stres. Penelitian dilakukan terhadap 112 responden yang mengisi kuesioner The Kessler Psychological Distress Scale (K10) untuk melihat kondisi stres. Sampel darah diambil untuk identifikasi variasi gen GABRA6 dan dianalisis menggunakan metode Polymerase Chain Reaction-Refractory Fragment Length Polymorphism (PCR-RFLP) dengan enzim restriksi AlwN1. Hasil identifikasi gen GABRA6 menunjukkan bahwa sebesar 84 responden (75%) memiliki genotipe CC, 14 responden (12,5%) memiliki genotipe CT, dan 14 responden (12,5%) lainnya memiliki genotipe TT. Meskipun mayoritas responden memiliki genotipe CC, namun data genotipe tidak memenuhi asas kesetimbangan Hardy-Weinberg serta tidak ada korelasi antara variasi gen GABRA6 dengan kondisi stres yang menggunakan analisis bivariate (Chi-Square).Kata Kunci: GABRA6, Gangguan Kecemasan, Indonesia, PCR-RFLP, SNPγ-Aminobutyric Acid Type A Receptor Subunit α-6 (GABRA6) Gene Polymorphism and Anxiety Disorder Anxiety disorder caused by environmental factor and individual genetic variations. Gamma-aminobutyric acid type A receptors Subunit α-6 (GABRA6) is γ-aminobutyric acid type A (GABA) receptor. Single Nucleotide Polymorphism (SNP) of GABRA6 gene at rs3219151 (T1521C) affected individual response of stress. The aim of present study was to identify GABRA6 genotype variations in Bandung city population and its correlation with stress condition. Samples were collected from 112 respondents who filled The Kessler Psychological Distress Scale (K10) questionnaire for stress condition. Blood samples were collected and identification of GABRA6 gene was analyzed using Polymerase Chain Reaction‑Refractory Fragment Length Polymorphism (PCR-RFLP) by AlwN1 restriction enzyme digestion. The result of present study showed that 84 respondents (75%) have CC genotype, 14 respondents (12.5%) have CT genotype, and other 14 respondents (12.5%) have TT genotype. Most of respondents have CC genotype but the data did not meet the Hardy-Weinberg equilibrium and showed no correlation between GABRA6 gene variations and stress condition using bivariate analysis (Chi-Square).Keywords: Anxiety disorder, GABRA6, Indonesia, PCR-RFLP, SNP

Perbedaan Jenis Terapi Antipsikotik terhadap Lama Rawat Inap Pasien Skizofrenia Fase Akut di RSJD Sungai Bangkong Pontianak Hariyanto Ih; Rizka A. Putri; Eka K. Untari
Indonesian Journal of Clinical Pharmacy Vol 5, No 2 (2016)
Publisher : Universitas Padjadjaran

Skizofrenia adalah salah satu gangguan jiwa berat yang mempengaruhi seseorang dalam berpikir, merasa, dan bertindak. Prevalensi skizofrenia di Kalimantan Barat pada tahun 2013 adalah 0,7 per 1000 penduduk. Penelitian ini bertujuan untuk menentukan ada atau tidaknya perbedaan lama rawat inap pasien antar jenis terapi antipsikotik yang diberikan kepada pasien skizofrenia fase akut di Rumah Sakit Jiwa Daerah (RSJD) Sungai Bangkong periode Januari–Desember 2014. Desain penelitian berupa analisis cross-sectional dengan metode pengumpulan data secara retrospektif. Penelitian ini dilakukan terhadap 98 rekam medik pasien yang menerima terapi antipsikotik. Data dianalisis dengan analisis univariat dan bivariat. Analisis univariat memberikan gambaran karakteristik pasien, sedangkan analisis bivariat bertujuan untuk melihat ada atau tidaknya perbedaan lama rawat inap pasien antar jenis terapi antipsikotik yang diberikan. Hasil penelitian didapatkan bahwa jenis antipsikotik dan adjuvant yang paling banyak digunakan pasien adalah risperidon dan triheksifenidil dengan frekuensi pemakaian masing-masing sebanyak 446 kali (25,32%) dan 340 kali (65,89%). Hasil analisis menggunakan One‑Way ANOVA menunjukkan bahwa lama rawat inap pasien skizofrenia fase akut yang mendapatkan terapi antipsikotik tunggal tipikal, tunggal atipikal, dan kombinasi tidak mengalami perbedaan yang signifikan (p>0,05). Hasil tersebut menunjukkan bahwa lama rawat inap antar jenis terapi antipsikotik tidak berbeda sehingga dapat disimpulkan jenis terapi antipsikotik yang diberikan tidak memengaruhi perbedaan lama rawat inap pasien.Kata kunci: Antipsikotik, jenis terapi, lama rawat inap, skizofreniaDifferent Type of Antipsychotic Therapies on Length of Stay of Acute Schizophrenia Patients in Sungai Bangkong Regional Mental Hospital Pontianak Schizophrenia is one of severe mental disorders that affects how a person thinks, feels, and acts. In 2013, the prevalence of schizophrenia in West Kalimantan was 0,7 per 1000 inhabitants. This study aimed to determine whether there was any difference in patients’ length of stay of inter-type of antipsychotic therapies given to acute phase schizophrenia patients in Sungai Bangkong Regional Mental Hospital in the period of January–December 2014. The study design was a cross-sectional analysis with retrospective data collecting method. This study was carried out to 98 patients’ medical records who received antipsychotic therapy. Data were analyzed with univariate and bivariate analysis. Univariate analysis gave an overview of patients’ characteristics while bivariate analysis was used to see whether there was any difference in patients’ length of stay of inter-type of antipsychotic therapies. The result showed that the most widely used antipsychotic and adjuvant by patients were risperidone and trihexyphenidyl as many as 446 times (25,32%) and 340 times (65,89%), respectively. Analysis result using One-Way ANOVA showed that the length of stay of acute phase schizophrenia patients, treated with typical monotherapy, atypical monotherapy, and polytherapy, had no significant difference (p>0,05). It showed that length of stay of inter-type of antipsychotic therapies were not different, thus it could be concluded that type of antipsychotic therapies didn’t affect the differences in patients’ length of stay.Keywords: Antipsychotic, length of stay, schizophrenia, type of therapies

Uji Validitas dan Reliabilitas Kuesioner EORTC QLQ C-30 untuk Menilai Kualitas Hidup Pasien Kanker Ginekologi di RSUP Sanglah Denpasar Rini Noviyani; I Ketut Tunas; Ayu Indrayathi; Nyoman G. Budiana
Indonesian Journal of Clinical Pharmacy Vol 5, No 2 (2016)
Publisher : Universitas Padjadjaran

Dampak dari penyakit dan pengobatan kanker dapat diukur dengan indikator kualitas hidup menggunakan kuesioner EORTC QLQ C-30. Penelitian cross-sectional dilakukan menggunakan 30 pasien. Data dikumpulkan melalui metode purposive sampling pada pasien yang memenuhi kriteria inklusi, yaitu wanita berusia 30–70 tahun yang didiagnosis kanker ginekologi, pernah menjalani kemoterapi di RSUP Sanglah Denpasar, dan bersedia menandatangani formulir persetujuan pasca penjelasan. Pasien yang tidak dapat berkomunikasi secara rasional menjadi bagian kelompok eksklusi. Validitas dan reliabilitas instrumen diuji menggunakan analisis faktor konfirmatori dengan program STATA® versi 12. Hasil analisis faktor konfirmatori menunjukkan seluruh item pertanyaan memiliki loading factor ( ) > 0,70 sehingga seluruh butir pertanyaan adalah valid. Uji reliabilitas item memberikan nilai >0,50 untuk seluruh item pertanyaan yang menunjukkan seluruh item pertanyaan adalah reliabel. Hasil perhitungan validitas konstrak menghasilkan nilai VE= 0,90 dan reliabilitas konstrak (RF) adalah 1 yang berarti kuesioner EORTC QLQ C-30 memenuhi validitas dan reliabilitas konstrak. Kuesioner EORTC QLQ C-30 sebagai alat ukur kualitas hidup pasien kanker ginekologi di RSUP Sanglah Denpasar adalah valid dan reliabel.Kata kunci: Analisis faktor konfirmatori, kanker ginekologi, kuesioner EORTC QLQ C-30, RSUP Sanglah Denpasar, uji validitas dan reliabilitas Validity and Reliability of EORTC QLQ C-30 Questionnaire in Assessing Quality of Life of Gynecological Cancer Patients in Sanglah Hospital Denpasar The impacts of cancer and its treatment can be measured by indicators of quality of life using the EORTC QLQ C-30 questionnaire. A cross-sectional study was done on 30 patients in Sanglah Hospital Denpasar. Data were collected through purposive sampling of patients who fit the inclusion criteria: women who were 30–70 years old were diagnosed with gynecological cancer, had chemotherapy in Sanglah Hospital, and had agreed to be part of the research by signing the informed consent form. Patients who were unable to rationally communicate became part of the exclusion group in this research. Validity and reliability of the tools in this study were tested using confirmatory factor analysis with STATA ®version 12. Confirmatory factor analysis indicates that all items have a loading factor ( )> 0.70 so that it can be said that all the questions are valid. Reliability items have the value > 0.50 for all questions which shows all questions are reliable. Construct validity of the results of the calculation produce a value VE = 0.90 and the reliability construct (RF) of 1, which meet both validity and reliability constructs. Questionnaire EORTC QLQ C-30 as a measurement of the quality of life of gynecological cancer patients in Sanglah Hospital are valid and reliable.Key words: EORTC QLQ C-30 questionnaire, confirmatory factor analysis, gynecological cancer,Sanglah Hospital Denpasar, the validity and reliability

Analisis Risiko Reaksi Obat yang Tidak Dikehendaki pada Pasien Lanjut Usia di Rumah Sakit Umum Surabaya Fauna Herawati; Andri Utomo
Indonesian Journal of Clinical Pharmacy Vol 5, No 2 (2016)
Publisher : Universitas Padjadjaran

Orang lanjut usia memiliki risiko tujuh kali lebih besar mengalami Reaksi Obat yang Tidak Dikehendaki (ROTD) dibandingkan dengan orang yang lebih muda. Penelitian yang dilakukan di rumah sakit di Irlandia melaporkan bahwa kejadian ROTD pada pasien lanjut usia sebesar 26%. Tujuan penelitian ini adalah untuk melihat tingkat risiko ROTD dan jenis obat yang digunakan pada pasien lanjut usia rawat inap di RSUD Dr. Moh. Soewandhie Surabaya Periode November–Desember 2014 dengan alat Gerontonet Score dan kriteria Screening Tool of Older People’s Prescriptions (STOPP). Penelitian ini merupakan studi potong lintang dengan jumlah responden 42 orang. Gerontonet score dan kriteria STOPP digunakan untuk melihat tingkat risiko dan jenis obat yang dapat meningkatkan ROTD. Gerontonet score terdiri dari 6 variabel (≥4 comorbid, gagal jantung, gangguan liver, jumlah obat, riwayat ROTD, dan gangguan ginjal); skor ≥4 menunjukkan pasien yang berisiko tinggi mengalami ROTD. Hasil penelitian menunjukkan variabel yang paling banyak menentukan skor adalah GFR ≤60 mL/menit/1,73 m2 dan jumlah obat yang diterima pasien; 15 orang memiliki risiko tinggi (skor ≥4) mengalami ROTD; dan 9,7% (6/62) jenis obat yang termasuk dalam kriteria STOPP, yaitu: furosemid, aspirin, digoksin, dan golongan OAINS (diklofenak, ketoprofen, dan meloksikam). Jadi, GFR ≤60 mL/menit/1,73 m2 dan jumlah obat merupakan faktor risiko yang dapat meningkatkan ROTD.Kata kunci: Gerontonet score, kriteria STOPP, lanjut usia, ROTD Analysis of the Risk of Adverse Drug Reaction on Elderly Patients in General Hospital Surabaya Abstract Elderly people have the risk of adverse drug reaction (ADR) seven times as high as the adult ones. A research conducted in one of the hospitals in Ireland reported that the incident of ADR was 26%. The objective of this study was to find out the level of ADR risk and types of drugs used to treat elderly inpatients in Dr. Moh. Soewandhi General Hospital Surabaya for the period of November–Desember 2014 utilizing gerontonet score and Screening Tool of Older People’s Prescriptions (STOPP) criteria. The method of this research is cross sectional with a total of 42 participants. In this study, gerontonet score and STOPP criteria was used to analyze the data in order to determine the level of risk and types of drugs. Gerontonet score consists of 6 variables (>4 comorbid, heart failure, liver disorder, amount of drug, history of ADR, and kidney failure); score of ≥4 at presentation identified that the patient is at high risk of ADR. The result of this study showed the variables that mostly determine score was GFR ≤60 mL/min/1,73 m2; 15 participant at high risk of ADR (≥4); and amount of drugs used for treatments; and 9,7% (6/62) kind of drugs used for treatments was included in STOPP criteria: furosemide, aspirin, digoxin, and NSAID (diclofenac, ketoprofen, and meloxicam). The conclusion of this study showed GFR ≤60 mL/min/1,73 m2 and amount of drugs used for treatments increased the risk of ADR.Key words: ADR, elderly, Gerontonet score, STOPP criteria

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