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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 7, No 1 (2018)" : 16 Documents clear

Analisis Cost of Illness Terapi Insulin dan Kombinasi Insulin-Metformin pada Pasien Diabetes Melitus Tipe 2 di Salah Satu Rumah Sakit di Bandung Mally G. Sholih; Ahmad Muhtadi; Siti Saidah
Indonesian Journal of Clinical Pharmacy Vol 7, No 1 (2018)
Publisher : Universitas Padjadjaran

Diabetes melitus (DM) tipe 2 merupakan suatu penyakit progresif yang berdampak pada biaya yang dikeluarkan pasien selama mengidap penyakit ini. Penelitian ini dilakukan dari bulan Mei hingga Juni di salah satu rumah sakit di Bandung. Penelitian ini bertujuan untuk memperoleh perhitungan biaya kesakitan penggunaan insulin monoterapi dan kombinasi insulin-metformin pada pasien DM tipe 2 dengan menggunakan analisis Cost of Illness (COI). Penelitian ini menggunakan metode potong lintang dengan pengambilan data secara retrospektif pada objek penelitian pasien rawat jalan dengan lama terapi selama 6 bulan pada tahun 2013. Komponen biaya yang diukur adalah biaya medik langsung (biaya kunjungan ke dokter, biaya obat, biaya komplikasi dan biaya pemeriksaan laboratorium) dan human capital (HC) seperti biaya tidak langsung non-medis (kehilangan pendapatan per hari). Hasil penelitian menunjukkan nilai COI selama 6 bulan terapi dengan insulin dan kombinasi insulin-metformin secara berurutan Rp661.063,59 dan Rp443.165,28. Penelitian ini menunjukkan bahwa penggunaan terapi kombinasi insulin-metformin memiliki biaya kesakitan yang lebih rendah dibandingkan dengan terapi insulin tunggal dan secara statistik (student t-test) menunjukkan perbedaan yang signifikan p=0,004 (p<0,05).Kata kunci: COI, diabetes melitus tipe 2, insulin, kombinasi insulin-metforminCost of Illness Analysis of Insulin and Insulin-Metformin Combination Usage towards Diabetes Mellitus Type 2 Patients at Hospital in BandungDiabetes mellitus (DM) type 2 is a progressive disease that impact on the patients incurred costs during the illness. This study was conducted on May to June at one of hospital in Bandung. This study aimed to obtain cost of illness calculation of insulin monotherapy and insulin-metformin combination in patients with type 2 diabetes using Cost of Illness analysis (COI). This study used cross-sectional method with retrospective data collection on outpatients with 6 months therapy period in 2013. The cost of the measured components are direct medical costs (the cost of doctor visits, medicine costs, costs of complications and the cost of laboratories test) and human capital (HC) such as indirect non-medical costs (lost revenue per day). The results show the value of COI in the six months treatment of insulin and insulin-metformin combination sequentially 661,063.59 IDR and 443,165.28 IDR. This study shows that the use of combination therapy of insulin-metformin has lower cost of illness compared with insulin monotherapy and statistically (student t-test) showed significant differences p=0.004 (p<0.05).Keywords: COI, diabetes mellitus type 2, insulin, insulin-metformin combination

Perbandingan Efektivitas Ampisilin dengan Ampisilin-Gentamisin pada Pasien Balita dengan Pneumonia Salma H. California; Rano K. Sinuraya; Eli Halimah; Anas Subarnas
Indonesian Journal of Clinical Pharmacy Vol 7, No 1 (2018)
Publisher : Universitas Padjadjaran

Pneumonia merupakan salah satu penyebab utama kematian anak usia di bawah lima tahun (balita) di dunia. Terapi antibiotik untuk pneumonia biasanya dipilih secara empirik karena mikroorganisme penyebab pneumonia belum dapat diketahui saat diagnosis. Penelitian ini bertujuan untuk membandingkan efektivitas terapi antibiotik empirik pneumonia dengan menggunakan ampisilin tunggal maupun dikombinasikan dengan gentamisin pada balita yang dirawat dengan pneumonia di salah satu rumah sakit di kota Bandung pada tahun 2013–2015. Metode penelitian yang digunakan adalah potong lintang dengan pengambilan data sekunder secara retrospektif. Data yang diperoleh dianalisis dengan uji Chi Square, uji Fisher, dan uji Mann-Whitney. Hasil penelitian menunjukkan bahwa tidak ada perbedaan efektivitas antara pasien yang diterapi menggunakan ampisilin maupun ampisilin-gentamisin dari parameter perbaikan batuk (p=0,381), sesak (p=0,294), demam (p=0,405), maupun laju pernapasan (p=0,306), namun terdapat perbedaan pada lama hari rawat (p<0,001). Tidak adanya perbedaan efektivitas pada parameter perbaikan gejala (sesak dan batuk) dan tanda (suhu tubuh dan laju pernapasan) tersebut dapat menjadi dasar untuk rekomendasi penggunaan ampisilin tunggal sebagai pilihan terapi utama pada pasien pneumonia balita. Selain pertimbangan efektivitas terapi, pemberian terapi antibiotik harus memperhatikan aspek lain seperti pola kepekaan bakteri, risiko efek samping pada pasien, serta efektivitas biaya.Kata kunci: Anak, antibiotik, efektivitas, pneumonia, terapi empirik Effectiveness of Ampicillin and Ampicillin-Gentamicin for Children under Five Years Old with PneumoniaPneumonia was one of the main causes of mortality in children aged under five years old. Empirical antibiotic therapy was usually selected in pneumonia because the microorganisms have not been known at diagnosis. The purpose of this study was to compare the effectiveness of empirical antibiotic therapy using ampicillin or ampicillin-gentamicin for children aged under five years old with pneumonia at one hospital in Bandung in period of 2013–2015. The method used in this study was cross-sectional method with retrospective data collection. Collected data were analyzed using Chi-Square, Fisher, and Mann-Whitney methods. The results showed that there was no difference in effectiveness between patients treated with ampicillin and ampicillin-gentamicin from improvement of cough (p=0.381), shortness of breath (p=0.294), fever (p=0.405), and respiratory rate (p=0.306) parameters but there was a difference in length of stay (p<0.001). Therefore, it might be the basis for the use of a single ampicillin as a primary treatment option in pneumonia for children aged under five years old. In addition, antibiotic therapy should consider other aspects such as bacterial susceptibility patterns, the risk of side effects in patients, as well as cost effectiveness.Keywords: Antibiotic, children, effectiveness, empirical therapy, pneumonia

Pengaruh Antipsikotik terhadap Penurunan Skor The Positive and Negative Syndrome Scale-Excited Component Ayuningtyas G. Purwandityo; Yosi Febrianti; Chynthia P. Sari; Vitarani D. A. Ningrum; Okky P. Sugiyarto
Indonesian Journal of Clinical Pharmacy Vol 7, No 1 (2018)
Publisher : Universitas Padjadjaran

Skizofrenia adalah gangguan kejiwaan dengan satu atau lebih kriteria seperti delusi, halusinasi, cara berpikir dan berbicara yang tidak teratur, gangguan perilaku, dan gejala negatif. Antipsikotik merupakan terapi utama untuk pengobatan skizofrenia. Respon terapi pengobatan pasien dengan gangguan syaraf maupun jiwa seperti skizofrenia hanya dapat dilihat dari perbaikan gejala dan penurunan tingkat keparahan pasien yang dapat diukur melalui diagnosis dokter berdasarkan instrumen pengukuran seperti The Positive and Negative Syndrome Scale-Excited Component (PANSS-EC). Penelitian ini bertujuan untuk mengetahui presentase pengaruh pemilihan antipsikotik terhadap penurunan skor PANSS-EC dan mengetahui jenis antipsikotik yang paling memengaruhi penurunan PANSS-EC. Penelitian ini dilakukan pada bulan Januari sampai Maret 2016 pada pasien skizofrenia akut di Rumah Sakit Jiwa Prof. Dr. Soerojo Magelang dengan menggunakan metode cross-sectional, observasional-analitik yang dilakukan secara prospektif. Data nilai selisih skor pre dan post PANSS-EC dari 97 pasien diambil secara acak (random) sebanyak 39 pasien. Berdasarkan hasil uji One Way ANOVA, diperoleh nilai signifikansi sebesar 0,021 (p <0,05), nilai linearitas F (0,03) <0,05, dan nilai Fhitung > Ftabel (2,584 >1,81), hal ini bermakna bahwa terdapat pengaruh yang signifikan antara pemilihan antipsikotik terhadap penurunan skor PANSS-EC. Hasil uji asosiasi Eta menunjukkan bahwa besar pengaruh dari pemilihan antipsikotik terhadap penurunan skor PANSS-EC pasien adalah 73,80%. Berdasarkan hasil uji post hoc ANOVA, monoterapi klozapin merupakan terapi antipsikotik yang paling berbeda signifikan dengan level signifikansi (mean difference) 0,05 dibandingkan dengan monoterapi dan kombinasi antipsikotik lainnya. Sebanyak 73,80% penggunaan antipsikotik memengaruhi penurunan skor PANSS-EC dan klozapin merupakan terapi antipsikotik yang paling berbeda signifikan di antara monoterapi maupun kombinasi antipsikotik lainnya.Kata kunci: Antipsikotik, klozapin, PANSS-EC, skizofrenia The Influence of Antipsychotic to Decrease the Score of The Positive and Negative Syndrome Scale-Excited ComponentSchizophrenia is a psychiatric disorder with one or more of the following criteria: delusions, hallucinations, ways of thinking and talking that is irregular, behavioral disorders and negative symptoms. The treatment responsed of patients with neurological or psychiatric disorders only be seen from patient’s improved of symptomps and severity decreased that can be measured through doctor’s diagnosis based on instrument measurement such as The Positive and Negative Syndrome Scale-Excited Component (PANSS-EC). The aim of this study were to find out percentage of the antipsychotics selection effect to decrease score of PANSS-EC and to find out which type of antipsychotic that mostly influence the decrease. This study was conducted from January to March 2016 in patients with acute schizophrenia at RSJ (mental hospital) Prof. Dr. Soerojo Magelang using cross-sectional, observational-analytic based on prospective. The difference of pre and post PANSS-EC score of 97 patients were taken randomly as many as 39 patients. Based on the result of one way anova test, the value of significance was 0.021 (p >0.05), linearity F value (0.03), F value counted > F table (2.584 >1.81), which means there was a significant influence between antipsychotics selection with decrease of the PANSS-EC score. The result of Eta association showed that the effect of antipsychotics selection to decrease patient’s PANSS-EC score was 73.80%. Based on the result of post hoc anova test, clozapine monotherapy was the most significant antipsychotic therapy with a significance level of 0.05 (mean difference) compared to monotherapy or combination antipsychotics. 73.80% of antipsychotics selection influenced the decrease of patient’s PANSS-EC score, and clozapine was the most siginficant antipsychotic therapy compared to monotherapy or other combination antipsychotics.Keywords: Antipsychotic, clozapine, PANSS-EC, schizophrenia

Potensi Polimer Poly-Lactic-co-Glicolyc Acid untuk Terapi Kanker dan Perkembangan Uji Kliniknya Patihul Husni
Indonesian Journal of Clinical Pharmacy Vol 7, No 1 (2018)
Publisher : Universitas Padjadjaran

Penyakit kanker merupakan salah satu penyebab kematian utama di seluruh dunia. Pada tahun 2012, kanker menjadi penyebab kematian sekitar 8,2 juta orang. Poly-Lactic-co-Glicolyc Acid (PLGA) merupakan salah satu polimer yang mampu terurai secara biologis (biodegradable) yang sering digunakan sebagai nanokarier yang efektif untuk penghantaran obat ke dalam sel. PLGA bersifat biodegradable karena diuraikan menjadi senyawa endogen yaitu asam laktat dan asam glikolat dan mudah dimetabolisme oleh tubuh melalui siklus Krebs sehingga memiliki sifat toksisitas sistemik yang rendah serta telah disetujui Food and Drug Administration (FDA) untuk terapi pada manusia. Banyak obat antikanker yang dienkapsulasi menggunakan PLGA dan telah dilakukan uji in vitro, in vivo dan uji klinik. Artikel review ini bertujuan untuk mengetahui potensi PLGA untuk terapi kanker dan perkembangan uji kliniknya saat ini. Metode penulisan artikel review ini dilakukan melalui penelusuran pustaka. Hasil review dari 38 artikel menunjukkan bahwa polimer PLGA sangat berpotensi dalam penghantaran obat antikanker baik secara pasif maupun aktif. Beberapa produk sedang berada dalam tahap uji in vitro, in vivo dan klinik. Namun, produk yang telah beredar di pasaran menunjukkan bahwa PLGA terbukti berpotensi dan aman sebagai polimer untuk menghantarkan obat ke sel kanker prostat.Kata kunci: PLGA, uji klinik, polimer, biodegradable, kanker Biodegradable Polymer Potential of Poly-Lactic-co-Glicolyc Acid for Cancer Therapy and Its Clinical TrialCancer is one of the leading causes of death worldwide. In 2012, cancer causes death of about 8.2 million people. Poly-Lactic-co-Glicolyc Acid (PLGA) is one of the biodegradable polymers that is often used as an effective nanocarrier for drug delivery into cells. PLGA is biodegradable because it is decomposed into endogenous compounds namely lactic acid and glycolic acid and easily metabolized by the body through the Krebs cycle, so it has low systemic toxicity properties and has been approved by Food and Drug Administration (FDA) for human therapy. Many anticancer drugs are encapsulated using PLGA and have been tested in vitro, in vivo and clinical trial. This review article aimed to determine the potential of PLGA for cancer therapy and the development of current clinical trials. Data in this review article is obtained from library search. The review result of 38 articles indicate that the PLGA polymer is highly potential in delivering anticancer drugs either passively or actively. Some products are undergoing in vitro test, in vivo test, and clinical trials. However, marketed products show that PLGA is proven to be potential and safe as a polymer to deliver drugs into prostate cancer cells.Keywords: PLGA, clinical study, polymer, biodegradable, cancer

Profil Penggunaan Antibiotik Pascapencanangan Penerapan Program Pengendalian Resistensi Antibiotik di Intensive Care Unit Rumah Sakit TNI-AL dr. Ramelan Surabaya Stefanie Setiawan; Widyati Widyati; Pandu Harijono
Indonesian Journal of Clinical Pharmacy Vol 7, No 1 (2018)
Publisher : Universitas Padjadjaran

Program Pengendalian Resistensi Antibiotik (PPRA) merupakan program wajib rumah sakit Indonesia sesuai Permenkes No. 8 tahun 2015. Rumkital dr. Ramelan Surabaya termasuk salah satu rumah sakit yang telah menerapkan PPRA. Tujuan penelitian ini adalah untuk mengetahui deskripsi kuantitatif-kualitatif pemakaian antibiotik, serta luaran klinis dan mikrobiologis yang teramati pascapencanangan penerapan PPRA di ICU Rumkital dr. Ramelan Surabaya. Desain penelitian adalah studi observasi cross-sectional yang dilakukan selama 3 bulan (Februari–Mei 2016) di ICU Rumkital dr. Ramelan. Deskripsi kuantitatif diamati menggunakan Days of Therapy (DOT/100 hari-pasien), deskripsi kualitatif menggunakan alur Gyssens. Pengamatan luaran klinis dilakukan terhadap infeksi nosokomial, mortalitas terkait infeksi, dan lama tinggal di ICU (Length of Stay/LOS). Pengamatan luaran mikrobiologis dilakukan terhadap pola penyebaran bakteri multiresisten. Hasil perhitungan jumlah konsumsi antibiotik didapatkan 151,63 DOT/100 hari-pasien. Penilaian kualitas antibiotik menunjukkan hasil 52,73% terapi tepat; 8,18% tidak tepat; 7,27% tanpa indikasi; 31,82% tidak tercapai kesepakatan antar penilai (κ=0,59; p<0,05). Infeksi nosokomial terbanyak yaitu Hospital Acquired Pneumonia (HAP)/Ventilator Associated Pneumonia (VAP), mortalitas terkait infeksi 44,68%; dan LOS rata-rata 7,17±1,9 hari (p<0,05). Belum ditemukan adanya insiden Methicillin-resistant Staphylococcus aureus (MRSA) ataupun Extended Spectrum Beta-Lactamase (ESBL), namun ditemukan dua kasus Multi Drug Resistant (MDR) Acinetobacter baumannii.Kata kunci: Alur Gyssens, DOT, ICU, PPRA, resistensi antibiotik Antibiotic Usage Profile after Antibiotic Stewardship Program Implementation in Intensive Care Unit of dr. Ramelan Naval Hospital SurabayaAntibiotic Stewardship Program (ASP) is mandatory to all Indonesian hospitals, in accordance to the 2015 Minister of Health Decree No. 8. Dr. Ramelan Naval Hospital Surabaya is one among the many hospitals in Indonesia that has implemented the ASP. The study objective was to describe quantitative-qualitatively the use of antibiotics, along with clinical and microbiological outcomes observed in an Intensive Care Unit (ICU) after ASP implementation in dr. Ramelan Naval Hospital Surabaya. The design was a 3-month (February–May 2016) cross-sectional observational study. Quantitative description was reported using Days of Therapy (DOT)/100 patient-days, the qualitative description was reviewed using Gyssens’ flowchart. Clinical outcomes observed include nosocomial infection, infection-related mortality, and average length of stay (LOS). Microbiological outcome was observed through the occurences of multi-drug resistant organism. The results showed overall antibiotic use was 151.63 DOT/100 patient-days. Quality of antibiotic use were 52.73% definitely appropriate; 8.18% inappropriate regarding dose, intervals, durations, and timing; 7.27% no indication; and no mutual agreement in 31.82% (κ=0.59; p<0.05). Hospital Acquired Pneumonias (HAPs)/Ventilator Associated Pneumonias (VAPs) were the most observed nosocomial infection, infection-related mortality rate was 44.68%; and average LOS were 7.17±1.9 days (p<0.05). No incidents of Methicillin-resistant Staphylococcus aureus (MRSA) or Extended Spectrum Beta-Lactamase (ESBL) have been found, but there were two cases of Multi Drug Resistant (MDR) Acinetobacter baumannii.Keywords: Antibiotic resistance, ASP, DOT, Gyssens’ flowchart, ICU

Hubungan antara Obesitas, Konsumsi Tinggi Purin, dan Pengobatan terhadap Kadar Asam Urat dengan Penggunaan Allopurinol pada Pasien Hiperurisemia Ema P. Yunita; Dinar I. Fitriana; Atma Gunawan
Indonesian Journal of Clinical Pharmacy Vol 7, No 1 (2018)
Publisher : Universitas Padjadjaran

Hiperurisemia adalah kondisi ketika kadar asam urat dalam darah melebihi nilai normal. Terdapat banyak faktor yang memengaruhi peningkatan kadar asam urat, seperti obesitas, konsumsi tinggi purin, dan pengobatan. Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara obesitas, konsumsi tinggi purin, dan pengobatan terhadap kadar asam urat dengan penggunaan allopurinol pada pasien hiperurisemia. Data diperoleh melalui rekam medis dan kuesioner dari RSUD Dr. Saiful Anwar, Malang, dan dengan studi potong melintang. Pengambilan sampel dilakukan selama satu bulan (April–Mei 2014). Data dianalisis secara deskriptif dan diuji hipotesis. Sampel penelitian ini adalah 45 pasien hiperurisemia yang memperoleh allopurinol sebagai terapinya selama satu bulan dan pasien dipilih dengan metode pengambilan sampel konsekutif. Hasil dari penelitian ini menunjukkan bahwa tidak terdapat hubungan komparasi yang bermakna secara statistik antara kadar asam urat terhadap obesitas (0,193), konsumsi tinggi purin yaitu makanan laut (0,420), daging (0,469), jerohan (0,054), dan polong-polongan (0,398) juga pengobatan yaitu furosemid (0,631), aspirin dosis rendah (0,773), hidroklorotiazid (0,216), dan spironolakton (0,246). Selain itu, tidak pula terdapat korelasi yang bermakna secara statistik antara kadar asam urat terhadap obesitas (0,197), konsumsi tinggi purin yaitu makanan laut (0,426), daging (0,476), jerohan (0,053), dan polong-polongan (0,404) juga pengobatan yaitu furosemid (0,637), aspirin dosis rendah (0,776), hidroklorotiazid (0,220), dan spironolakton (0,250).Kata kunci: Allopurinol, asam urat, penghambat xantin oksidase Associations between Obesity, High Purine Consumptions, and Medications on Uric Acid Level with the Use of Allopurinol in Hyperuricemia PatientsHyperuricemia is a condition when the blood uric acid level exceeds the normal amount. There are many factors that can increase the uric acid level, such as obesity, high purine consumptions, and medications. The aim of this study was to determine the associations between obesity, high purine consumptions, and medications on uric acid level with the use of allopurinol in hyperuricemia patients. Data were collected through medical records and questionnaires from General Hospital of Dr. Saiful Anwar, Malang, and delivered within a cross-sectional study. Sampling was conducted for one month (April–May 2014). Data were analyzed descriptively and tested hypothetically. The samples of this study were 45 hyperuricemia patients who had gotten allopurinol as their therapy for a month and they were choosen by the consecutive sampling method. The results of this study showed that there were no statistically significant comparative association between uric acid level on obesity (0.193), high purine consumptions i.e. seafoods (0.420), meats (0.469), organ meats (0.054), and pods (0.398) also medications i.e. furosemide (0.631), low dose aspirin (0.773), hydrochlorotiazide (0.216), and spironolactone (0.246). In particular, there were no statistically significant correlations between uric acid level on obesity (0.197), high purine consumptions i.e. seafoods (0.426), meats (0.476), organ meats (0.053), and pods (0.404) also medicines i.e. furosemide (0.637), low dose aspirin (0.776), hydrochlorotiazide (0.220), and spironolactone (0.250).Keywords: Allopurinol, uric acid, xanthin oxidase inhibitor

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