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Jurnal Farmasi Klinik Indonesia

ijcp
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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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Articles 540 Documents

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Efek Samping Obat Antituberkulosis Kategori I dan II Pasien Tuberkolosis Paru Dewasa di Rumah Sakit Hasan Sadikin Elsa P. Pratiwi; Enny Rohmawaty; Iceu D. Kulsum
Indonesian Journal of Clinical Pharmacy Vol 7, No 4 (2018)
Publisher : Universitas Padjadjaran

Terapi tuberkulosis (TB) menggunakan beberapa antibiotik yang sering diberikan dalam Kombinasi Dosis Tetap (KDT) kategori I dan II berdasarkan Directly Observed Treatment Short-course (DOTS). Kombinasi berbagai jenis obat antituberkulosis (OAT) dan durasi terapi yang lama bisa menimbulkan efek samping. Tujuan penelitian ini adalah untuk mengetahui gambaran dan frekuensi efek samping OAT kategori I dan II. Penelitian cross-sectional ini mengambil data dari rekam medis pasien TB paru dewasa di Klinik DOTS Rumah Sakit Dr. Hasan Sadikin Bandung, Indonesia, pada periode Juli 2015–Juni 2016. Data yang diambil adalah jenis TB, jenis OAT, efek samping dan waktu kemunculan efek samping. Dari 178 pasien, 27 pasien (15,2%) mengalami efek samping. Jumlah pasien dengan OAT kategori I yang mengalami efek samping sebanyak 22 pasien, sedangkan OAT kategori II sebanyak 5 pasien. Efek samping terbanyak adalah hepatotoksisitas. Efek samping di kategori I paling banyak adalah hepatotoksisitas (52%) sedangkan di kategori II frekuensinya sama yaitu 20% yang terdiri dari hepatotoksisitas, gangguan gastrointestinal, ruam dan gatal, gangguan neurologi dan gagal ginjal. Efek samping pada kategori I banyak terjadi di bulan pertama (48%), sedangkan kategori II banyak terjadi di bulan pertama dan kedua yang masing-masing adalah 40%. Efek samping tidak berhubungan dengan usia dan jenis kelamin (nilai p>0,05). Kesimpulan penelitian ini adalah kejadian efek samping OAT kategori I dan II bervariasi dan terdapat 27 pasien yang mengalami satu atau lebih efek samping dengan efek samping terbanyak adalah hepatotoksisitas.Kata Kunci: Efek samping, obat antituberkulosis, tuberkulosis paru Adverse Reactions of Category I and II Regimens of Anti-tuberculosis Drugs among Adult Pulmonary Tuberculosis Patients in Hasan Sadikin General HospitalAbstractAnti-tuberculosis therapy (ATT) with multiple antibiotics, administered as category I and II regimens fixed dose combination (FDC) which based on Directly Observed Treatment Short-course (DOTS) is commonly used. Since the process of this treatment is long-term and consists of multidrug, adverse reaction may occur. The aim of this study was to find the description and frequency of adverse reactions during the therapy of category I and II regimens of ATT. This cross-sectional study used data which was taken from adult pulmonary TB medical record at DOTS clinic of Hasan Sadikin General Hospital, Bandung, Indonesia, in the period of July 2015–June 2016. The data consisted of type of TB, drug choice, adverse effect and the time of emergence. Among 178 patients, 27 patients (15.2%) experienced adverse effects which consisted of 22 patients in category I regimens and 5 patients in category II regimens. The majority of adverse effects is hepatotoxicity. Adverse effects occurred in category I regimens mostly was hepatotoxicity (52%) and in category II regimens were hepatotoxicity, gastrointestinal disorder, skin reactions, neurological disorder and renal failure, with each frequency was 20%. Adverse effects in category I regimens mostly occurred in first month (48%) and in category II regimens mostly occurred in first and second month, with both frequencies were 40%. Side effects were not related to age and sex (p-value >0.05). The conclusion of this study is there were various pattern of adverse reactions of category I and II regimens of ATT. A total of 27 patients experienced one or more adverse reactions, the most frequent reaction was hepatotoxicity.Keywords: Adverse effects, anti-tuberculosis drugs, pulmonary tuberculosis

The Impacts of Lifestyle Modification Education towards Cardiovascular Risk Profile Fonny Cokro; Abdul Rahem; Lisa Aditama; Franciscus C. Kristianto
Indonesian Journal of Clinical Pharmacy Vol 7, No 3 (2018)
Publisher : Universitas Padjadjaran

Obesity is one of the risk factors of cardiovascular disease. The prevalence of obesity in Indonesia has increased in the last few years, therefore some efforts to reduce the risk is needed. In the current study, efforts are given through 3-week lifestyle modification education, with 3-month total of follow-up (from March to June 2014) and then the impacts on cardiovascular risk profile were observed and seen on 24 sedentary male workers in University of Surabaya with obese II. This study used before-after study design in order to see the impacts of the 3-week lifestyle modification education towards change of knowledge, dietary behavior, body mass index (BMI), waist circumference, and cardiovascular risk profile through various educational methods (face-to-face session, given recorder of face-to-face session, and combination of both methods). Statistical analysis was performed using Wilcoxon signed test. Result showed an increasing knowledge in face-to-face group (p=0.046). However, there were no significant changes in other variables (dietary behavior based on healthy diet indicator (HDI), BMI, waist circumference, and also cardiovascular risk profile) in all groups between before and after education intervention (p>0.05). In conclusion, lifestyle modification education given for 3 weeks did not reduce the cardiovascular risk profile on sedentary male workers with obese II. Longer term intervention and multicomponent program including behavior therapy may be needed to succeed lifestyle changes and reduce cardiovascular risk.Keywords: Behaviour, cardiovascular risk, education, knowledge, lifestyle modification Pengaruh Edukasi Gaya Hidup terhadap Perubahan Risiko Penyakit KardiovaskularAbstrakObesitas merupakan salah satu faktor risiko penyakit kardiovaskular. Prevalensi obesitas di Indonesia mengalami peningkatan beberapa tahun terakhir, sehingga diperlukan upaya untuk menguranginya. Pada penelitian ini, upaya dilakukan melalui pemberian edukasi gaya hidup yang dilakukan selama 3 minggu, dengan total follow-up sampai dengan 3 bulan dari bulan Maret hingga Juni 2014, kemudian dilihat dan diamati ada atau tidaknya penurunan risiko penyakit kardiovaskular pada 24 orang karyawan pria obese II di Universitas Surabaya. Penelitian ini memiliki rancangan before-after study design untuk menguji pengaruh edukasi gaya hidup yang diberikan selama 3 minggu terhadap variabel pengetahuan, perubahan perilaku, body mass index (BMI), lingkar perut, dan risiko penyakit kardiovaskular melalui berbagai metode pemberian edukasi (tatap muka, rekaman/recorder, dan kombinasi). Analisis dengan Wilcoxon signed test menunjukkan bahwa terdapat peningkatan pengetahuan hanya pada subgrup tatap muka (p=0,046). Tidak terdapat perubahan yang signifikan terhadap variabel lainnya (perubahan perilaku berdasarkan healthy diet indicator (HDI), BMI dan lingkar perut, serta risiko penyakit kardiovaskular) pada semua subgrup antara sebelum dan sesudah edukasi (p>0,05). Edukasi gaya hidup yang diberikan selama tiga minggu tidak memberikan penurunan risiko penyakit kardiovaskular pada karyawan pria obese II. Dibutuhkan intervensi jangka panjang dan program multikomponen yang memuat terapi perilaku untuk menyukseskan perubahan perilaku dan menurunkan risiko kardiovaskular.Kata kunci: Edukasi, gaya hidup, pengetahuan, perilaku, risiko kardiovaskular

Acute Iron Dextran Injection Increases Liver Weight and Reduces Glycerol Kinase Expression in Liver Ramdan Panigoro; Fadhal M. Ahmad; Uni Gamayani; Neni Anggraeni; Rini Widyastuti; Mohammad Ghozali; Mas Rizky A.A Syamsunarno
Indonesian Journal of Clinical Pharmacy Vol 7, No 4 (2018)
Publisher : Universitas Padjadjaran

Iron is essential and needed in a very small amount. When iron exceeds normal need, metabolic alteration occurs, causing hepatosteatosis. The mechanism of iron inducing hepatosteatosis remains unclear. Glycerol kinase, the enzyme responsible in triglyceride synthesis initiation, is assumed to have a role in the pathomechanism of hepatosteatosis. This study aimed to investigate the gene expression of glycerol kinase in an acute iron overload condition. This study was conducted in Animal Laboratory Faculty of Medicine and Central Laboratory Universitas Padjadjaran from May to June 2017. Three groups of mice were divided by the dose of iron dextran injection (0, 0.1, 0.3 mg/day/mice). After 19 days, mice were terminated, liver weight was measured and glycerol kinase gene expression in the liver was determined by semi-qualitative PCR. Quantification of PCR result was calculated by ImageJ software. There was a significant change in liver weight of the mice in a dose-dependent manner of iron injection. The expression of glycerol kinase tended to decrease, but statistically insignificant. Acute iron dextran injection increases liver weight and tends to reduce glycerol kinase gene expression in mice liver.Keywords: Glycerol kinase, hepatosteatosis, iron overload Efek Zat Besi Dosis Tinggi Akut dalam Meningkatkan Berat Organ dan Menurunkan Ekspresi Gliserol Kinase HeparAbstrakZat besi merupakan nutrien esensial dan diperlukan dalam jumlah yang sangat kecil. Ketika kadar zat besi melebihi kadar normal dalam tubuh, terjadi perubahan metabolisme yang menyebabkan hepatosteatosis. Mekanisme zat besi dalam menyebabkan hepatosteatosis masih belum diketahui secara pasti. Gliserol kinase, enzim yang menginisiasi sintesis trigliserida, diduga berperan dalam patomekanisme hepatosteatosis. Penelitian ini bertujuan untuk meneliti ekspresi gen gliserol kinase pada hepar pada kondisi tinggi zat besi akut. Penelitian ini dilakukan di Laboratorium Hewan Fakultas Kedokteran dan Laboratorium Sentral Universitas Padjadjaran dari bulan Mei sampai dengan Juni 2017. Tiga kelompok mencit dibagi berdasarkan dosis injeksi iron dextran intraperitoneal (0, 0,1, 0,3 mg/hari/ekor). Setelah 19 hari, mencit diterminasi, berat hepar ditimbang dan ekspresi gen gliserol kinase diukur dengan metode semi-kualitatif PCR. Kuantifikasi hasil PCR dilakukan dengan menggunakan aplikasi ImageJ. Terdapat peningkatan berat hepar secara signifikan yang sejalan dengan dosis ijeksi zat besi. Ekspresi gen gliserol kinase cenderung menurun, meskipun secara statistik tidak signifikan. Keadaan tinggi kadar zat besi yang akut meningkatkan berat hepar dan cenderung menurunkan ekspresi gen gliserol kinase pada hepar mencit.Kata kunci: Gliserol kinase, hepatosteatosis, zat besi berlebih

Analisis Tingkat Kepuasan Pasien Rawat Inap Diabetes Melitus Tipe 2 dengan Komplikasi Ginjal di Fasilitas Kesehatan Tingkat Lanjut Gilang S. Pramanik; Irma M. Puspitasari; Cherry Rahayu; Auliya A. Suwantika
Indonesian Journal of Clinical Pharmacy Vol 7, No 3 (2018)
Publisher : Universitas Padjadjaran

Diabetes melitus merupakan penyakit dengan pengobatan seumur hidup, oleh karena itu kepuasan pasien perlu diperhatikan agar pasien memiliki kemauan dalam menjalani pengobatannya terus-menerus guna mencapai keberhasilan terapi. Proporsi diabetes melitus pada tahun 2013 sebesar 6,9% dengan perkiraan jumlah absolut penderita diabetes sebanyak 12.191.564 jiwa di Indonesia, dan satu per enam dari pasien diabetes melitus tipe 2 mengalami komplikasi ginjal. Penelitian ini bertujuan untuk mengetahui tingkat kepuasan pasien rawat inap diabetes melitus tipe 2 dengan komplikasi ginjal menggunakan kuesioner The Patient Satisfaction Quesionnaire Short-Form (PSQ-18). Penelitian ini adalah penelitian observasional dengan rancangan penelitian deskriptif. Pengambilan data secara konkuren berasal dari kuesioner PSQ-18 yang sudah divalidasi. Subjek penelitian merupakan pasien rawat inap di RSUP Dr. Hasan Sadikin Bandung pada tahun 2016 sampai 2017 dengan diagnosis utama non-insulin-dependent diabetes mellitus with renal complication (kode ICD: E11,2+). Hasil pengukuran rata-rata skor kepuasan pasien secara keseluruhan sebesar 3,62. Pengelompokan berdasarkan tahun rawat inap memiliki rata-rata skor total sebesar 3,59 pada tahun 2016 dan 3,66 pada tahun 2017. Kategori kepuasan pasien dengan skor tertinggi adalah kualitas interpersonal (3,93) dan terendah adalah aspek keuangan (3,18). Pada pengelompokan kepuasan berdasarkan terapi insulin, kelompok kombinasi insulin Glargine-Aspart memiliki rata-rata skor tertinggi (3,8) dan kombinasi insulin Detemir-Aspart dengan rata-rata skor terendah (3,3). Secara keseluruhan, pasien diabetes melitus tipe 2 dengan komplikasi ginjal yang menjalani rawat inap di fasiltas kesehatan tingkat lanjut merasa puas dengan pelayanan kesehatan yang diberikan. Berdasarkan level kepuasan pasien, kombinasi insulin glargine-insulin aspart dapat direkomendasikan sebagai pilihan pengobatan.Kata kunci: Diabetes melitus tipe 2, gangguan ginjal, kepuasan pasien The Satisfaction Level of Inpatients Diagnosed with Type 2 Diabetes Mellitus and Renal Complications in an Advanced Health FacilityAbstractDiabetes mellitus is a disease that requires a lifelong treatment. Therefore, patient satisfaction should be well-maintained to keep them motivated in undergoing the continuous treatment. The prevalence of diabetes mellitus in 2013 reached 6.9% with an estimated total of 12.191.564 patients diagnosed with this disease in Indonesia. One per six patients with type 2 diabetes mellitus was identified to also suffer from renal complications. This study aimed to find the satisfaction level of inpatients diagnosed with type 2 diabetes mellitus and renal complications in an advanced health facility. This observational research was done using a descriptive research design. A set of validated questionnaire (PSQ-18) was employed to concurrently collect relevant data related to patient satisfaction. The subjects of this research were inpatients of RSUP Dr. Hasan Sadikin Bandung during year 2016–2017 who were diagnosed with non-insulin-dependent diabetes mellitus with renal complication (code ICD: E11.2+). The overall average score of patient satisfaction was 3.62. Based on the hospitalization year, the average score in 2016 was 3.59 and increased to 3.66 in 2017. Interpersonal quality appeared to be the aspect of patient satisfaction that obtained the highest score (2.93), while financial was the lowest one (3.18). Based on the result of satisfaction upon insulin therapy, the group patients who took a combined insulin glargine-insulin aspart therapy had the highest average score (3.8), while the ones of a combined insulin detemir-insulin aspart obtained the lowest score (3.3). Overall, inpatients who suffered from diabetes mellitus type 2 with renal complication showed high satisfaction with the health care provided in the advanced health care facility. Based on the level of patient satisfaction, the combination of insulin glargine and insulin aspart would be the best-recommended treatment for patients to take.Keywords: Type 2 diabetes mellitus, kidney disease, inpatient satisfaction

Evaluasi Drug Related Problems pada Pasien dengan Diagnosis Vertigo Perifer di Instalasi Rawat Jalan Rumah Sakit Bethesda Yogyakarta Andreas K. Rendra; Rizaldy T. Pinzon
Indonesian Journal of Clinical Pharmacy Vol 7, No 3 (2018)
Publisher : Universitas Padjadjaran

Penyakit vertigo dapat berlangsung beberapa detik, menit hingga beberapa jam, tergantung dari penyebab, jenis serta lama durasi. Gejala yang muncul dapat menurunkan kenyamanan dan produktivitas kerja pasien. Tingginya angka kunjungan pasien ke dokter terkait keluhan vertigo akan memperbesar kemungkinan terjadinya Drug Related Problems (DRPs). Tujuan dari penelitian ini adalah untuk mendeskripsikan karakteristik pasien, gambaran umum pengobatan dan mengindentifikasi DRPs terkait penggunaan obat anti vertigo pada pengobatan pasien vertigo perifer di instalasi rawat jalan Rumah Sakit Bethesda Yogyakarta pada periode Januari–Juni 2016. Penelitian ini merupakan penelitian non-eksperimental deskriptif evaluatif dengan rancangan case series dan menggunakan data retrospektif. Evaluasi penggunaan obat antivertigo dianalisis dengan metode subjective, objective, assessment, plan (SOAP). Data 75 pasien vertigo perifer terdiri dari 28 laki-laki (37%) dan 47 perempuan (63%). Golongan obat antivertigo yang paling banyak diresepkan yaitu golongan histaminergik (97,33%) dan golongan antagonis kalsium (53,33%). Kejadian DRPs yang muncul yaitu obat kurang efektif (10,66%), dosis kurang (36%) serta interaksi dan efek samping (48%).Kata kunci: DRPs, obat antivertigo, rawat jalan, vertigo perifer Drug Related Problems Evaluation in Vertigo Perifer Diagnosed at Outpatient Care Bethesda Hospital YogyakartaAbstractVertigo disease is able to last for a few seconds, minutes to several hours, depends on the cause, type and duration. The symptoms can reduce the patient’s comfort and productivity. High number of patient visitation to physicians related to vertigo will increase the possibility of the occurance of Drug Related Problems (DRPs). The purpose of this study was to describe the characteristics of the patients, general treatment, and identify DRPs related to antivertigo drug in the medical treatment of patients diagnosed with peripheral vertigo at outpatient care Bethesda Hospital in Yogyakarta from January–June 2016. The study employed a non-experimental evaluative descriptive that used case series design and retrospective data. The antivertigo drug use evaluation was analyzed using subjective, objective, assessment, plan (SOAP) method. Data collected from 75 patients diagnosed with peripheral vertigo consisted of 28 men (37%) and 47 women (63%). The group of antivertigo drug which mostly prescribed were histaminergic (97.33%) and calcium antagonists (53.33%). The DRPs found in this study are ineffective drug (10.66%), too low dosage (36%) and also interactions and adverse drug reaction (48%).Keywords: Antivertigo drug, DRPs, peripheral vertigo, outpatient care

Kajian Penggunaan, Ketepatan, dan Biaya Antibiotik pada Pasien Rawat Inap Anak di Sebuah Rumah Sakit Umum di Surabaya Silvia Monica; Sylvi Irawati; Eko Setiawan
Indonesian Journal of Clinical Pharmacy Vol 7, No 3 (2018)
Publisher : Universitas Padjadjaran

Ketepatan penggunaan antibiotik merupakan salah satu aspek penting untuk memastikan efektivitas dan keamanan terapi pada semua kelompok pasien, terutama kelompok pasien dengan perbedaan fisiologi dan profil farmakokinetika. Penelitian ini bertujuan untuk mengkaji penggunaan, ketepatan, dan biaya antibiotik pada bangsal rawat inap anak selama periode November–Desember 2015. Metode pengumpulan data pada penelitian ini adalah observasi yang dilakukan secara prospektif terhadap seluruh data rekam medis pasien rawat inap anak yang mendapatkan antibiotik selama periode pengambilan data. Data pasien rawat inap anak yang mendapatkan antibiotik dengan indikasi profilaksis sebelum pembedahan, menghendaki pulang paksa, dan memerlukan perawatan khusus pada saat pengambilan data dieksklusi dari penelitian. Total terdapat 109 rekam medis pasien yang memenuhi kriteria inklusi dan eksklusi. Sebesar 82 pasien (75,23%) pada penelitian ini berusia 1–24 bulan. Terdapat 5 pasien (4,59%) dengan diagnosis keluar noninfeksi dan tidak memiliki tanda infeksi yang menerima antibiotik. Tidak terdapat pasien yang mendapatkan kultur bakteri. Golongan antibiotik yang paling banyak digunakan adalah sefalosporin generasi III yaitu sebesar 114 antibiotik (90,48%), dan sebanyak 63 antibiotik (55,26%) di antaranya adalah seftriakson. Penggunaan antibiotik pada 21 pasien (45,65%) dinyatakan sesuai dosis, pada 19 pasien (41,30%) hanya sesuai dosis dan frekuensi, serta pada 6 pasien diklasifikasikan sebagai tidak ada yang sesuai. Biaya rata-rata antibiotik per pasien pada penelitian ini adalah sebesar Rp209.731,72. Penggunaan antibiotik pada pasien rawat inap anak pada rumah sakit tempat pengambilan data perlu dioptimalkan ketepatannya. Kultur bakteri dan uji sensitivitas perlu diupayakan di rumah sakit tempat pengambilan data sebagai upaya penjaminan ketepatan antibiotik.Kata kunci: Antibiotik, pediatrik, review penggunaan obat Review of the Utilization, Appropriateness, and Cost of Antibiotics among Paediatric Inpatients in a Public Hospital in SurabayaAbstractAn appropriate utilization of antibiotics is one of important aspects to assure treatment effectiveness and safety in all patient groups, especially in patients with distinctive physiology and pharmacokinetic profile. This study aimed to assess the utilization, appropriateness and cost of antibiotics administered in a pediatric hospital ward during November–December 2015. Method used to collect the data was observation conducted prospectively towards all medical records of paediatric inpatients receiving antibiotics during the study period. Medical records of patients receiving prophylaxis antibiotics before surgery, patients discharged against medical advice, and patients suddenly needed medical treatment in a special ward were excluded from the study. Overall, a total of 109 medical records met inclusion and exclusion criteria, in which 82 (75.23%) patients’ age ranged from 1 month to 2 years. There were 5 (4.59%) patients with non-infectious diagnoses and no signs of infection receiving antibiotics. No patients were tested for a microbial culture. The most utilized antibiotic class was the 3rd generation of cephalosporins (114 antibiotics, 90.48%); 63 (55.26%) of which was ceftriaxone. The utilization of antibiotics in 21 (45.65%) patients was considered dose appropriate, in 19 (41.30%) patients were dose-frequency appropriate and in 6 patients was classified as none appropriate. The mean of the cost of antibiotic per patient was IDR 209,731.72. There is a need to optimalize the appropriateness of antibiotic utilization in hospitalized pediatrics at the study hospital. Microbial culture and sensitivity tests would plausibly be one of preliminary steps to guard the appropriateness of antibiotic utilization.Keywords: Antibiotics, drug utilization review, paediatrics

Kajian Penggunaan Antihipertensi pada Pasien Strok di Instalasi Rawat Inap RSU Anutapura Palu Tahun 2017 Joni Tandi; Dian S. Waruwu; Ayu Martina
Indonesian Journal of Clinical Pharmacy Vol 7, No 4 (2018)
Publisher : Universitas Padjadjaran

Strok adalah gangguan serebrovaskular yang sering menyebabkan kerusakan yang luas dan jangka panjang pada kesehatan pasien. Hipertensi merupakan faktor risiko terpenting untuk strok. Pengobatan hipertensi tidak dilakukan dalam jangka pendek, oleh sebab itu, dibutuhkan perhatian khusus untuk penatalaksanaannya. Penelitian ini bertujuan untuk mengkaji jenis maupun golongan obat antihipertensi yang digunakan pada pasien strok dalam hubungannya dengan potensi terjadinya drug related problems (DRPs) terkait pemilihan obat dan dosis antihipertensi. Penelitian ini merupakan penelitian deskriptif dengan pengumpulan data secara prospektif pada periode September–Desember tahun 2017 yang didasarkan pada catatan rekam medis pasien strok di instalasi rawat inap RSU Anutapura Palu. Teknik pengambilan sampel dilakukan secara purposive sampling yang memenuhi kriteria inklusi. Hasil penelitian terhadap 32 pasien strok menunjukkan penggunaan jenis dan golongan antihipertensi terbanyak yaitu amlodipin yang termasuk golongan calcium channel blocker (CCB) sebanyak 28 pasien (56%), captopril yang termasuk golongan angiotensin converting enzyme inhibitor sebanyak 6 pasien (12%), candesartan yang termasuk golongan angiotensin receptor blocker sebanyak 5 pasien (10%), nikardipin sebanyak 3 pasien (6%) dan diltiazem sebanyak 4 pasien (8%) yang termasuk golongan CCB. Adapun DRPs yang ditemukan terkait pemilihan obat dan dosis antihipertensi pada pasien strok yaitu adanya obat antihipertensi yang tidak tepat sebanyak 6 pasien (18,75%) dan adanya dosis terlalu tinggi sebanyak 9 pasien (28,12%). Diharapkan apoteker dapat berperan dalam mengidentifikasi adanya kemungkinan DRPs penggunaan antihipertensi pada pasien strok untuk meminimalkan persentase kejadian.Kata kunci: Antihipertensi, drug related problems (DRPs), hipertensi, strok Study of Antihypertensive Use in Stroke Patients at Inpatient Installation of Anutapura General Hospital Palu in 2017AbstractStroke is a cerebrovascular disorder that often causes extensive and long-term damage to the patient’s health. Hypertension is the most important risk factor for stroke. Treatment of hypertension is not done in the short term, therefore special attention is needed for its management. This study aimed to examine the types and classes of antihypertensive drugs used in stroke patients in relation to the potential occurrence of drug related problems (DRPs) related to drug selection and antihypertensive doses. This research was a descriptive research with prospective data collected from September-December 2017 based on the medical record of stroke patient at inpatient installation of Anutapura General Hospital Palu. Sampling was done by purposive sampling technique which fulfilled the inclusion criteria. The results of the study of 32 stroke patients showed that the highest use of antihypertensive type and class are amlodipine as many as 28 patients (56%) with class of calcium channel blocker (CCB), captopril 6 patients (12%) with class of angiotensin-converting enzyme inhibitor, candesartan 5 patients (10%) with class of angiotensin receptor blocker, nicardipin 3 patients (6%) and diltiazem 4 patients (8%) with class of CCB. The DRPs that were found to be related to drug selection and antihypertensive doses in stroke patients were due to the presence of inappropriate antihypertensive drugs found in 6 patients (18.75%) and the number of high doses in 9 patients (28.12%). The role of pharmacists is intended for identifying the possibility of DRPs for antihypertension in stroke patients to minimize the percentage of events.Keywords: Antihypertensive, drug related problems (DRPs), hypertension, stroke

Profil Mean Arterial Pressure dan Tekanan Darah pada Pasien Hipertensi Krisis dengan Kombinasi Amlodipin Ria Angelina; Nurmainah Nurmainah; Robiyanto Robiyanto
Indonesian Journal of Clinical Pharmacy Vol 7, No 3 (2018)
Publisher : Universitas Padjadjaran

Berdasarkan pedoman pengobatan hipertensi krisis, pengobatan hipertensi emergensi menggunakan antihipertensi parenteral sedangkan hipertensi urgensi menggunakan antihipertensi oral. Tujuannya agar tercapai penurunan Mean Arterial Pressure (MAP) di bawah 25% dan tekanan darah sistolik/diastolik (TDS/TDD) di bawah atau sama dengan 160/100 mmHg. Penelitian ini bertujuan untuk mendeskripsikan penurunan MAP dan TDS/TDD setelah 24 jam pemberian amlodipin oral dengan berbagai kombinasi pada pasien hipertensi krisis. Penelitian ini merupakan penelitian observasional dengan rancangan potong lintang (cross-sectional) yang bersifat deskriptif. Pengumpulan data dilakukan secara retrospektif berdasarkan data rekam medis pasien hipertensi krisis rawat inap di RSUD Sultan Syarif Mohamad Alkadrie Kota Pontianak periode Januari 2016–Desember 2017. Sampel yang diperoleh sebanyak 38 pasien. Hasil penelitian menunjukkan bahwa pasien hipertensi emergensi yang menggunakan amlodipin secara oral dengan kombinasi antihipertensi lainnya memiliki nilai MAP setelah 24 jam sebesar 24% dan beberapa pasien hipertensi emergensi menunjukkan pencapaian MAP-nya sebesar 32%. Namun demikian, penurunan TDS/TDD setelah 24 jam mencapai di bawah atau sama dengan 160/100 mmHg. Penggunaan amlodipin oral dengan berbagai kombinasi terapi antihipertensi lainnya pada pasien hipertensi urgensi menunjukkan pencapaian MAP berkisar 20–23%. Sementara itu, TDS/TDD setelah 24 jam mencapai sekitar dan di bawah 160/100 mmHg. Penggunaan amlodipin secara oral dengan kombinasi antihipertensi lainnya pada pasien hipertensi emergensi belum mampu menunjukkan penurunan MAP sesuai yang diinginkan. Di sisi lain, penanganan hipertensi urgensi dengan menggunakan amlodipin oral dengan berbagai kombinasi terapi antihipertensi lainnya menunjukkan pencapaian penurunan MAP sesuai dengan pedoman pengobatan hipertensi krisis.Kata kunci: Amlodipin, hipertensi krisis, mean arterial pressure, tekanan darah Mean Arterial Pressure and Blood Pressure Profile in Hypertensive Crises Patients with Amlodipine Therapy CombinationAbstractBased on treatment guidelines of crisis hypertension, emergency hypertensive treatment uses parenteral antihypertensive whereas urgency hypertensive uses oral antihypertensive. The goal is to achieve a drop in Mean Arterial Pressure (MAP) below 25% and systolic/diastolic blood pressure (SBP/DBP) below or equal to 160/100 mmHg. This study aimed to describe the decrease in MAP and SBP/DBP after 24 hours of oral amlodipine administration with various combinations in patients with crisis hypertension. This research was an observational research with cross-sectional design which was descriptive. Data collection was done retrospectively based on medical record data of hypertensive crisis patients that hospitalized at RSUD Sultan Syarif Mohamad Alkadrie Pontianak City from January 2016 until December 2017. The samples obtained were 38 patients. Results from the study showed that emergency hypertension patients who used oral amlodipine with other antihypertensive combinations had 24-hour MAP values of 24% and some emergency hypertension patients showed a MAP attainment of 32% with decreased SBP/DBP after 24 hours reached under 160/100 mmHg. The use of oral amlodipine amlodipine with other antihypertensive combinations in urgency hypertensive patients showed an achievement of 20–23% reduction in MAP with decreased SBP/DBP after 24 hours under 160/100 mmHg. The use of oral amlodipine with other antihypertensive combinations in emergency hypertensive patients did not show a desirable reduction in MAP. Treatment of urgency hypertensive by using oral amlodipine with various combinations of other antihypertensive therapies showed a decrease in MAP according to crisis hypertension treatment guidelines.Keywords: Amlodipine, blood pressure, hypertensive crises, mean arterial pressure

Efek Perseptif Penggunaan Kombinasi Antidiabetes Oral-Insulin pada Pasien Diabetes Melitus Tipe 2 di Kota Pontianak dan Sekitarnya Winona Madelina; Eka K. Untari; Esy Nansy
Indonesian Journal of Clinical Pharmacy Vol 7, No 3 (2018)
Publisher : Universitas Padjadjaran

Penggunaan antidiabetes oral dan insulin yang benar dapat menimbulkan efek perseptif positif akibat terkontrolnya kadar gula darah dengan baik sehingga gejala klinik diabetes dapat berkurang atau tidak ada sama sekali. Penelitian ini bertujuan untuk mendeskripsikan lama penggunaan kombinasi antidiabetes oral-insulin dengan efek perseptif yang dirasakan. Penelitian ini merupakan penelitian observasional dengan rancangan penelitian potong lintang (cross-sectional) yang bersifat deskriptif. Selama penelitian diperoleh 23 subjek penelitian yang memenuhi kriteria inklusi. Pengambilan data dan wawancara dilakukan pada bulan November–Desember tahun 2016 di Kota Pontianak dan sekitarnya. Penelitian ini menunjukkan bahwa subjek penelitian sebagian besar wanita (73,9%), usia terbanyak pada 55–64 tahun (43,47%), pendidikan terakhir yakni Sekolah Dasar (34,7%), serta pekerjaan ibu rumah tangga (43,4%) dengan lama penyakit ≥10 tahun (52%), dan memiliki komorbid (86.9%). Kombinasi long-acting dan antidiabetes oral (ADO) golongan biguanid paling banyak digunakan (39,13%). Lama penggunaan kombinasi antidiabetes oral-insulin sebagian besar subjek penelitian adalah ≥6 bulan (60,87%). Empat belas subjek merasakan efek perseptif (60,87%); 8 dari 14 subjek (57,14%) merasakan berkurangnya rasa lemas yang merupakan jenis efek perseptif, dan 4 subjek (28,57%) subjek merasakan adanya efek samping perseptif.Kata kunci: Diabetes melitus tipe 2, efek perseptif, kombinasi antidiabetes oral-insulin Perceptive Effect of Combination Use of Oral Antidiabetic-Insulin in Type 2 Diabetes Mellitus Patients in Pontianak City and Surrounding AreasAbstractThe use of oral and insulin antidiabetic is suspected causing a positive perceptive effect due to controlled blood sugar levels, thus the clinical symptoms of diabetes can be reduced. The study was aimed to describe the term of combination use of oral antidiabetic and insulin with perceptive effect. This research was an observational-descriptive study using cross-sectional design. Interview and data were collected from November–Desember 2016 in Pontianak City and its surrounding areas. During the research, 23 subjects were eligible for inclusion criteria of the study. This study showed that the subjects were mostly women (73.9%), dominantly aged 55–64 years (43.47%) and took the last education in elementary school (34.7%). The occupation of most subjects are housewives (43.4%), most of them had period of disease ≥10 years (52%) and had comorbid (86.9%). About 39.13% subjects mostly used combination of long-acting type insulin and biguanide class oral antidiabetic. The longest term of oral antidiabetic-insulin use was ≥6 months (60.86%). A total of 14 subjects felt perceptive effects (60.87%), of which 8 subjects (57.14%) had a lesser feeling of weakness, which is one of perceptive effects, and 4 subjects (28.57%) experienced side effect perceptively.Keywords: Combination of oral antidiabetic-insulin, perceptive effects, type 2 diabetes mellitus

Pengaruh Patient Decision Aid terhadap Knowledge, Attitude, Practice, dan Tekanan Darah Pasien Hipertensi di UPTD Puskesmas Tabanan III Ni Made Maharianingsih; Abdul Rahem; Lisa Aditama
Indonesian Journal of Clinical Pharmacy Vol 7, No 4 (2018)
Publisher : Universitas Padjadjaran

Prevalensi pasien hipertensi semakin meningkat dan salah satu penyebab utamanya adalah faktor perilaku. Perubahan perilaku dan outcome terapi hipertensi dapat dilakukan oleh apoteker melalui edukasi dengan metode knowledge, attitude, practice (KAP). Teori perilaku yang sesuai untuk mengukur perubahan perilaku dalam diri pasien adalah health belief model (HBM). Sarana edukasi yaitu patient decision aid (PDA) berupa booklet digunakan untuk mengedukasi pasien hipertensi. Tujuan penelitian ini adalah mengetahui perbedaan KAP dan tekanan darah pasien hipertensi sebelum dan sesudah mendapatkan intervensi PDA. Metode penelitian pre-experimental one group pretest-posttest melibatkan 55 pasien hipertensi berusia 18–65 tahun peserta Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan yang berobat di UPTD Puskesmas Tabanan III, Bali, Indonesia, pada bulan Agustus–Oktober 2017. Setiap pasien memperoleh satu kali edukasi melalui PDA berupa booklet disertai komunikasi interaktif kemudian KAP diukur melalui kuesioner KAP yang tervalidasi dan diukur tekanan darah pre-post. Kuesioner KAP dibuat berdasarkan konstruk HBM. Diperoleh hasil yaitu perbedaan practice pasien hipertensi (p<0,05) pada perceived susceptibility, perceived severity, perceived barrier, cues to action; terdapat perbedaan attitude dan practice (p<0,05) pada self-efficacy; terdapat perbedaan KAP (p<0,05) dari segi perceived benefit serta terdapat perbedaan tekanan darah sistolik dan diastolik pasien (p<0,05). Disimpulkan bahwa terdapat perbedaan knowledge, attitude, practice dan tekanan darah pasien hipertensi di Puskesmas pre-post studi.Kata kunci: Booklet, HBM, hipertensi, KAP, PDA, tekanan darahInfluence of Patient Decision Aid to Knowledge, Attitude, Practice and Blood Pressure of Hypertensive Patient in a Primary Health Care Tabanan IIIAbstractThe prevalence of hypertensive patients is increasing and one of the main causes is behavior factor. Appropriate method of behavioral theory for measuring behavioral changes in patients is health belief model (HBM). Patient decision aid (PDA) in a form of booklet was used to educate hypertensive patient. The aim of this research was to know the difference of knowledge, attitude, practice (KAP) and blood pressure of hypertensive patient before and after getting PDA intervention. The method used was pre-experimental one group pretest-posttest study involving 55 hypertensive patients aged 18–65 years which were participants of The Indonesian National Health Insurance in primary health care Tabanan III, Bali, Indonesia, in the period of August–October 2017. Each subject received PDA education from booklet with interactive communication, then their KAP was measured through validated KAP questionnaire as well as pre-post blood pressure. KAP questionaire was made based on HBM’s construct. There were differences in practice of hypertensive patients (p<0.05) on HBM domain in perceived susceptibility, perceived severity, perceived barrier, and cues to action; there was a difference of attitude and practice (p<0.05) in self-efficacy; difference of KAP (p<0.05) in perceived benefit; and difference of systolic and diastolic blood pressure. It was concluded that there were differences of KAP and blood pressure of hypertensive patients in primary health care pre-post study.Keywords: Booklet, blood pressure, HBM, hypertension, KAP, PDA

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