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"ABSTRAKPenelitian ini merupakan penelitian kualitatif dengan pendekatan fenomenologi yang bertujuan untuk memahami berbagai pengalaman ILWHA (Injecting Drug User Living with HIV/AIDS) dalam menjalani terapi ARV pada saat terapi rumatan metadon. Partisipan dalam penelitian ini berjumlah 6 orang yang telah menjalani terapi ARV lebih dari 3 bulan dan sedang menjalani terapi rumatan metadon. Partisipan dipilih dengan cara purposive sampling. Pengumpulan data adalah dengan wawancara mendalam dan analisis serta sintesis menggunakan metode ?Colaizzi?s?. Hasil penelitian menunjukan pengalaman ILWHa dalam menjalani terapi ARV pada saat terapi rumatan metadon yang diungkapkan secara mendalam dengan berbagai penjelasan yang penuh emosi dan digambarkan dengan pernyataan-pernyataan tematik. Penelitian ini menyimpulkaan setiap ILWHA mengalami kebuaran dan lebih fungsional dalam hidup. Setiap ILWHA mengalami: 1)beban fisik akibat efek ARVdan gejala putus obat, 2)beban psikologi, yaitu ketidakberdayaan, kecemasan dan gangguan mood, 3)beban sosial, yaitu stigma dan diskriminasi serta kehilangan kesempatan bekerja. Menjalani terapi ARV pada saat terapi rumatan metadon merupakan proses pembelajaran dan dijalani dengan kepasrahan. Terdapat berbagai kebutuhan pelayanan kesehatan yaitu pelayanan yang terintegrasi antara ARV dan metadon, informasi penanggulangan efek ARV dan gizi serta informasi HIV, ARV dan emtadon bagi masyarakat. . Berdasarkan hal tersebut, perawat medikal bedah perlu memahami aspek fisik, psikologis, dan sosial serta kedinamisan ILWHA dalam terapi ARV pada saat terapi rumatan metadon selain itu juga perlu mengidentifikasi dan mengembangkan lebih lanjut kebutuhan pelayanan kesehatan pada ILWHA yang sedang menjalani terapi ARV.

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ABSTRACTThis is a qualitative research with phenomenological approach which was aimed to understand ILWHA experiences in receiving ARV therapy during methadone maintenance therapy. Six participants who have had received ARV therapy for more than 3 months and were undergoing methadone maintenance therapy were chosen using purposive sampling. Data was collected with a deep interview and further was analyzed and synthesized with Colaizzi?s. The results showed ILWHA experiences in receiving ARV therapy during methadone maintenance therapy were expressed in depth with various emotional explanations and were described with thematic statements. The conclusion of this research was every ILWHA experiences fitness and more functional in live. Every ILWHA experiences: 1) physical burden as the effect of ARV and drug withdrawal, 2) psychological burden, including helplessness, anxiety and mood disturbance, 3) social burden, such as stigma, discrimination and losing opportunity to work. Receiving ARV therapy during methadone maintenance therapy is a learning process and should be through in a sincere heart. There are health service needs such as integrated service between ARV and methadone, information of ARV effects, nutrition, and knowledge related to HIV, ARV and methadone for community. Based on this fact, medical surgical nurses need to understand physical, psychological and social aspects and ILWHA dynamicity in receiving ARV therapy during methadone maintenance therapy. The nurses are also necessary to identify and develop a further nursing care needs among ILWHA who are receiving ARV."

"Pemantauan Terapi Obat (PTO) merupakan proses yang mencakup kegiatan seperti pengkajian terkait obat yang digunakan pasien, pemberian rekomendasi penyelesaian masalah terkait obat serta pemantauan efektivitas dan efek samping obat. Data penggunaan obat merupakan komponen penting dalam proses PTO. Analisis yang dapat dilakukan berdasarkan data penggunaan obat adalah penilaian kualitas penggunaan antibiotik serta analisis MTO pengobatan yang diterima pasien. Masalah Terkait Obat (MTO) yang terjadi pada pengobatan pasien dan memberikan rekomendasi tindak lanjut menggunakan metode SOAP. PTO dilakukan pada pasien berinisial NAN yang didiagnosis sindrom gangguan pernapasan akut, perdarahan intraserebral dan PDVK. Masalah Terkait Obat (MTO) yang terjadi pada pengobatan pasien N di ruangan PICU RSUP Fatmawati dengan diagnosis sindrom gangguan pernapasan akut, perdarahan intraserebral dan PDVK adalah adanya ketidaksesuaian dosis yaitu amikasin 1x60 mg. Kemudian ditemukan Reaksi Obat yang Tidak Diinginkan (ROTD) terjadi pada pasien yaitu hipoalbumin yang merupakan ROTD dari parasetamol dan hiperglikemi akibat pemberian deksametason. Interaksi obat yang terjadi yaitu antara amikasin dan mannitol, asam valproate dan meropenem, parasetamol dan fenitoin, fenitoin dan asam valproate, amikasin dan furosemide, seftriakson dan furosemide, serta omeprazole dan fenitoin. Penilaian kualitas penggunaan antibiotik menggunakan metode gyssens menunjukkan bahwa penggunaan antibiotik seftriakson sudah tepat atau bijak karena masuk ke dalam kategori 0. Kemudian Penggunaan meropenem masuk kategori IVA dan IIIA yang menginterpretasikan bahwa ada antibiotik lain yang lebih efektif daripada meropenem karena berdasarkan hasil kultur yaitu seftazidim dan sefepim masih sensitif terhadap pasien serta penggunaan antibiotik terlalu lama (lebih dari 14 hari). Penggunaan amikasin masuk kategori IIA dan IIB yang menunjukkan bahwa dosis dan interval yang tidak tepat.

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Drug Therapy Monitoring (DTM) is a process that includes activities such as assessments related to drugs used by patients, providing recommendations for solving drug-related problems, and monitoring the effectiveness and side effects of drugs. Drug use data is an important component of the DTM process. Analysis that can be carried out based on drug use data is an assessment of the quality of antibiotic use as well as an DRP analysis of the treatment the patient receives. Drug-Related Problems (DRP) that occur in patient treatment and provide follow-up recommendations using the SOAP method. DTM was performed on a patient with the initials NAN who was diagnosed with acute respiratory distress syndrome, intracerebral hemorrhage, and PDVK. Drug-Related Problems (DRP) that occurred in the treatment of patient N in the PICU room at Fatmawati Hospital with a diagnosis of acute respiratory distress syndrome, intracerebral hemorrhage, and PDVK was a dose mismatch, namely amikacin 1x60 mg. Then it was found that adverse drug reactions (ADR) occurred in patients, namely hypoalbumin which was ADR from paracetamol, and hyperglycemia due to dexamethasone administration. Drug interactions that occur are between amikacin and mannitol, valproic acid and meropenem, paracetamol and phenytoin, phenytoin and valproic acid, amikacin and furosemide, ceftriaxone and furosemide, and omeprazole and phenytoin. Assessment of the quality of antibiotic use using the Gyssens method showed that the use of ceftriaxone was appropriate or wise because it was included in category 0. Then the use of meropenem was included in categories IVA and IIIA which interpreted that other antibiotics were more effective than meropenem because they were based on culture results, namely ceftazidime and cefepime. still sensitive to patients and the use of antibiotics for too long (more than 14 days). The use of amikacin is in categories IIA and IIB which shows that the dose and interval are incorrect."

"Pemantauan terapi obat pada pasien dengan diagnosis hipertensi emergency, intraventricular hemorrhage, hydrocephalus, dan pneumonia menjadi krusial dalam upaya pengelolaan kondisi kesehatan yang kompleks. Penelitian ini mengevaluasi pendekatan pemantauan terapi obat yang efektif untuk memastikan penggunaan obat yang optimal dan meminimalkan risiko efek samping yang mungkin terjadi pada pasien. Fokus utama studi ini adalah pada pemilihan obat dan pemantauan respons terhadap terapi obat antihipertensi, pengobatan intraventrikular dan manajemen tekanan intrakranial, serta antibiotik untuk pneumonia. Hasil dari pemantauan ini diharapkan dapat memberikan wawasan dalam memahami peran dan tugas Apoteker di Rumah Sakit dalam melakukan Pemantauan Terapi Obat (PTO) meliputi alur, tata laksana, maupun etika Apoteker kepada tenaga kesehatan lain dalam merekomendasikan perubahan obat pada pasien berdasarkan diagnosa yang diberikan...... Monitoring drug therapy in patients with a diagnosis of hypertensive emergency, intraventricular hemorrhage, hydrocephalus, and pneumonia is crucial in efforts to manage complex health conditions. This study evaluates effective drug therapy monitoring approaches to ensure optimal drug use and minimize the risk of possible side effects in patients. The primary focus of the study was on drug selection and monitoring response to antihypertensive drug therapy, intraventricular treatment and intracranial pressure management, as well as antibiotics for pneumonia. It is hoped that the results of this monitoring will provide insight into understanding the role and duties of Pharmacists in Hospitals in carrying out Drug Therapy Monitoring (PTO) including the flow, management and ethics of Pharmacists to other health workers in recommending drug changes to patients based on the diagnosis given."

"HIV (Human Immunodeficiency Virus) melemahkan sistem kekebalan tubuh dan dapat berkembang menjadi AIDS (Acquired Immune Deficiency Syndrome) jika tidak ditangani. Terapi antiretroviral (ARV) sangat penting dalam pengelolaan HIV, tetapi memerlukan kepatuhan tinggi karena ketidakpatuhan dapat menyebabkan resistensi obat dan hasil terapi yang buruk. Penelitian ini memantau terapi obat pada pasien HIV dengan komorbiditas di RSUD Cengkareng menggunakan metode SOAP (Subjective, Objective, Assessment, Plan) untuk mengidentifikasi dan mengatasi masalah terkait obat (Drug-Related Problems/DRP). Masalah yang ditemukan meliputi dosis yang tidak tepat, kepatuhan yang rendah, penggunaan antibiotik yang tidak rasional, dan efek samping obat. Rekomendasi mencakup penyesuaian regimen obat, meningkatkan edukasi pasien, dan evaluasi rutin. Hasil penelitian ini menegaskan peran penting apoteker dalam mengoptimalkan terapi, mengurangi risiko, dan meningkatkan hasil pengobatan pasien.

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HIV (Human Immunodeficiency Virus) weakens the immune system and, if untreated, can progress to AIDS (Acquired Immune Deficiency Syndrome), a condition marked by opportunistic infections and high mortality rates. Antiretroviral (ARV) therapy is the cornerstone of HIV management, requiring strict adherence to ensure viral suppression, improved immune function, and reduced transmission risks. However, noncompliance and drug-related problems (DRPs), such as dosing errors, irrational drug use, and adverse effects, often hinder therapeutic success. This study monitored drug therapy for hospitalized HIV patients with comorbidities at RSUD Cengkareng using the SOAP (Subjective, Objective, Assessment, Plan) method to identify and address DRPs comprehensively. Key findings highlighted issues in medication adherence, irrational antibiotic transitions without culture-based evidence, and potential adverse drug reactions such as hepatotoxicity and anemia. Recommendations included optimizing ARV regimens, ensuring rational antibiotic use based on culture results, enhancing patient counseling on medication adherence, and routine monitoring of drug effects. Additionally, pharmacists' interventions were essential in improving drug safety and effectiveness by providing tailored recommendations and ensuring the appropriateness of therapy. This research underscores the critical role of pharmacists in HIV management, particularly in identifying, preventing, and resolving DRPs, thereby supporting better clinical outcomes and enhancing patient safety. "

"Pemantauan Terapi Obat (PTO) merupakan serangkaian kegiatan untuk memastikan bahwa terapi obat yang diberikan kepada pasien bersifat aman, efektif, dan rasional. Penelitian ini menganalisis Pemantauan Terapi Obat (PTO) pasien spondilitis tuberkulosis di RSUP Fatmawati. Studi dilakukan untuk mengevaluasi masalah terapi obat, memberikan rekomendasi intervensi, serta memahami peran apoteker dalam pelayanan farmasi klinis. Berdasarkan evaluasi menggunakan metode PCNE dan Gyssens, beberapa masalah terkait obat ditemukan, seperti penggunaan antibiotik yang berpotensi efek samping, durasi pemberian obat yang tidak sesuai, dan interaksi obat. Intervensi yang dilakukan melibatkan penyesuaian regimen obat untuk meminimalkan risiko Reaksi Obat Tidak Dikehendaki (ROTD) dan meningkatkan efektivitas terapi. Hasil menunjukkan bahwa kombinasi obat antituberkulosis (OAT) yang diberikan pasien, yaitu rifampisin dan etambutol, sudah sesuai dengan panduan klinis, tetapi ditemukan beberapa kejadian masalah terkait obat lain, seperti risiko hepatotoksik pada kombinasi rifampisin dan parasetamol serta interaksi ceftriaxone dengan larutan infus. Intervensi terhadap masalah tersebut berhasil diselesaikan. Analisis Gyssens mengidentifikasi bahwa pemilihan antibiotik cefixime sebaiknya menggunakan alternatif yang lebih aman untuk perawatan lanjutan. Kesimpulannya, PTO membantu meningkatkan kualitas terapi pasien dan mencegah risiko ROTD. Diharapkan, PTO terus dilaksanakan sejak awal perawatan hingga pasca-perawatan untuk mencapai terapi yang lebih optimal.

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Drug Therapy Monitoring encompasses a series of activities to ensure that patient medication is safe, effective, and rational. This study analyzed Drug Therapy Monitoring for tuberculosis spondylitis patients at RSUP Fatmawati. The study aimed to evaluate drug-related problems (DRPs), provide intervention recommendations, and understand the pharmacist's role in clinical pharmacy services. Based on evaluations using the PCNE and Gyssens methods, several drug-related issues were identified, such as the use of antibiotics with potential adverse effects, inappropriate drug durations, and drug interactions. Interventions involved adjusting drug regimens to minimize the risk of Adverse Drug Reactions (ADRs) and enhance therapeutic efficacy. The findings showed that the antituberculosis drug combination (rifampicin and ethambutol) administered to patients aligned with clinical guidelines. However, some drug-related issues were noted, such as hepatotoxic risk from the combination of rifampicin and paracetamol and interactions between ceftriaxone and infusion solutions. These issues were successfully resolved through interventions. The Gyssens analysis identified that cefixime could be substituted with safer alternatives for long-term treatment. In conclusion, this monitoring improves the quality of patient therapy and reduces ADR risks. Continuous from admission to post-care is recommended to optimize therapy and ensure patient safety. "