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"Sediaan tertahan di lambung (gastroretentive) merupakan sediaan yang didesain untuk dapat memperpanjang waktu tinggal sediaan di lambung yang merupakan salah satu tempat terjadinya absorbsi obat di dalam tubuh. Sistem penghantaran mukoadhesif merupakan salah satu bentuk sediaan tersebut dengan mekanisme penempelan pada mukosa lambung. Oleh karena itu pengembangkan eksipien baru untuk bentuk sediaan tersebut perlu untuk dilakukan.Penelitian ini bertujuan untuk melihat kemampuan eksipien koproses pragelatinasi pati singkong propionat (PPSP) dan karagenan sebagai matriks sediaan mukoadhesif tertahan di lambung. Pembuatan eksipien koproses ini didahului dengan pembuatan PPSP menggunakan anhidrida asam propionat sebagai agen pensubtitusi gugus alkilnya. Kemudian di koproses dengan campuran kappa-iota karagenan (1:1) dengan perbandingan campuran kappa-iota karagenan (1:1) : PPSP 1:1, 1:2 dan 1:3.Hasil karakterisasi eksipien koproses menunjukan peningkatan viskositas dan kemampuan bioadhesif dibandingkan dengan eksipien penyusunnya. Eksipien koproses yang dihasilkan tersebut kemudian dibuat sediaan granul mukoadhesif. Granul mukoadhesif berbahan dasar eksipien koproses (F1, F2 dan F3) dan berbahan dasar PPSP (F4) serta karagenan (F5) dapat menempel pada mukosa lambung dan mengatur pelepasan obat hingga 32 jam untuk F1, F2, F3 dan F5, sedangkan 16 jam untuk F4. Granul F3 yang berbahan dasar eksipien koproses C memiliki kekuatan mukoadhesif pada mukosa lambung paling besar yaitu 5,2 gF dan dapat bertahan selama 10 jam pada uji bioadhesif in vitro dan 3 jam pada uji wash off, serta memiliki kadar obat dalam lambung tertinggi pada jam ke-1, 2 dan 4 yaitu berturut-turut 92,19%; 76,84%; 47,33% pada uji bioadhesif in vivo. Sebagai kesimpulan, penelitian ini memberikan gambaran bahwa eksipien koproses C yang merupakan campuran PPSP dengan karaginan kappa-iota (1:1) dengan ratio 3:1 berpotensi untuk digunakan sebagai polimer bioadhesif.

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Gastroretentive dosage form has been designed to prolong gastric residence time of drug delivery system, mucoadhesive is one of of kind of them which is retained dosage form on the stomach with adhesiveness, so development in excipient for gastroretentive dosage form is needed.The purpose of the present study was to develop and characterize coprocessed excipient pregelatinized cassava starch propionate (PCSP) and carrageenan. Coprocessed excipient product consists of carrageenan (kappa-iota = 1:1) and PCSP in ratio 1:1, 1:2 and 1:3. PCSP was prepared with propionic anhydride in aqueous medium. The product was mixed with carragenan (kappa-iota = 1:1), and characterized physicochemical and functional properties. After that, the coprocessed excipient was used as mucoadhesive granules. Granules F1, F2 and F3 were made from coprocessed excipient while granules F4 and F5 were made from PCSP and carrageenan respectively.The result of these studies indicated that coprocessed excipient carrageenan-PCSP is suitable material for gastroretentive dosage form and drug controlled release. All formula of granules can adhere to gastric mucus and can controlled drug release for 32 hours for F!, F2, F3 and F3, while 16 hours for F4. The F3 granules were made from excipient coprocessed C have highest mukoadhesive properties on stomach, still remain for 10 hours in bioadhesive in vitro test and 3 hours in wash off test and also have highest percentage drug on the stomach at 1st, 2nd and 4th hours with values 92,19%; 76,84%; 47,33% respectively.pada uji bioadhesif in vivo. These results suggested that excipient coprocessed C were a promising polimer for gastroretentive dosage form."

"Di Indonesia, antibiotik masih sangat mudah didapatkan di apotek-apotek tanpa resep dokter. Perilaku petugas apotek menjadi faktor penting yang berperan dalam maraknya swamedikasi antibiotik di apotek. Edukasi merupakan salah satu cara untuk memperbaiki perilaku petugas apotek dalam praktek swamedikasi antibiotik. Hingga saat ini belum ditemukan jenis media yang paling efektif untuk memperbaiki praktek swamedikasi antibiotik. Penelitian ini bertujuan untuk menganalisis efektivitas pemasangan media banner dalam memperbaiki praktek swamedikasi di apotek. Penelitian merupakan pre-eksperimental multicenter-one group pre-test post-test design. Sampel terdiri dari 79 apotek yang tersebar di wilayah Depok. Metode pseudopatient digunakan untuk mendapatkan data berdasarkan pelayanan oleh petugas apotek atas permintaan antibiotik tanpa resep untuk penyakit ISPA tanpa komplikasi. Data yang direkam dan didokumentasikan diambil pada sebelum dan 1 bulan sesudah pemasangan banner. Data dianalisis secara statistik menggunakan SPSS 18,0. Antibiotik yang paling sering diberikan adalah amoksisilin 500 mg generik. Terdapat perbedaan bermakna pada pemberian informasi obat oleh petugas apotek pada sebelum dan 1 bulan setelah pemasangan banner (p ≤ 0,05).Pemasangan media edukasi banner tidak terbukti efektif dalam memperbaiki praktek swamedikasi antibiotik di apotek. Informasi dalam media edukasi banner hanya mampu memperbaiki informasi obat yang disampaikan oleh petugas apotek dan tidak memperbaiki perilaku petugas dalam pelayanan swamedikasi antibiotik.

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In Indonesia, antibiotics could easily be obtained without a prescription from community pharmacies. Pharmacy workers behavior can be a substantially factor impacting antibiotics self-medication practices in community pharmacies. Education is one of way to improve pharmacy workers behavior in antibiotics self-medication practices. Appropriate media used to improve antibiotics self-medication practices effectively has not provided yet. The aim of this study was to analyse the effectiveness of banner setting to improve antibiotics self-medication practices in community pharmacies. This study was pre-experimental multicenter-one group pre-test post-test design. Sample was 79 community pharmacies spread in Depok. Pseudopatient method was used to obtain data based on pharmacy worker’s behavior to dispense antibiotics without prescription for uncomplicated URTI. Data was recorded and documented before and after the 1 month intervention. Data was analysed with SPSS 18.0. Result showed that antibiotic that mostly given was generic amoxicillin 500 mg. Significant difference was seen in the type of information that provide by pharmacy worker before and after 1 month banner setting (p ≤ 0.05). Banner educational media setting were ineffective to improve antibiotics self-medication practices in community pharmacies. Information provided in banner could improve the drug information that given by pharmacy worker, but could not improve pharmacy worker’s behavior in antibiotics self-medication practices."

"[ABSTRAKPenggunaan obat golongan statin (penghambat hidroksimetil glutaril-CoA reduktase) sebagai terapi lini pertama pada hiperkolesterolemia dapat menyebabkan terjadinya beberapa reaksi obat yang tidak dikehendaki (ROTD). Tujuan penelitian ini adalah menilai risiko penggunaan obat golongan statin terhadap kejadian ROTD pada pasien hiperkolesterolemia di Instalasi Rawat Jalan RSUD Pasar Rebo, Jakarta. Penelitian dilakukan dengan metode kohort prospektif pada pasien yang menggunakan atorvastatin dan simvastatin. Data primer diperoleh melalui wawancara dengan menggunakan kuesioner, data sekunder diperoleh melalui rekam medis dan resep yang diterima oleh pasien. Data yang diperoleh dianalisis menggunakan chi-square dan regresi logistik. Dari penelitian diketahui bahwa ROTD terjadi pada 38.20% pasien yang menggunakan obat golongan statin, kejadian ROTD terbesar adalah gangguan sistem pencernaan (35.45%) dan gangguan sistem saraf (23.64%). Sedangkan ROTD pada otot dan hati masing-masing sebesar 2.73%. Pasien yang menggunakan simvastatin memiliki risiko relatif mengalami ROTD lebih besar jika dibandingkan dengan pasien yang menggunakan atorvastatin (RR: 6.439; CI: 2.963-13.992). Variabel perancu yang secara signifikan mempengaruhi kejadian ROTD adalah aktivitas fisik. Pasien yang mengalami ROTD memiliki risiko relatif lebih besar mengalami putus obat daripada pasien yang tidak mengalami ROTD (RR: 2.554; CI: 1.724- 3.754).

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ABSTRACTThe use derivate of statin (hydroxymethylglutaryl-CoA reductase inhibitors) for management of hypercholesterolemia can cause advers drug reactions (ADR). The purpose of this study was to assess the risk of the use of statins on the incidence of ADR in hypercholesterolemic patients in the Outpatient Installation in RSUD Pasar Rebo, Jakarta. This study was conducted using a prospective cohort to the patients using atorvastatin and simvastatin, the data obtained by interview with questionnaires, medical records, and patient prescriptions. The data collected analyzed using chi-square and logistic regression. ADR occurred in 38.20% patients who treated with statins, the most often ADR experienced by patient are gastrointestinal disorder (35.45%) and nerve system disorder (23.64%). Muscle and liver disorder experienced by 2.73% patients respectively. The patients using simvastatin have a greater risk of experiencing ADR compared to atorvastatin (RR: 6.439; CI: 2.963-13.992). Physical activity is the confounding variable significantly influence the incidence of ADR. Patients who experience ADR had a greater risk for experiencing drug withdrawal than patients who did not experience ADR (RR: 2.554; CI: 1.724- 3.754).;The use derivate of statin (hydroxymethylglutaryl-CoA reductase inhibitors) for management of hypercholesterolemia can cause advers drug reactions (ADR). The purpose of this study was to assess the risk of the use of statins on the incidence of ADR in hypercholesterolemic patients in the Outpatient Installation in RSUD Pasar Rebo, Jakarta. This study was conducted using a prospective cohort to the patients using atorvastatin and simvastatin, the data obtained by interview with questionnaires, medical records, and patient prescriptions. The data collected analyzed using chi-square and logistic regression. ADR occurred in 38.20% patients who treated with statins, the most often ADR experienced by patient are gastrointestinal disorder (35.45%) and nerve system disorder (23.64%). Muscle and liver disorder experienced by 2.73% patients respectively. The patients using simvastatin have a greater risk of experiencing ADR compared to atorvastatin (RR: 6.439; CI: 2.963-13.992). Physical activity is the confounding variable significantly influence the incidence of ADR. Patients who experience ADR had a greater risk for experiencing drug withdrawal than patients who did not experience ADR (RR: 2.554; CI: 1.724- 3.754)., The use derivate of statin (hydroxymethylglutaryl-CoA reductase inhibitors) for management of hypercholesterolemia can cause advers drug reactions (ADR). The purpose of this study was to assess the risk of the use of statins on the incidence of ADR in hypercholesterolemic patients in the Outpatient Installation in RSUD Pasar Rebo, Jakarta. This study was conducted using a prospective cohort to the patients using atorvastatin and simvastatin, the data obtained by interview with questionnaires, medical records, and patient prescriptions. The data collected analyzed using chi-square and logistic regression. ADR occurred in 38.20% patients who treated with statins, the most often ADR experienced by patient are gastrointestinal disorder (35.45%) and nerve system disorder (23.64%). Muscle and liver disorder experienced by 2.73% patients respectively. The patients using simvastatin have a greater risk of experiencing ADR compared to atorvastatin (RR: 6.439; CI: 2.963-13.992). Physical activity is the confounding variable significantly influence the incidence of ADR. Patients who experience ADR had a greater risk for experiencing drug withdrawal than patients who did not experience ADR (RR: 2.554; CI: 1.724- 3.754).]"

"[ABSTRAKPenggunaan angiotensin converting enzyme inhibitor (ACEi) sebagai antihipertensi dapat menyebabkan efek samping berupa batuk kering. Penelitian ini bertujuan untuk menilai risiko penggunaan ACEi, yaitu kaptopril sebagai standar dibandingkan ACEi lain terhadap kejadian batuk kering pada pasien hipertensi di RSUD Cengkareng Jakarta Barat dan RSUD Tarakan Jakarta Pusat. Desain penelitian ini adalah kohort prospektif. Kriteria inklusi adalah pasien hipertensi rawat jalan yang mendapatkan terapi obat golongan ACEi selama ≤ 3 bulan dan bersedia untuk diikutsertakan sebagai sampel dalam penelitian di RSUD Cengkareng Jakarta Barat dan RSUD Tarakan tahun 2014. Sampel terdiri dari 54 pasien yang mendapat kaptopril dan 54 pasien yang mendapat obat ACEi bukan kaptopril yang diambil secara consecutive sampling pada bulan Januari-Juli 2014. Alat pengumpul data menggunakan wawancara terstruktur dan rekam medis pasien. Kejadian batuk kering akibat ACEi dievaluasi dengan menggunakan Algoritma Naranjo dan analisis data menggunakan uji Chi Square. Kejadian batuk kering terjadi pada 19,44% sampel. Faktor usia, jenis kelamin, suku bangsa, komorbiditas, body mass index (BMI), dosis obat, dan lama penggunaan tidak berhubungan bermakna dengan kejadian batuk kering akibat penggunaan ACEi. Tidak ada perbedaan risiko penggunaan ACEi kelompok kaptopril dibanding bukan kaptopril terhadap kejadian batuk kering.

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ABSTRACTUse of angiotensin converting enzyme inhibitors (ACEi) as an antihypertensive agent can cause side effects such as dry cough. This study aimed to evaluate the risk of ACEi administration with captopril as the standard against another ACEi on dry cough incidence in hypertensive patients from various tribes at RSUD Cengkareng West Jakarta and RSUD Tarakan Central Jakarta. The design of this study is prospective cohort. The inclusion criteria were patients who received ACEi as hypertension therapy for ≤ 3 months gathered from outpatient polyclinics and those willing to participate as sample in this study at RSUD Cengkareng West Jakarta and RSUD Tarakan Central Jakarta. Sample consist of 54 patients who received captopril and 54 patients received non captopril ACEi, taken by consecutive sampling from January-July 2014. The data was collected using structured interviews and from medical record. Dry cough incidence due to ACEi was evaluated using Naranjo Algorithm and the data was analyzed using Chi Square test. Dry cough incidence was found in 19,44% of sample. No significant relationship of age, gender, tribe, comorbidity, body mass index (BMI), dosage, and duration of use with dry cough incidence due to the use of ACEi. Furthermore there is no difference in risk between the use of captopril group and non captopril ACEi group on dry cough incidence.;Use of angiotensin converting enzyme inhibitors (ACEi) as an antihypertensive agent can cause side effects such as dry cough. This study aimed to evaluate the risk of ACEi administration with captopril as the standard against another ACEi on dry cough incidence in hypertensive patients from various tribes at RSUD Cengkareng West Jakarta and RSUD Tarakan Central Jakarta. The design of this study is prospective cohort. The inclusion criteria were patients who received ACEi as hypertension therapy for ≤ 3 months gathered from outpatient polyclinics and those willing to participate as sample in this study at RSUD Cengkareng West Jakarta and RSUD Tarakan Central Jakarta. Sample consist of 54 patients who received captopril and 54 patients received non captopril ACEi, taken by consecutive sampling from January-July 2014. The data was collected using structured interviews and from medical record. Dry cough incidence due to ACEi was evaluated using Naranjo Algorithm and the data was analyzed using Chi Square test. Dry cough incidence was found in 19,44% of sample. No significant relationship of age, gender, tribe, comorbidity, body mass index (BMI), dosage, and duration of use with dry cough incidence due to the use of ACEi. Furthermore there is no difference in risk between the use of captopril group and non captopril ACEi group on dry cough incidence., Use of angiotensin converting enzyme inhibitors (ACEi) as an antihypertensive agent can cause side effects such as dry cough. This study aimed to evaluate the risk of ACEi administration with captopril as the standard against another ACEi on dry cough incidence in hypertensive patients from various tribes at RSUD Cengkareng West Jakarta and RSUD Tarakan Central Jakarta. The design of this study is prospective cohort. The inclusion criteria were patients who received ACEi as hypertension therapy for ≤ 3 months gathered from outpatient polyclinics and those willing to participate as sample in this study at RSUD Cengkareng West Jakarta and RSUD Tarakan Central Jakarta. Sample consist of 54 patients who received captopril and 54 patients received non captopril ACEi, taken by consecutive sampling from January-July 2014. The data was collected using structured interviews and from medical record. Dry cough incidence due to ACEi was evaluated using Naranjo Algorithm and the data was analyzed using Chi Square test. Dry cough incidence was found in 19,44% of sample. No significant relationship of age, gender, tribe, comorbidity, body mass index (BMI), dosage, and duration of use with dry cough incidence due to the use of ACEi. Furthermore there is no difference in risk between the use of captopril group and non captopril ACEi group on dry cough incidence.]"

"Pengobatan pada pasien lansia sangat kompleks karena biasanya bersifat multipatologi sehingga menyebabkan peningkatan jumlah obat yang digunakan (polifarmasi) untuk kondisi klinis yang berbeda-beda. Terdapatnya hipertensi, diabetes dan/atau dislipidemia menyebabkan pengobatan yang berpotensi menimbulkan Reaksi Obat yang Tidak Dikehendaki (ROTD), karena umumnya pengobatan pada pasien dengan hipertensi, diabetes dan/atau dislipidemia bersifat jangka panjang dengan menggunakan beberapa jenis obat. Penelitian ini bertujuan untuk menilai pengaruh umur lansia terhadap kejadian reaksi obat yang tidak dikehendaki pada pasien dengan hipertensi, diabetes dan/atau dislipidemia di Puskesmas Pancoran Mas, Puskesmas Tanah Baru, dan Puskesmas Beji kota Depok. Penelitian menggunakan rancangan kohort prospektif. Sampel penelitian terdiri dari 62 pasien lansia sebagai kelompok kohort dan 62 pasien non lansia sebagai kelompok kontrol. Pengambilan sampel dilakukan selama Januari-Juni 2014. Sampel dimonitoring keadaannya setiap minggu selama satu bulan. Manifestasi klinik ROTD merupakan hasil evaluasi terhadap keluhan-keluhan yang dialami pasien yang dievaluasi menggunakan skala Naranjo. Manifestasi klinik ROTD yang didapat pada kedua kelompok dianalisis menggunakan uji kaikuadrat dan uji regresi logistik. Pasien dengan hipertensi, diabetes dan/atau dislipidemia yang mengalami kejadian ROTD 30,6% dengan frekuensi kejadian 39 kali, presentase terbesar adalah batuk kering karena kaptopril (56,3%), dan tingkat keparahan manifestasi klinik ROTD yang terjadi pada mayoritas (53,8%) pasien tersebut adalah level 2 (mild/sedang). Risiko umur lansia 3,577 kali lebih besar untuk terjadinya ROTD.

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Treatment in elderly patients is very complex, because it is usually multiphatology thus causing an increase in number of drugs used (polypharmacy) for every clinical conditions. The presence of hypertension, diabetes and/or dyslipidemia will increase the risk of cause Adverse Drug Reaction (ADR) because of polypharmacy and long term of treatment. This study aimed to assess the effect of elderly age on the incidence of ADR in patients with hypertension, diabetes and/or dyslipidemia at Puskesmas Pancoran Mas, Beji, and Tanah Baru Depok. The design of the study is cohort study. The Sampling was conducted at January- June 2014. 62 elderly patients was collected as a risk factor group and 62 non- elderly patients as a control group. Sample was monitored every weeks in a month. Clinical Manifestation of ADR event was an evaluation result of the recording complaints experienced by the sampel using Naranjo scale. Clinical manifestation of ADR events obtained in the both group were analyzed using Chi- Square and Logistic Regression test. Patient with hypertension, diabetes and/or dyslipidemia experienced ADR event 30,6% with a frequency of accurrence was 39 times. Dry cough because of captopril (56,3%) was the most common clinical manifestation found, while severity level clinical manifestation ADR which occured in most of patient (53,8%) was at level 2 (mild). The risk of elderly age was 3,577 times greater for ADR event."