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Abstrak :
Secara etnofarmakologi, B. javanica (L.) Merr. dikenal sebagai salah satu tanaman obat yang berhasiat menurunkan tekanan darah pada penderita hipertensi. Pada penelitian ini dilakukan pengujian efek antihipertensi ekstrak buah B. javanica menggunakan tikus yang mengalami hipertensi akibat pemberian adrenalin. Tikus hipertensi dibagi menjadi 4 kelompok, diberikan fraksi air B. javanica, fraksi heksana B. javanica, bisoprolol, serta kontrol yang tidak diberikan apapun kecuali adrenalin. Tekanan darah sistolik diukur menggunakan prosedur tail-cuff. Setelah mengalami hipertensi, tikus yang diberikan fraksi air, fraksi heksana dan bisoprolol menunjukkan penurunan tekanan darah berturut-turut sebesar 72.75 mmHg (-34%), 58.5 mmHg (-28%) and 23.25 mmHg (-12%), sementara ada peningkatan sebesar 15.00 mmHg (+9%) pada kelompok kontrol. Fraksi air diketahui mengandung flavonoid dan alkaloid, sementara fraksi heksana mengandung alkaloid. Berdasarkan hasil penelitian ini, kami menduga bahwa flavonoid dan alkaloid yang terkandung dalam buah B. javanica berkerja secara sinergis menurunkan tekanan darah, kemungkinan melalui jalur terkait reseptor β 1-adrenergik.

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Abstract
Ethnopharmacologically, the fruit of Brucea javanica (L.) Merr. is acknowledged in the Indonesian community to lower blood pressure. This study assessed the antihypertensive effect of B. javanica fruit extract using adrenaline-induced hypertensive Sprague Dawley rats. Hypertensive rats were divided into 4 groups: group A was given B. javanica water fraction and adrenaline, group B was given B. javanica hexane fraction and adrenaline, group C was given bisoprolol and adrenaline and group D was given adrenaline solely. Systolic blood pressure was regularly measured using the tail-cuff method. Treatment of adrenaline-induced hypertensive rats independently given B. javanica water fraction, the hexane fraction, and the bisoprolol group proved to significantly reduce blood pressure by 72.75 mmHg (-34%), 58.5 mmHg (-28%) and 23.25 mmHg (-12%) respectively, while there was an increase of 15.00 mmHg (+9%) SBP in the negative control group given solely adrenaline. The water fraction contains flavonoid and alkaloid. The hexane fraction of this fruit contains alkaloid. Our study suggest that the flavanoid and alkaloid content in B. javanica fruit work synergistically to alleviate hypertension, possibly through β1-adrenergic receptor-related mechanism.

Abstrak :
Penggunaan obat antihipertensi dari angiotensin converting enzyme inhibitor (ACEI) dan angiotensin receptor blocker (ARB) kelompok memiliki efek renoprotektif dan direkomendasikan pada pasien dengan diabetes mellitus dengan hipertensi di Indonesia. Penelitian ini dilakukan untuk menentukan efektivitas kelompok ACEI atau ARB pada fungsi ginjal, morbiditas, dan efek samping dari peningkatan nilai kalium. Penelitian ini dilakukan pada 123 pasien dengan metode kohort prospektif-retrospektif menggunakan kuesioner yang divalidasi, pengumpulan data pada catatan medis, dan pengukuran laboratorium di RSUPN Dr. Ciptomangunkusumo pada November 2018 hingga April 2019. Setelah 3 bulan pengamatan, tidak ada perubahan dalam parameter dalam kelompok ACEI kecuali untuk peningkatan BMI (p = 0,046), sedangkan pada kelompok ARB tidak ada perubahan dalam parameter kecuali untuk penurunan LDL (p = 0,016) dan penurunan HDL (p = 0,004). Tidak ada perbedaan pada kedua kelompok dalam hal perubahan nilai Urine Albumin Creatinine Ratio (UACR) (p = 0,675), eLFG (p = 0,062), morbiditas (p = 0,309), dan nilai kalium (p = 0,166 ) 3 bulan. Pengaruh BMI> 25 OR = 2.780 (95% CI = 1.181-6.544), durasi ACEI / ARB> 6 bulan ATAU 3.705 (95% CI = 1.164-11.795) dan UACR 30-300 pada awal penelitian 3.158 ( 95% CI = 1.233 -8.089) melawan UACR. Pengaruh jenis kelamin laki-laki OR = 3.674 (95% CI = 1.544-8.741), LDL OR = 3.168 (95% CI = 1.246-8.057), trigliserida 0 bulan OR = 3.024 (95% CI = 1.274-7.175), dan tekanan darah sistolik OR = 3.317 (95% CI = 1.255-8.769) terhadap eLFG. Pengaruh usia ≤ 60 tahun OR = 3.040 (95% CI = 1.378-6.710) dan kalium pada awal penelitian ≤ 5 mmol / L OR = 4.178 (95% CI = 1.791-9.748) pada peningkatan kalium. Peningkatan delta LDL OR = 10.072 (95% CI = 1.618-62.709), HDL 40-60 mg / dL OR yang dikontrol 0 bulan = 14.741 (95% CI = 3.074-70.680), peningkatan delta trigliserida OR = 6.390 (95% CI = 957 CI 1,215-33,615) dan total kolesterol yang dikontrol OR = 5,718 (95% CI = 1,570-20,828) terhadap morbiditas. Penggunaan ARB memiliki nilai eLFG signifikan yang meningkat atau tetap (p = 0,042) (OR = 2,370, 95% CI = 1,031-5,4449) setelah mengendalikan variabel pengganggu jenis kelamin, LDL, trigliserida, dan tekanan darah sistolik. Kesimpulan dari penelitian ini adalah bahwa penggunaan ARB meningkatkan eLFG atau mempertahankan eLFG dibandingkan dengan ACEI dengan beberapa variabel terkontrol.

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The use of antihypertensive drugs of the angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) groups has a renoprotective effect and is recommended in patients with diabetes mellitus with hypertension in Indonesia. The study was conducted to determine the effectiveness of the ACEI or ARB group on kidney function, morbidity, and side effects of increasing potassium values. The study was conducted on 123 patients with a retrospective-prospective cohort method using a validated questionnaire, data collection on medical records, and laboratory measurements at RSUPN Dr. Ciptomangunkusumo in November 2018 until April 2019. After 3 months of observation, there were no changes in parameters in the ACEI group except for an increase in BMI (p = 0.046), whereas in the ARB group there were no changes in parameters except for a decrease in LDL (p = 0.016) and a decrease HDL (p = 0.004). There were no differences in the two groups in terms of changes in the value of Urine Albumin Creatinine Ratio (UACR) (p = 0.675), eLFG (p = 0.062), morbidity (p = 0.309), and potassium value (p = 0.166) 3 months. Effect of BMI> 25 OR = 2,780 (95% CI = 1,181-6,544), duration of ACEI / ARB> 6 months OR 3,705 (95% CI = 1,164-11,795) and UACR 30-300 at the start of the study 3,158 (95% CI = 1,233 -8,089) against UACR. Effect of male sex OR = 3,674 (95% CI = 1,544-8,741), LDL OR = 3,168 (95% CI = 1,246-8,057), triglyceride 0 months OR = 3,024 (95% CI = 1,274-7,175), and blood pressure systolic OR = 3,317 (95% CI = 1,255-8,769) against eLFG. Effect of age ≤ 60 years OR = 3,040 (95% CI = 1,378-6,710) and potassium at the start of the study ≤ 5 mmol/L OR = 4,178 (95% CI = 1,791-9,748) on the increase in potassium. Increased LDL delta OR = 10,072 (95% CI = 1,618-62,709), 0 month controlled HDL 40-60 mg/dL OR = 14,741 (95% CI = 3,074-70,680), increase in triglyceride delta OR = 6,390 (95% CI = 957 CI 1,215-33,615) and total cholesterol controlled OR = 5,718 (95% CI = 1,570-20,828) to morbidity. The use of ARB had a significant value of eLFG that increased or remained (p = 0.042) (OR = 2.370 95% CI = 1.031-5.4449) after controlling for confounding variables of gender, LDL, triglycerides, and systolic blood pressure. The conclusion of this study is that the use of ARB either increases eLFG or maintains eLFG compared to ACEI with several controlled variables.

Abstrak :
Candesartan cilexetil adalah obat antihipertensi antagonis reseptor angiotensin II dan memiliki kelarutan yang rendah. Di saluran usus mengalami absorpsi tidak sempurna. Dalam proses penyerapan ini, candesartan cilexetil diubah menjadi bentuk aktifnya yaitu candesartan yang lebih mudah diserap saluran usus, sehingga dapat diketahui kadar candesartan cilexetil yang diserap dalam tubuh dibutuhkan candesartan sebagai standar pembanding. Penelitian ini Penelitian ini bertujuan untuk mendapatkan metode preparasi candesartan dari candesartan cilexetil, memperoleh data karakterisasi candesartan yang telah dihasilkan, dan memperoleh kadar candesartan terhidrolisis. Pembuatan candesartan dari candesartan cilexetil menggunakan proses hidrolisis dengan basa natrium hidroksida 1N dalam waktu 1 jam. Senyawa hasil hidrolisis senyawa tersebut diidentifikasi dengan spektroskopi inframerah, Spektrometri H-NMR dan titik leleh, sedangkan kadar senyawa terhidrolisis ditentukan kromatografi cair kinerja tinggi fase terbalik. Sistem kromatografi cair kinerja tinggi dengan fase gerak asetonitril-asam asetat glasial-aquabidest dengan rasio (90:1:10), fase diam C18 dengan laju alir 0,8 ml/menit dan detektor UV pada panjang gelombang 254nm. Berdasarkan sistem kromatografi diperoleh regresi linier y= 49144x+83310 dan nilai r = 0,99924 dengan rentang konsentrasi 2-20 ppm. nilai LOD dan LOQ yang dihasilkan adalah 0,36 dan 1,21. Tingkat rata-rata yang dihasilkan adalah 87,63%.

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Candesartan cilexetil is antihypertensive drug angiotensin II and has low solubility. In the intestinal tract undergo incomplete absorption. In this absorption process, candesartan cilexetil is converted into its active form, namely candesartan which is more easily absorbed by the intestinal tract, so it can be seen that the level of candesartan cilexetil absorbed in the body requires candesartan as a standard of comparison. This study aims to obtain the method of preparation of candesartan from candesartan cilexetil, obtain data on the characterization of candesartan that has been produced, and obtain the levels of hydrolyzed candesartan. Making candesartan from candesartan cilexetil using a hydrolysis process with 1N sodium hydroxide base in 1 hour. The compounds resulting from the hydrolysis of these compounds were identified by infrared spectroscopy, H-NMR spectrometry and melting point, while the levels of the hydrolyzed compounds were determined. Reverse phase high performance liquid chromatography. High performance liquid chromatography system with mobile phase acetonitrile-glacial acetic acid-aquabidest ratio (90:1:10), C18 stationary phase with flow rate 0.8 ml/min and UV detector at 254nm wavelength. Based on the chromatographic system obtained linear regression y = 49144x+83310 and the value of r = 0.99924 with a concentration range of 2-20 ppm. The resulting LOD and LOQ values ​​are 0.36 and 1.21. The resulting average rate is 87.63%.

Abstrak :
[ABSTRAK
Latar belakang:Hipertensimerupakan salah satu faktor risiko gagal jantung kongestif. Di rawat inap RSUD Pasar Rebo pada tahun 2014, gagal jantung kongestif masuk dalam 10 penyakit terbanyak, dengan biaya total yang cukup besar dan terdapat selisih tarif antara tarif RS dengan tarif JKN, sehingga perlu dilakukan analisis minimalisasi biaya salah satunya pada obat antihipertensi. Tujuan: Penelitian ini bertujuan untuk memilih alternatif yang lebih cost- minimize antara ramipril-spironolakton dengan valsartan pada pengobatan gagal jantung kongestif di RSUD Pasar Rebo tahun 2014. Metode Penelitian: Penelitian ini merupakan penelitian kuantitatifberupa analisis cross-sectional retrospektif. Penelitian dilakukan dengan membandingkan nilai rata-rata biaya total dua alternatif pengobatan gagal jantung kongestif, yaitu ramipril-spironolakton dengan valsartan dengan menggunakan perspektif Rumah Sakit. Komponen biaya langsung medis yang dihitung adalah biaya obat, biaya jasa dokter dan biaya rawat inap. Sedangkan efektivitas dipastikan memiliki efek yang setara. Hasil: Berdasarkan hasil penelitian yang telah dilakukan pada pasien gagal jantung kongestif di RSUD Pasar Rebo tahun 2014 didapatkan bahwa: (1) Nilairata-rata biaya total penggunaan kombinasi obat ramipril-spironolakton sebesar Rp.2.527.743; (2) Rata-rata biaya total penggunaan obat valsartan sebesar Rp.2.430.923; (3) Obat ramipril-spironolakton efektivitasnya tidak berbeda signifikan atau setara dengan obat valsartan; (4) Adanya penghematan pada rata- rata biaya total obat valsartan sebesar Rp.96.820 per pasien; (5) Adanya penghematan pada biaya rawat inap obat valsartan sebesar Rp.299.031 per pasien. Kesimpulan: Obat valsartan memberikan nilai rupiah yang terendah dan menjadi pilihan yang lebih cost-minimize dibandingkan obat ramipril-spironolakton pada pasien gagal jantung kongestif di RSUD Pasar Rebo Tahun 2014.

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ABSTRACT
Background: Hypertension once of risk factor for congestive heart failure. The Pasar Rebo Hospital inpatient care in 2014, congestive heart failure is the top 10 most prevalent diseases, with a large of number total cost and there is a difference between tariff rates RS and JKN rate, so we need a cost-effectiveness analysis one with antihypertensive drug. Objective: This study aimed to choose an alternative that is more cost-minimize between the ramipril-spironolactone with valsartan in the treatment of congestive heart failure at Pasar Rebo Hospital in 2014. Methods: This is a quantitative research in the form of a retrospective cross- sectional analysis. The study was conducted by comparing the average value of total cost of two alternative treatment of congestive heart failure, ramipril- spironolactone with valsartan by using Hospital’s perspective. The direct medical cost component are cost of drugs, cost of physician services and cost of hospitalizations. Whereas effectiveness measuredand firmly to be equivalent. Results: Based on the research that has been conducted in patients with congestive heart failure at Pasar Rebo Hospital in 2014 found that: (1) The average total cost of ramipril-spironolactone’s drugare Rp.2.527.743; (2) The average total cost of valsartan’s drug are Rp.2.430.923; (3) Ramipril- spironolactone’s drug effectiveness does not significantly difference to valsartan’s drug; (4) There is cost saving on the average of total cost using valsartan’s drug Rp.96.820 per patient; (5) There is cost saving on hospitalization cost using valsartan’s drug Rp.299.031 per patient. Conclusions:V alsartan’ s drug give lowest rupiah value and be more cost minimizes option than ramipril-spironolactone’s drug for patient with congestive heart failure at Pasar Rebo Hospital in 2014., Background: Hypertension once of risk factor for congestive heart failure. The Pasar Rebo Hospital inpatient care in 2014, congestive heart failure is the top 10 most prevalent diseases, with a large of number total cost and there is a difference between tariff rates RS and JKN rate, so we need a cost-effectiveness analysis one with antihypertensive drug. Objective: This study aimed to choose an alternative that is more cost-minimize between the ramipril-spironolactone with valsartan in the treatment of congestive heart failure at Pasar Rebo Hospital in 2014. Methods: This is a quantitative research in the form of a retrospective cross- sectional analysis. The study was conducted by comparing the average value of total cost of two alternative treatment of congestive heart failure, ramipril- spironolactone with valsartan by using Hospital’s perspective. The direct medical cost component are cost of drugs, cost of physician services and cost of hospitalizations. Whereas effectiveness measuredand firmly to be equivalent. Results: Based on the research that has been conducted in patients with congestive heart failure at Pasar Rebo Hospital in 2014 found that: (1) The average total cost of ramipril-spironolactone’s drugare Rp.2.527.743; (2) The average total cost of valsartan’s drug are Rp.2.430.923; (3) Ramipril- spironolactone’s drug effectiveness does not significantly difference to valsartan’s drug; (4) There is cost saving on the average of total cost using valsartan’s drug Rp.96.820 per patient; (5) There is cost saving on hospitalization cost using valsartan’s drug Rp.299.031 per patient. Conclusions:V alsartan’ s drug give lowest rupiah value and be more cost minimizes option than ramipril-spironolactone’s drug for patient with congestive heart failure at Pasar Rebo Hospital in 2014.]

Abstrak :
Latar Belakang: Morning Blood Pressure Surge (MBPS) atau puncak tekanan darah pagi hari merupakan suatu bentuk peningkatan tekanan darah yang terjadi pada pagi hari. MBPS dapat meningkatkan kejadian stroke dan penyakit kardiovaskular jika tekanan darah sistolik meningkat >135 mmHg dan diastolik >85 mmHg pada pagi hari. Penggunaan obat antihipertensi dengan waktu paruh yang panjang cukup efektif untuk mengatasi MBPS yang berlebihan, namun ketersediaan jenis obat antihipertensi di fasilitas kesehatan tingkat I masih sangat terbatas karena sistem aturan yang dibuat oleh Badan Penyelenggara Jaminan Sosial (BPJS) hanya memakai empat golongan obat antihipertensi saja. Selain itu, pemanfaatan obat tersebut juga masih belum optimal. Metode: Tujuan penelitian ini untuk mengetahui apakah penggunaan obat antihipertensi di Puskesmas Cinere sudah cukup efektif untuk mengontrol MBPS. Metode penelitian yang digunakan adalah cross-sectional. Jumlah sampel yang digunakan sebanyak 80 orang. Pengambilan data dengan cara mengukur tekanan darah subjek penelitian sebanyak 2 kali, lalu hasil tersebut dianalisis dengan mengikuti kriteria inklusi dan eksklusi. Data dianalisis secara univariat dan bivariat menggunakan uji chi square. Hasil: Hasil analisis dalam penelitian ini terdapat hubungan yang bermakna antara penggunaan obat antihipertensi terhadap puncak tekanan darah pagi hari dengan p: 0,004. Presentase yang terkontrol sebanyak 52,5% yang terkontrol dan 47,5% tidak terkontrol tekanan darah paginya. Kesimpulan: Hal ini menjelaskan pengobatan antihipertensi di Puskesmas Cinere sudah cukup efektif untuk mengontrol tekanan darah di pagi hari.

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Background: Morning Blood Pressure Surge (MBPS) is a form of increased blood pressure that occurs in the morning. MBPS can increase the incidence of stroke and cardiovascular disease if systolic blood pressure rises> 135 mmHg and diastolic> 85 mmHg in the morning. The use of antihypertensive drugs with a long half-life is effective enough to overcome excessive MBPS, but the availability of antihypertensive drugs in health facilities at level I is still very limited because the regulatory system made by Badan Penyelenggara Jaminan Sosial (BPJS) only uses four groups antihypertensive drugs only. In addition, the use of these drugs is also still not optimal. Methods: The purpose of this study was to determine whether the use of antihypertensive drugs at the Cinere Health Center was effective enough to control MBPS. The research method used was cross-sectional. The number of samples used was 80 people. Retrieval of data by measuring the blood pressure of research subjects 2 times, then the results are analyzed by following the inclusion and exclusion criteria. Data were analyzed univariately and bivariately using the chi square test. Results: The results of the analysis in this study there is a significant relationship between the use of antihypertensive drugs to blood pressure surge in the morning with p: 0.004. The percentage controlled was 52.5% controlled and 47.5% was not controlled in the morning blood pressure. Conclusion: This explains the antihypertensive treatment at the Cinere Health Center is effective enough to control blood pressure in the morning.

Abstrak :
Apotek adalah sarana pelayanan kefarmasian tempat di mana seorang apoteker melakukan pekerjaan kefarmasian. Apoteker merupakan bagian dari tenaga kesehatan yang mempunyai kewenangan dan kewajiban untuk melakukan pekerjaan kefarmasian yaitu pembuatan termasuk pengendalian mutu sediaan farmasi, pengadaan, penyimpanan dan pendistribusian obat, pengelolaan obat, pelayanan obat atas resep dokter, pelayanan informasi obat, serta pengembangan obat. Dalam mengola apotek, seorang apoteker harus mampu melaksanakan peran profesinya sebagai tenaga kesehatan yang mengimplementasikan ilmu pengetahuannya dalam memberikan pelayanan kefarmasian yang terbaik, serta mampu menjalankan peran manajerial di apotek. Karena pentingnya peran apoteker dalam mengelola apotek, maka dilakukan Praktik Kerja Profesi Apoteker (PKPA) di apotek. Kegiatan tersebut bertujuan agar calon apoteker dapat memahami secara langsung mengenai peranan apoteker di apotek, sebagai sarana pelatihan untuk menerapkan ilmu yang telah didapatkan, serta mempelajari segala kegiatan dan permasalahan yang ada di apotek. Tugas khusus yang diberikan saat Praktik Kerja Profesi Apoteker adalah “Analisis Perencanaan Persediaan Obat Antihipertensi di Apotek Roxy Jakasampurna”. Tugas khusus ini bertujuan untuk melatih dan meningkatkan pemahaman terhadap perencanaan pengadaan yang baik di apotek, sehingga dapat menghindari terjadinya penumpukan dan kekosongan stok obat di apotek. ......Pharmacy is a pharmaceutical service facility where a pharmacist performs pharmaceutical work. Pharmacists are part of health workers who have the authority and obligation to carry out pharmaceutical work, namely manufacturing including quality control of pharmaceutical preparations, procurement, storage and distribution of drugs, drug management, drug services based on doctor's prescriptions, drug information services, and drug development. In managing a pharmacy, a pharmacist must be able to carry out his professional role as a health worker who implements his knowledge in providing the best pharmaceutical services, and is able to carry out a managerial role in a pharmacy. Because of the important role of pharmacists in managing pharmacies, a Pharmacist Professional Work Practice (PKPA) is carried out in pharmacies. This activity aims so that prospective pharmacists can understand the role of pharmacists in pharmacies, as a means of training to apply the knowledge that has been obtained, as well as learn about all activities and problems that exist in pharmacies. The specific task given during the Pharmacist Professional Practice is "Analysis of Antihypertensive Drug Inventory Planning at the Roxy Jakasampurna Pharmacy". This special task aims to train and improve understanding of good procurement planning in pharmacies, so as to avoid the accumulation and emptiness of drug stock in pharmacies.