PENGARUH KONSELING FARMASIS TERHADAP PENCAPAIAN TARGET TERAPI PADA PASIEN HIPERTENSI RAWAT JALAN DI RSUD SARAS HUSADA PURWOREJO

Hypertension is one of chronic diseases, so a hypertension patients always need drugs to control her/his blood pressure for the rest of her/his life. The use of drugs in a long term might cause the patient indiscipline in taking the drugs. Uncontrolled blood pressure might cause some diseases such as coronary heart disease, infarct heart disease, stroke, kidney failure and damages in blood-vessels. The damages in human body cause the high level of death. To investigate the effect of a pharmacist counseling toward the achievement target of < 140/90 mmHg blood pressure on a non-diabetes mellitus hypertension patients and < 130/80 mmHg blood pressure on patients with diabetes mellitus who are being outpatients of RSUD Saras Husada Purworejo. This was an experimental research. The subjects of the research were randomly selected and were divided into intervention group (that received a pharmacist counseling) and control group (without a pharmacist counseling). The data collecting was done through interviews, questionnaires filling, and blood pressure measurement at the beginning and end of the research. There were 94 subjects who had involved in the research from the beginning to the end, consisted of 46 (48.9%) of control group and 48 (51.1%) of intervention group. Both non-diabetes mellitus hypertension patients and with diabetes mellitus hypertension patients who had received a pharmacist counseling, there was a significant decrease in the blood pressure and the attaining of blood pressure target. The results showed that a pharmacist counseling had a significant effect toward the achievement target of < 140/90 mmHg blood pressure on the non-diabetes mellitus hypertension patients (p = 0.000) and < 130/80 mmHg on the hypertension patients with diabetes mellitus (p = 0.001

MONITORING EFEK SAMPING PEMBERIAN FORMULA EKSTRAK DAUN LEGUNDI (Vitex trifolia L) DAN RIMPANG TEMULAWAK (Curcuma xanthorrhiza Roxb) PADA PENDERITA ALERGI RHINITIS

Temulawak and legundi has been scientifically shown to inhibit mast cell activation. Information undesirable side effects of legundi leaves and temulawak rhizome considered to be essential for development of the two materials into fitofarmaka anti-allergic preparation. The aim of this research is to determine the side effects of combination legundi leaf extract (Vitex trivolia L) and temulawak extract (Curcuma xanthorrhiza L) on allergic rhinitis patients. Observation of side effect used 33 subjects that divided into 3 groups namely the placebo group, treatment with the dose of 1500 mg / day treatment and the dose of 4500 mg/day. Blood chemical examinations performed before and after the treatment, observation of side effects symptoms performed 3 times daily for 14 days. Qualitative analysis carried out on observation of the organ systemby looking at the results of the side effects blank monitoring on the gastrointestinal system, central nervous system, respiratory system, cardiovascular system and organs of the skin. A quantitative analysis was also conducted statistical tests on organ systems and on blood chemical: physiology of the liver (SGPT and SGOT) and kidney physiology (kreatinine and BUN). The results of statistic test showed that no side effects on observation of systems gastrointestinal, central nervous, respiratory, cardiovascular and organs of the skin due to a combination of legundi leaf extract and temulawak extract in patients with allergic rhinitis on treatment of the dose of 1500 mg/day and 4500 mg/day. Similarly on the observation of physiological function of liver and kidney, no side effects occured on treatment with the dose of 1500 mg/day and 4500 mg/day for 14 days on patients with allergic rhiniti

EVALUASI ADVERSE DRUG REACTIONS DAN EFEKTIVITAS PENGGUNAAN KETOROLAK PADA PASIEN PASCA BEDAH SARAF DI RUMAH SAKIT UMUM PENDIDIKAN DR. WAHIDIN SUDIROHUSODO MAKASSAR

Pain is often experienced by patients treated in the hospital and is themost frequently reported events in post-surgical patients. Pain management in post-surgery patients are necessary to improve the quality of life for patients hospitalized patient include long associated with patient care costs and suffering caused by the pain. Ketorolac is widely used as an analgesic for acute postoperative pain restricted to a maximum of 5 days only. Restriction on duration of ketorolac use associated with the incidence of adverse drug reactions include, the incidence of acute renal failure and bleeding disorders. The purpose of the study was to observe and report on the profile of adverse reactions include the effects on renal function and hemostasis as well as the effectiveness of the analgesic ketorolac. Research using pre and post design with prospective study conducted from January 2012 to May 2013 in the post-neurosurgical patients department at dr. Wahidin Sudirohusodo Hospital, Makassar. A total of 20 patients who received ketorolac in comparison to the value of the glomerular filtration rate (GFR), bleeding time (BT), Blood Clotting Time (CT), prothrombin time (PT) and International Normalized Ratio (INR) between before and after patients received ketorolac. The value of the Visual Analog Scale (VAS) score was compared from day 1 until day 5 on ketorolac consumption. One of 20 patients (5%) who use ketorolac for 5 days had decrease GFR by 66.7%. Whereas for hemostasis testing showed that ketorolac can influence the hemostatic seen from increasing on BT (0,0

EVALUASI EFEK TERAPI INISIAL KORTIKOSTEROID DAN FAKTOR - FAKTOR YANG MEMPENGARUHI PADA ANAK DENGAN SINDROM NEFROTIK IDIOPATIK DI RS DR SARDJITO YOGYAKARTA

Corticosteroids are the first-line treatment of idiopathic nephrotic syndrome in children. Children with nephrotic syndrome who respond to corticosteroid have 60-90 % chance of having one or more relapses. Initial treatment with a minimum period of 4 weeks is effective but its lead to many side effects. The aims of this study are to determine the effect of initial corticosteroid therapy, identify adverse events that occur in patients and to determine the affect of age, sex, use of albumin, type of corticosteroid and the use of another drug (captopril and furosemide) towards the effect of initial corticosteroid therapy in children with idiopathic nephrotic syndrome in Dr. Sardjito Hospital Yogyakarta. This study is a cross sectional analytic study with retrospective data collection based on the medical records in Dr. Sardjito Hospital Yogyakarta. Evaluation of the effectiveness of initial corticosteroid therapy was done by comparing the concentration of protein in urine and edema before and after therapy. Identify the side effects made descriptively. The evaluation was also conducted on the factors that might impact on the effectiveness of therapies such as age, albumin infusion, gender, type of corticosteroid used and the use of another drug (captopril and furosemide). The number of the subjects of this research were 56 patients. Concentration of protein in urine and edema conditions before and after treatment was significantly different (p <0.05). Initial corticosteroid therapy in children with idiopathic nephrotic syndrome in Dr Sardjito Hospital Yogyakarta can reduce levels of protein in the urine and improve the condition of edema. Based on bivariate analysis age, sex, use of albumin, types of corticosteroids and use of other drug (furosemide) did not affect the therapeutic effects of initial corticosteroid therapy (p> 0.05). Thirty eight children or about 68% of patients experience side effects due to the use of corticosteroids. Side effects due to corticosteroid therapy were moonface, gastritis, hirsuitism, delayed puberty, acne, hypertension, and stomatitis. The most frequent side effects was Moonface (27%)

PENGARUH PEMBERIAN OBAT ANTIHIPERTENSI TERHADAP PENURUNAN TEKANAN DARAH PASIEN STROKE ISKEMIK AKUT YANG MENJALANI RAWAT INAP DI RSUP DR. SARDJITO YOGYAKARTA

Stroke is the second leading cause of death in the world and the third leading cause of death in the United States, under cardiovascular disease and cancer. Strokes can be either ischemic or bleeding. The report from the American Heart Association (AHA) shows the incidence for ischemic stroke was 88%, while haemorrhagic stroke was 12%. One focus of acute stroke management is the management of hypertension. Blood pressure reduction in ischemic stroke patients could potentially reduce the risk of brain edema, the risk of hemorrhage, and prevent further vascular damage. However, an aggressive blood pressure reduction can cause a decrease in perfusion pressure to the ischemic area. Most hypertensive patients require two or more antihypertensive drugs to achieve blood pressure targets. This study used observational study design with retrospective data collection, to determine the management of antihypertensive drug therapy in patients with acute ischemic stroke, the effect of antihypertensive drugs on blood pressure reduction in acute ischemic stroke patients and compared the ability of a single antihypertensive medication and the combination of antihypertensive medication to lower blood pressure of acute ischemic stroke patients. The effectiveness of therapy was measured by looking at the number of acute ischemic stroke patients who experienced a decrease in blood pressure. Inclusion criteria included: patients with a diagnosis of acute ischemic stroke by age 35 years or older who is hospitalized in RSUP Dr. Sardjito Yogyakarta who meet indication for three days antihypertensive drug therapy during hospitalization. Therapeutic effectiveness in lowering blood pressure analyzed with chi square test. Initial antihypertensive drug use in patients with acute ischemic stroke in RSUP Dr. Sardjito are 13 types of five classes of antihypertensive drugs. Effect of antihypertensive drug to acute ischemic stroke patients is not always a decline in blood pressure, but there is a fixed or even increase. a. After getting a single antihypertensive drug, patients who experienced a decrease in systolic blood pressure on day-3 is 60%, while 17% fixed and 23% rise. b. After getting a combination of antihypertensive drugs, patients who experienced a decrease in systolic blood pressure on day-3 is 75%, while 10% fixed and 15% rise. Antihypertensive drug therapy alone or in combination have the same ability to lower systolic blood pressure (p = 0.260) and diastolic (p = 0.567) in patients with acute ischemic stroke in RSUP Dr. Sardjito Yogyakarta

PERBEDAAN KUALITAS HIDUP PADA PASIEN ASMA RAWAT JALAN YANG LEBIH PATUH DAN KURANG PATUH PADA PENGGUNAAN OBAT ASMA INHALASI

Failure to adhere to drug regimen can increase morbidity and mortality. While Medication Adherence Report Scale for Asthma (MARS-A-10) is a specific psychometric to measure adherence to a regimen of inhaled asthma medications, Asthma Quality of Life Questionnaire (AQLQ) measures quality of life. The average difference of 0.5 points per item per domain of total score for each intervention illustrates the difference in minimal clinically important difference (MCID). This study aims to verify whether patients who fail to adhere to the regimen have quality of life scores 0.5 points lower than those who strictly adhere to a regimen of inhaled asthma medication. Subjects of the study are patients at Poliklinik Paru of Sardjito Hospital and Poliklinik Penyakit Dalam Sleman General Hospital, Yogyakarta. The study also attempts to reveal factors other than adherence to drug regimen that may affect quality of life. Since the study is cross-sectional, it makes the most of data gathered from a survey on adult asthma patients at Poliklinik Paru of Sardjito Hospital and Poliklinik Penyakit Dalam Sleman General Hospital, Yogyakarta. The independent variable in the study is adherence to a drug regimen which is measured using MARS-A-10 modified with Visual Analogue Scale (VAS) as a response to answer for each item. Adherence scores range from 0-900 with a cut point at <810 which will be considered as failure to strictly adhere. The difference in AQLQ score of 0.5 points, a clinically significant value, becomes the minimum value separating patients who adhere to drug regime less strictly and those who adhere more strictly to the regimen of inhaled asthma medication. Multivariate regression analysis is used to identify variables that demonstrate a statistically significant relationship with the AQLQ as the dependent variable. Stepwise method is used to remove variables with p values less than 0.5. There are 53 subjects of the study, 36 of whom are women, the mean age is 49.26 ± 10.64 years (mean ± SD), mean disease duration is 21.15 ± 13.51 years with asthma (mean ± SD), the mean time use of inhaled asthma medication is 9.09 ± 6.51 years (mean ± SD). The mean adherence score is 600.99 ± 173.40, with 84.9% of them adhere to drug regimen less strictly (score <810). The average difference in AQLQ total score between those who adhere to drug regimen less strictly and those who adhere more strictly is 0.67 points. The multivariate analysis model consisting of adherence as independent variables and three confounding variables (medical record concerning treatment in ICU, the level of asthma control and how long the patient is on inhaled asthma medication) produces R2 of 0.445. Better quality of life is closely associated with better asthma control, minimum incidence of hospitalization in the ICU, duration of inhaled asthma medication use, and high score of adherence to the drug regimen