Kajian Keamanan Pemakaian Obat Anti-hipertensi Di Poliklinik Usia Lanjut Instalasi Rawat Jalan RS Dr Sardjito

Increasing age is generally followed by increasing chronic diseases so that the elderly needs much therapy using drugs for therapy of numerous diseases they have. Hyper-tension is one of diseases of which its prevalence increases along with increasing age.Most of the elderly diagnosed as having hypertension finally take therapy using anti-hypertension drugs. Physiological changes that happen to the elderly lead to use ofdrugs for side effect diseases of which their consumption should be considered while having anti-hypertension drugs. Changes in biological system to the elderly will af-fect the process of drug molecular interaction, which finally affects clinical efficacyand pharmacotherapeutic safety. Meanwhile, minimizing the problem of drug use insecurity is one of good prescription demands in the implementation of clinical pharmacy. To identify and study safety of anti-hypertension drug use at the elderlypolyclinic of Dr. Sardjito Hospital Outpatient Installation by identifying and evalu-ating contraindication, interaction and side effect of anti-hypertension drugs. This was a descriptive study with data taken prospectivelly from 80 patients of the elderly polyclinic of Dr. Sardjito Hospital Outpatients Installation from November 14 to December 13, 2005. Data were obtained from medical records, interviews and ques-tionnaires. The study on contraindication, interaction and side effect of drugs whichhappened was based on a guideline book. There was 27.5% of patients took anti-hypertension drugs which were not beneficial to patients’ clinical condition, so the that use of  antihypertension drugs needs monitoring. As much as 41.3% of patients took combined drugs potential to cause interaction, 8.7% of which had clinical symp-toms presumed to be related with possibility of increasing drug interaction effect. Asmuch as 33.8% of patients had at least one drug side effect considered to be related or possibly related with anti-hypertension medication. Use of anti-hypertension drugsamong the elderly had not been relatively safe because there was drug combination potential of causing interaction, light drug side effect and the possibility of contrain-dication due to use of anti-hypertension drugs which was not beneficial to patients’clinical condition so that monitoring to use of anti-hypertension drugs was needed

STEADY-STATE PHARMACOKINETICS OF METFORMIN IN OBESE PATIENTS WITH TYPE 2 DIABETES MELLITUS: A PRELIMINARY STUDY

Objective: This study aimed to determine the metformin plasma steady-state concentration (PSSC) either trough and peak level in Type 2 diabetesmellitus patients with obesity and the impact of SLC22A1 gene organic cation transporter 1 (OCT) rs628031 A>G on PSSC of metformin.Methods: Validated reversed-phase high-performance liquid chromatography method with ultraviolet detector was used to determine the metforminPSSC, as well as genotype variation was performed using the restriction fragment length polymorphisms-polymerase chain reaction method.Results: A total of 13 patients were recruited from five Primary Health Centers in Yogyakarta Province of Indonesia. The results showed that themeans of their trough and peak PSSC were 0.285±0.192 and 1.175±0.814 μg/ml, respectively. Only 10 patients (77%) had peak PSSC within theplasma therapeutic level (PTL) of metformin, and 14-fold variability was observed for the peak PSSC. None of the patients achieved the PTL ofmetformin with regard to their trough PSSC. The PSSC of metformin was independent of the OCT1 genotype in rs628031 (A>G) 408M/V SLC22A1.Conclusion: This study found a huge variability in the trough concentration of metformin (>100-fold) and 14-fold for the peak PSSC, and no impactof a variant of rs628013 SLC22A1 OCT1 on metformin PSSC was revealed.Keywords: Metformin, Steady-state pharmacokinetics, Obesity, Type 2 diabetes mellitus

Effectiveness of Antiemetic Treatment Among Breast Cancer Patients in Inpatient Unit Sardjito General Hospital

Nausea and vomiting are chemotherapy adverse events that influence breast cancer patient’s quality of life. Antiemetic regimen as premedication was given to prevent those adverse events and need to be evaluated. This study aimed to present the effectiveness of antiemetic treatment among breast cancer patients in the inpatient unit, Rumah Sakit Umum Pusat Dr. Sardjito [Central Public Hospital Dr. Sardjito] Yogyakarta, Indonesia.A cohort study was used in this study during July 2008 to January 2009. Thirty-one breast cancer patients, who are receiving antiemetic therapy and having no disease that induced nausea and vomiting were involved, signed informed consent and had been followed by before-post chemotherapy. The data was gained from chemotherapy and antiemetic regimens, medical records, patient’s interviews, and finally analyzedusing descriptive, evaluative approach. This study presented that antiemetic treatment among breast cancer patient in the inpatient unit was 61.40 % ineffective reducing incidence of nausea vomiting events. The majority of cases of nausea and vomiting onset among patients were acute-delayed (56.2 %; 52.0 %), severity of nausea and vomiting laid mostly in the second level (54.54 %; 52.00 %), and appropriateness antiemetic treatment complied to NCCN guideline 2007 and ASCO guideline 2006 was only applied in low emetic risk of chemotherapy-induced nausea and vomiting. Antiemetic regimens that had been implemented need to be evaluated because of majority cases of nausea and vomiting were the acute-delayed type, level two of severity and inappropriateness of international guideline. This study should be followed with the future study of the evaluation of the effectiveness of another medication supported the patient in receiving chemotherapy. Keywords: Antiemetic, Breast cancer, Effectiveness, Nausea, Vomiting

Pola Hubungan Kerja Sama Kolaboratif antara Farmasis dan Dokter dalam Pelayanan Kesehatan

Background: Pharmacist is one of health provider, but the role of pharmacist in health care system is still limited due to the poor relationship between pharmacists and physician in clinical care setting. To deal with this issue, it is important to improve a good collaborative working relationship between physician and pharmacist in health care system. Objectives: The study aims to observe how far the relationship between pharmacist and physician has been implemented in Indonesia and how to develop it. Method: An observation concerning the relationship between pharmacist and physician in Indonesia was carried out using a model of relationship proposed by McDonough and Doucette\u27 as the reference. Results: Most of the pharmacy-physician relationship in Indonesia falls in stage 0 of the model, very few in stage 1 and 2, and none reached stage 4 and 5. The determinant factors are the competency of the pharmacist, the openness of the physicians toward the role of pharmacist in clinical practice, and the policy of the hospital administrator on clinical pharmacy practice. The new regulation is required to optimize the role of pharmacist in health care system. Keywords: pharmacist - physician relationship, clinical pharmacy practic

Mentoring sebagai suatu Inovasi dalam Peningkatan Kinerja

Mentoring is a strategy to improve work performance within an organization. This type of research is literature research. Technique of collecting data is done by documentation method that is reading every information that there is relation with study. The data collected from reading results is then analyzed by selecting the appropriate materials or still related to the study. Based on the results of data analysis then synthesized and concluded to be a conclusion of the topic under study. The result of the mentoring process is intentional, does not happen by chance. The key to ensuring the desired outcomes and the sustainability of the mentoring process is to use all the best practices of human performance technology in the needs assessment, planning, design, implementation, and evaluation phase. Mentoring must be closely linked to the organization\u27s mission, objectives, and strategy priorities. Only an integrated quality, capable of facilitating the process associated with current and future missions that can be expected to deal with exposure to the winds of change. The rapidly changing environment demands multi-skilled, flexible workers, and the level of mastery of core competencies. A mentoring process is important to facilitate the improvement of human performance. With the important assumption that individual behavior (mantees and mentors) can be changed as it is aware of each individual is obliged to continuously learn (long life learner). Keywords: Mentoring, Performance Improvement, Innovatio

Pelatihan Strategi Feedback Efektif dalam Pembelajaran Kepada Guru Smk

Memberi feedback dalam setiap pembelajaran diyakini efektif untuk menjawab masalah belajar, asalkan guru bisa memahami langkah dan strategi yang sesuai karakter siswa, untuk itu pelatihan ini sangat dibutuhkan oleh karena itu guru-guru SMK Islam Darussalam sangat membutuhkan pelatihan-pelatihan seperti ini. Target program ini agar guru bisa menguasai, memahami, dan menerapkan strategi umpan Balik (feedback) dalam setiap pembelajaran. Metode yang digunakan dalam pelatihan ini yaitu pembinaan secara partisipatif. Adapun teknik pelaksanaan program ini akan dilakukan secara tim yang terdiri dari dosen, ditugaskan untuk mendampingi guru-guru agar pelaksanaan pelatihan berjalan secara optimal. Pelatihan ini dikhususkan guna memantapkan dan meningkatkan kemampuan guru dalam mengembangkan kreativitas mengajar guru di kelas serta memahami metode memberi feedbcak afektif. Program pelatihan ini dilaksanakan di SMK Islam Darussalam dengan melibatkan guru sebagai peserta. Berdasarkan hasil pelaksanaan pelatihan bahwa kemajuan kegiatan hingga laporan ini dibuat telah mencapai 90% mengacu pada proposal yang telah disusun sebelumnya dan serta berdasarkan target awal bahwa: (1) Guru sangat antusias mengikuti proses pelatihan, (2) Guru sudah bisa memahami strategi umpan Balik (feedback), (3) Ada inovasi baru bagi guru untuk memecahkan masalah kesulitan belajar siswa, (4) adanya respon baik guru bahwa 85% guru sangat puas, (5) dari mitra yaitu kepala sekolah berharap kegiatan seperti sangat bermanfaat sehingga dapat dilanjutkan kembali untuk program pengabdian berikutnya