Assessment of Potentially Inappropriate Medication (PIMs) in Older Adult Patients at the Geriatric Polyclinic of a General Hospital in Central Java

One of the most critical issues affecting older adults is the increasing use of potentially inappropriate medication (PIMs). The use of PIMs is associated with drug-related problems, as well as undesirable drug effects. This study aimed to assess the prevalence of potentially inappropriate medication and the most commonly prescribed PIMs category in older adults. This research method is observational with a cross-sectional design. Drugs were analyzed using the 2019 Beers criteria compiled by The American Geriatrics Society (AGS), classifying PIMs into five categories. The inclusion criteria in this study were patients aged ≥65 years, using at least one drug, with a duration of drug use of at least one month, and analyzing this research data descriptively. The results showed that out of 134 prescriptions consisting of 773 drug items, 95 drug items were potentially inappropriate for use in older adults. The prevalence of PIMs was 12%, and if classified by category, then partly in order, inappropriate medication included category 1 (8.2%); category 2 (0.6%); category 3 (2.8%); category 4 (0.3%); category 5 (0.1%). The most common drugs included in category 1 PIMs criteria were proton pump inhibitors (PPIs), namely lansoprazole and omeprazole. Conclusion: In this study, the prevalence of potentially inappropriate Medication in older adults was 95 drug items (12%), and the more commonly prescribed category of PIMs is category one drugs and should avoid category one drugs in older adults

Viral infection in a murine model of allergic airways inflammation: actions of corticosteroids

Viral respiratory infection exacerbates asthma symptoms in almost all patients with allergic asthma. Asthma symptoms in viral associated asthma exacerbation are often severe and require urgent care as well as hospitalisation. Corticosteroids are the mainstay treatment for asthma. However, they are less effective in treating virus associated asthma exacerbation. The main aim of the thesis is to determine the role of virus infection in airway allergic inflammation and then define the effects of corticosteroids in virus associated exacerbations of airway allergic inflammation. Mice sensitised and challenged with ovalbumin demonstrated most of the main features of asthma including lung cellular inflammation with eosinophilia, early phase asthmatic responses (EAR), late phase asthmatic responses (LAR), and airway hyperresponsiveness (AHR) to methacholine provocations. Treatment with either systemic (dexamethasone: DEX) or inhaled (fluticasone propionate: FP) corticosteroids in the murine ovalbumin allergic airways inflammation model attenuated inflammatory cells influx and eosinophilia, LAR, and the AHR. Influenza A (H1N1/PR8) is the most infective to mice compared to human parainfluenza virus type 3 (HPIV3), and a synthetic dsRNA, poly (I:C). Influenza infection in mice caused a significant increase of inflammatory cell influx in the airways with marked neutrophilia, and AHR. Ovalbumin challenge in the acute course of influenza infection on a murine model of allergic airways inflammation exacerbated the inflammatory cells influx, LAR, and AHR. Treatment with either DEX or FP attenuated the airway cellular inflammation, LAR, but not the AHR. Mice only infected with influenza were resistant to the corticosteroids (DEX and FP) treatment. DEX but not FP showed antiviral activity against HPIV3 and influenza A in vitro. These data suggest that influenza infection in a murine model of allergic airways inflammation exacerbates the inflammation and alters the sensitivity toward corticosteroids. It is also suggested that some elements in the influenza associated exacerbation of murine model of allergic airways inflammation are refractory or not regulated by corticosteroid treatment

Evaluasi Penggunaan Antibiotik pada Pasien Infeksi Saluran Kemih di RSPAU dr. S. Hardjolukito Yogyakarta Tahun 2014

A urinary tract infection (UTI) is an infection in any part of your urinary system such as kidneys, ureters, bladder and urethra. Most infections involve the lower urinary tract, the bladder and the urethra. This type of research is an observational (non-experimental) with a descriptive study design and the data was collected by purposive sampling technique. The samples of this study were the patients who suffer from urinary tract infections in RSPAU dr. S. Hardjolukito Yogyakarta. The purpose of this study was to evaluate the accuracy of the antibiotics usage for the patients who suffer from urinary tract infections in RSPAU dr. S. Hardjolukito Yogyakarta in 2014, with the proper parameters indication, the right drug, right patient, right dosage and use standards references ofPermenkes 2014, IDSA Guideline in 2011 and Guidelines for the management of serve and septic shock in 2004 in the book of Dipiro 2008. Based on the results of this study, it is concluded that the proper indication that meet the criteria of 100% for 40 patients, the right patients 100% for 40 patients, 90% for the right medication and the right dosage for 36 patients 17.5% for 7 patients by the rational usage of antibiotics as 17.5% for 7 patients. Antibiotics which is often use is ciprofloxacin as a drug of choic

Evaluasi Penggunaan Obat pada Pasien Balita Terkena Diare pada Pasien Rawat Inap RSUD Kota Surakarta Tahun 2014

Diarrhea is a disease which marked by increasing frequency of defecation more than three times in a day that accompanied by liquid stools with or without blood or mucus. According to Word Gastroenterology organisation (2012), management of children with acute diarrhea consist of oral rehidration, zinksuplements therapy, diet, probiotics, and antibiotics. The purpose of this research is to evaluate the rational use of antibiotics, antidiarrhearesion, and probiotics prescribing in children (0-5 year old) with diarrhea inpatient of X hospital. The research is a-non experimental research. Datarestropectively was obtained from medical record. Data was descriptively analyzedsixty nine patients were included as sample by purposive sampling method. Results of the evaluation of antibiotic use in X hospital were given with right indication 46.38%, with the right patients 100%, with the right drug 100%, and the right dose 4.35%. Results of the evaluation of Zink with the right indication, patients, drug were 94.20%, and the right dose were given to 53 patients 76,81%. Results of the evaluation of probiotics with the rightindication, patients, drug were89.68%, and the right dose were 14.50%

Faktor-Faktor Yang Mempengaruhi Ketidakpatuhan Pada Pasien Asma Rawat Jalan Di Rsud Kota Surakarta Periode November-Desember 2017

Lack of patient knowledge about health is the most important issue in compliance. Compliance of patients in therapy is needed to achieve the success of therapy. Non-adherence to therapy can have a negative effect, one of which is the uncontrolled asthma or frequent asthma relapse. This research includes analytic type research. The research was done by cross sectional approach that is research done at one time or at the same time to know relation between independent variable and dependent variable. Respondents in the research conducted in RSUD Surakarta period November-December 2017 as many as 68 respondents. The variables that influence non-compliance are education (p value = 0,017), knowledge (p value = 0,049) and communication (p value = 0,003)

Hubungan Persepsi Tentang Hipertensi Dengan Kepatuhan Meminum ObatPada Pasien Hipertensi Di Poliklinik Penyakit Dalam RSUD Wates Yogyakarta

Hypertension is widely known as a cardiovascular disease in which the patient has a blood pressure a bove normal and it is a chronic disease that needs to be treated properly and continuosly. One determinant of the success of therapy is medication adherence by patients. This study aims to determine the relationship between the perception of patients about hypertension with adherence to taking drugs in hypertensive patients in the internal diseases clinic in wates local hospital, Yogyakarta. Primary data were obtained from 96 respondents taken using purposive sampling technique. Data were analyzed by descriptive method and chi square. The result of descriptive analysis shows that 62,5% of respondents have high perception or good, and 37,5 % perception is low. There were 65,6% of respondent had high medication adherence and 34,4% medication adherence was moderate. The result of chi square analysis showed that there was a positive and significant correlation between perception about hypertension with medication adherence which is shown by chi square 6,23 with p-value 0,013 < 0,05. The higher the level of respondent perception, the higher the level of compliance

Evaluasi Penggunaan Antibiotik pada Pasien Pneumonia di RSUD Sukoharjo Tahun 2014

Pneumonia is an infection of the lung tissue caused by viruses or bacteria. Antibiotics used as a treatment in pneumonia to inhibit the growth of virus or bacteria. Antibiotics are used improperly can lead to less effective in the treatment. This research aimed to evaluate the accuracy of the use of antibiotics in pneumonia patients in hospitals Sukoharjo 2014 compared with the guidelines of the Association of Physicians Pulmonary Indonesia 2003. This research is non-experimental with retrospective data collection in adult patients, then the data were analyzed descriptively. Samples were taken by purposive sampling method. Of the 28 adult patients diagnosed with pneumonia, found the use of antibiotic penggunan cefixime (57,14%), cefadroxil (3,57%), levofloxacin (21,42%), ceftazidime (7,14%), dan cefotaxime (10,71%). Further analysis is appropriate indications, patient, medication and dosage based Association of Physicians Pulmonary Indonesia in 2003, acquired a 100% accuracy indication, patients 100% accuracy, precision medicine by 100%, and accuracy of the dose by 78,571%. Then, from this evaluation showed that 22 patients (78,571%) use of antibiotic were rationa

NEUROTOXICITY EFFECT IN CANCER REGIMENT CARBOPLATIN-PACLITAXEL

Objective: Side effects due to chemotherapy were frequently reported and some of them require immediate treatment. Cervical cancer, breast cancer, and ovarian cancer are types of cancer that are often found in Dr. Moewardi Surakarta Hospital and 45% of the three types of cancer used the chemotherapy regimen of carboplatin-paclitaxel. Carboplatin-paclitaxel was chosen because it is a regimen that has fewer side effects. Methods: This study aims to identify the type of adverse drug reactions (ADRs) neurotoxicity, percentage, and severity, as well as to determine the risk factors for the occurrence of ADRs such as age, gender, type of cancer, number of cycles, length of stay, and types of comorbidities in cancer patients using carboplatin-paclitaxel therapy regimen in RSUD Dr. Moewardi Surakarta for the period September to December 2019. This study was an observational study with a cross-sectional design through prospective data searches. The inclusion criteria in this study were adult cancer patients on carboplatin-paclitaxel therapy who were willing to be research subjects. Results: The incidences of ADRs in patients using the carboplatin-paclitaxel therapy regimen in this study were sensory peripheral neuropathy (77.69%); motor peripheral neuropathy (3.31%); joint pain (53.72%); and muscle weakness (37.19%) The instrument to measure the severity in this study used common terminology criteria for adverse events with the results of ADRs with grade 1 (35.08%), grade 2 (61.02), grade 3 (2.88%), and at grades 4 and 5 (0%). Risk factors for gender, age, length of stay, type of cancer, number of cycles, and comorbidities did not affect the incidence of neurotoxicity in cancer patients with the carboplatin-paclitaxel therapy regimen

Evaluasi Penggunaan Antibiotik Pada Pasien Anak Terdiagnosa Infeksi Saluran Pernapasan Atas Akut (Ispaa) di Instalasi Rawat Jalan Balai Besar Kesehatan Paru Masyarakat Surakarta Tahun 2014-2016

Acute upper respiratory tract infection (AURTI) is an acute infection of one of the upper respiratory tract components including the nose, sinus, pharynx, and larynx. AURTI often attacks children because the immune system is still weak. The rationale of antibiotic use will affect the success and safety of therapy. This study aims to determine the rationality of therapy based on precise parameters of patients, exact drugs, and exact doses in BBKPM Surakarta 2014-2016. Subjects were 96 subjects with inclusion criteria of patients diagnosed with AURTI age 0-12 years who underwent outpatient and received antibiotic therapy with complete medical record. Retrospective data collection using purposive sampling method using medical record in BBKPM Surakarta. Data were analyzed descriptively. Evaluation of antibiotic prescribing in AURTI child patients in terms of the patient's exact, precise, and exact dose. Rationality of usage of antibiotics covering 96 patients (100%), exact medicine 67 cases (69,54%), exact dose of antibiotics 1 case (1.22%), exact frequency of 81 cases (98,78 %), and the exact duration of 6 cases (7.32%). The most widely used antibiotic is cefadroxil in 75 cases (78%)

Identifikasi DRPs (Drug Related Problems) Pada Pasien Rawat Inap Diabetes Mellitus Tipe 2 Geriatri Di Rumah Sakit Umum Aisyiyah Ponorogo Tahun 2019

Diabetes mellitus is a metabolic disease characterized by hyperglycemia that occurs because the pancreas is unable to secrete insulin, insulin work disorders, or both, resulting in long-term damage and failure of various organs such as the eyes, kidneys, nerves, heart, and blood vessels when in a state of chronic hyperglycemia. An elderly patient (geriatric) is someone who reaches the age of 60 (sixty years) and over. Elderly patients generally experience decreased organ function and receive various kinds of drugs, making them prone to experiencing DRPs. DRPs are conditions associated with drug therapy that significantly or potentially interfere with desired clinical health outcomes. This study aims to identify the types of DRPs and to analyze the influence of age, sex, polypharmacy, comorbidities and length of stay on the incidence of DRPs in geriatric patients undergoing hospitalization. This research is a descriptive cross sectional study with 125 medical records for the period March - May 2019 at the Inpatient Installation of Aisyiyah Hospital, Ponorogo. The inclusion criteria in this study were geriatric patients aged over 60 years with a diagnosis of type 2 diabetes mellitus, receiving diabetes drug therapy during treatment at Aisyiyah Ponorogo Hospital and having complete medical record data. The results of the study of 125 patients studied, there were 78 patients (62.4%) who experienced DRPs. In the DRPs problem category there were 82 events with the following details: unnecessary drug therapy was 74 events (90.24%), adverse drug reaction was 3 events (3.66%), indications or symptoms were not handled as many as 3 events 3.66%), and the treatment effect was not optimal for 2 events (2.44%). Whereas in the category of causes of DRPs there were 91 causes with the following details: DRPs that occurred because of drug selection, there were 77 events (84.62%), 14 events (15.38%) in the choice of dose. There is a relationship between risk factors for polypharmacy and comorbidities with the incidence of DRPs. Polypharmacy p value = 0.015, comorbidities p value = 0.009 the value is <0.05, the test uses the chi square, the confidence level used is 5% with OR and CI values of 2.750 (1.277-5.924) and 3.571 (1.418-8.993) respectively