Metoclopramide-OROS Dispersible Tablets Optimized Formula Bioavailability Study

BACKGROUND: Bioavailability and bioequivalence studies required by regulations to ensure therapeutic equivalence between a pharmaceutically equivalent test product and a reference product. AIM: This study aimed to evaluate the bioavailability performance between the optimum formula of OROS dispersible tablet-metoclopramide dosage forms (FCL-6) and the Primperan® as the reference product. METHODS: The FCL-6 formula was design by simplex lattice design model with a three components mixture of excipients: Solid tapai extract, corn starch, and Avicel. The optimum formula of OROS dispersible tablet (ODT)-metoclopramide consists of solid tapai extract (27.038 mg), corn starch (27.407 mg), and Avicel (53.555 mg), metoclopramide hydrochloric acid (HCl) (10.00 mg), LH-11 (22.50 mg), aspartame (5.00 mg), talcum BP (3.00 mg), and Mg stearate (1.50 mg). The in vivo test was done by cross-over design method using six rabbits. The level of metoclopramide concentration from in vivo test was measured by high-performance liquid chromatography instrument. RESULTS: The study revealed that the tmax, Cmax, and area under curve (AUC) of ODT-metoclopramide FCL-6 were 60 min, 1.95 ± 0.13 μg/mL, and 1118.20 ± 150 μg/mL. min consecutively. The Cmax and the concentration of the drug absorbed in the blood (AUC) of ODT-metoclopramide were larger than Primperan® tablets. Statistical data of the optimized ODT-metoclopramide compared with Primperan® showed that the Cmax and AUC significance values were <0.05 (p < 0.05). CONCLUSION: The optimized formula of ODT-metoclopramide revealed a better characteristic of Cmax and AUC concentration compared with Primperan®. The optimized ODT-metoclopramide with tapai extract was found to be promising to improved bioavailability of metoclopramide

The Development of Top 200 Prescribed Drugs in Community Pharmacies at Medan City as a Learning Tools

Objective: The pharmacy student at clerk-ship level and pharmacists need the drug information literature contains information of prescribed drug that utilized in pharmaceutical practice daily in order to learn effectively. The aims of the study was to develop top 200 prescribed drugs in community pharmacies at Medan city as a learning tools for the pharmacy students at clerk-ship level and pharmacists.Methods: The study was a descriptive study that used a cross sectional survey methodology. The top 200 items of prescribed drugs obtained from the pharmacies selected regarding to random sampling method. The study was conducted from August to November 2016. The top 200 prescribed drugs lists was developed in to a draft of drug information book and a group of pharmacy students at clerk-ship level and pharmacists was asked to evaluate the book and gave suggestions using a set of  questionnaire.Results: The top 200 prescribed drugs list revealed that the five most prescribed drugs was amoxicilline (5.55 %), followed by dexamethasone (4.44%), mefenamic acid (3.73%), cetirizine (3.16%), and ciprofloxacine (2.97%). The result of a draft of drugs information book evaluation that was evaluated by 120 pharmacy students and pharmacists showed the drug information book draft was good and able to publish. The respondents mention some suggestion for the book i.e.  Image made more attractive and in various colors and the image adjusted with an indication of drug†(43.74%) and Using language that is easily understood and more detailed information†(16.85%).Conclusions: The study has developed top 200 prescribed drugs in community pharmacies at Medan city in to a validated drug information book as a learning tool. The drug information book very useful for a continuing professional development program for pharmacists and build the pharmacy student's confidence before they face the real patients at the community pharmacy practice setting.Key words: Prescribed drugs, drug information, learning tool

DRUG THERAPY PROBLEMS IN MANAGEMENT OF HYPERTENSIVE OUTPATIENTS ADMITTED TO FOUR INDONESIAN PRIMARY HEALTH CENTERS

ABSTRACTObjective: This study aimed to evaluate the antihypertensive utilization and drug therapy problems (DTPs) in the treatment of patients withhypertension.Methods: This prospective analytical study used a self-determined questionnaire to collect 2-month period data of hypertensive patients (n=107)admitted to four primary health centers in Medan (Medan Deli, Helvetia, Glugur Darat, and Teladan). Inclusion criteria were patients diagnosedwith hypertension, age ≥18 years, and under treatment of antihypertensive drugs. Data collected include gender, age, education, the administeredantihypertensive drugs, and DTPs. Characteristics of the patients were descriptively analyzed. DTPs were identified based on strand classificationsystem and trustable literature. All analyzes were performed using Statistical Package for the Social Sciences (SPSS, version 19, Chicago, IL, USA)(p<0.05 was considered significant).Results: Characteristics of the patients: Male, 25.2%; female, 74.8%; mean age, 61.6±10.3 (years). Education: Primary school, 25.2%; junior highschool, 17.8%; senior high school, 43.9%; university, 13.1%. The most frequently provided antihypertensive drugs were amlodipine (47.7%) andcaptopril (22.4%). Overall, there were 66 DTPs experienced by 45.8% of the patients. Patients experienced: 1 DTP, 75.5%; 2 DTPs, 18.3%; 3 DTPs,2.1%; 4 DTPs, 4.1%. There was no significant association between the patients' education and DTPs, p=0.88. The most frequently occurred DTP (47%)was indication without drug therapy in which patients with hypertension Stage 2 only received single antihypertensive drugs mostly was captopril.Conclusion: The most frequently provided antihypertensive drug was captopril. DTPs in the management of hypertensive patients are still high inprimary health centers in Medan and need to be resolved.Keywords: Hypertension, Drug therapy problems, Strand classification

ANTIBIOTIC PRESCRIBING PROFILE FOR PEDIATRIC AT THE PHARMACY OF MEDAN CITY IN 2016

Objective: The aim of this study was to determine antibiotics prescribing profile for pediatric in Medan, Sumatra Utara (Indonesia) in 2016.Methods: This study was using a retrospective cross-sectional method study which conducted from October to November 2016 with data from July to August 2016. From 93 pharmacies, there are 2195 prescribed for pediatric and 740 (33.71%) prescriptions contained antibiotic. The antibiotic analyzed based on the group, type, duration of administration, and dosage-drug form along with the dose.Results: The antibiotic that mostly prescribed for pediatric was penicillin (amoxicillin) 329 prescriptions (44.46%). The onset of antibiotic revealed that 581 prescriptions (78.51%) were valid. The dosage form that most prescribed was syrup 230 prescriptions (31.08%). From 278 prescriptions, it showed that 177 (61.67%) prescriptions within an appropriate dose.Conclusion: It shows that penicillin (amoxicillin) was the most prescribed antibiotic for pediatric in Medan and there are still in appropriate dose selections

Characteristics, Antihyperglycemics Utilization, and Quality of Life in Patients with Type 2 Diabetes Mellitus Admitted to a Primary Health Center

Abstract. This study aimed to assess the characteristics, utilization of antihyperglycemic drugs, and to analyze the quality of life (QOL) in type 2 diabetes mellitus (T2DM) patients. This two-month prospective descriptive cross-sectional study was undertaken by distributing the European Quality of Life - 5 Dimensions 3 Level (EQ-5D-3L) questionnaire to the patients with T2DM  (n=50) admitted to Helvetia primary health center Medan to assessed their QOL. The patients’ characteristics and the utilization of antihyperglycemic drugs were assessed from the patients’ medical records using a self-designed questionnaire. The inclusion criteria were T2DM patients with age of 18 years or older,  had no mental disorders,  and agreed to sign the informed consent. The patients’ characteristics, their QOL, utilization of antihyperglycemic drugs, and association among their characteristics and QOL were analyzed using descriptive and Chi-Square tests. All analyses were performed using the Statistical Package for the Social Sciences (SPSS, version 19, Chicago, IL, USA) (p value <0.05 was considered significant). It was found that the mean age of the T2DM patients was 59.70 ± 10.44 (years). Most (66%) of them were females. Majority (80%) of the patients graduated from primary to senior high schools.  Nearly half (44%) of the patients was provided glibenclamide. The mean QOL of the patients was 0.79 ± 0.14. There was no significant association between the patients’ QOL and their characteristics (p values >0.05). This study proved that most of the T2DM patients were females. Glibenclamide was the most frequently prescribed drug for the patients. The QOL of the patients was 79% of full health. Keyword: Antihyperglycemic Drugs , EQ-5D, QOL, T2D

ANALISA COST OF ILLNESS AKIBAT PENGGUNAAN NSAIDS DI SEBUAH APOTEK DI KOTA MEDAN, INDONESIA

Background: A drug therapy problem is any undesirable event experienced by a patient which involves, or is suspected to involve drug therapy and that interferes with achieving the desired goals of therapy. Drug Therapy Problems (DTPs) can lead to ineffective pharmacotherapy and may cause drug-related morbidity and mortality.Objective: The study aimed to estimates the direct medical cost of illness caused by the drug morbidity or mortality related to NSAID utilization in a community pharmacy setting at Medan, Indonesia.Method: Thisstudy used 7 (seven) categories probabilities and costs associated with the therapeutic outcomes to estimate the direct medical cost of illness resulting from morbidity related NSAIDs utilization. Direct non medical costs, indirect costs, and intangible costs related to drug-related-morbidity and mortality were not valued in this cost-of-illness analysis.The duration of the study was from July 2009 to October 2010.Result: The patient that experienced NSAIDs-related morbidity estimated to spend Rp.467.848,- each and Rp.11.696.200,- in total to managing the morbidity. Every Rp.1,- spent on NSAIDs therapy, an additional Rp.1,45,- was estimated to spent in managing morbidity related NSAIDs utilization.Conclusion: This result showed the cost of illnessrelated morbidity of NSAIDs utilization exceeds the cost of the medications themselve

Pengetahuan Asma: Pengaruh Pemberian Buku Edukasi Asma Terhadap Peningkatan Pengetahuan Guru-guru Sekolah Dasar

The knowledge of teachers on asthma and its managements are very important, in order that teachers can provide the assistance required by the students in primary school who suffered an asthma attack while at school. This study aimed to examine the effect of an educational book to improve knowledge among primary school teachers on asthma and its management. This study was descriptive study, using questionnaires and educational book “Asthma: The Role of Teachers in the Management of Asthma in Schools”. The research was conducted in 3 phases: (1) asses the knowledge of teachers on asthma before being given an educational book, (2) administration of an educational book “Asthma: The Role of Teachers in the Management of Asthma in Schools”, (3) re-asses the knowledge of teachers on asthma after administration an educational book. A total of 48 teachers from three primary schools in the Medan Deli District involved in the study. In general, their knowledge of asthma before being given education is fairly low. After administering education the teacher knowledge increased, this can be seen from the increase in the number of teachers who answered correctly on any given question. An increase of almost 30% of teachers who correctly answer to questions about the causes of asthma after booklet administration and about 20% for questions about symptoms, and treatment of asthma. It can be concluded that the educational materials such as educational book has the effect to increase the knowledge of teachers about asthma and its treatment. It can be seen from the existence of increase in the number of teachers who answered correct on every the question given. This study concluded that the educational book entitle “Asthma: The Role of Teachers in the Management of Asthma in Schools “ has effective to improve knowledge among primary school teachers on asthma and its managements.Pengetahuan guru terhadap penyakit asma dan perawatannya adalah sangat penting agar guru-guru dapat memberikan bantuan yang diperlukan oleh murid-murid di sekolah dasar yang mengalami serangan asma ketika waktu sekolah. Penelitian ini bertujuan untuk menguji pengaruh edukasi berupa buku untuk meningkatkan pengetahuan guru sekolah dasar terhadap penyakit asma dan perawatannya. Penelitian ini merupakan penelitian deskriptif menggunakan kuesioner dan bahan edukasi berupa buku “Asma: Peranan Guru dalam Pengobatan Asma di Sekolah”. Penelitian ini dilakukan dalam 3 tahap yakni: (1) menilai tingkat pengetahuan guru sebelum edukasi, (2) pemberian buku edukasi, dan (3) menilai kembali tingkat pengetahuan guru setelah edukasi. Sebanyak 48 orang guru dari 3 Sekolah Dasar di Kecamatan Medan Deli terlibat dalam penelitian ini. Secara umum tingkat pengetahuan mereka terhadap asma sebelum diberikan edukasi adalah cukup rendah. Setelah pemberian edukasi pengetahuan guru meningkat hal ini dapat dilihat dari adanya peningkatan jumlah guru yang menjawab benar pada setiap pertanyaan yang diberikan. Terjadi peningkatan sebanyak hampir 30% guru menjawab benar pada pertanyaan mengenai penyebab asma setelah pemberian buklet dan sekitar 20% untuk pertanyaan mengenai gejala, dan perawatan asma. Penelitian ini dapat disimpulkan bahwa bahan edukasi berupa buku “Asma: Peranan Guru dalam Pengobatan Asma di Sekolah” mempunyai pengaruh untuk meningkatkan pengetahuan guru-guru mengenai penyakit asma dan perawatannya

Evaluation of antibiotics using ATC/DDD and DU 90% methods on ICU patients at Universitas Sumatera Utara Hospital

Background: Evaluation of the use of antibiotics is the control of antimicrobial resistance. The ATC/DDD method was recommended to evaluate drug use quantitatively which can be used to compare the quantity of antibiotic use between hospitals and between countries. This research was a descriptive study with retrospective data collection cross-sectional. This research was conducted at the ICU of Universitas Sumatera Utara hospital in August-November 2022 from medical record data for the period January-December 2021 which included patient demographics, patient diagnoses, antibiotic dosage forms, routes of administration, types of antibiotics, dosage, duration of antibiotics use, and duration of treatment. Methods: Evaluation of antibiotic doses using the ATC/DDD method. The results of the study from 57 medical records that met the inclusion criteria showed that the ICU patients who used the most antibiotics were male (59.7%), the age group was >56 years (56.14%), patient diagnoses with COVID-19 (33.33%), and the dosage form was injection with the intravenous route of administration. The most frequently used antibiotics were levofloxacin (48.54%) 45.61 DDD/100 patient-days and ceftriaxone (30.06%) 28.25 DDD/100 patient-days, and the average value of Length of Stay (LOS) is 5.4 ±3.98 days with a total DDD/100 patient-days value of 93.96 (reference value of 51–67 DDD/100 patient-days). DU 90% segment namely levofloxacin (48.69%), ceftriaxone (30.16%) and meropenem (12.82%). The results of the study concluded that the use of antibiotics in ICU patients at Universitas Sumatera Utara Hospital showed a high DDD/100 patient-days rate. Therefore, it is necessary for hospital to continuously monitor and evaluated the rational use of antibiotics to prevent resistance of antibiotics

Pengembangan Minuman Herbal Sumber Antioksidan dari Limbah Buah Kopi Desa Gajah Kabupaten Karo

                                                                                                                           Abstrak Desa Gajah Kecamatan Simpang Empat Kabupaten Karo merupakan salah satu desa dataran tinggi di Kabupaten Karo dimana mayoritas masyarakatnya merupakan petani buah dan sayur, seperti petani kopi. Biasanya biji kopilah yang dijual ke pasaran dan kulitnya (cascara) akan dibuang. Namun, dengan aktivitas antioksidan kulit kopi dapat memberi potensi yang besar baik untuk kesehatan maupun ekonomi masyarakat apabila dimanfaatkan sebagai minuman kesehatan herbal. Cascara apabila dikombinasikan dengan jahe dapat memberi berbagai manfaat seperti menghangatkan badan, meredakan mual, melindungi lambung dan mengurangi frekuensi GERD, dan kesehatan kardiovaskular. Pengabdian masyarakat ini dilaksanakan melalui ceramah oleh tim dosen Fakultas Farmasi USU, demonstrasi video pembuatan RaJa, dan pre-test dan post-test. Uji keamanan produk juga dilakukan – Uji AKK memberikan hasil 1855 koloni/g pada jaeh, dan 1120 koloni/g pada cascara; Uji Sari Larut Etanol memberikan hasil 18,75% untuk jahe dan 55% untuk cascara; dan Uji Abu Tidak Larut Asam memberikan hasil 2,05% untuk jahe dan 0,21% untuk cascara. Hasil ini menunjukkan bahwa teh RaJa aman untuk dikonsumsi. Dapat disimpulkan bahwa pengabdian masyarakat telah menunjukkan efektivitasnya dalam membantu dan menguntungkan masyarakat.   Kata Kunci: cascara, jahe, antioksidan, teh, desa gajah &nbsp

Variety of Learning Resolutions in the Covid 19

Variety of Learning Resolutions in the Covid 19 is a book presenting the various teaching learning methods implemented by the educators in different countries.&nbsp