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"Drug-drug interactions in pharmaceutical development comprehensively reviews the relevant science, industrial practice, and regulatory agency positions on drug-drug interactions. It focuses on the evaluation of potential drug-drug interactions, allowing researchers to address risk factors before a drug is put to market. The book covers both clinical and nonclinical aspects for understanding drug-drug interactions as well as in vitro and in vivo studies for use in studying interactions at the drug discovery stage."

"Pelayanan kefarmasian di apotek saat ini berorientasi pada kebutuhan pasien berdasarkan kondisi klinis atau penyakit. Pada beberapa kasus, pasien yang menebus resep pada apotek memiliki jumlah obat melebihi satu atau resep polifarmasi sehingga apoteker berperan dalam pengkajian dan analisis terkait efek samping dan interaksi dari obat-obat setiap bulan. Pengkajian dilakukan pada dua resep polifarmasi bulan Februari 2023 di Apotek Roxy Depok secara klinis melalui literatur klinis kemudian dilanjutkan dengan analisis mekanisme masing-masing obat dan mekanisme interaksi terhadap obat-obat lainnya terhadap kondisi klinis pasien sehingga diperoleh rekomendasi peresepan polifarmasi. Berdasarkan proses tersebut, resep polifarmasi 1 diperoleh 4 jenis efek samping yang tidak diresepkan obat lain dan 6 jenis interaksi obat yang perlu diedukasi serta resep polifarmasi 2 diperoleh 3 jenis efek samping yang tidak diresepkan obat lain, 1 jenis efek samping yang diresepkan obat lain, dan 1 jenis interaksi obat yang perlu diedukasi.

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Pharmaceutical services in pharmacies are currently oriented towards the needs of patients based on clinical conditions or diseases. In some cases, patients who fill prescriptions at the pharmacy have more than one drug or polypharmacy prescriptions, so pharmacists play a role in assessing and analyzing the side effects and interactions of drugs every month. The review was conducted on two polypharmacy prescriptions in February 2023 in Roxy Pharmacy Depok clinically through clinical literature then continued with the analysis of the mechanism of each drug and the mechanism of interaction with other drugs against the patient's clinical condition to obtain recommendations for polypharmacy prescribing. Based on this process, polypharmacy prescription 1 obtained 4 types of side effects that were not prescribed other drugs and 6 types of drug interactions that needed to be educated and polypharmacy prescription 2 obtained 3 types of side effects that were not prescribed other drugs, 1 type of side effect that was prescribed other drugs, and 1 type of drug interaction that needed to be educated."

"Hipertensi merupakan penyakit yang banyak di temukan di Indonesia, biasanya didefinisikan dengan peningkatan kronis tekanan arteri sistemik di atas nilai ambang tertentu dan ditentukan oleh jumlah darah yang dipompa oleh jantung dan resistensi arteri. Akibatnya, jantung bekerja lebih keras dan tekanan darah yang mengalir melalui pembuluh darah meningkat. Penyebab hipertensi dibedakan menjadi dua yaitu yaitu hipertensi primer dan hipertensi sekunder. hipertensi primer atau biasa disebut hipertensi esensial mendapatkan 95% penyebab hipertensi, dan 5% merupakan penyebab hipertensi sekunder yang disebabkan oleh penyakit ginjal atau biasa disebut dengan hipertensi renal. Penderita hipertensi ginjal biasanya mendapatkan jumlah obat yang lebih banyak dari penyakit hipertensi saja. Hal ini menyebabkan adanya lebih banyak interaksi obat yang terjadi, sehingga perlu dilakukan evaluasi pada setiap resep pasien dan juga pasien polifarmasi hipertensi. Penelitian ini bertujuan untuk menganalisis potensi interaksi obat dan memberikan solusi penanganan pada pasien poli hipertensi ginjal yang mendapatkan polifarmasi di Rumah Sakit Universitas Indonesia. Penelitian ini dilaksanakan dengan pengumpulan data variabel untuk mendapatkan gambaran interaksi obat pada pasien polifarmasi. Pengambilan data dilakukan secara retrospektif yaitu dengan melakukan penelusuran dokumen terdahulu pada resep dan web afya di Instalasi Rawat Jalan Rumah Sakit Universitas Indonesia. Hasil penelitian ini menunjukkan persentasi potensi interaksi obat minor didapatkan sebanyak 65%, moderat 60%, dan mayor 15%.

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Hypertension is a disease that is often found in Indonesia, usually defined by a chronic increase in systemic arterial pressure above a certain threshold value, and is determined by the amount of blood pumped by the heart and arterial resistance. As a result, the heart works harder and the blood pressure flowing through the blood vessels increases. The causes of hypertension are divided into two, namely primary hypertension and secondary hypertension. Primary hypertension or what is usually called essential hypertension accounts for 95% of the causes of hypertension, and 5% is the cause of secondary hypertension which is caused by kidney disease or what is usually called renal hypertension. Renal hypertension sufferers usually receive a greater amount of medication than those with hypertension alone. This causes more drug interactions to occur, so it is necessary to evaluate each patient's prescription and also hypertensive polypharmacy patients. This study aims to analyze potential drug interactions and provide treatment solutions for renal poly hypertension patients who receive polypharmacy at the University of Indonesia Hospital. This research was carried out by collecting variable data to obtain an overview of drug interactions in polypharmacy patients. Data collection was carried out retrospectively, namely by searching previous documents on prescriptions and the AFYA website at the Outpatient Installation of the University of Indonesia Hospital. The results of this study showed that the percentage of potential minor drug interactions was 65%, moderate 60%, and major 15%."

"Tuberkulosis merupakan salah satu penyakit infeksi pernapasan. Terdapat peningkatan kasus tuberkulosis dari tahun ke tahun, sehingga perlu upaya untuk meningkatkan keberhasilan terapi tuberkulosis, salah satunya manajemen interaksi obat. Penelitian ini bertujuan untuk menganalisis potensi interaksi obat pada pasien tuberkulosis di Rumah Sakit Universitas Indonesia periode 2022 - 2023. Penelitian ini menggunakan desain studi cross-sectional, jenis data restrospektif dari rekam medis pasien TBSO dan TBRO mulai usia anak hingga lansia. Analisis interaksi menggunakan Lexi-Interact®. Pasien tuberkulosis paru di Rumah Sakit Universitas Indonesia mayoritas berjenis kelamin laki-laki (51,8%), berusia dewasa (38,2%), memiliki jenis tuberkulosis sensitif obat (56,4%), dan mayoritas pasien memiliki komorbid (81,8%). Hasil analisis menunjukkan dari 110 pasien tercatat sebanyak 256 jenis interaksi obat, berdasarkan kategori risiko sebanyak 14,8% interaksi tergolong kategori B (No action needed), 66.4% interaksi kategori C (Monitor therapy), 15,6% interaksi kategori D (Consider modification therapy), dan 3,1% interaksi kategori X (Avoid combination). Berdasarkan mekanisme, tercatat 33,2% interaksi memiliki mekanisme farmakokinetik, 50,4% mekanisme farmakodinamik, 1,9% mekanisme farmakokinetik dan farmakodinamik, dan 14,5% mekanisme tidak diketahui. Berdasarkan tingkat keparahan 24,2% termasuk kelompok minor, 62,9% kelompok moderate, dan 12,9% kelompok major. Berdasarkan tingkat reliabilitas hanya 0,8% dari 256 jenis interaksi termasuk poor, selain itu 62,1% termasuk fair, 31,6% termasuk good, dan 5,5% termasuk excellent. Hasil uji korelasi Spearman’s rho menunjukkan adanya korelasi antara jumlah potensi interaksi obat dengan jumlah obat (p<0,05). Selain itu, hasil uji beda rerata menunjukkan adanya perbedaan rerata interaksi obat pada variabel komorbid, kategori tuberkulosis, dan usia (p<0,05). Dapat disimpulkan terdapat berbagai macam interaksi obat yang berpotensi terjadi pada pasien tuberkulosis di Rumah Sakit Universitas Indonesia, sehingga tenaga kesehatan perlu mempertimbangkan adanya modifikasi terapi dan pemantauan lanjutan terhadap efek samping yang mungkin timbul dari adanya interaksi obat.

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Tuberculosis is a respiratory infectious diseases. There is an increase in tuberculosis cases, so drug interaction management is needed to improve the therapy. This study aimed to analyze the potential drug interactions in tuberculosis patients at Universitas Indonesia Hospital for the period 2022 - 2023. The design is cross-sectional study, using retrospective data from all of pulmonary TB patients in age children until elderly. Interaction analysis using Lexi-Interact®. The majority of pulmonary tuberculosis patients at Universitas Indonesia Hospital were male (51.8%), aged adults (38.2%), had drug-sensitive tuberculosis (56.4%), and the majority of patients had comorbidities (81.8%). The results showed from 110 patients, 256 types of drug interactions were recorded. Based on the risk category, 14.8% category B (No action needed), 66.4% category C (Monitor therapy), 15.6% category D (Consider modification therapy), and 3.1% category X (Avoid combination). Based on mechanism, 33.2% of interactions had pharmacokinetic mechanism, 50.4% pharmacodynamic mechanism, 1.9% dual mechanism, and 14.5% unknown mechanism. Based on severity, 24.2% in the minor group, 62.9% in the moderate group, and 12.9% in the major group. Based on the level of reliability, only 0.8% from 256 types of interactions were poor, 62.1% were fair, 31.6% were good, and 5.5% were excellent. Spearman's rho correlation test results showed a correlation between the number of potential drug interactions with the number of drugs (p<0.05). Besides that, the mean difference test results showed a difference in the mean of drug interactions between variable comorbidities, tuberculosis categories, and age (p<0.05). The conclusion is there are various types of drug interactions in tuberculosis patients at Universitas Indonesia Hospital, so health workers should consider modifying therapy and monitoring of side effects that may arise from drug interactions."

"Penelitian ini bertujuan menganalisis efek samping dan interaksi obat pada resep polifarmasi di Apotek Roxy Depok selama Maret 2023. Metode penelitian menggunakan convenience sampling dengan total 3 resep. Hasilnya menunjukkan adanya interaksi obat signifikan. Pada resep pertama, terdapat 1 interaksi obat mayor (Captopril dan Spironolakton) dan 10 interaksi obat moderate, seperti Asam Asetilsalisilat dengan Captopril, Clopidogrel, dan Furosemide. Pada resep kedua, terdapat 1 interaksi obat mayor (Candesartan dan Spironolakton) dan 1 interaksi obat moderate (Bisoprolol Fumarate dan Ivabradin). Pada resep ketiga, terdapat 3 interaksi obat moderate(Amlodipin dengan Clopidogrel dan Fenitoin). Implikasi penelitian ini adalah kesadaran penting terhadap potensi efek samping dan interaksi obat pada resep polifarmasi. Interaksi obat dapat meningkatkan risiko efek samping serius, seperti hipotensi, nefrotoksik, hiperkalemia, dan gangguan gastrointestinal. Pengetahuan mengenai interaksi obat pada resep polifarmasi dapat membantu apoteker dan tenaga medis dalam mengevaluasi risiko manfaat obat yang diresepkan kepada pasien. Kesimpulan penelitian ini adalah terdapat 19 interaksi obat pada resep polifarmasi yang dianalisis, terdiri dari 1 interaksi mayor dan 18 interaksi moderate. Potensi efek samping obat meningkat akibat interaksi obat atau akumulasi efek samping dari penggunaan obat polifarmasi. Penting bagi tenaga medis mempertimbangkan efek samping dan interaksi obat saat meresepkan obat polifarmasi kepada pasien, serta melakukan pemantauan yang tepat terhadap pasien yang mengonsumsi obat tersebut.

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This study aims to analyze the side effects and drug interactions in polypharmacy prescriptions at Roxy Depok Pharmacy during March 2023. The research utilized a convenience sampling method with a total of 3 prescriptions. The results indicated significant drug interactions. In the first prescription, there was 1 major drug interaction (Captopril and Spironolactone) and 10 moderate drug interactions, such as Aspirin with Captopril, Clopidogrel, and Furosemide. In the second prescription, there was 1 major drug interaction (Candesartan and Spironolactone) and 1 moderate drug interaction (Bisoprolol Fumarate and Ivabradine). In the third prescription, there were 3 moderate drug interactions (Amlodipine with Clopidogrel and Phenytoin). The implications of this study highlight the importance of awareness regarding the potential side effects and drug interactions in polypharmacy prescriptions. Drug interactions can increase the risk of serious side effects, such as hypotension, nephrotoxicity, hyperkalemia, and gastrointestinal disturbances. Knowledge about drug interactions in polypharmacy prescriptions can assist pharmacists and healthcare professionals in evaluating the riskbenefit profile of prescribed medications for patients. In conclusion, this study identified 19 drug interactions in the analyzed polypharmacy prescriptions, including 1 major interaction and 18 moderate interactions. The potential for drug-related side effects is increased due to drug interactions or the cumulative effects of polypharmacy. Healthcare professionals need to consider the side effects and drug interactions when prescribing polypharmacy regimens to patients and to provide appropriate monitoring for patients consuming these medications."