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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."

"Summary:A range of new and innovative tools used for preformulation and formulation of medicines help optimize pharmaceutical development projects. Such tools also assist with the performance evaluation of the pharmaceutical process, allowing any potential gaps to be identified. This book considers these key research and industrial tools."

"Pendahuluan: PGK merupakan penyakit yang sering memiliki beberapa komorbid sehingga perlu menggunakan berbagai terapi kombinasi obat. Oleh sebab itu, polifarmasi sering dilakukan dan salah satu konsekuensinya adalah terjadinya potensi interaksi obat (PIO). PIO dianggap sebagai masalah pengobatan yang dapat dicegah, namun dalam praktik klinis dapat mengakibatkan efek samping obat (ESO) atau reaksi obat yang merugikan. Hal tersebut tentu akan mempengaruhi klinis dan keberhasilan pengobatan serta keamanan penggunaan obat pada pasien PGK. Penelitian ini bertujuan untuk mengetahui pola peresepan pasien PGK dan pengaruhnya terhadap potensi interaksi dan efek samping obat yang dicurigai akibat interaksi obat. Metode: Penelitian ini merupakan penelitian non eksperimental dan pengambilan data dilakukan secara potong lintang pada pasien PGK rawat jalan stadium 3-5 pre-dialisis di rumah sakit Cipto Mangunkusumo (RSCM) dalam periode Januari 2019 sampai dengan Desember 2020. Data diambil dari electronic health record dan pusat rekam medis RSCM. Rujukan potensi interaksi obat menggunakan software Micromedex. Hasil: Terdapat 106 pasien yang memenuhi persyaratan dan diambil menjadi subjek penelitian. Hasil penelitian menunjukkan bahwa pada pasien PGK rawat jalan stadium 3- 5 pre-dialisis di RSCM tahun 2019-2020, terdapat 111 jenis obat yang diresepkan dan obat yang paling sering diresepkan adalah bisoprolol (36,5%). Proporsi pasien yang mendapatkan pengobatan dengan potensi interaksi obat adalah 76% (81 pasien), sedangkan proporsi pasien yang mengalami ESO yang dicurigai akibat interaksi obat adalah 28% (23 pasien) dari 81 pasien dengan PIO. ESO tersebut berupa hiperglikemi (17 pasien), hipertensi (1 pasien), hiperkalemi (1 pasien) dan hipotensi (1 pasien). Terdapat hubungan yang bermakna secara statistik antara variabel perancu yaitu, jumlah obat > 10, komorbid jantung dan DM dengan ESO yang dicurigai akibat interaksi obat (p<0.05). Hasil multivariat mendapatkan hanya komorbid jantung (gagal jantung dan penyakit jantung koroner) yang memiliki hubungan yang bermakna secara statistik dengan ESO yang dicurigai akibat interaksi obat (p = 0,03). Kesimpulan: Pada penelitian ini, sebanyak 76% pasien mendapatkan pengobatan dengan PIO. Sedangkan 28% pasien dari 81 pasien dengan PIO mengalami ESO yang dicurigai akibat interaksi obat. ESO yang paling banyak dialami adalah hiperglikemi. Komorbid jantung merupakan faktor risiko terjadinya ESO yang dicurigai akibat interaksi obat.

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Introduction: CKD often has several comorbidities so it is necessary to use various drug combination therapies. Therefore, it can lead to polypharmacy and one of its consequences is the occurrence of potential drug-drug interactions (DDI). DDI is considered a problem that can be prevented, but in clinical practice it can result in adverse drug reactions (ADR). This will certainly affect the clinical and treatment success as well as the safety of the drug use in CKD patients. This study was aimed to determine the prescribing pattern and its effect on potential DDI and ADR that are suspected due to DDI.

Methods: This was a non-experimental cross-sectional study, conducted on CKD outpatients stage 3-5 pre-dialysis at Cipto Mangunkusumo Hospital in the period January 2019 to December 2020. Data were taken from electronic health records and the hospital’s medical record. The Micromedex software was used as a reference for potential drug interactions.

Results: There were 106 patients who met the requirements and were taken as research subjects. The results showed that in CKD out-patients stage 3-5 pre-dialysis at RSCM in 2019-2020, there were 111 types of drugs prescribed and the most frequently prescribed drug was bisoprolol (36.5%). The proportion of patients who received treatment with a potential DDI was 76% (81 patients), while the proportion of patients who experienced ADR suspected due to DDI was 28% (23 patients) from 81 patients with suspected DDI. The ADRs were hyperglycemia (17 patients), hypertension (1 patient), hyperkalemia (1 patient) and hypotension (1 patient). There was a statistically significant association between the confounding variables, namely, number of drugs, cardiovascular disease and DM with ADR suspected due to DDI (p<0.05). Multivariate analysis found that only cardiovascular disease (congestive heart failure and coronary artery disease) had a statistically significant relationship with ADR suspected due to DDI (p = 0.03).

Conclusion: In this study, 76% of patients received treatment with potential DDI. Meanwhile, 23% from 81 patients patients with DDI experienced ADR suspected due to drug interactions. The most often occuring ADR is hyperglycemia. It was found that cardivascular comorbidity is a risk factor for having an ADR suspected cause by DDI."

"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%."