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"A reduction in lung capacity to oxygenize blood as well as in cardiovascular capacity to distribute blood may cause hypoxemia, which could then lead to tissue hypoxia and cellular death. The aim of oxygen treatment is to supply the minimum oxygen concentration needed to achieve adequate tissue oxygenation. There are various methods that can be used to supply oxygen, and the amount of oxygen requirement could also be calculated. Treatment methods are classified into STOT and LTOT. The benefit of oxygen treatment is increased survival, influence on the blood vessels, improved exercise capacity, and positive influence on the respiratory and neuropsychological systems. As with the case with pharmacological treatment, oxygen should be administered at certain doses to achieve greatest efficacy with the least toxicity."

"Long-term oxygen therapy (LTOT) usually represents the final step in the management of severe chronic respiratory diseases. The focus of this volume is on new insights and novel perspectives of LTOT. Starting from consolidated experiences, it's aim is also to emphasize the strategic value of developing technologies and innovative organizational models uniquely to find out even more opportunities and advantages for the management of chronic respiratory patients needing long-term oxygen treatment."

"Keluhan utama yang paling sering dirasakan pasien PPOK adalah sesak. Salah satu intervensi keperawatan untuk meningkatkan kepercayaan diri dalam upaya mengatasi sesak pasien PPOK adalah efikasi diri pursed lip breathing. Penelitian ini bertujuan mengetahui pengaruh efikasi diri pursed lip breathing terhadap penurunan sesak dan peningkatan saturasi oksigen pasien PPOK. Desain penelitian adalah randomized controlled trial dengan rancangan penelitian pretest-postest design. Penelitian ini melibatkan 36 responden dengan menggunakan teknik randomisasi blok terbagi menjadi 18 responden kelompok intervensi dan 18 responden kelompok kontrol. Hasil analisis statistik didapatkan bahwa terdapat perbedaan yang bermakna penurunan sesak dan peningkatan saturasi oksigen antara kelompok intervensi dan kelompok kontrol setelah intervensi dengan nilai p < 0.001. Efikasi diri pursed lip breathing dapat dijadikan salah satu alternatif intervensi keperawatan manajemen jalan napas pada pasien PPOK.

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The main complaints are most often perceived COPD patient is dyspnea. One of nursing interventions to increase self confidence in the effort to overcome the dyspnea of COPD patients are self-efficacy of pursed-lips breathing. This study objective was to see the influence of self-efficacy of pursed-lips breathing on dyspnea reduction and oxygen saturation increase in COPD patients. A randomized controlled trial with pretest-postest method were used as the study design. This study involved 36 respondents divided into intervention and control group by block randomization. The statistic analysis result shows a difference between the two groups after the interventions were made which means there were dyspnea reduction and oxygen saturation increase at value p < 0.001. selfefficacy of pursed-lips breathing can be applied as one of alternative nursing intervention for COPD airway management."

"Apoteker memiliki berbagai peran penting dalam pengaturan praktik farmasi. Penyelenggaraan praktik atau pekerjaan kefarmasian meliputi pekerjaan kefarmasian dalam pengadaan, produksi, distribusi, dan pelayanan sediaan farmasi. Seorang profesi apoteker perlu menguasai standar kompetensi apoteker dalam melakukan praktik kefarmasian sesuai dengan kompetensi profesi. Standar tersebut memastikan bahwa seorang apoteker memiliki seluruh kompetensi yang relevan untuk mejalankan perannya dan mampu memberikan pelayanan kefarmasian sesuai ketentuan tentang praktik kefarmasian, peraturan, etika, kode etik, dan pedoman praktik apoteker. Terdapat sepuluh (10) elemen standar kompetensi apoteker yang perlu dikuasai sebagai persyaratan untuk memasuki dunia kerja dan menjalani praktik profesi. Standar kompetensi telah dilengkapi oleh elemen yang perlu dikuasai oleh apoteker pada saat lulus dan masuk ke tempat praktik/kerja. Sebagai calon apoteker, pentingnya membekali mahasiswa dengan pengetahuan dan kemampuan tentang peran, fungsi dan tanggung jawab apoteker melalui Praktik Kerja Profesi Apoteker (PKPA). Dengan dilaksanakannya PKPA, seorang calon apoteker diharapkan memiliki wawasan, pengetahuan, keterampilan dan pengalaman untuk melakukan pekerjaan kefarmasian sehingga menjadi siap untuk memasuki dunia kerja sebagai tenaga farmasi yang professional.

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Pharmacists work in diverse roles and practice settings. The implementation of pharmacy practice includes pharmaceutical work in the procurement, production, distribution of pharmaceutical preparations and and pharmaceutical care. A pharmacist is expected to master pharmacy standard competency to maintain and practice within the limits of professional competence. The standard competency is a commitment to practice with an an obligation to do in accordance with expected behaviours as set down in professional codes, standards and guidelines which results in facilitating professional practice and growth. There are 10 elements of pharmacy competency standards which need to be attained by an individual to practise effectively as a pharmacist. It is important to equip students with knowledge and abilities about the roles and responsibilities of pharmacists in the real field through an internship program. A future pharmacist is expected to have the insight, knowledge, skills and experience through the internship program in order to be become a professional in the pharmacy practice."

"Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality worldwide. By 2020, COPD is expected to be the fifth leading cause of disability and the third leading cause of death. COPD is associated with significant co-morbid illnesses including cardiovascular disease, pulmonary vascular disease, osteoporosis, depression and thoracic malignancies. In addition, COPD patients often have systemic manifestations of their disease, including peripheral muscle dysfunction, decreased activity levels and nutritional abnormalities, all of which contribute to poor functional status, decreased quality of life and increased health care utilization. Lack of recognition and understanding of the complex interactions of these common co-morbid conditions and systemic effects often contributes to sub-optimal care for patients with COPD."

"ABSTRAKNama:Nining IndrawatiProgram Studi:Magister KeperawatanJudul :Pengaruh Home Based Nursing Pulmonary Rehabilitation terhadap Sesak Napas dan Fatigue pada pasien PPOKPembimbing:Prof. Dr. Ratna Sitorus, S.Kp., M.App.Sc.Dr. Debie Dahlia, S.Kp., MHSM Home based nursing pulmonary rehabilitation adalah program rehabilitasi paru keperawatan di rumah yang berfokus pada kebutuhan pasien. Penelitian ini bertujuan untuk mengetahui pengaruh home based nursing pulmonary rehabilitation terhadap sesak napas dan fatigue pada pasien PPOK. Penelitian ini menggunakan desain quasy experimental pre test and post test control group. Sampel terdiri dari 30 pasien PPOK yang terbagi atas 15 orang pada kelompok intervensi dan 15 orang pada kelompok kontrol. Analisis data menggunakan uji t-test untuk sesak napas dan fatigue. Hasil analisis menunjukkan ada perbedaan yang bermakna antara sesak napas sebelum dan sesudah dilakukan home based nursing pulmonary rehabilitation pada kelompok intervensi dan kelompok kontrol p= 0,0005 ; p< ? . Hasil analisis selanjutnya menunjukkan ada perbedaan yang bermakna antara fatigue sebelum dan sesudah dilakukan home based nursing pulmonary rehabilitation pada kelompok intervensi p= 0,0005 ; p< ? . Home based nursing pulmonary rehabilitation merupakan intervensi yang terbukti efektif, murah dan mudah dilakukan untuk mengatasi sesak napas dan fatigue pada pasien PPOK.Kata kunci :fatigue, home based nursing pulmonary rehabilitation, pasien PPOK, sesak napas

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ABSTRACTName Nining IndrawatiStudy Program Master of Nursing Title The Effect of Home Based Nursing Pulmonary Rehabilitation on Dyspnea and Fatigue in Patients with Chronic Obstructive Pulmonary Disease COPD Counsellor Prof. Dr. Ratna Sitorus, S.Kp., M.App.Sc.Dr. Debie Dahlia, S.Kp., MHSM Home based nursing pulmonary rehabilitation is a pulmonary rehabilitation that focuses on patients needs. The objective of this study is to find out the effect of home based nursing pulmonary rehabilitation on dyspnea and fatigue in Chronic Obstructive Pulmonary Disease COPD patients. This study used a quasi experimental pre test and post test control group design. The sample consisted of 30 COPD patients divided into experimental group 15 patients and control group 15 patients. T test was used in analyzing data for dyspnea and fatigue. The results show that there are significant differences on dyspnea between before and after the implementation of home based based nursing pulmonary rehabilitation to experimental group and control group p 0.0005 p "

"Tuberkulosis dan empiema merupakan kondisi penyakit pernapasan yang dapat mempengaruhi pasien secara signifikan serta memerlukan manajemen terapi yang baik dan tindakan yang sesuai. Pengobatan tuberkulosis yangdisertai empiema bergantung pada keparahan dan kompleksitas dari kondisinya. Pemantauan terapi obat berperan penting pada pasien rawat inap dengan tuberkulosis dan empiema. Penggunaan obat antituberkulosis dapat menyebabkan efek samping termasuk hepatotoksisitas yang parah hingga mengancam jiwa. Maka dari itu, pasien menderita tuberkulosis harus dimonitor terkait efek samping, khususnya pada pasien yang memiliki komorbiditas, sedang menerima obat-obatan lainnya (polifarmasi) yang mungkin dapat menimbulkan interaksi antar obat, dan gangguan ginjal. Penelitian dilakukan dengan menyeleksi pasien, mengumpulkan data terkait pasien, melakukan pemantauan terapi obat, dan menelaah keberadaan masalah terkait obat. Berdasarkan pementauan dan analisis terapi obat pasien yang telah dilakukan, beberapa masalah terkait obat yang dapat diidentifikasi berdasarkan panduan PCNE dan metode Hepler and Strand yaitu indikasi tanpa terapi, interaksi obat, efek samping, dosis obat berlebih, dosis obat kurang, dan durasi penggunaan obat berlebih. Selebihnya, terapi yang diterima oleh Tn. D tepat indikasi dan tepat dosis. Masalah terkait obat yang muncul dapat direkomendasikan penyelesaian berupa pemberian obat yang sesuai, pemantauan efek terapi obat melalui hasil laboratorium dan gejala yang timbulkan, pemberian jeda konsumsi obat, dan penyeseuiaan dosis sesuai tatalaksana dan kondisi pasien.

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Tuberculosis and empyema are respiratory disease conditions that can affect patients significantly and require good therapeutic management and appropriate measures. Treatment of tuberculosis accompanied by empyema depends on the severity and complexity of the condition. Monitoring drug therapy plays an important role in hospitalized patients with tuberculosis and empyema. The use of antituberculosis drugs can cause side effects including severe hepatotoxicity to life threatening. Therefore, patients suffering from tuberculosis must be monitored for side effects, especially in patients who have comorbidities, are receiving other drugs (polypharmacy) that may cause interactions between drugs, and kidney disorders. Research is carried out by selecting patients, collecting patient-related data, monitoring drug therapy, and examining the existence of drug-related problems. Based on the monitoring and analysis of patient drug therapy that has been carried out, several drug-related problems that can be identified based on the PCNE guidelines and the Hepler and Strand method are indications for no therapy, drug interactions, side effects, excessive drug doses, insufficient drug doses, and duration of excessive drug use. The rest, the therapy received bythe patients is proper in terms of indications and doses. Drug-related problems that arise can be recommended for solutions in the form of administering appropriate drugs, monitoring the effects of drug therapy through laboratory results and the symptoms they cause, giving pauses in drug consumption, and adjusting doses according to the management and condition of the patient."

"Eksaserbasi akut penyakit paru obstruktif kronik (PPOK) merupakan bagian terbesar dari total beban PPOK dalam sistem perawatan kesehatan. Meskipun algoritma terapi merekomendasikan monoterapi sebagai pilihan pertama, terapi kombinasi lebih sering diresepkan pada pasien dengan eksaserbasi PPOK akut di Rumah Sakit Persahabatan pada tahun 2018. Oleh karena itu, analisis efektivitas biaya perlu dilakukan sebagai pertimbangan untuk pemilihan masa depan. terapi. Tujuan dari penelitian ini adalah untuk menganalisis efektivitas biaya menggunakan terapi kombinasi ipratropium-salbutamol dibandingkan dengan salbutamol pada pasien dengan eksaserbasi akut pasien rawat inap PPOK di Rumah Sakit Persahabatan. Penelitian ini menggunakan desain cross-sectional deskriptif retrospektif dengan data sekunder dalam bentuk rekam medis pasien. Subjek penelitian adalah eksaserbasi akut pada pasien PPOK yang menerima terapi kombinasi dengan ipratropium-salbutamol atau salbutamol di Rumah Sakit Persahabatan pada tahun 2018. Karakteristik pasien dianalisis dengan metode statistik deskriptif menggunakan IBM SPSS v25.0. Efektivitas ditentukan berdasarkan peningkatan aliran ekspirasi puncak pasien ≥10% dan biaya yang digunakan dilihat dari perspektif rumah sakit dengan komponen biaya medis langsung. Berdasarkan penelitian, dapat disimpulkan bahwa pemilihan terapi kombinasi ipratropium-salbutamol akan membutuhkan biaya tambahan sebesar Rp 1.090.362,87 untuk meningkatkan 1 unit efektivitas.

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Acute exacerbation of chronic obstructive pulmonary disease (COPD) constitutes the largest part of the total burden of COPD in the health care system. Although the therapeutic algorithm recommends monotherapy as the first choice, combination therapy is more often prescribed in patients with acute exacerbation of COPD at Friendship Hospital in 2018. Therefore, a cost-effectiveness analysis needs to be carried out as a consideration for the selection of future therapies. The purpose of this study was to analyze the cost-effectiveness of using ipratropium-salbutamol combination therapy compared with salbutamol in patients with acute exacerbation of COPD inpatients at the Friendship Hospital. This study used a retrospective descriptive cross-sectional design with secondary data in the form of a patient's medical record. Subjects were acute exacerbation of COPD inpatients who received combination therapy with ipratropium-salbutamol or salbutamol at Friendship Hospital in 2018. Patient characteristics were analyzed by descriptive statistical methods using IBM SPSS v25.0. Effectiveness is determined based on an increase in the patient's peak expiratory flow ≥10% and the cost used is seen from a hospital perspective with a direct medical cost component. Based on the research, it can be concluded that the selection of ipratropium-salbutamol combination therapy will require an additional cost of Rp 1,090,362.87 to increase 1 unit of effectiveness."

"Penyakit Paru Obstruktif Kronik (PPOK) adalah penyakit yang ditandai dengan keterbatasan aliran udara yang tidak sepenuhnya reversibel. Kematian akibat PPOK ini menyumbang 6% dari semua kematian secara global. Data prevalensi spesifik untuk PPOK di Indonesia berdasarkan data Riset Kesehatan Dasar (RISKESDAS) tahun 2013 yaitu 3,7 per seribu orang. Penelitian terdahulu di Indonesia menyatakan bahwa terapi salmeterol-flutikason lebih efektif-biaya apabila dibandingkan dengan terapi formoterol-budesonid. Tujuan dari penelitian ini adalah untuk menganalisis efektivitas-biaya yang lebih baik antara terapi terapi salmeterol-flutikason dan terapi formoterol-budesonid pada pasien PPOK rawat jalan di RSUP Persahabatan tahun 2021-2022. Penelitian retrospektif ini merupakan penelitian observasional yang menggunakan desain penelitian cross-sectional dengan menggunakan data rekam medis pasien, yaitu nilai COPD Assesmen Test (CAT), jenis kelamin, usia, dan komorbiditas. Selain itu, digunakan data billing pasien dilihat dari perspektif rumah sakit yang terdiri atas biaya obat, biaya obat lain, biaya laboratorium, biaya jasa tenaga kesehatan, dan total biaya pengobatan. Sampel yang digunakan pada penelitian ini sebanyak 64 sampel, yang terdiri atas 32 sampel terapi salmeterol-flutikason dan 32 sampel terapi formoterol-budesonid. Berdasarkan hasil penelitian, didapatkan nilai inkremental efektivitas antara kedua terapi sebesar 46,9%. Kemudian didapatkan nilai inkremental biaya antara kedua terapi sebesar Rp11.561. Sementara itu, berdasarkan perhitungan didapatkan rasio efektivitas-biaya (REB) untuk terapi salmeterol-flutikason adalah sebesar Rp982.164 /unit efektivitas dan untuk terapi formoterol-budesonid adalah sebesar Rp2.287.610/unit efektivitas. Berdasarkan penelitian, dapat disimpulkan bahwa terapi salmeterol-flutikason lebih memiliki efektivitas-biaya dengan nilai rasio inkremental efektivitas-biaya terapi sebesar Rp247/unit efektivitas.

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Chronic Obstructive Pulmonary Disease (COPD) is a disease characterized by airflow limitation that is not completely reversible. The total number of deaths from COPD reaches 6% of all deaths globally. Specific prevalence data for COPD in Indonesia are based on Basic Health Research (RISKESDAS) data in 2013 is 3.7 per thousand people. Previous research in Indonesia stated that salmeterol-fluticasone therapy is more cost-effective than formoterol-budesonide therapy. The purpose of this study is to analyze the better cost-effectiveness between salmeterol-fluticasone therapy and formoterol-budesonide therapy in COPD outpatient at Persahabatan General Hospital in 2021-2022. This retrospective study is an observational study with cross-sectional study design using patient medical record data, which consisted of COPD Assessment Test (CAT) scores, gender, age, and comorbidities. In addition, patient billing data is used from a hospital perspective which consisted of drug costs, other drug costs, laboratory fees, health worker service fees, and total medical costs. There were 64 samples used in this study, consisting of 32 samples from salmeterol-fluticasone group and 32 samples from formoterol-budesonide group. Based on results of the study, the increased effectiveness value between the two therapies was 46,9%. Then, the incremental cost value between the two therapies was obtained at IDR11.561. Meanwhile, based on calculations, the average cost-effectiveness ratio (ACER) for salmeterol-fluticasone therapy was IDR 982.164/effectiveness unit and for formoterol-budesonide therapy was IDR 2.287.610/effectiveness unit. Based on the research, it can be concluded that salmeterol-fluticasone therapy is more cost-effective with an incremental cost-effectiveness ratio is Rp247 per unit of effectiveness.

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