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"Background: Hypokalemia is one of the most common electrolyte disorders in hospitalized patients. If hypokalemia were found, the underlying cause should be identified and treated. The incidence study of hypokalemia in Indonesia hospitalized patients is rarely reported.Objective: To investigate the incidence of hypokalemia in medical patients at the medical wards of department of internal medicine Gatot Soebroto Army Hospital.Method: Patients who required administration of parenteral fluid for various indications, irrespective of diagnosis, length of stay and types of infusion or medications were included in this study. Serum sodium and potassium concentration were checked twice, first at their admission and the second at discharge. The study form contained data record of patient's initials, age, gender, dates of admission and discharge, medical record number, laboratory findings of serum sodium and potassium concentration at admission and discharge.Result: 103 subjects were enrolled with mean age 49 years old (ratio of female: male = 70:30). Serum sodium concentration at admission and discharged were not significantly different. Incidence of hypokalemia was 26%. Furthermore, serum potassium concentration at admission and discharge showed significant reduction from mean concentration of 4.06 mmoUL to 3.83 mmol/L (with P=0.02). The number of patients with hypokalemia increased significantly during hospitalization (from 27 to 45 patients.with p= 0.023). Additional data showed that the types of infusion solutions given to patients are as follows: ringer's lactate (52 patients), normal saline (22 patients), D5W (20 patients) and asering/ringer's acetate (9 patients).Conclusion: The incidence of hypokalemia in medical patients at the medical wards of department of internal medicine Gatot Soebroto Army Hospital was 26%. These patients did not have sodium abnormalities. Number of patients with hypokalemia increased during hospitalization. Most infusion solutions administered contain very low concentration of potassium (ringer's lactate and ringer's acetate 4 mmol/L) or no potassium at all (normal saline, D5W)."

"Pemantauan terapi obat adalah kegiatan untuk memastikan terapi obat yang aman, efektif, dan rasional bagi pasien dengan mengkaji pemilihan obat, dosis, cara pemberian obat, respons terapi, reaksi obat yang tidak dikehendaki, dan rekomendasi perubahan atau alternatif terapi. Kondisi pasien yang perlu dilakukan pemantauan terapi obat antara lain pasien hamil dan menyusui, pasien yang menerima regimen yang kompleks (polifarmasi) serta pasien geriatri dan pediatri. Tujuan laporan PKPA ini adalah untuk menganalisa dan mengevaluasi drug related problem (DRP) pada pasien dan diklasifikasikan sesuai kategori Hepler dan Strand. Kegiatan dilakukan melalui pengambilan data pasien dengan diagnosis syok kardiogenik dengan gagal jantung, gangguan ginjal akut, DM tipe 2, dan hipokalemia. Data yang diambil merupakan kombinasi data primer dan sekunder. Berdasarkan hasil analisis, diketahui bahwa pengobatan yang diterima oleh pasien hampir seluruhnya tepat indikasi dan dosis kecuali dosis pada sukralfat dan allopurinol yang melebihi rentang dosis seharusnya. Selain itu, ditemukan DRP berupa interaksi obat yang bersifat potensial, pemilihan obat tidak tepat, serta indikasi tanpa obat. DRP tersebut telah diatasi dengan pemberian terapi yang sesuai.

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Drug therapy monitoring is an activity to ensure safe, effective, and rational drug therapy for patients by reviewing the selection of drugs, dosages, methods of drug administration, therapeutic response, unwanted drug reactions, and recommendations for changes or alternative therapies. Patients who need to be monitored for drug therapy include pregnant and lactating patients, patients receiving complex regimens (polypharmacy), as well as geriatric and pediatric patients. The purpose of this PKPA report is to analyze and evaluate drug-related problems (DRP) in patients and classify them according to the Hepler and Strand categories. Activities are carried out through the data collection of patients with a diagnosis of cardiogenic shock with heart failure, acute kidney disorder, type 2 DM, and hypokalemia. The data was took is a combination of primary and secondary data. Based on the results of the analysis, it was known that the treatment received by the patients was almost entirely in accordance with the right indication and dosage, except for the doses of sucralfate and allopurinol, which exceeded the proper dosage range. In addition, DRP was found in the form of potential drug interactions, inappropriate drug selection, and indications without drugs. The DRP has been overcome by administering appropriate therapy."

"COVID-19 adalah penyakit yang disebabkan oleh Severe Acute Respiratory Syndrome-related Coronavirus 2 (SARS-CoV-2) yang telah ditetapkan sebagai pandemik sejak tanggal 11 Maret 2020 oleh World Health Organization (WHO). Diketahui bahwa paru-paru yang terinfeksi langsung oleh virus dapat mengakibatkan manifestasi klinis berupa pneumonia virus. Sistem kekebalan tubuh dapat mengalami perubahan imunologis dalam tubuh seperti leukopenia, limfopenia, dan inflamasi badai sitokin, sehingga dapat menyebabkan peningkatan risiko infeksi lainnya. Maka dari itu, diperlukan adanya Pemantauan Terapi Obat (PTO) untuk mengoptimalkan efek terapi dan menekan angka morbiditas pasien COVID-19. Pada penulisan ini akan dibahas mengenai PTO pada pasien COVID-19 dengan pneumonia, hipokalemia berulang, dan anemia defisiensi zat besi di ruangan Melati COVID di RSUD Tarakan, Jakarta. Hal ini diharapkan dapat menggambarkan peran apoteker klinis dalam Pemantauan Terapi Obat sehingga mampu meminimalisasi risiko masalah terkait obat, progresivitas penyakit, serta dapat meningkatkan kualitas hidup pasien. Pengambilan data dilakukan dengan pemantauan data rekam medik pasien dari sejak pertama kali masuk rumah sakit hingga pasien dapat dipulangkan. Selanjutnya, dilakukan penetapan asesmen dan rencana yang akan didiskusikan bersama apoteker penanggung jawab ruangan tersebut. Hasil analisis PTO yang dilakukan terhadap pasien tersebut ialah terdapat satu obat yang tidak tepat dosis, yaitu urotractin. Selain itu, terdapat masalah terkait kegagalan penerimaan vitamin C yang diresepkan dan interaksi antarsuplemen kalsium karbonat dan vitamin D3 yang dapat meningkatkan risiko hiperkalsemia pada pasien.

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COVID-19 is a disease caused by Severe Acute Respiratory Syndrome-related Coronavirus 2 (SARS-CoV-2) which has been comes up as a pandemic since March 11, 2020 by World Health Organization (WHO). It is known that lungs directly infected by viruses can result in clinical manifestations in the form of viral pneumonia. The immune system can experience immunological changes in the body such as leukopenia, lymphopenia, and inflammatory cytokine storms, which can cause an increased risk of other infections. Therefore, there is a need for Monitoring Drug Therapy (MDT) to optimize the therapeutic effect and reducing the morbidity rate of COVID-19 patients. In this article, we will discuss MDT in COVID-19 patients with pneumonia, recurrent hypokalemia, and iron deficiency anemia in the Melati COVID room at Tarakan Hospital, Jakarta. It is hoped that this will illustrate the role of clinical pharmacists in MDT so that they can minimize the risk of drug-related problems (DRPs), disease progression, and can improve the patient's quality of life. Data collection is carried out by monitoring the patient's medical record data from the time they are first admitted to the hospital until the patient can be discharged. Next, an assessment and plan is carried out which will be discussed with the pharmacist in charge of the room. The results of the MDT analysis carried out on this patient were that one drug was not dosed correctly, urotractin. In addition, there are problems related to failure to receive prescribed vitamin C and interactions between calcium carbonate and vitamin D supplements which can increase the risk of hypercalcemia in patients.

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"Pemantauan Terapi Obat (PTO) merupakan upaya pemastian pengobatan yang diberikan kepada pasien aman, efektif, dan rasional. PTO dilakukan pada pasien dengan kriteria yang sesuai dalam Kepmenkes RI No. 72 Thn 2016. PTO dilakukan pada pasien RSUP Fatmawati, yaitu Rumah Sakit Pusat Rujukan Daerah Jakarta. Pasien terpilih mendapatkan diagnosis utama Sindrom Koroner Akut (SKA) disertai hipokalemia, hipertensi, pneumonia, Diabetes Miletus Tipe 2 dan Cedera Ginjal Akut. PTO dilakukan pada periode 03 Juli 2023–30 Agustus 2023 sebagai bentuk penelitian observasional deskriptif bersifat prospektif yang dituangkan dalam karya tulis. Tahapan penelitian meliputi: penseleksian pasien berdasarkan kriteria; pencatatan identitas, hasil pemeriksaan dan pengobatan pasien terpilih secara berkesinambungan; melakukan interpretasi hasil pemeriksaan penunjang dan tanda vital; evaluasi tata laksana, kesesuaian dosis, efek samping, dan interaksi obat; analisis DRP dengan metode PCNE dan SOAP; merekomendasikan penyelesaian Drug Related Problem; analisis pengobatan antibiotik. Hasil analisis menunjukkan terdapat kode P1.2 efek terapi obat tidak terlalu optimal dalam pemberian Diltiazem, nitrokaf, dan ceftriakson karena pemberian dosis dibawah anjuran literatur, landasan dokter adalah pasien menerima obat lainnya dengan efek terapi serupa sehingga dosis disesuaikan dengan respon pasien. Interaksi obat-obat yang terjadi adalah kategori C dan disarankan melakukan pemantauan timbulnya ADR. Analisis alur gyssens menunjukkan pemilihan antibiotik dalam pengobatan pneumonia belum sesuai dengan PNPK tatalaksana pneumonia 2023 dan pengobatannya diputuskan rawat jalan. Disimpulkan mayoritas pengobatan sudah sesuai dengan indikasi, dosis literatur, dan respon pasien relatif membaik.

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Drug Therapy Monitoring (PTO) is an effort to ensure that the treatment given to patients is safe, effective and rational. PTO is carried out on patients who meet the criteria in the Republic of Indonesia Minister of Health Decree No. 72 of 2016. PTO is carried out on patients at Fatmawati Hospital, namely the Jakarta Regional Referral Center Hospital. Selected patients received a primary diagnosis of Acute Coronary Syndrome (ACS) accompanied by hypokalemia, hypertension, pneumonia, Diabetes Miletus Type 2 and Acute Kidney Injury. PTO was carried out in the period 03 July 2023–30 August 2023 as a form of prospective descriptive observational research outlined in written work. Research stages include: patient examination based on criteria; Recording identity, examination results and continuous treatment on selected patients; interpret examination results and vital signs; evaluation of management, dose suitability, side effects, and drug interactions; Drug-Related Problems (DRP) analysis using the PCNE and SOAP methods; providing solutions to DRP; analysis of antibiotic treatment. The results of the analysis show that there is code P1.2, the therapeutic effect of the drug is not very optimal in administering Diltiazem, Nitrocaf, and ceftriaxone because the given dose is under literature recommendations. The drug-drug interactions that occur are category C and recommended to monitor the emergence of ADRs. Gyssens Flow Analysis shows that the choice of antibiotics in the treatment of pneumonia is not in accordance with the 2023 PNPK for pneumonia management and the treatment is decided as an outpatient basis. It was concluded that most of the treatments were in accordance with the indications, dosages in the literature, and the patient's response was relatively improved"

"Pemantauan Terapi Obat atau PTO adalah proses yang mencakup kegiatan bertujuan untuk memastikan terapi obat yang diberikan aman, efektif dan rasional bagi pasien. Kegiatan PTO seharusnya dilakukan untuk semua pasien, namun mengingat terbatasnya jumlah apoteker dibanding jumlah pasien sehingga perlu dilakukan prioritas pasien yang dipantau. Klasifikasi pada DRP dapat dilakukan yaitu dengan menggunakan tools Pharmaceutical Care Network Europe (PCNE) berdasarkan data yang telah diperoleh dan dianalisis. Berdasarkan kegiatan pemantauan terapi obat yang dilakukan, pengobatan yang diberikan kepada Ny. E telah sesuai dengan indikasi dan rute pemberian pada pedoman tata laksana terapi yang direkomendasikan oleh Kementrian Kesehatan RI; terdapat analisis DRP terkait tidak tepat dosis, yang mana terdapat obat yang melebihi dari dosis maksimal harian yang dianjurkan oleh Kementrian Kesehatan RI pada terapi dengan menggunakan Seftazidim.; serta terdapat analisis DRP terkait lama waktu pemberian, yang mana terdapat obat yang melebihi dari anjuran waktu maksimal pemberian obat yang dianjurkan oleh Kementrian Kesehatan RI pada terapi menggunakan Azitromisin.

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Drug Therapy Monitoring or PTO is a process that includes activities aimed at ensuring that drug therapy is given safely, effectively and rationally for patients. PTO activities should be carried out for all patients, but given the limited number of pharmacists compared to the number of patients, it is necessary to prioritize patients to be monitored. Classification on DRP can be done by using Pharmaceutical Care Network Europe (PCNE) tools based on the data that has been obtained and analyzed. Based on the drug therapy monitoring activities carried out, the treatment given to Mrs. Has complied with the indications and route of administration in the guidelines for managing therapy recommended by the Indonesian Ministry of Health; DRP analysis related to inappropriate dosage, in which there are drugs that exceed the maximum daily dose recommended by the Indonesian Ministry of Health for therapy using ceftazidime; as well as there is a DRP analysis related to the length of time for administration, in which there are drugs that exceed the recommended maximum time for drug administration recommended by the Indonesian Ministry of Health for therapy using Azithromycin."

"Epilepsi merupakan suatu kondisi kronis yang disebabkan oleh gangguan fungsi otak. Keadaan ini merupakan penyulit yang biasa ditemukan pada berbagai gangguan neurologis seperti kelumpuhan otak (cerebral palsy: CP) yang dapat mengakibatkan kerusakan otak lebih lanjut, terutama apabila disertai dengan serangan kejang yang berlangsung lama. Insidens epilepsi pada penyandang CP berkisar antara 25 ? 35%. Insidens epilepsi yang sering pada pasien penyandang CP menunjukkan bahwa kedua kelainan tersebut agaknya mempunyai penyebab yang sama atau saling berhubungan. Kami melaksanakan suatu studi retrospektif untuk menentukan apakah insidens epilepsi berbeda tergantung pada tipe CP. Data diambil dari rekam medik, meliputi: nama, jenis kelamin, paritas, usia ibu, penatalaksanaan pra, peri dan pasca lahir serta hasil rekaman EEG. Pengolahan data menggunakan uji statistik X2 pada P < 0,05. Didapatkan di antara 67 kasus dengan CP, 53 bertipe CP spastik, 13 kasus campuran dan 1 CP diskinetik. Lelaki 47,8%, Perempuan 52,2% dengan usia rerata 50,3 (SD 36,3) bulan. Pada 25 pasien dengan CP yang berhubungan dengan epilepsi ditemukan 72% dengan kejang umum, 20% dengan kejang parsial, dan 8% dengan spasme infantil. Insidens epilepsi ternyata menunjukkan perbedaan yang bermakna (P < 0,05) tergantung tipe CP dan usia kehamilan saat pasien dilahirkan. Disimpulkan bahwa insidens epilepsi pada pasien penyandang CP di YPAC medan ialah 37,3%, dan terdapat perbedaan bermakna sesuai tipe CP dan usia kehamilan saat pasien dilahirkan. (Med J Indones 2002; 11: 158-63)

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Epilepsy is a chronic condition due to cerebral function disorders. Epilepsy occurs as a common complication of many neurological disorders such as cerebral palsy (CP) that can cause further brain damage if especially they are accompanied with prolonged seizure. The incidence of epilepsy among patients with CP varies, 25-35%. The high incidence of epilepsy among patients with CP suggests that these disorders has common or related origins. We carried out a retrospective study to determine the incidence of epilepsy among patients with CP registered July 1988 to June 1998 in YPAC Medan and to determine whether the incidence of epilepsy was different according to type of CP. Data was compiled from medical records, including name, sex, parity, mothers age, prenatal, perinatal, and postnatal history, and EEG resuts. Data were analysed using statistical computer program and its significance was evaluated by chi square test at p < 0.05. There were 67 cases with CP, 53 cases spastic CP, 13 cases mixed CP and one case dyskinetic CP. Of the 67 cases CP, 47.8% were male, 52.2% female with the mean age of 50.3 (SD 36.9) months. There were 25 (37.3%) patients CP associated with epilepsy, 72% general seizures, 20% partial seizures, and 8% infantile spasm. The incidence of epilepsy was significantly different among patients with CP associated with the type of CP and gestational age, p < 0.05. We concluded that the incidence of epilepsy among patient with CP in YPAC Medan was 37.3% and showed significant difference in CP according to type and gestational age. (Med J Indones 2002; 11: 158-63)"

"AbstrakVenous thromboembolism (VTE) is a fatal yet potentially preventable complication of surgery. Routine thromboprophylaxis is still unequivocal prescription is problematic due to perception of low VTE incidence among Asian population. This study aims to investigate the incidence of VTE and thromboprophylaxis prescription among patients undergoing major surgery in a Singapore hospital.Methods: This was a cross-sectional study. Data were obtained from medical record of 1,103 patients who had underwent major orthopaedic or abdominal surgery in 2011-2012 at Khoo Teck Puat Hospital, Singapore. Incidence of VTE events either in the same admission or re-admission in less than one month time were noted as study parameters.Results: Incidence of VTE was 2.1% (95% CI: 1.67 - 2.53) of which 1.3% and 0.8% were DVT and PE cases respectively. Age, gender, history of VTE, ischemic heart disease, and mechanical prophylaxis were associated with VTE incidence based on bivariate analysis. The prescription of pharmacological thromboprophylaxis was associated with prior anticoagulant medication, type of surgery, and incidence of new bleeding.Conclusion: Subsequent to major surgeries, VTE is as common in Asian patients as published data in other populations. Pharmacologic thromboprophylaxis should be considered as recommended in non-Asian guidelines."