MPI (Media Pharmaceutica Indonesiana)

Implementasi Pelayanan Telefarmasi di Apotek Sesuai Standar Pelayanan Kefarmasian

2022-12-29T13:41:03+00:00

Penelitian ini ditujukan untuk menggambarkan implementasi pelayanan telefarmasi pada pelayanan farmasi klinis di apotek yang dipandang dari perspektif apoteker pemberi layanan. Penelitian ini merupakan penelitian deskriptif dengan metode survey menggunakan kuesioner. Kuesioner disusun berdasarkan standar pelayanan kefarmasian di apotek, dan pelayanan farmasi klinis yang terdiri dari 7 domain. Validasi kuesioner terlebih dahulu diuji validitas rupa (face validity). Sampel penelitian terdiri dari 40 apoteker yang berpraktik dan menyediakan pelayanan telefarmasi di apotek jaringan di Surabaya dan Sidoarjo. Sejumlah 34 apoteker yang memenuhi kriteria inklusi dan eksklusi terlibat dalam penelitian ini. Hasil penelitian menunjukkan bahwa pengkajian resep, dispensing dan KIE, pelayanan informasi obat, konseling, pemantauan terapi obat, home pharmacy care, dan monitoring efek samping obat selalu dan sering dilakukan oleh apoteker. Namun, dokumentasi konseling dan pemantauan terapi obat hanya dilakukan oleh 47,1% dan 55,9% responden. Berdasarkan hasil penelitian, dapat disimpulkan bahwa pelayanan telefarmasi pada pelayanan farmasi klinis sudah dilakukan dengan baik oleh apoteker.

Telepharmacy services have become part of pharmaceutical services in community pharmacy. Based on regulations, this service must be provided in accordance with pharmaceutical service standards in the community. This study aimed to describe the implementation of telepharmacy services in the community from the perspective of practicing pharmacists. This study is a descriptive research using survey method with a questionnaire. Questionnaires were prepared based on pharmaceutical service standards in pharmacies, and clinical pharmacy services consisting of 7 domains. The validity of the questionnaire was tested for face validity. The sample of this study was consisted of 40 pharmacists who practice and provide telepharmacy services at network pharmacies in Surabaya and Sidoarjo. A total of 34 pharmacists who met the inclusion and exclusion criteria were involved in this study. The results showed that the assessment of prescriptions, dispensing and communication-information-education, drug information services, counseling, monitoring of drug therapy, home pharmacy care, and monitoring of drug side effects were always and often carried out by pharmacists. However, documentation of counseling and monitoring of drug therapy was only carried out by 47.1% and 55.9% of respondents. Based on the results of this study, it can be concluded that telepharmacy in clinical pharmacy services have been carried out by pharmacist properly.

Characterization of Water Kefir from Broccoli Stem Extract with Addition of Palm Sugar

2022-12-29T13:40:46+00:00

Water kefir is a fermented carbonated beverage and functional food with probiotic properties. Broccoli is an edible green plant which a rich source of vitamins A, B1, B2, B3, and C; it also contains isothiocyanate compounds that have anti-cancer and fiber for digestive system. Palm sugar is a sweetener obtained from concentrated coconut sap and is known to have a low glycaemic index. The purpose of this study was to investigate the effect of broccoli stem extract and palm sugar concentration on its biochemical and microbiological characteristics. Subsequently, the acceptance of the product by the panelists were evaluated through organoleptic tests. Water kefir with sugar content of 15% had the highest lactic acid, antioxidant activity, lactic acid bacteria, yeast, ethanol content, and water kefir with a concentration of 1:5 and sugar content of 15% found the highest acceptance by the panelists. Water kefir obtained in this study did not have contaminant bacteria. This product also met the codex standard.

Profil Tipe dan Ketepatan Rekomendasi Apoteker pada Kasus Vignette Dispesia di Salah Satu Kabupaten di Jawa Timur Indonesia

2022-12-29T13:40:29+00:00

Dispepsia merupakan salah satu gejala yang umum dijumpai di apotek, dan oleh karena itu apoteker perlu untuk mampu memberikan rekomendasi yang tepat pada pasien dengan gejala dispepsia. Penelitian ini bertujuan untuk mendeskripsikan tipe dan ketepatan rekomendasi pada dua kasus vignette dispepsia. Penelitian ini menggunakan desain potong lintang dan 42 apoteker berpartisipasi dalam penelitian ini. Instrumen penelitian menggunakan kuesioner yang berisi: (1) karakteristik apoteker dan apotek serta (2) dua kasus vignette: kasus dispepsia tanpa alarm symptoms dan kasus dispepsia karena Na diklofenak. Pengambilan data dilakukan dengan wawancara terstruktur. Analisis data dilakukan dengan inductive content analysis. Ketepatan rekomendasi dinilai berdasarkan literatur dan opini expert panel. Tipe rekomendasi yang paling sering diberikan oleh apoteker pada dua kasus di atas adalah memberikan produk untuk gejala dispepsia. Ketepatan rekomendasi pada kasus dispepsia tanpa alarm symptom dan pada kasus dispepsia karena Na diklofenak secara berturut-turut adalah 83% dan 21% dari 42 apoteker yang berpartisipasi. Dapat disimpulkan bahwa ketepatan rekomendasi bervariasi tergantung kasus. Perlu adanya peningkatan kemampuan apoteker dalam memberikan rekomendasi yang tepat, terutama pada kasus swamedikasi dispepsia yang membutuhkan rujukan ke dokter.

Dyspepsia is a symptom commonly seen in community pharmacies, and therefore pharmacists need to be able to provide appropriate recommendations for patients with dyspepsia. This study aims to describe the types and the appropriateness of the recommendation provided by pharmacists when responding to two vignette cases of dyspepsia. This study was a cross sectional study, and 42 community pharmacists participated in the study. A questionnaire consisting of (1) pharmacists and pharmacy characteristics, and (2) two vignette cases of dyspepsia without alarm symptoms and dyspepsia due to Na diclofenac was developed. A structured interview was used for data collection, and an inductive content analysis was used to analyse the cases. The appropriateness of the recommendation was assessed based on the literature and expert panel opinion. The most common type of recommendation provided in the 2 vignette cases was recommending product for dyspepsia. Appropriate recommendation was provided by 83% and 21% of the 42 participating pharmacists in the case of dyspepsia without alarm symptoms and in the case of dyspepia due to Na diclofenac respectively. The appropriateness of the recommendation varied depending on the case. There is a need to improve the capability of pharmacists in providing appropriate recommendation, particularly for a dyspepsia case that needs medical referral.

Secondary Metabolites of Various Indonesian Medicinal Plants as SARS-CoV-2 Inhibitors: In Silico Study

2022-12-29T13:40:10+00:00

Corona virus disease 2019 caused by SARS-CoV-2 infection emerged in late 2019 and still become a worldwide pandemic up to this point with the drug remain unavailable. Meanwhile, Indonesia has an abundance variety of medicinal plants that are potential to be developed as inhibitors. By using the key role proteins as drug targets, namely spike glycoprotein and RNA-dependent RNA polymerase (RdRp) of delta variant of SARS-CoV-2 (which is known as strongly transmitted and highly virulent), we can develop inhibitors for the target proteins from potential Indonesian medicinal plants to prevent the protein interactions for viral entry and proliferation that leading to organ disfunction and death. This study aimed to identify the secondary metabolites of various Indonesian medicinal plants as SARS-CoV-2 inhibitors. The 184 ligands from nine plants were collected from IJAH webserver and their SMILES notation were collected from PubChem. Meanwhile 3D structures of spike glycoprotein (PDB ID: 6VXX) and RdRp (PDB ID: 6M71) were obtained from protein data bank (PDB). Molecular docking was conducted between ligands and the two SARS-CoV-2 proteins using Autodock Vina in PyRx with hesperidin and remdesivir as control compounds. Several potential compounds were selected for drug-likeness analysis and toxicity analysis. Results showed that lantanolic acid has the same amino acid interaction with RdRp as the control compound. It formed a hydrogen bond with Ser784 and hydrophobic bonds with Tyr32 and Ser7709. It had lower binding affinity than the control compounds, eligible as oral drug, and had LD50 of 2589 mg/kg.

Validasi Metode Analisis Kurkuminoid dan Xantorizol pada Rimpang Temulawak (Curcuma xanthorrhiza) dengan KLT- Densitometri

2022-12-29T13:39:53+00:00

Rimpang temulawak (Curcuma xanthorrhiza) merupakan bagian tanaman yang banyak dimanfaatkan untuk pengobatan tradisional. Metabolit sekunder yang memberikan aktivitas farmakologisnya adalah senyawa kurkuminoid dan xantorizol. Penelitian ini bertujuan untuk memperoleh metode analisis kurkuminoid dan xantorizol yang tervalidasi, cepat, dan sederhana. Analisis dilakukan dengan menggunakan fase diam berupa lempeng KLT silika gel 60 GF254 dan fase gerak diklorometana-kloroform (4:6). Pemindaian (scanning) densitometrik dilakukan pada 224 nm untuk xantorizol dan 425 nm untuk kurkuminoid. Metode menunjukan linieritas, akurasi, dan presisi yang baik, dengan batas deteksi kurkuminoid dan xantorizol yaitu 7,88 bpj dan 28,23 bpj dan batas kuantitasi kurkuminoid dan xantorizol yaitu 23,89 bpj dan 85,55 bpj. Kadar kurkuminoid dan xantorizol pada ekstrak rimpang temulawak adalah 4,95 ± 0,01 dan 31,30 ± 0,09 mg/g serbuk simplisia.

The rhizome of temulawak (Curcuma xanthorrhiza) is a part of the plant that is widely used for traditional medicine. Secondary metabolites that provide pharmacological activity are curcuminoids and xanthorrhizol. This study aims to obtain a validated, fast, and simple analytical method for curcuminoids and xanthorrhizol. The analysis was carried out with the stationary phase TLC plates silica gel 60 GF254. The mobile phase used was dichloromethane-chloroform (4:6), with densitometric scanning at 224 nm for xanthorrhizol and 425 nm for curcuminoids. The method showed good linearity, accuracy, and precision, with curcuminoids and xanthorrhizol detection limits of 7.88 ppm and 28.23 ppm, curcuminoids and xanthorrhizol quantitation limits of 23.89 ppm and 85.55 ppm, respectively. The content of curcuminoids and xanthorrhizol in temulawak rhizome extract were 4.95 ± 0.01 and 31.30 ± 0.09 mg/g Simplicia powder, respectively.

Identification of Potential COVID-19 Targets and Pathways Derivate from Various Phenolic Compounds from Chives (Allium schoenoprasum) by Using Network Pharmacology Approach

2022-12-29T13:39:35+00:00

With the uncertainty of COVID-19 disease around the world, the discovery and development of novel treatments for COVID-19 becoming an emerging trend. Network pharmacology has been used for determining the potential targets from several diseases. This research mainly focused on the potential of Allium schoenoprasum against COVID-19 based on a network pharmacology approach. The methods consist of target identification of the compounds, target identification related to COVID-19 disease, compound-target interaction network, protein-protein interaction network and gene ontology and pathway enrichment analysis. Fifthy three main targets obtained from the compound-COVID-19 were identified as main targets from the compounds with MMP9, MPO, TLR4, MMP2, CCNB1, AURKB, PLK1, TOP2A, ALOX5, and CD38 becoming the top 10 core targets. Phenolic compounds in Allium schoenoprasum may act as anti-COVID-19 through several inflammatory and immune response pathways. Based on these results, it seems that phenolic compounds in Allium schoenoprasum might act as anti-COVID-19 via network pharmacology approaches.

Penetapan Kadar Fenolik Total dan Uji Aktivitas Antioksidan Fraksi dari Ekstrak Etanol Daun Cempedak (Artocarpus integer) dengan Metode DPPH

2022-12-29T13:39:18+00:00

Daun cempedak (Artocarpus integer) dimanfaatkan secara tradisional oleh masyarakat Kalimantan Selatan dalam pengobatan. Golongan fenolik terkandung dalam ekstrak daun cempedak dan memiliki kemampuan sebagai antioksidan. Fraksi dari ekstrak daun cempedak belum pernah ditetapkan kadar fenolik total dan akivitas antioksidannya. Penelitian ini bertujuan untuk mengetahui fraksi dari ekstrak daun cempedak yang mengandung kadar fenolik dan aktivitas antioksidan tertinggi. Penelitian dimulai dengan pengeringan daun segar menggunakan lemari pengering, pembuatan serbuk simplisia, proses ekstraksi secara maserasi, pengeringan ekstrak dengan lemari pengering, dan proses fraksinasi dengan pelarut n-heksan, etil asetat dan aquadest. Penetapan kadar fenolik total dapat dilakukan dengan reagen Folin-Ciocalteu dan menggunakan baku pembanding asam galat. Aktivitas antioksidan dilakukan menggunakan metode DPPH berdasarkan nilai IC50 dan dengan pembanding kuersetin. Kadar fenolik total pada fraksi n-heksan 9,352 ± 0,113% b/b, fraksi etil asetat 12,595 ± 0,415% b/b, dan fraksi aquadest 9,992 ± 0,485% b/b ekivalen asam galat. Fraksi n-heksan, etil asetat, dan aquadest masing-masing memiliki nilai IC50 sebesar 89,192 ± 2,91 bpj (kuat), 64,754 ± 2,803 bpj (kuat), dan 82,247 ± 23,034 bpj (kuat). Kesimpulan dari penelitian ini bahwa fraksi etil asetat memiliki kadar fenolik total tertinggi dan aktivitas antioksidan paling kuat dibandingkan fraksi n-heksan dan fraksi aquadest dari ekstrak daun cempedak.

Cempedak (Artocarpus integer) leaves are traditionally used by people in South Kalimantan as medicine. The phenolic group contained in cempedak leaf extract has known as an antioxidant. The fraction of cempedak leaf extract has never been determined for total phenolic content and antioxidant activity. This study aimed to determine the fraction of cempedak leaf extract that contains the highest levels of phenolic and antioxidant activity. The study started with drying of fresh leaves using a drying cabinet, simplicia powder preparation, maceration extraction, extract drying, and fractionation with n-hexane, ethyl acetate and aquadest as solvents. Determination of total phenolic content was obtained with Folin-Ciocalteu reagent and gallic acid as a standard for comparison. Antioxidant activity was measured using the DPPH method based on the IC50 value and comparison with quercetin. The total phenolic content of the n-hexane, ethyl acetate and aquadest fraction were 9.352 ± 0.113% w/w, ethyl acetate fraction 12.595 ± 0.415% w/w, and aquadest fraction 9.992 ± 0.485% w/w equivalent gallic acid, respectively. The n-hexane, ethyl acetate, and aquadest fractions showed IC50 values of 89.192 ± 2.91 ppm (strong), 64.754 ± 2.803 ppm (strong), and 82.247 ± 23.034 ppm (strong), respectively. The conclusion of this study was that the ethyl acetate fraction had highest total phenolic content and strongest antioxidant activity compared to n-hexane and aquadest fraction from cempedak leaf extract.

Uji Flavonoid Total dan Antioksidan Kulit Batang Balik Angin (Alphitonia excelsa (Fenzl) Reis Ex. Endl)

2022-12-29T13:39:02+00:00

Alphitonia excelsa merupakan salah satu tanaman yang berpotensi sebagai antioksidan dan telah digunakan secara turun temurun di masyarakat sebagai terapi berbagai macam penyakit. Hal tersebut mendasari tujuan penelitian ini, yaitu menentukan aktivitas antioksidan dan total flavonoid kulit batang A. excelsa. Metode yang di gunakan dalam pengujian antioksidan adalah peredaman terhadap radikal 2,2-difenil-1-pikrilhidrazil (DPPH), sedangkan pengujian flavonoid total dengan AlCl3 dilakukan secara kolorimetri. Hasil yang didapatkan dari penelitian ini adalah nilai IC50 aktivitas antioksidan A. excelsa sebesar 37,00 ± 1,46 μg/ml (bpj) dan flavonoid total senilai 1,17% ± 0.04 QE (quercetin equivalent). Berdasarkan nilai tersebut dapat disimpulkan bahwa kulit batang A. excelsa memiliki kemampuan antioksidan yang sangat kuat.

Alphitonia excelsa is a plant that potential to be tested for its antioxidant ability and has been used as medicine. This underlies the purpose of this study, namely to determine the antioxidant activity and total flavonoids of the stem bark of A. excelsa. The method used in antioxidant evaluaion was 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging, while the total flavonoid assay with AlCl3 was carried out colorimetrically. The results obtained from this study were the IC50 value of the antioxidant activity and total flavonoids of A. excelsa, with the value of 37.00 ± 1.46 μg/ml and 1.17% ± 0.04 quercetin equivalent, respectively. Based on these values, it can be concluded that the stem bark of A. excelsa has a very strong antioxidant capacity.

Aktivitas Sitotoksik Ekstrak Biji Alpukat (Persea americana Mill.) pada Sel Kanker Payudara dan Serviks Secara In Silico dan In Vitro

2022-12-29T13:38:46+00:00

Kanker payudara dan servik merupakan kanker dengan jumlah terbanyak di Indonesia. Kemoterapi sebagai terapi kanker memiliki banyak efek samping, oleh karena itu diperlukan pengembangan obat antikanker terutama dari bahan alam yang efektif dan memiliki efek samping minimal. Salah satu bahan alam yang diprediksi mempunyai aktivitas antikanker adalah biji alpukat (Persea americana Mill.). Penelitian ini bertujuan untuk menentukan aktivitas sitotoksik ekstrak etanol biji alpukat pada sel kanker payudara dan serviks secara in silico dan in vitro. Senyawa aktif dalam biji alpukat di docking dengan reseptor estrogen (PDB code: 3ERT) and reseptor SIRT1 (PDB code: 4I5I) menggunakan program Molegro Virtual Docker 5.5 (MVD). Aktivitas sitotoksik secara in vitro dilakukan menggunakan metode Microculture Tetrazolium Technique (MTT) pada sel kanker payudara (MCF7), sel kanker serviks (HeLa) dan sel normal (Vero). Biji alpukat berisi 10 senyawa aktif yang diprediksi mempunyai aktivitas sitotoksik. Hasil uji in silico menunjukkan bahwa epicatechin gallate mempunyai nilai rerank score paling rendah yaitu -118,397 kkal/mol pada reseptor estrogen dan -133,694 kkal/mol pada reseptor SIRT1. Aktivitas sitotoksik secara in vitro ditunjukkan dengan nilai IC50 sebesar 537,37 μg/mL (MCF7), 383,21 μg/mL (HeLa) dan 541,67 μg/mL (Vero). Dari hasil uji in vitro menyatakan bahwa ekstrak etanol biji alpukat tidak memiliki aktivitas sitotoksik pada sel kanker MCF7 dan memiliki aktivitas sitotoksik lemah pada sel HeLa.

Breast and cervical cancer are cancers with the highest number in Indonesia. Chemotherapy, as one of the mainstay treatments of cancer, can cause harmful side effects; and, therefore, it is necessary to develop anticancer drug from natural ingredients with good efficacy and minimal side effects. One of the natural ingredients that is predicted to have anticancer activity is avocado seed (Persea americana Mill.). This study aimed to evaluate the in-vitro and in-silico cytotoxic activity of avocado seed extract on breast and cervical cancer cells. The active compounds in avocado seeds were docked with estrogen receptors (PDB code: 3ERT) and SIRT1 receptors (PDB code: 4I5I) using the MVD program. Cytotoxic activity in vitro was carried out using the MTT method on breast cancer cells (MCF7), cervical cancer cells (HeLa) and normal cells (Vero). Avocado seed contains 10 active compounds which are predicted to have cytotoxic activity. The findings from in-silico test showed that the “epicatechin gallate” had the lowest rerank score, i.e. -118.397 kcal/mol for the estrogen receptor and -133.694 kcal/ mol for the SIRT1 receptor. Cytotoxic activity in vitro was shown by IC50 values of 537.37 μg/mL (MCF7), 383.21 μg/mL (HeLa) and 541.67 μg/mL (Vero), respectively. The findings from in-vitro test showed that the avocado seed extract did not have cytotoxic activity on MCF7 cells and had weak cytotoxic activity on HeLa cells.

Effectiveness of Voriconazole in Treating Fungal Keratitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2022-12-29T13:38:31+00:00

Antifungal intervention fails in approximately half of fungal keratitis patients, demonstrating its limitations. Voriconazole use for fungal keratitis has raised new interest because of its broad spectrum and good ocular penetration. However, its effectiveness has not been systematically evaluated. Here we try to clarify the benefits of voriconazole in fungal keratitis cases. Randomized controlled trials (RCTs) comparing voriconazole to placebo or other antifungal medications for fungal keratitis were searched in several databases, including PubMed, Scopus, Cochrane Library, ClinicalTrials, and WHO-ICTRP. The primary outcome that analyzed was best spectacle-corrected vision acuity (BSCVA). The secondary outcomes were treatment success, corneal perforation or need for therapeutic penetrating keratoplasty (TPK). From 621 records, nine studies were selected for analysis. The results were as follows: As an initial therapy, topical natamycin outperformed voriconazole in BSCVA (mean difference = 0.14; 95% CI 0.02 to 0.26; P =.03). Voriconazole also has a greater risk of corneal perforation or TPK than natamycin (RR=1.69; 95% CI 1.11 to 2.58; P=.02). As an adjuvant, there is no significant difference found in BSCVA, treatment success, event of corneal perforation, or need for TPK between voriconazole and the other antifungal agents (itraconazole, ketoconazole, amphotericin B, natamycin, and placebo). This study shows that voriconazole is less superior than natamycin in treating early infections of fungal keratitis. More RCTs with larger samples are needed to evaluate voriconazole's adjuvant efficacy.