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PENGARUH KETEPATAN TERAPI DAN KEPATUHAN TERHADAP HASIL TERAPI HIPERTENSI DI POLIKLINIK PENYAKIT DALAM RSUP Dr. SARDJITO YOGYAKARTA Ramadhan, Adam M.
Journal of Tropical Pharmacy and Chemistry Vol 2 No 5 (2014): Journal of Tropical Pharmacy and Chemistry
Publisher : Faculty of Pharmacy, Universitas Mulawarman, Samarinda, Indonesia, 75117

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (83.596 KB) | DOI: 10.25026/jtpc.v2i5.79

Abstract

Hipertensi merupakan salah satu penyebab kematian. Komplikasi pembuluh darah yang disebabkan hipertensi dapat menyebabkan kematian jantung koroner, infark jantung, stroke, dan gagal ginjal. Pemberian obat antihipertensi tunggal maupun kombinasi sangatlah penting bagi pasien tergantung pada tekanan darah dan ada tidaknya komplikasi. Penelitian ini bertujuan untuk melihat gambaran penggunaan obat antihipertensi di poliklinik penyakit dalam instalasi rawat jalan RSUP Dr. Sardjito Yogyakarta, ketepatan terapi dan hasil terapi serta pengaruh kepatuhan dalam menurunkan tekanan darah. Penelitian dilakukan dengan rancangan studi observasional dengan pengambilan data secara prospektif, kemudian dilakukan analisis terhadap data yang diperoleh untuk melihat ketepatan terapi dan kepatuhan pasien hipertensi. Penilaian keberhasilan terapi  The Seventh Report of Joint National Committee (JNC VII) on Detection, Evaluation, and Treatment of High Blood Pressure tahun 2003, sedangkan penilaian kepatuhan menggunakan kuisoner new 8-item self report Morisky Medication Adherence Scale (MMAS). Berdasarkan penelitian, obat antihipertensi yang digunakan adalah terapi tunggal dan kombinasi. Penggunaan terapi tunggal sebesar (20%) yang terbanyak adalah golongan CCB (8%) sedangkan penggunaan terapi kombinasi sebesar (80%) yang paling banyak adalah golongan ARB dengan CCB sebesar (55%). Dari 100 pasien rawat jalan yang termasuk kriteria inklusi ada (93%) mendapatkan tepat terapi antihipertensi, dan (7%) mendapatkan tidak tepat terapi antihipertensi, sedangkan (91%) mendapatkan tepat dosis antihipertensi, dan 9% mendapatkan tidak tepat dosis antihipertensi. Penilaian tekanan darah pasien yang mendapatkan (tepat obat dan dosis) dan tekanan darahnya mencapai target terapi masing-masing sebesar (68%) dan (68%). Pasien yang mendapatkan (tepat obat dan dosis) tetapi tekanan darah tidak tercapai masing-masing sebesar (25%) dan (23%). Sedangkan pasien yang mendapatkan (tidak tepat obat dan dosis) tetapi tekanan darahnya tercapai masing-masing sebesar (6%) dan (6%). Pasien yang mendapatkan (tidak tepat obat dan dosis) dan tekanan darah tidak mencapai target terapi masing-masing sebesar (1%) dan (3%). Berdasarkan kepatuhan pasien dalam mengkonsumsi obat antihipertensi (50%) dengan tingkat kepatuhan tinggi, (41%) tingkat kepatuhan sedang dan (9%) tingkat kepatuhan rendah. Dari uji analisis chi-square angka signifikansi 0,002 (p<0,05) didapatkan adanya perbedaan yang signifikan antara kepatuhan dengan hasil penurunan tekanan darah sehingga dapat disimpulkan bahwa kepatuhan yang tinggi dapat menurunkan tekanan darah. Kata Kunci : Hipertensi, Ketepatan Terapi, Kepatuhan Abstract Hypertension is considered as one of the leading causes of death. Complication in blood tissue that is caused by hypertension and that is becoming the leading cause of death might include several diseases such as coronary artery disease (CAD), hearth attack, and stroke and kidney failure. The therapy of antihypertensive drug either in monotherapy or in combination therapy plays a very essential role for patients in which the therapy in this case must be given in consideration of the blood pressure and possibility of complication. This research is aimed to observe a description of antihypertensive drug treatment in policlinic of internal disease of RSUP Dr, Sardjito Yogyakarta, accurate treatment and treatment result and effect of medication adherence in decreasing blood pressure. This research is performed using a design of observational study supported by data prospectively taken in order to observe the accurate treatment and medication adherence of the hypertensive patient. The assessment for the therapy achievement was performed using The Seventh Report of Joint National Committee (JNC VII) on Detection, Evaluation, and Treatment of High Blood Pressure in 2003, meanwhile, the assessment for medication adherence was done by using questionnaire of new 8-item self report Morisky Medication Adherence Scale (MMAS). Based on the research, it is found that the antihypertensive drug could be in monotherapy and in combination therapy. The use of monotherapy was at (20%) in which it was mostly dominated by CCB category at (8%), while the use of combination therapy was at (80%) mostly dominated by the category of ARB and CCB, namely at (55%). Of 100 out-patients including the inclusion criteria, it was (93%) of them that had the accurate treatment of antihypertension and (7%) of them that did not get the accurate treatment of antihypertension. Again, it was at (91%) that had the accurate dosage of antihypertension and (9%) had no the accurate dosage of antihypertension. In the assessment of blood pressure, the number of the patients obtaining (the accurate medicine and dosage) with the blood pressure that could achieve the target of therapy was at (68%) and (68%). On the other hand, the number of the patients obtaining (the accurate medicine and dosage) but with the blood pressure not achieving the target of therapy was at (25%) and (23%). Furthermore, those obtaining (inaccurate medication and dosage) with the achievement of the blood pressure to the target of the therapy was at (6%) and (6%). It was only (1%) and (3%) for the patients not obtaining (inaccurate medication and dosage), not achieving the target of the therapy. Based on the medication adherence of patients in taking antihypertensive drug was at (50%) with a high level of adherence, (41%) with medium level and (9%) with low level.  From the test of chi-square analysis and from the significant level of 0,002 (p<0,05) it is found a significant difference between adherence and the result of the decrease of blood pressure. Thus, it can be concluded that a high adherence can decrease the blood pressure.  Key words : Hypertension, Accurate Treatment, Adherence
SINTESIS 2,6-BIS(2′-HIDROKSIBENZILIDIN)SIKLOHEKSANON DARI HIDROKSIBENZALDEHID DAN SIKLOHEKSANON DENGAN KATALIS NATRIUM HIDROKSIDA Ramadhan, Adam M.; Utami, Dwi; Sardjiman, Sardjiman
Journal of Tropical Pharmacy and Chemistry Vol 3 No 1 (2015): Journal of Tropical Pharmacy and Chemistry
Publisher : Faculty of Pharmacy, Universitas Mulawarman, Samarinda, Indonesia, 75117

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (564.132 KB) | DOI: 10.25026/jtpc.v3i1.82

Abstract

The synthesis of ciklovalon (HGV-0) analogue was done by substituent modification on aromatic ring. One of the ciklovalon analogues is 2,6-bis(2′-hydroxybenzylidene)cyclohexanone. The objective of this study was obtaining the amount of mol NaOH catalyst in order to find the highest rendement.  The synthesis of 2,6-bis(2′-hydroxybenzylidene)cyclohexanone has been done using aldol condentation reaction from 2′-hydroxybenzaldehyde and cyclohexanone. The variation of mol catalyst NaOH used in this research were 0.2 mole; 0.4 mole and 0.8 mole. The synthesized product was purified by recrystalization with ethanol and cold water. The structure of the synthesized compound was determined by UV-Vis, IR, 1H-NMR, and GC-MS.  The result showed that the average rendement the variation of mol catalyst NaOH 0.2 mole; 0.4 mol and 0.8 mole were (25.12±0.86)%, (11.23±0.40)% and (9.50±0.56)%. The highest rendement was obtained when the 0.2 mole NaOH used. Statistical analysis using tukey test resulted significant differences. The spectroscopic analysis using UV-Vis, IR spectrometry, 1H-NMR spectrometry, and GC-MS showed that synthesized compound was 2,6-bis(2′-hydroxybenzylidene)cyclohexanone.   Keywords: 2,6-bis(2′-hydroxybenzylidene)cyclohexanone, synthesis, catalyst, rendement     ABSTRAK   Sintesis analog siklovalon (HGV-0) dilakukan melalui modifikasi substituen pada cincin aromatiknya. Salah satu analog siklovalon tersebut adalah 2,6-bis(2′-hidroksibenzilidin)sikloheksanon. Tujuan penelitian adalah untuk mengetahui jumlah mol katalis NaOH yang menghasilkan rendemen paling besar.  Sintesis 2,6-bis(2′-hidroksibenzilidin)sikloheksanon dilakukan melalui reaksi kondensasi aldol dari 2-hidroksibenzaldehid dan sikloheksanon dengan menggunakan katalis natrium hidroksida. Variasi jumlah mol katalis NaOH yang digunakan dalam penelitian ini adalah 0,2 mol; 0,4 mol dan 0,8 mol. Pemurnian hasil sintesis dilakukan dengan rekristalisasi menggunakan etanol dan aquades dingin. Struktur senyawa hasil sintesis ditentukan dengan cara spektrofotometri UV-Vis, spektrometri Inframerah, spektrometri Resonansi Magnetik Inti (1H-RMI), dan GC-MS.  Dari hasil penelitian menunjukkan bahwa rerata rendemen dari variasi jumlah mol NaOH 0,2 mol; 0,4 mol dan 0,8 mol berturut-turut adalah (25,12±0,86)%, (11,23±0,40)% dan (9,50±0,56)%. Rendemen paling optimal diperoleh pada jumlah mol katalis NaOH 0,2 mol. Hasil uji Tukey menunjukkan adanya perbedaan yang signifikan pada masing-masing kelompok. Berdasarkan data spektrofotometri UV-Vis, spektrometri Inframerah, spektrometri 1H-RMI, dan GC-MS menunjukkan bahwa senyawa yang dihasilkan adalah 2,6-bis(2′-hidroksibenzilidin) sikloheksanon. Kata kunci: 2,6-bis(2′-hydroxybenzylidene)cyclohexanone, sintesis, katalis,  rendemen
METABOLIT SEKUNDER DAN AKTIVITAS FRAKSI ETIL ASETAT KULIT BUAH JENGKOL (PITHECELLOBIUM JIRINGA (JACK) PRAIN.) TERHADAP BAKTERI PSEUDOMONAS AERUGINOSA DAN BACILLUS SUBTILIS Ramadhan, Adam M.; Pangaribuan, Ririn; Ibrahim, Arsyik
Journal of Tropical Pharmacy and Chemistry Vol 3 No 2 (2015): Journal of Tropical Pharmacy and Chemistry
Publisher : Faculty of Pharmacy, Universitas Mulawarman, Samarinda, Indonesia, 75117

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (210.137 KB) | DOI: 10.25026/jtpc.v3i2.92

Abstract

This research aims to determine the identification of secondary metabolites and antibacterial activity of ethyl acetate fraction of Jengkol fruit peel (Pithecellobium jiringa (Jack) Prain.) against the bacteria Pseudomonas aeruginosa and Bacillus subtilis. Identification of secondary metabolites is done by testing be qualitative. Antibacterial activity assays performed by agar diffusion method with a test concentration are 0,5%, 1%, 5%, 10% and 15%. The results of identification of secondary metabolites are flavanoid, fenolic and tannin. Data has been analyzed with measuring the diameter of the kill zone of ethyl acetat fraction of Jengkol fruit peel against bacterial growth. The result of research showed that ethyl acetat fraction of Jengkol fruit peel produce radical zone. The effective concentration of ethyl acetate of Jengkol fruit peel was 15% against the bacteria Pseudomonas aeruginosa and Bacillus subtilis.Keywords: Secondary metabolites, antibacterial activity, Pithecellobium jiringa (Jack) Prain.ABSTRAKPenelitian ini bertujuan untuk mengidentifikasi golongan senyawa metabolit sekunder dan mengetahui aktivitas antibakteri fraksi etil asetat kulit buah jengkol (Pithecellobium jiringa (Jack) Prain.) terhadap bakteri Pseudomonas aeruginosa dan Bacillus subtilis. Identifikasi metabolit sekunder dilakukan dengan uji kualitatif. Pengujian aktivitas antibakteri dilakukan dengan metode difusi agar dengan konsentrasi uji 0,5%, 1%, 5%, 10% dan 15%. Hasil identifikasi golongan senyawa metabolit sekunder terdapat senyawa flavanoid, fenolik dan tanin. Data hasil penelitian aktivitas antibakteri dianalisis dengan mengukur diameter zona bunuh fraksi etil asetat kulit buah jengkol terhadap pertumbuhan bakteri. Hasil penelitian menunjukkan bahwa fraksi etil asetat kulit buah jengkol memiliki aktivitas dalam membunuh pertumbuhan baktri uji. Konsentrasi efektif fraksi etil asetat kulit buah jengkol untuk membunuh bakteri Pseudomonas aeruginosa dan Bacillus subtilis yaitu pada konsentrasi 15%.Kata kunci: Metabolit sekunder, aktivitas antibakteri, Pithecellobium jiringa (Jack) Prain.
PENGARUH JUS BUAH PEPAYA (Carica papaya L.) TERHADAP PROFIL FARMAKOKINETIK SIMETIDIN PADA TIKUS PUTIH (Rattus norvegicus) Julaicha, Siti; Ramadhan, Adam M.; Rusli, Rolan
Journal of Tropical Pharmacy and Chemistry Vol 3 No 3 (2016): Journal of Tropical Pharmacy and Chemistry
Publisher : Faculty of Pharmacy, Universitas Mulawarman, Samarinda, Indonesia, 75117

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (385.933 KB) | DOI: 10.25026/jtpc.v3i3.101

Abstract

Drugs used with foods or drinks can affect the drug effects. This study aims to observe the effect of papaya juice (Carica papaya L.) to the pharmacokinetics profile of cimetidine in white rats. The animal were randomly in three group. Group 1 (cimetidine) was given a single oral cimetidine 3,6 mg/200gBW. Group 2 (cimetidine and papaya juice dose I) was given cimetidine 3,6 mg/200gBW together with papaya juice 4,5 g /200gBW. Group 3 (cimetidine and papaya juice dose II) was given cimetidine 3,6 mg/200gBW together with papaya juice 9 g /200gBW. The serial blood was collected for 4 hours on lateralis vein of rats tail. Determination of cimetidine in plasma performed by spectrophotometer UV. The pharmacokinetic parameters of cimetidine were calculated by regresi linear method and recidual method and were analyzed by One Way ANOVA using 95 % confidence interval. Based on research results showed that the group II and group III increased of ka, Cpmaks, tmaks, Cl, AUC and decreased ke, t½ab and t½el. Group III provides the most affect the cimetidine pharmacokinetics profile with decreased absorption and elimination and increased metabolism of cimetidine in rat.
Observasi Klinik Ekstrak Air Umbi Segar Bawang Dayak (Eleutherine palmifolia L. Merr) Sebagai Obat Kista Ovarium Ramadhan, Adam M.; Sulistiarini, Riski; Rijai, Laode; Bahtiar, Emil
Journal of Tropical Pharmacy and Chemistry Vol 3 No 4 (2016): Journal of Tropical Pharmacy and Chemistry
Publisher : Faculty of Pharmacy, Universitas Mulawarman, Samarinda, Indonesia, 75117

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (388.452 KB) | DOI: 10.25026/jtpc.v3i4.122

Abstract

Penelitian ini bertujuan untuk memastikan secara observasi klinik tentang kemampuan ekstrak air umbi segar bawang dayak menghilangkan benjolan pada rahim (kista) ovarium dan memastikan waktu yang diperlukan atau lama pemberian ekstrak tersebut yang dapat menghilangkan benjolan atau kista rahim wanita. Kegiatan yang dilakukan adalah membuat sediaan teh herbal dari umbi segar bawang dayak. Dosis yang digunakan dalam teh herbal sebesar 8,4 gram/hari. Setiap partisipan mengkonsumsi teh herbal sebanyak 2 kali sehari  selama 7 hari dilanjutkan mengkonsumsi selama 14 hari. Kemudian dilakukan pemeriksaan USG untuk melihat ukuran kista ovarium baik sebelum mengkonsumsi maupun setelah mengkonsumsi teh herbal. Hasil penelitian observasi klinik umbi segar bawang dayak menunjukkan bahwa teh herbal memberikan perubahan ukuran kista ovarium terhadap masing-masing responden. Pemakaian teh herbal dalam observasi penelitian ini sebesar 4,2 gram dengan aturan minum 2 kali sehari (8,4 gram/sehari) dan terjadi perubahan ukuran kista ovarium yang dikonsumsi selama 7-14 hari. Kata kunci : Bawang Dayak, Teh Herbal, Kista Ovarium ABSTRACT This study aimed to ascertain clinical observations about the ability of the water extract of fresh garlic bulbs dayak eliminate lumps in the uterus (cysts) ovarian and ensure the necessary time or duration of administration of the extract to remove the lump or cyst woman's uterus. The activities are making herbal tea preparation of fresh garlic bulbs dayak. Doses used in herbal teas of 8.4 grams / day. Each participant consumed herbal tea 2 times a day for 7 days continued to consume for 14 days. Then do an ultrasound to see the size of ovarian cysts before consuming or after consuming a herbal tea. The results of the study of fresh garlic bulbs clinical observations show that the herbal tea dayak give change ovarian cyst size of each respondent. Use of herbal tea in the observation of this study was 4.2 grams with the rules of drinking 2 times daily (8.4 grams / day) and change the size of ovarian cysts are consumed during the 7 days and continued for 14 days. Keywords: Onion Dayak, Herbal Tea, Ovarian Cysts