Rianto Setiabudy
Department of Pharmacology, Faculty of Medicine, Universitas Indonesia, Jakarta

Published : 25 Documents
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The Treatment of Fever in Children

Journal of the Indonesian Medical Association Vol. 58 No. 9 September 2008
Publisher : Journal of the Indonesian Medical Association

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What Should be Considered by Physicians Before Novel Medications Are Prescribed?

Journal of the Indonesian Medical Association Vol. 59 No. 3 March 2009
Publisher : Journal of the Indonesian Medical Association

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Effect of Jamu X on Blood Glucose Level in Healthy Volunteer

Jurnal Medika Planta Vol 1, No 2 (2010)
Publisher : Jurnal Medika Planta

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Abstract

In the line with the governments policy to encourage the save and effective use of traditional medicines, the development of the traditional medicine is impressive today. After passing phases 1 and 2 clinical trials, a medicinal herb can be formally used in health care services. Jamu X has passed the safety and efficacy on preclinical tests. Obviously these data opens possibility to explore the safety and efficacy of the herbs in man.Objective: To find out the pharmacodynamic effect and the effective dose of Jamu X to reduce blood glucose levels following fasting and/or two hours after taking an oral glucose dose of 75 grams in healthy subject.Method: This study used a "before and after" design. Each healthy subject was given the product in 2 dosages in 2 separate periods. The first dose was 1 capsule three times a day for seven days. After a washout period of 2 weeks, the subject was given 1 capsule twice a day for another seven days. The parameters evaluated were the fasting blood glucose and the blood glucose levels at 2 hours after the ingestion of 75g oral glucose.Results: at a dose twice a day over 7 days can significantly reduce the blood glucose levels of healthy subjects. The mean level of fasting glucose reduced 5.2% (p=0.01) and the mean level of 2 hours after taking an oral glucose dose of 75 grams reduced 7.3% (p=0.01).Conclusion: Jamu X reduces blood glucose levels in healthy subject and the reduction in blood glucose levels is dose dependent. Further clinical trials on diabetic patients are required to establish the clinical efficacy and safety of this product as a potential herbal medicine in the management of diabetes mellitus.

Comparison of the efficacy and safety of isepamicin plus metronidazole and amikacin plus metronidazole in intra-abdominal infections

Medical Journal of Indonesia Vol 10, No 2 (2001): April-June
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

Intra-abdominal infections due to penetrating wound through the abdominal wall or rupture of the gastrointestinal tract are acute conditions requiring prompt surgical intervention and the use of appropriate antimicrobial agents. Isepamicin is an effective aminoglycoside against various Gram-negative pathogens causing intra-abdominal infections. The objective of the present study is to compare the efficacy and safety of isepamicin (15 mg/kgBW IV o.d.) with amikacin (7.5 mg/kgBB b.i.d.), in conjunction with metronidazole for both drugs. An open, randomized, parallel design was applied in this trial. The subject allocation ratio for isepamicin: amikacin is 2:1. Out of 50 patients enrolled in this study, 27 fuffilled the criteria for safety and efficacy population, and 46 for intent-to-treat population. In the safety and efficacy population, the clinical success rare for isepamicin and amikacin group did not differ significantly (i.e., 95% and 100%, respectively). In the intent-to-treat population, the clinical success rates for isepamicin and amikacin group were also insignifficantly different (i.e., 97% and 100%, respectively). The rates of bacteriological elimination for isepamicin and amikacin, were 95% and 100%, respectively in the efficacy and safety population, and 90% and 93%, respectively in the intent-to-treat population. Streptococci and staphylococci were the most frequent (40%) pathogens isolated from pus, and Acinetobacter anitratus (55%) was the most common one isolated from blood. In the efficacy and safety population, the mean (± SD) length of hospital stay in the isepamicin and amikacin groups was 10.7 ± 3.9 and 11.1 ± 3.8 days, respectively, while in the intent-to-treat population, the mean (± SD) length of hospital stay in the isepamicin and amikacin groups was 10.1 ± 3.4 and 10.5 ± 3 days, respectively. In the present study, both aminoglycosides were well tolerated and there was no patient withdrawal associated with side effect. It is concluded that for intra-abdominal infections, intravenous isepamicin given once daily is as effective as intravenous amikacin given twice daily in combination with metronidazole. (Med J Indones 2001; 10: 88-94)Keywords : Isepamicin, amikacin, inta-abdominal infections

Effect of a combination of Phaseolus vulgaris L. extract and acarbose on postprandial glucose level after cooked rice intake in healthy volunteers

Medical Journal of Indonesia Vol 18, No 1 (2009): January-March
Publisher : Faculty of Medicine Universitas Indonesia

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Aim This study was aimed to measure the effects of combination Phaseolus vulgaris extract and acarbose compared to acarbose alone on postprandial glucose concentration in healthy volunteers after cooked rice intake.Methods Blood sample were obtained at several time points up to three hours after cooked rice intake. The parameter for postprandial glucose concentration is the area under the curve (AUC) of glucose concentration vs.time for three hours after cooked rice intake.Results After taking this combination, postprandial glucose concentration was reduced by 21.6%, while the reduction by acarbose alone was 22.9%.Conclusions The reduction of postprandial glucose concentration after administration of this combination was not significantly different compared to that after administration of acarbose alone. (Med J Indones 2009; 18: 25-30)Keywords: Phaseolus vulgaris extract, acarbose, postprandial glucose concentration

Incretin-based therapies for type 2 diabetes mellitus in Asian patients: Analysis of clinical trials

Medical Journal of Indonesia Vol 19, No 3 (2010): August
Publisher : Faculty of Medicine Universitas Indonesia

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Aim To review the effi cacy and safety data on incretin-based therapies currently available (exenatide, liraglutide, sitagliptin, vildagliptin) for the treatment of type 2 diabetes mellitus in Asian population.Methods We conducted Medline search of all relevant randomized clinical trials of incretin-based therapies for type 2 diabetes mellitus in Asian populations. Data pertinent to the efficacy and safety of GLP-1 mimetics and DPP-4 inhibitors were extracted and used.Results We found 14 randomized controlled trials of incretin based-therapy which included 3567 type 2 diabetes mellitus in Asian population (Japanese, Chinese, Korean, Indian). It was shown that incretin-based therapies improved HbA1c at higher extent (up to -1.42% in exenatide 10 mcg bid, -1.85% for liraglutide 0.9 mg qd, -1.4% for sitagliptin 100 mg and -1.4% for vildagliptin 50 mg bid) compared to the effects observed in studies with Caucasian population, with comparable safety profile.Conclusion The efficacy of incretin-based therapies in Asian patients improved glycemic parameters in a higher magnitude on some glycemic parameters compared with those in Caucasian population. These results indicate that incretin-based therapies may be more effective in Asian population than in Caucasian. (Med J Indones 2010; 19: 205-12)Key words: exenatide, incretin, liraglutide, sitagliptin, type-2 diabetes, vildagliptin

Rational Use of Drugs and Traditional Herbal Medicine

Medical Journal of Indonesia Vol 19, No 1 (2010): February
Publisher : Faculty of Medicine Universitas Indonesia

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CYP2A6 gene polymorphisms impact to nicotine metabolism

Medical Journal of Indonesia Vol 19, No 1 (2010): February
Publisher : Faculty of Medicine Universitas Indonesia

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Nicotine is a major addictive compound in tobacco cigarette smoke. After being absorbed by the lung nicotine is rapidly metabolized and mainly inactivated to cotinine by hepatic cytochrome P450 2A6 (CYP2A6) enzyme. Genetic polymorphisms in CYP2A6 may play a role in smoking behavior and nicotine dependence. CYP2A6*1A is the wild type of the CYP2A6 gene which is associated with normal or extensive nicotine metabolism. In the CYP2A6 gene, several polymorphic alleles have been reported such as CYP2A6*4, CYP2A6*7, CYP2A6*9, and CYP2A6*10 which are related to decreasing nicotine metabolism activity. The variation of nicotine metabolism activity could alter nicotine plasma levels. Smokers need a certain level of nicotine in their brain and must smoke regularly because of nicotine’s short half-life; this increases the number of smoked cigarettes in extensive metabolizers. Meanwhile, in slow metabolizers, nicotine plasma level may increase and results in nicotine toxicity. This will eventually lower the risk of dependence. (Med J Indones 2010; 19:46-51)Keywords: cotinine, hepatic cytochrome P450 2A6, smoking behavior

A survey on the appropriateness of drug therapy in patients with renal dysfunction at the Internal Medicine Ward FMUI/Dr. Cipto Mangunkusumo Hospital

Medical Journal of Indonesia Vol 18, No 2 (2009): April-June
Publisher : Faculty of Medicine Universitas Indonesia

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Aim Dose adjusment and drug selection is important in patient with renal dysfuction.This study was aimed to assess the accuracy of dose adjustment and drug selection for renal dysfunction patient at the Internal Medicine Ward FMUI/Dr. Cipto Mangunkusumo Hospital, Jakarta.Methods Patients ≥ 18 years old with estimated creatinine clearance < 60 mL/minute based on Cockroft-Gault formula were included in this study. The drugs assessed were those excreted by the kidney or having nephrotoxic effect. The appropriateness of drug selection is assessed based on the preserce or not contraindication or potential of drug-drug interaction. The accuracy of dose adjustment were assessed based on information available in various textbooks, literatures, and drug brochures. Data were collected between May to July 2007.Results Data obtained from 43 patients met the inclusion criterias demonstrated that 164 out of 385 drug prescriptions were mainly eliminated by the kidney or have nephrotoxic characteristic. Out of 164 drug prescriptions, 142 (86.5%) were appropriately adjusted, while the other 22 (13.5%) were inappropriately adjusted for the dose. There was only one contraindication for the usage of the drug and 15.1% potentially drug interaction.Conclusion Dose adjustment and drug selections in patients with renal dysfunction at the Internal Medicine Ward FMUI/Dr. Cipto Mangunkusumo Hospital are conducted appropriately. (Med J Indones 2009; 18: 108-13)Key words: renal dysfunction, drug interaction, contraindication, dose adjusment

Primaquine decreased plasma concentration of ritonavir: single- and repeated-dose study in Sprague Dawley rats

Medical Journal of Indonesia Vol 20, No 3 (2011): August
Publisher : Faculty of Medicine Universitas Indonesia

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Background: The present study was aimed to explore the effects of ritonavir and primaquine combination given as a singledose or repeated-dose compared to ritonavir alone on ritonavir plasma concentration in the rats.Methods: In single-dose study, 30 male Spraque Dawley rats were randomly allocated to receive ritonavir 20 mg/kg BW or ritonavir 20 mg/kg BW + primaquine 1.2 mg/kg BW or ritonavir 20 mg/kg BW + ketokonazole 10 mg/kg BW. Ketokonazole was used as positive control of ritonavir metabolism inhibitor. In the repeated-dose study, thirty Spraque Dawley male rats were randomly allocated to receive ritonavir 20 mg/kg BW/day or ritonavir 20 mg/kg BW/day + primaquine 1.2 mg/kg BW/day or ritonavir 20 mg/kg BW/day + rifampicin 100 mg/kg BW/day. Rifampicin was used as a positive control of ritonavir metabolism inducer.Results: In the single-dose study, ketokonazole increased the area under the plasma concentration (AUC) of ritonavir (↑114.8%, p< 0.05), while primaquine tended to decrease the AUC of ritonavir (↓ 32.6%, p> 0.05). Repeated-dose study showed that rifampicin decreases the AUC of ritonavir (↓ 42.8%, p< 0.001), and primaquine decreased the AUC of ritonavir plasma concentration (↓ 46.6%, p< 0.001).Conclusion: Concomitant administration of primaquine and ritonavir decreases the AUC of ritonavir. This effect may result in the insufficient concentration of ritonavir as anti-HIV, which may lead to treatment failure with ritonavir. (Med J Indones 2011; 20:190-4)Keywords: drug interaction, metabolism, primaquine, ritonavir