Nurul Maziyyah, Nurul
Fakultas Farmasi, Universitas Gadjah Mada, Yogyakarta

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Analisis Outcome Pasien Post Stroke Hyperglycemia Tanpa Terapi Antihiperglikemia Maziyyah, Nurul; Sugiyanto, Sugiyanto; Inayati, Inayati
PHARMACY: Jurnal Farmasi Indonesia (Pharmaceutical Journal of Indonesia) Jurnal Pharmacy, Vol. 13 No. 01 Juli 2016
Publisher : Fakultas Farmasi, Universitas Muhammadiyah Purwokerto

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Abstract

ABSTRAK Poststroke Hyperglycemia (PSH) merupakan kejadian peningkatan kadar gula darah yang signifikan setelah terjadinya serangan stroke. Kejadian PSH telah diketahui dapat menimbulkan dampak yang buruk bagi pasien. Saat ini rekomendasi terapi untuk pasien PSH adalah terapi berbasis insulin. Namun pendekatan di klinik pada kenyataannya masih berbeda–beda, salah satunya adalah tidak diberikannya terapi antihiperglikemia pada pasien-pasien tertentu. Penelitian ini bertujuan untuk mengetahui gambaran outcome pada pasien PSH yang tidak mendapatkan terapi antihiperglikemia di rumah sakit. Penelitian ini menggunakan rancangan non eksperimental secara deskriptif-analitik. Data diperoleh secara retrospektif dengan menelusuri rekam medik pasien stroke yang dirawat inap pada periode Oktober 2011–Oktober 2012 di sebuah rumah sakit swasta di Yogyakarta. Pasien dinyatakan mengalami PSH jika kadar gula darah pasien saat masuk rumah sakit ≥140 mg/dL. Pasien PSH dikelompokkan berdasarkan riwayat diabetes mellitus (DM) sebelum stroke. Analisis dilakukan terhadap outcome pasien PSH yang tidak diberikan terapi antihiperglikemia berupa kadar gula darah pasien setelah ±24 jam di rumah sakit dan kondisi pasien di akhir perawatan di rumah sakit. Hasil penelitian menunjukkan bahwa sebagian besar (96,88%) pasien PSH yang tidak mendapatkan terapi antihiperglikemia adalah pasien tanpa riwayat DM dengan baseline kadar gula darah saat masuk rumah sakit berada pada rentang 140–180 mg/dL (71,88%). Gambaran kadar gula darah setelah ± 24 jam perawatan memperlihatkan bahwa 55,38% pasien tidak terekam kadar gula darahnya sementara 33,85% mengalami penurunan dan sisanya 10,77% mengalami peningkatan kadar gula darah. Kondisi pasien di akhir perawatan sebagian besar membaik (68,75%), namun terdapat 29,69% pasien yang meninggal selama perawatan. Outcome yang beragam pada pasien PSH perlu menjadi perhatian khususnya oleh para klinisi, agar kadar gula darah pasien dapat terekam dengan jelas selama fase akut stroke di rumah sakit untuk mengambil keputusan yang tepat terkait terapi pasien. Hal ini untuk menghindari dampak buruk dari kondisi hiperglikemia (termasuk tingkatan hiperglikemia ringan) pada pasien stroke. Kata kunci: poststroke hyperglycemia, outcome, antihiperglikemia. ABSTRACT Poststroke Hyperglycemia (PSH) occurs when there is a significant increase in blood glucose level after stroke attack. PSH has been known to cause various negative effects on stroke patients. PSH therapy recommendation from various guidelines nowadays is insulin-based therapy. On the other hand, many clinicians use various approaches in overcoming this condition, one of which is not treating PSH patients (probably specific PSH patients). This study aims to describe outcomes in PSH patients untreated with antihyperglycemia agent. This study uses a non experimental design with a descriptive and analytical approach. Data was obtained retrospectively through medical records of stroke patients hospitalized from October 2011–October 2012 in a private hospital in Yogyakarta. Patients were stated as PSH if the admission blood glucose level was ≥140 mg/dL. PSH patients were classified based on their history of diabetes mellitus (DM); diabetic or non diabetic. Outcome in untreated PSH patients was described through blood glucose level after ±24 hours hospitalized and their final condition in the hospital. The result of this study showed that most of untreated PSH patients (96.88%) were non diabetic patients with a baseline of 140–180 mg/dL on their admission blood glucose level (71.88%). Outcome of blood glucose level after ±24 hours of hospitalization revealed 55.38% of the patients didn’t have their blood glucose level recorded, while 33,85% had a decrease in glucose level and the remaining 10.77% had a rise in their glucose level. Patients’ final conditions were mostly getting better (68.75%), but there were 29.69% of patients who died during hospitalization. The various outcomes seen in untreated PSH patients should give awareness for clinicians to have a complete record on patients’ blood glucose level throughout the acute phase of stroke in order to decide for the best treatment. Hence, negative effect following hyperglycemia condition (including mild hyperglycemia) in stroke patients could be prevented.. Key words: poststroke hyperglycemia, outcome, antihyperglycemia.
EVALUASI POLA PENGGUNAAN OBAT DALAM TERAPI PASIEN KETERGANTUNGAN NARKOTIKA DI SEBUAH RUMAH SAKIT DI DIY Maziyyah, Nurul; Nugroho, Agung Endro
PHARMACY: Jurnal Farmasi Indonesia (Pharmaceutical Journal of Indonesia) Jurnal Pharmacy, Vol. 09 No. 01 April 2012
Publisher : Fakultas Farmasi, Universitas Muhammadiyah Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/pji.v9i1.689

Abstract

ABSTRAK Narkotika sebagai salah satu obat pengurang nyeri dalam dunia medis, sering disalahgunakan oleh masyarakat karena efek lain yang ditimbulkan. Tidak jarang penyalahgunaan ini menimbulkan sifat ketergantungan terhadap penggunaan narkotika yang dapat mengakibatkan berbagai kondisi klinis yang merugikan bagi pemakainya. Oleh karena itu diperlukan tatalaksana terapi yang tepat untuk menanggulangi kondisi klinis yang diderita pasien. Tujuan dari penelitian ini adalah untuk memberi gambaran serta mengevaluasi penggunaan obat pada penatalaksanaan terapi pasien ketergantungan narkotika yang menjalani perawatan di sebuah Rumah Sakit di DIY selama periode Januari hingga Desember 2009. Penelitian ini menggunakan rancangan penelitian non-eksperimental secara deskriptif analitik dengan mengambil data secara retrospektif. Data dari rekam medik pasien dikumpulkan dan dianalisis mengenai terapi obat yang diberikan pada tiap pasien dengan mengacu pada standar yang digunakan dalam penelitian, yaitu SPM RS, UK Guideline, WHO Guideline, NICE Guideline, Pharmacotherapy: A Pathophysiologic Approach edisi ke-7, Drug Information Handbook, dan IONI. Analisis meliputi ketepatan indikasi, ketepatan obat, ketepatan dosis, dan ketepatan pasien. Hasil penelitian menunjukkan bahwa terapi ketergantungan narkotika yang dilakukan di Rumah Sakit selama tahun 2009 meliputi terapi ketergantungan opioid yang berupa terapi substitusi opioid dengan sediaan buprenorfin dan kombinasi buprenorfin-nalokson, terapi simtomatik, dan terapi suportif, serta terapi ketergantungan stimulansia yang berupa terapi simtomatik, terapi suportif, dan terapi komplikasi akibat penyalahgunaan stimulansia. Hasil evaluasi penggunaan obat pada terapi pasien ketergantungan narkotika di Rumah Sakit selama tahun 2009 menunjukkan ketepatan indikasi sebesar 55,88 %, ketepatan pemilihan obat sebesar 55,88 %, ketepatan regimen dosis sebesar 50,00 %, serta ketepatan pasien terhadap terapi yang diberikan sebesar 100 %. Ketepatan penggunaan obat, baik tepat indikasi, tepat obat, tepat dosis, dan tepat pasien terlihat pada 15 kasus pasien atau sebesar 44,12 % dari seluruh kasus yang dievaluasi. Kata Kunci: ketergantungan, narkotika, evaluasi, terapi ABSTRACT Narcotic as a pain killer drug has been often misused intentionally because of other effects it possesses. This drug abuse behavior has often cause dependency toward narcotic usage, which could lead to various unwanted clinical conditions for the users. Therefore, an appropriate therapy procedure is necessary to overcome these clinical conditions. The objective of this study is to give a description and evaluation on drug usage in the therapy of narcotic dependence patients’ ongoing medication in a hospital in DIY from January until December 2009. This study used a nonexperimental design study with analitical descriptive method by obtaining data retrospectively. Data from patients’ medical record was collected and analyzed about the medication given to each patient by refering to the standards used in this study, which is The Hospital’s Medical Service Standard, UK Guideline, WHO Guideline, NICE Guideline, Pharmacotherapy: A Pathophysiologic Approach 7th edition, Drug Information Handbook, and IONI. The analysis included appropriate indication, appropriate drug, appropriate dosage, and appropriate patient. The result of the study showed that narcotic dependence therapy in the hospital during 2009 included opioid dependence therapy in the form of opioid substitution therapy with buprenorfin alone and in combination with nalokson, symptomatic therapy, and supportive therapy, and stimulant dependence therapy in the form of symptomatic therapy, supportive therapy, and complication therapy due to stimulant abuse. The result of evaluation on drug usage in narcotic dependence patients in the hospital during 2009 showed 55,88% of appropriate indication, 55,88% for appropriate drug selection, 50,00% appropriate dosage regimen, and 100% for appropriate patients. Appropriate drug usage, which includes appropriate indication, appropriate drug, appropriate dosage, and appropriate patient was seen in 15 cases or 44,12% from all cases evaluated. Keywords: dependence, narcotic, evaluation, therapy
Identification of Potential Drug Interaction with Complementary and Alternative Medicines among Chronic Disease Outpatients Maziyyah, Nurul; Nurdianto, Apri; Fajria, Arsitania Kun
International Journal of Public Health Science (IJPHS) Vol 7, No 1: March 2018
Publisher : Institute of Advanced Engineering and Science

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v7i1.11438

Abstract

Chronic diseases such as congestive heart failure (CHF) and chronic kidney disease (CKD) are related with multiple drug prescription which can lead to drug interaction. The high usage of complementary and alternative medicines (CAM) in Indonesians can also increase the risk for drug interaction. The objective of this study is to describe CAMs use and identify potential drug interaction with CAMs in CHF and CKD outpatients. The study is a cross sectional study. Data of prescribed drugs and CAMs consumed by the patients was collected by using medication reconciliation process. Data of routine CAMs and prescribed medicines were compared to identify potential drug interactions which were then classified based on their mechanism and significance. The result showed that 6,90 % of CHF patients and 25 % of CKD patients consumed CAMs. Potential drug interaction between the CAMs and the prescribed drugs was identified in 2.74% of patients consuming CAMs. Based on the mechanism, interaction was dominated by pharmacodynamics interaction (69.2%) while interaction significancy was various. It can be concluded that CAMs usage was more familiar in CKD patients compared to CHF patients. Potential drug interaction with CAMs was able to be identified through medication reconciliation process and should be taken into awareness by the healthcare team.