Jurnal Sains Farmasi & Klinis
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Formulation of Nanoemulsion Gel Cayenne Pepper (Capsicum frutescens) Extract as an Anti-inflammatory in Gout Arthritis Pain
Full text linkCayenne pepper fruit extract has anti-inflammatory effects and could be a natural remedy of arthritis gout pain. The research aims to find the optimal formula for cayenne pepper extract nanoemulsion gel to improve its permeation capability and assess its effect on inflammation in mice induced by 1.5% carrageenan. Extraction using the maceration method followed by standardizing the extract. The optimal nanoemulsion formula is determined by constructing a pseudo-ternary diagram of the nanoemulsion base. The optimal formula obtained was 80% aquadest, 2% VCO, 18% SMIX (surfactant and cosurfactant). The cayenne pepper extract nanoemulsion is integrated with a gel base followed by evaluation. The extract nanoemulsion has been proven to form globules with a size of 54.4 nm, zeta potential of -23.6 mV, and polydispersity index of 0.403. Exudate volume and TNF-α levels were measured using the air pouch method to assess for anti-inflammatory activity. In comparison to other treatment groups, rats treated with chili pepper extract nanoemulsion gel had the lowest average exudate volume, with a statistically significant difference (DNMRT; P <0.05), according to the results of an ANOVA test combined with Duncan's post-hoc test. Meanwhile, the test for TNF-α levels did not show any significant difference
Formulation and Evaluation of Sunscreen Body Butter Preparation Containing Soursop Leaf Extract (Annona muricata L.) and Its Influence on Sun Protection Factor (SPF) Value
Full text linkThe leaf part of the soursop plant (Annona muricata L.) contains phenolic compounds, especially flavonoids and tannins, which have sunscreen potential due to the presence of chromophore groups. These groups have conjugated double bonds capable of absorbing ultraviolet rays, thus reducing their intensity on the skin. This study aims to formulate sunscreen body butter preparations from soursop leaf extract with good stability and to determine the effect of varying concentrations of soursop leaf extract on the SPF value of the preparations. Soursop leaf ethanol extract was obtained by maceration with 70% ethanol. Body butter was formulated due to its efficacy in preserving skin hydration, improving softness, and protecting against environmental stressors. SPF value measurements were conducted using spectrophotometric methods. The evaluation results of sunscreen body butter from formulas 1, 2, and 3 were sequentially light green, strong green, and dark green in color; with a typical weak extract odor, homogeneous, pH 7, and a spreadability of 6 - 6.5 cm. Stability testing with a cycling test showed that all three preparation formulas were stable. The SPF values of sunscreen body butter containing ethanol extract of soursop leaves for F1 extract 1% were 7.07, categorized as extra protection; F2 extract 2% was 10.51, categorized as maximum protection; and F3 extract 3% was categorized as ultra protection. The higher the concentration of extract in the preparation, the higher the SPF value it possesse
Evaluation of Chitosan as a Natural Disintegrant in the Formulation of Aspirin Orally Disintegrating Tablets
Full text linkAspirin is an antiplatelet that is used for the therapy and prevention of stroke, many strokes occur in elderly people. Orally Disintegrating Tablet (ODT) can be dissolved quickly making it easier for geriatric patients to swallow. This study aims to determine the effect of variation in the concentration of chitosan as a disintegrating agent on the physical properties of ODT aspirin. Aspirin ODT tablets were produced by direct compression in 3 formulas with variations of chitosan of 3.5%, 7% and 14%. The results showed that a chitosan concentration of 3.5% yielded optimal tablet properties: disintegration time of 23.66 seconds, friability of 0.41%, and dissolution of 96.81%. Statistically significant differences (p < 0.05) were observed among the formulations in terms of in hardness (p = 0.027), friability (p = 0.010) and disintegration time (p = 0.000). The disintegration mechanism of chitosan involves swelling, wicking, and strain recovery. At lower concentrations, chitosan promotes rapid water uptake and particle expansion, facilitating fast breakdown of the tablet matrix. In contrast, higher chitosan levels may induce gel formation that hinders water penetration, thus delaying disintegration. In conclusion, chitosan at a concentration of 3.5% effectively functions as a natural disintegrant in aspirin ODTs, offering rapid disintegration and high dissolution, which is suitable for geriatric patients with swallowing difficulties
Optimization of Xanthorrhizol Nanoemulsion Formulation Using The Design of Experiment Approach (Box-Behnken Methods)
Full text linkNanoemulsion is an effective drug delivery system to enhance the penetration of active substances. Xanthorrhizol (XNT) shows potential as an anti-aging agent with collagenesis activity and photo-aging inhibition, but its lipophilic nature limits skin penetration and reduces its effectiveness in reaching the stratum corneum. Therefore, this study aims to optimize the formulation of xanthorrhizol nanoemulsion using the Design of Experiment (DoE) statistical approach with the Box-Behnken Design (BBD) method on the Design Expert® software. The optimization in this study involved three independent variables (X): (X₁) the concentration of Smix (Tween 80 and PEG 400), (X₂) stirring time, and (X₃) stirring speed. The responses (Y) evaluated to determine the optimization outcome were (Y₁) percent transmittance (%T) and (Y₂) pH. Based on the optimization results, the base formula with the amount of Smix 60%, stirring speed 875 rpm and stirring time 15 minutes gave a 98.4%T response and pH 7.05. The xanthorrhizol nanoemulsion formula was yellow in color and had a distinctive xanthorrhizol odor. The formulation exhibited a globule size of 13.76 ± 0.2 nm, a polydispersity index of 0.059 ± 0.000, and a zeta potential of −48.03 ± 1.423 mV. It also showed 95.5 ± 0.31% transmittance, had a pH of 7.12 ± 0.01, and was classified as an oil-in-water (O/W) nanoemulsion. The nanoemulsion remained stable after freeze-thaw and centrifugation tests, with an entrapment efficiency of 58.6%. Based on these findings, the developed formulation can be considered a promising nanoemulsion system for xanthorrhizol deliver
Pembentukan dan karakterisasi kristal cair aceklofenak untuk sistem penghantaran transdermal
No full textAceclofenac is a phenylacetic acid derivative classified as a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain caused by inflammation. It has potential for topical application through a transdermal delivery system. One promising approach is the use of liquid crystals as carriers in transdermal dosage forms. This study aims to develop a simple liquid crystal cream formulation for aceclofenac, using glyceryl monostearate as a mesogen and Pluronic as a stabilizer. The aceclofenac liquid crystal cream was characterized using Polarized Light Microscopy (PLM), Attenuated Total Reflectance-Fourier Transform Infrared Spectroscopy (ATR-FTIR), and Differential Scanning Calorimetry (DSC). Evaluations included drug release, permeation, viscosity, flow properties, zeta potential, and freeze-thaw stability. The optimal formulation consisted of oil: glyceryl monostearate–Pluronic P123: water in a 5:15:80% ratio. PLM results showed birefringence and a lamellar phase texture. FTIR analysis confirmed no new chemical bonds, while DSC indicated a reduced melting point and increased enthalpy of fusion. The release and permeation of aceclofenac after 6 hours were 27.849 ± 0.5479 µg/cm² and 21.093 ± 0.5761 µg/cm², respectively—higher than non-liquid crystal preparations. The cream exhibited thixotropic flow behavior, a zeta potential of -50.8 mV, and remained stable after six freeze-thaw cycles. In coclusion, Aceclofenac can be formulated into a liquid crystal cream with glyceryl monostearate as a mesogen, showing a birefringent lamellar phase that enhances its release and permeatio
Antibiotic Use for Genitourinary Infections in an Indonesian Hospital During COVID-19: A Retrospective Study
Full text linkThe management of genitourinary infections presents a growing challenge due to antimicrobial resistance, shifting regional patterns, and evolving etiologies. This study aimed to elucidate antibiotic utilization trends and patterns for genitourinary system diseases at an Indonesian teaching hospital during the COVID-19 pandemic. This retrospective, cross-sectional study analyzed antibiotic use in an Indonesian teaching hospital's inpatient department in 2021. Data on systemic antibiotics (ATC: J01) for genitourinary diseases (ICD-10: N00-N99) were extracted from electronic records. Prescription patterns were evaluated by patient characteristics, disease profiles, administration routes, and WHO AWaRe classification. Among the 47,696 hospitalized patients who received antibiotics, 1,752 were treated with J01 antibiotics for genitourinary disorders, mostly in elderly men with prostatic hyperplasia and obstructive uropathy. Cephalosporins, especially ceftriaxone (724 prescriptions) and cefazolin (294 prescriptions), were the most commonly prescribed, while amoxicillin/beta-lactamase inhibitors were the least prescribed. Parenteral administration was more common than oral, and "Watch" category antibiotics were prescribed twice as often as "Access" antibiotics in adults and the elderly. Genitourinary disorders like prostatic hyperplasia and obstructive uropathy significantly impact elderly men. This study reveals a trend of high broad-spectrum antibiotic use, such as ceftriaxone and cefazolin injections, in hospitalized patients with these conditions
Phytochemical Constituents and Evaluation of Lipoxygenase Activity of Tetracera macrophylla Twigs Wall.ex Hook.f. & Thoms
Full text linkLipoxygenase is an enzyme that catalyzes the formation of leukotriene, which is involved in various diseases such as asthma, osteoporosis and atherosclerosis. Inhibition of this enzyme can overcome inflammatory diseases. Tetracera macrophylla Wall.ex Hook. f.& Thoms plant has shown various biological activities, especially as an anti-inflammatory. This study aims to analyze phytochemical constituents and evaluate the lipoxygenase activity of Tetracera macrophylla twig extract. The sample was gradually macerated using n-hexane, ethyl acetate, and methanol. Phytochemical analysis of the extract was carried out using the LC-MS/MS method. Lipoxygenase assay was performed in vitro using RAW 264.7 macrophage cells induced with lipopolysaccharide using spectrofluorometry. As a comparison, zileuton, which has been established as a 5-LOX inhibitor and quercetin, which has the potential as a 5-LOX inhibitor. The results showed that methanol extract of Tetracera macrophylla twigs (RM3) had lower specific LOX activity (0.350 mU/mL) than standard zileuton (7.927 mU/mL) and quercetin (12.837 mU/mL). Decreased LOX activity can lessen the generation of leukotrienes, which cause inflammation. The study showed that methanol extract of Tetracera macrophylla twigs contains active compounds that can be developed as lipoxygenase inhibitorsLipoxygenase is an enzyme that catalyzes the formation of leukotriene, which is involved in various diseases such as asthma, osteoporosis and atherosclerosis. Inhibition of this enzyme can overcome inflammatory diseases. Tetracera macrophylla Wall.ex Hook. f.& Thoms plant has shown various biological activities, especially as an anti-inflammatory. This study aims to analyze phytochemical constituents and evaluate the lipoxygenase activity of Tetracera macrophylla twig extract. The sample was gradually macerated using n-hexane, ethyl acetate, and methanol. Phytochemical analysis of the extract was carried out using the LC-MS/MS method. Lipoxygenase assay was performed in vitro using RAW 264.7 macrophage cells induced with lipopolysaccharide using spectrofluorometry. As a comparison, zileuton, which has been established as a 5-LOX inhibitor and quercetin, which has the potential as a 5-LOX inhibitor. The results showed that methanol extract of Tetracera macrophylla twigs (RM3) had lower specific LOX activity (0.350 mU/mL) than standard zileuton (7.927 mU/mL) and quercetin (12.837 mU/mL). Decreased LOX activity can lessen the generation of leukotrienes, which cause inflammation. The study showed that methanol extract of Tetracera macrophylla twigs contains active compounds that can be developed as lipoxygenase inhibitor
Amlodipine-Candesartan Combination: A Cost-Effective Strategy for Successful Therapy of Hypertension
Full text linkIntroduction: The combination of amlodipine and candesartan can have a better effect, although the cost-effectiveness analysis was not yet determined. This research aimed to establish the Incremental Cost-Effectiveness Ratio (ICER) value among outpatients with hypertension who used amlodipine-candesartan. Method: This research is a descriptive study that retrospectively gathered data from medical records. It focused on information for hypertensive patients at Universitas Andalas Hospital in 2021. This study compared the standard treatment involving amlodipine-candesartan and sole amlodipine, next to calculate the ICER using cost-effectiveness analysis. Results: Out of the total population of 284, as many as 73 patients were involved in this study. Among these, 21 patients (28.77%) were treated with amlodipine alone, while 52 (71.23%) received an amlodipine-candesartan combination. The Incremental Cost-Effectiveness Ratio (ICER) for reducing systolic blood pressure was IDR 74,738.10 per one mmHg decrease in the northeast quadrant of the cost-effectiveness chart. The ICER for lowering diastolic blood pressure was IDR 205,918.24 per one mmHg decrease in the northeast quadrant on the cost-effectiveness chart. Conclusion: The cost of the amlodipine-candesartan combination yields superior effects; however, warranting a probabilistic sensitivity analysis to determine its ICER robustness is essential for its effective implementatio
Hubungan Antara Penggunaan Cephalosporin dengan Peningkatan APTT Dan PT Pada Pasien Kardiovaskular Di Antara Pasien Di Rumah Sakit Pemerintah Bengkulu
No full textThe interaction that occurs between warfarin and antibiotics is a pharmacokinetic interaction which cause bleeding. This study aims to determine whether there is a relationship between the use of cephalosporins and an increase in APTT and PT in cardiovascular patients. This retrospective observational study employs case-control analysis to examine APTT and PT features in cardiovascular patients receiving single anticoagulant or anticoagulant + cephalosporin therapy for the period JulyDecember 2020. The sampling method used in this study is a convenient sampling method that meets the inclusion and exclusion criteria. Analysis of the data used is Logistic Regression. The study found among 65 male and 15 female, 40 patients used anticoagulant, and another 40 patients used anticoagulant and cephalosporine. Among 40 patients who used combination anticoagulant and cephalosporin, 22 of them had experienced of increasing APTT and PT. Cephalosporins showed a significant correlation with APTT and PT, with a P-value of 0.015. From this study, it can be concluded that the use of cephalosporins increases in APTT and PT values in cardiovascular patients who are given anticoagulant drugs and cephalosporins
Salah satu obat yang digunakan untuk mengatasi penyakit kardiovaskular adalah antikoagulan, antikoagulan merupakan salah satu jenis obat yang digunakan untuk menurunkan tekanan darah. Sefalosporin adalah kelompok antibiotik beta-laktam terbesar. Mekanisme kerja sefalosporin adalah dengan menghambat sintesis dinding sel mikroba. Sefalosporin dicirikan oleh adanya rantai samping N-methylthiotetrasol (NMTT) yang memungkinkan mereka menghambat faktor koagulasi melalui mekanisme yang sama seperti warfarin. Interaksi kedua jenis obat tersebut dapat menyebabkan konsentrasi antikoagulan warfarin meningkat sehingga menyebabkan peningkatan efek samping warfarin yaitu perdarahan. Interaksi yang terjadi antara warfarin dan antibiotik merupakan interaksi farmakokinetik. Pemeriksaan rutin untuk menilai aktivasi koagulasi adalah Protrombin Time (PT), Activated Partial Thromboplastin Time (APTT), dan kadar fibrinogen, sedangkan pemeriksaan hemostasis rutin untuk menilai aktivasi fibrinolisis adalah pemeriksaan D-dimer. Penelitian ini bertujuan untuk mengetahui apakah ada hubungan penggunaan sefalosporin dengan peningkatan APTT dan PT pada pasien kardiovaskular. Penelitian ini merupakan penelitian observasional retrospektif dengan analisis kasus kontrol untuk menganalisis gambaran APTT dan PT pada pasien kardiovaskular yang diberikan terapi antikoagulan tunggal dan antikoagulan + sefalosporin periode Juli-Desember 2020. Metode pengambilan sampel yang digunakan dalam penelitian ini adalah a. metode pengambilan sampel yang nyaman yang memenuhi kriteria inklusi dan eksklusi. Analisis data yang digunakan adalah Regresi Logistik (metode enter). Penelitian menemukan di antara 65 laki-laki dan 15 perempuan, 40 pasien menggunakan antikoagulan, dan 40 pasien lainnya menggunakan antikoagulan dan sefalosporin. Di antara 40 pasien yang menggunakan kombinasi antikoagulan dan sefalosporin, 22 diantaranya pernah mengalami peningkatan APTT dan PT. Dari penelitian ini dapat disimpulkan bahwa sefalosporin berpengaruh terhadap APTT dan PT dengan nilai P = 0,015
Comparative Economic and Clinical Utility of Adding Candesartan for Hypertension Management
Full text linkIntroduction: Antihypertensive drugs require high costs because they are used over a long period. Therefore, consideration is needed in drug selection requirements, effectiveness, and price. This study aimed to see the beneficial results of hypertension therapy and the non-medical costs incurred by patients using cost-utility analysis (CUA). Method: This research was a prospective study. The incremental Cost-Utility Ratio (ICUR) of antihypertensive treatment was calculated using cost-utility data obtained through EQ-5D-5L questionnaires from outpatients at Universitas Andalas Hospital in January- March 2023 who met the inclusion and exclusion criteria. The costs used were from a patient perspective, consisting of direct medical and non-medical costs. This study compared standard treatment (amlodipine) with the addition of candesartan. Results: The number of respondents in this study was 67, consisting of 23 respondents (34.33%) using amlodipine alone and 44 respondents (65.67%) using the amlodipine-candesartan combination. The ICUR value obtained was IDR7,318,674/QALY. The difference in the average utility value of the amlodipine-candesartan combination with amlodipine alone is -0.02, and the difference in cost is -IDR12,224. Based on the cost-utility diagram, the amlodipine-candesartan combination group is included in the southwest quadrant (quadrant III), which illustrates that the cost required for the amlodipine-candesartan combination group is lower than the cost of the amlodipine single treatment group and the outcome is also not better (slightly lower or the same). Conclusion: It was recommended to prioritize using amlodipine alone for hypertension management, as it provides similar outcomes to the amlodipine-candesartan combination while incurring lower costs