Indonesian Journal of Pharmacy
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Effect of Pharmacist Interventions on Medication Adherence to Capecitabine in Cancer Patients: A Systematic Review
No full textOral chemotherapy poses challenges regarding patient medication adherence. Pharmacists play a vital role in supporting medication adherence to achieve the effectiveness of therapy. This review aimed to evaluate the impact of pharmacist interventions on medication adherence in patients with cancer taking capecitabine. The literature was systematically reviewed using Scopus, ScienceDirect, Sage Journal, Springer Link, PubMed, and Google Scholar. Key text words included “adherence, pharmacist intervention, capecitabine, oral chemotherapy, and cancer.” We collected original articles published from January 2010 to June 2021 in English that reported pharmacist interventions to enhance capecitabine adherence in adult patients with cancer and assessed adherence rates pre- and post-intervention. Two independent researchers extracted data relevant to inclusion criteria and determined the methodological quality of studies using the Joanna Briggs Institute Critical Appraisal Checklist Tools. A total of 4179 articles were retrieved, of which five were eligible for review. The most common pharmacist intervention strategy was a combination of patient education, with oral and written information provided. Components of patient education were the characteristics of capecitabine, including its mechanism of action, side effects, and their management; current therapeutic regimen; importance of adherence; and risk of non-adherence. Pharmacist interventions provide beneficial impacts on medication adherence, beliefs about medication, and tolerability of side effects. The findings suggest that pharmacist interventions support medication adherence improvement and highlight the role of pharmacist interventions in pharmaceutical oncology care services. Further studies are necessary to assess pharmacist interventions’ long-term effects and clinical outcomes
Antibacterial and Anti-biofilm- Forming Activity of Secondary Metabolites from Sansevieria trifasciata- Leaves Against Pseudomonas aeruginosa
Get PDFSansevieria trifasciata is a herbaceous plant frequently used in traditional medicine with antibacterial potency against Pseudomonas aeruginosa. P. aeruginosa is a known bacterial pathogen that often becomes resistant to traditional antibiotics due to its ability to form biofilms. The objective of this research was to determine whether the ethanolic extract of S. trifasciata has any antibacterial or anti-biofilm-forming activity against P. aeruginosa. Bacterial cell damage with a potential fraction of S. trifasciata ethanolic extract treatment was observed by scanning electron microscopy (SEM). An Anti-biofilm assay was perfomed in 96 wells with crystal violet stain. The minimum inhibitory concentration (MIC) results revealed that at a concentration of 4 mg/mL, the potential fraction of S. trifasciata ethanolic could inhibit bacterial growth. At this concentration, the potential fraction of S. trifasciata ethanolic extract could inhibit the biofilm by 60%. The identification of compounds using gas chromatography-Mass Spectrometry (GC-MS) revealed that Neophytadiene was the main active component in the extract. These compounds have the potential to be used as therapeutic agents in the prevention of bacterial biofilms and virulence-related infectious illnesse
Immunomodulatory Activity of Begonia Medicinalis Ethanolic Extract in Experimental Animals
Get PDFBenalu batu (B. medicinalis) is a plant endemic to Central Sulawesi that has been reported to possess anticancer, antioxidant, and antiviral activities. The mechanism of action of these activities is still unclear. This study aimed to evaluate the immunostimulatory effect of ethanol extract of B. medicinalis on an in vivo model by measuring the macrophage phagocytotic activity and cytokine production of tumor necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ) on male mice and rats, respectively. The extract was obtained by the maceration method for 3 × 24 h using 70% ethanol. The doses of the extract were 60, 120, and 240 mg/kg body weight (bw). The percentage of macrophage phagocytosis and the TNF-α, and IFN-γ levels were measured on the eighth day, one hour after intraperitoneal injection of Staphylococcus aureus ATCC 25923. The result showed that ethanol extract of B. medicinalis activated macrophage phagocytosis in a dose-dependent manner, with a significant increase in cytokine expression of TNF-α and IFN-γ. The optimal dose was 240 mg/kg bw, with a higher percentage of phagocytic activity and higher levels of TNF-α and IFN-γ than Stimuno® as a positive control and other dosage treatments. This study suggests that B. medicinalis ethanol extract has the effect of an immunomodulator and provides a scientific basis for traditional usage of this herb plant
Fat Analysis of House Rat (Rattus tanezumi) in Meatball Using Gas Chromatography-mass Spectrometry (GC-MS) Combined with Principal Component Analysis
Get PDFCounterfeit food products are starting to become a new problem around the people of Indonesia. Problems that are getting special attention especially the concern of contamination of food products by non-halal meat. This research aim was to analyze the fatty acids contained in house rat. The method that used was GC-MS method combined with Principle Component Analysis (PCA). Method of extraction grease was using oven at 90ºC - 100ºC for approximately one hour. After that, the derivatization process changed the fat into a methyl esters that easily evaporated. The derivatization process were using NaOCH3 and BF3. Methyl Esther compounds were injected into the chromatography instrument system GC-MS. GC-MS analysis results shows that the composition of fatty acid compounds from house rat fat with SI values > 90. Composition of fatty acids of house rat fats include: Myristate (0,19±0,03)%, Palmitoleat (2,40±0,29)%, Methyl Palmitate (27,65±0,32)%, oleate (45,81±3,25)%, and Stearate (4,65±0,28)%. Total content of house rat fatty acids was as high as 48.21% of unsaturated fatty acid and 31.49% of saturated fatty acids. The GC-MS method combined with PCA can post the fat of house rat. House rat fatty acids based on PCA's chemetrics demonstrate the resemblance of chemical physical properties with chicken fatty acids
Pharmacists’ Roles and Practices in Pharmaceutical Services During Covid-19 Pandemic: a Qualitative Study
Get PDFThe World Health Organization (WHO) declared COVID-19 a global pandemic on March 11, 2020. Pharmacists as health workers also have an important role in this pandemic. This study wants to look deeper into how pharmacists perceive their role and pharmaceutical services during this pandemic. A qualitative study with Focus Group Discussions (FGDs) was utilized. Fifteen pharmacists from Kepulauan Riau province were involved. They were purposively selected to include pharmacists from the community pharmacies, hospitals, and community health centers. The FGDs were conducted with Zoom meetings and were recorded. The data were then transcribed and analyzed with inductive content analysis. This study found five themes with 18 sub-themes. The five themes are the roles and efforts of pharmacists in managing medicines, medical devices, and disposable medical materials (personal protective equipment); the roles of pharmacists in providing pharmaceutical care; community behaviors during the pandemic; development of pharmacists’ roles and capacity during the pandemic; and external factors influencing the roles and practice of pharmacists during the pandemic. During the pandemic, pharmacists continued to work according to their previous roles and adjusted their roles and practice in pharmaceutical services to follow changes in community behaviors. This condition also encouraged pharmacists to develop their roles and capacities. The healthcare management team, the government, and the professional organizations influenced their roles, both positively and negatively. The results of this study provide a deeper understanding of pharmacist roles and practices during the pandemic. This understanding will be useful for the pharmacist in developing their potential and capability to be involved as healthcare professionals, specifically during the pandemic situation and generally in disaster management
Comparing Responses of Ursolic Acid in Murine Macrophages Infected with Mycobacterium smegmatis and Mycobacterium avium
Get PDFMycobacterium smegmatis and Mycobacterium avium offer an advantage in examining tuberculosis-like effects and host immune defense. Therefore, the study aims to examine the effect of ursolic acid (UA) on the host immune system by analyzing cytokines concentration, such as TNF-α, IL-6, IL-1β, and nitrite oxide produced by murine macrophages infected with Mycobacterium smegmatis and Mycobacterium avium. Femurs of female C57BL/6 mice aged 6–8 weeks were used to culture the Bone marrow-derived macrophages (BMDM). On day 10, BMDM was infected with Mycobacterium smegmatis and Mycobacterium avium using a multiplicity of infection (MOI) amounting to 8:1, then TNF-α, IL-6, and IL-1β were analyzed using ELISA and nitrite oxide with Griess reagent. The results showed that UA decreased the production of three respective pro-inflammatory cytokines used in the study, both in BMDM infected by Mycobacterium smegmatis and Mycobacterium avium. For TNF-α, the reduction was nearly 65%-90% compared to the control. The decrease in the production of IL-6 occurred from 2700 pg/ml to 750 pg/ml for BMDM infected with Mycobacterium smegmatis, while the reduction was more significant in those infected using Mycobacterium avium with approximately 150 pg/ml compared to the control. Moreover, UA reduced by over 90% of IL-1β and this result was in line with the reduction of nitrite. UA decreases the production of pro-inflammatory cytokines such as TNF-α, IL-6, IL-1β, and nitrite. This result is preliminary but supports further study on the role of UA in immune defense from pathogenic and non-pathogenic mycobacterial infections
Educational Interventions to Improve Pharmacy Students’ Empathy Towards Geriatrics: A Systematic Review
No full textEmpathy is defined as the ability to understand other's feelings, thereby allowing them to feel understood. Empathy must be cultivated in the educational method to help pharmacy students to learn about patients, particularly the elderly. The main objective of this systematic review was to find, evaluate, and synthesize studies about educational interventions that improve the empathy of pharmacy students towards geriatrics. Three databases (PubMed, Science Direct, and Google Scholar) searched for articles with criteria that were educational intervention articles and focused on outcome measures related to improving empathy (or its subdivision) towards geriatrics. The Medical Education Research Study Quality Instrument was used to assess the possibility of bias. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to guide this review. Of the nine included studies, eight studies have been designed with quasi-experimental pre-post-test measurements. Four studies were carried out at the university in the United States, two in Malaysia, one in Australia, one in Brazil, and one in Singapore. Three studies used simulation and three studies used direct interaction with the elderly, as an educational intervention. Significant increase in empathy reported that 8 reviewed studies resulted from the statistically significant increase in empathy toward geriatrics. It was obvious that the educational intervention could help pharmacy students to develop empathy for the elderly. We recognize that the included studies are heterogeneous, implying that more research is needed to determine the best effective empathy education methods. Transfer to practice and longer-term changes in empathy should also be considered as study outcomes in future investigations
Acute and Subchronic Oral Toxicities Study of Channa striata
Get PDFFood and drug control authorities in each country have issued warnings about the toxic effect potential of using commonly consumed traditional medicines. The safety assurance, standardization, and market regulation of herbal medicines being sold need to be determined. This study's goal is to investigate the acute and subchronic toxicity of cold-processed snakehead fish (Channa striata) flesh. In-vivo rats models were given dosages of 350, 1400, and 5600 mg/kg processed snakehead fish (SF) and were monitored for toxic symptoms and mortality for 14 days. Meanwhile, regarding subchronic toxicity, doses of 350, 700, and 1400 mg/kg SF were administered orally for 28 days. Afterward, the animal subjects were sacrificed for histopathological, hematological, and biochemical examinations. There were no evidence of toxicity or mortality in rats during the acute examination, which lasted 14 days. The subchronic toxicity results showed no significant changes in most of the hematological, biochemical, and histological profiles of the organs. Some changes observed in blood biochemistry and relative organ weight were assumed as a temporary effect and not a sign of toxicity. The overall results showed that the SF was non-toxic up to 1400 mg/kg, which can be considered a safe dose for the application of health supplement raw materials
Enhancement Peripheral Regeneration as a Target of Potential Diabetic Neuropathy Treatment from Lumbricus rubellus Fraction DLBS1033N: the role of cell viability and migration
Get PDFDiabetic Peripheral Neuropathy (DPN) significantly affects the quality of life with no definitive therapy currently. Given the pathologic basis for DPN treatment, it's critical to promote neuron regeneration while also restricting nerve degeneration. Schwann cells that play pivotal roles against peripheral regeneration manifest cell proliferation and survival inhibition in diabetic patients consecutively decreased peripheral regeneration capacity. DLBS1033N, a protein hydrolysate obtained from Lumbricus rubellus, has been confirmed to promote Schwann cell line RSC96 growth and survival by induction Nerve Growth Factor (NGF) expression via phosphatidylinositol-3‑kinase (PI3K) pathway. This pathway has an important contribution against Schwann cell proliferation and migration. Herein, the contribution of DLBS1033N to peripheral regeneration on high-glucose (50mM)-induced rat Schwann cell line RSC96 injury, a well-known DPN in vitro cell model. RSC96 were treated with high glucose (50mM) with or without DLBS1033N 25, 50, and 100μg/mL for 24, 48, and 72 h. MTS assay kit were used to evaluate cell viability. DLBS1033N significantly improved cell proliferation in 48 h incubation time with a dose-dependent manner (p < 0.05). Furthermore, DLBS1033N 100μg/ml significantly promoted cell migration by 16% in 48 H incubation (p < 0.05) determined by scratch assay, as the beneficial action to accomplish peripheral regeneration. In conclusion, DLBS1033N enhanced peripheral regeneration which could be used as an effective and promising DPN treatment
Evaluation of trough-based vancomycin therapy in achieving targeted area under the curve in haemodialysis cases.
Get PDFBackground & Objectives: Recently published IDSA guidelines on vancomycin dosing no longer advocates the use of trough concentrations as surrogate markers for clinical efficacy. Protocols developed prior to revised targets may not reflect to the true efficacy marker for vancomycin that is AUC/MIC 400-600. This study aimed to evaluate the local vancomycin dosing protocol in achieving the target trough concentration and extrapolated AUC/MIC of 400-600 in patients with haemodialysis.
Methods: A retrospective analysis of therapeutic drug monitoring forms and individual medical records of haemodialysis patients was conducted. Vancomycin AUC of each individual was extrapolated via the use of a pharmacokinetic modelling software, PrecisePK®. Chi-square test of independence was used to determine the association of factors affecting AUC/MIC. A p value of 0.05 was considered statistically significant.
Results: A total number of 80 haemodialysis-dependent cases who were on vancomycin were recruited. More than 62% of haemodialysis patients showed AUC/MIC > 800. AUC/MIC was heavily influenced by minimum inhibitory concentration of the infecting microorganism. Interpretation & Conclusions: Exclusive trough-guided dosing may not translate well in achieving clinical efficacy of vancomycin in haemodialysis patients. Other contributing factors, especially MIC should be factored, as small MIC values account for greater reciprocal AUC/MIC values that increase the risk of loss of residual kidney function; a factor which is associated with overall mortality of HD patients