Indonesian Journal of Pharmacy
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3 Co-TEAM: A logic model for pharmacy health coaching among substance use disorders patients
Get PDFPharmacy health coaching on various chronic diseases has been widely used with promising results. Drug addiction is a chronic disease, however, the intervention model of pharmacy health coaching in these patients has not been previously reported. Developing a logic model for pharmacy health coaching among substance use disorders patients that can be used by community pharmacists as a tool to support development, innovation, monitoring, and evaluating the performance of pharmacy health coaching. A logic model used to develop an intervention model of pharmacy health coaching following a process consisting of four steps: (1) a literature review to identify key values, scope, delivery & tools, the content of the session, and competencies for pharmacy health coaching; (2) focus groups discussion (FGD) to obtain information from specific sources and discuss the results of the literature review; (3) developing a logic model based on the finding from steps 1 and 2; and (4) FGD to discuss and fine-tune the model. A logic model was successfully constructed and generated 3 Co-TEAM models for pharmacy health coaching among substance use disorders patients. The 3 Co-TEAM consists of communication, collaboration, consultation, training, education, attitude, and motivational interviewing. The 3 Co-TEAM model for pharmacy health coaching provides steps to implement this service in an objective, organized and comprehensive manner. The proposed model can function as a tool that provides guidance and reference for pharmacists in the process of implementing pharmacy health coaching among substance use disorders patients and collaborating with other health professionals
The Effect of Xylocarpus granatum J. Koenig Seed Extract Cream on The Number of Fibroblast and Re-Epithelialization in IIA Degree Burn Wound Healing
Get PDFBurns require a recovery process that multiplies complex biological mechanisms including anti-inflammatory, proliferation, and tissue remodeling. X.granatum J.Koenig (XG) is a popular plant that grows in the mangrove forest Bali. Traditionally, this plant is used mainly for antiinflammation, dysentery, fever, skin emolliating, wound treatment, and abdominal problems. Flavonoids, tannins and saponins are active metabolites of this plant, which has antiinflammation, antioxidant and wound healing effects. IL-1β, IL-6 and TNF-α are pro-inflammatory cytokines that are involved in the pathophysiology of wound. Fibroblasts support granulation tissue synthesis, ECM production, and collagen synthesis. Re-epithelialization plays a role in wound closure. The aim of present study to evaluate the effectiveness XG extract seeds cream on burn wound grade IIA in mice. XG extract was evaluated for antioxidant activity by DPPH method. The two cream formulations were measured for physical quality for organoleptic, homogeneity, and pH. The wound healing activity of XG creams were evaluated from wound contraction, histological analysis of fibroblast proliferation and re-epithelialization in mice. Statistical analyses were performed with post hoc Tukey using analysis of variance and were analyzed using Statistical Package for the Social Science (SPSS, Version 26). XG extract has a very strong antioxidant activity with an IC50 value of 7,939 ppm. The preparation of XG extract cream has homogeneous and pH of 6,5. The treatment with XGC 15% promote significant increases in wound contraction rate, proliferation of fibroblasts and re-epithelialization with SSD (p>0,05). These results suggest that XGC 15% is effective in wound healing in mice by increasing wound contraction rate, proliferation of fibroblasts and re-epithelialization
An Investigation on The Use of Colistin in Critically Ill Patients at A Teaching Hospital in Ho Chi Minh City
No full textColistin is reintroduced into therapeutic protocols as one of the last resort antibiotics against multidrug-resistant (MDR) pathogens. In February 2019, the International Consensus Guidelines (ICG 2019) on optimizing the administration of colistin has for the first time stipulated an official recommendation for higher colistin dosing regimen based on pharmacokinetic/pharmacodynamic (PK/PD) modeling data. This study aimed at assessing the current dosing of colistin at University Medical Center (UMC) of Ho Chi Minh City (HCMC) and to identify rates and risk factors of colistin-induced nephrotoxicity. A cross sectional study was conducted on patients admitted to Intensive Care Unit (ICU), being treated for severe infection with at least 5 days of colistin IV administration from April 2018 to April 2019. KDIGO criteria were used to evaluate nephrotoxicity during treatment. Colistin-resistance was detected in 4 cases during the study period. The majority (n=104, 87.4%) of patients was diagnosed with pneumonia due to mainly Acinetobacter baumannii. Rational dosing according to PK/PD approach, EMA, FDA was observed in 33 cases (27.8%), 39 cases (32,8%), and 44 cases (38,2%), respectively. 85 cases (71,4%) were evaluated as rational dosing in accordance with at least one of the three guidelines. Clinical efficacy was recorded in 59 infected patients (49.6%). Lower average maintenance dose was observed in patients with treatment failure (p = 0.002). KDIGO-defined acute kidney injury (AKI) developed in 70 patients (58,8%). Multivariate analysis showed that concomitant administration of vasopressors (OR = 16.52; 95% CI 5.3750.83; p = 0.001), furosemide (OR = 5.24; 95% CI 1.89–14.55; p = 0.001) and hypoalbuminemia (< 25 g/l) (OR = 6.24; 95% CI 2.17–17.93; p = 0.001) were significantly associated with nephrotoxicity. Consistent with previous studies, due to a very modest clinical cure rate with a high frequency of colistin-induced AKI and the development of colistin-resistant strains, alternative agents such as new beta-lactam/beta-lactamase inhibitor combinations with favourable safety data are strongly preferred for the treatment of carbapenem-resistant infection
Antioxidant and Antihyperlipidemic Effect of Purple Sweet Potato Leaf Extract (Ipomoea batatas L.) and Red Yeast Rice Combination In Hypercholesterol Rats
No full textHyperlipidemia is a condition of lipid such as cholesterol and triglycerides in the blood are high, which is the cause of other diseases. This condition also causes an increase in free radicals resulting in oxidative stress. Purple sweet potato leaves and red yeast rice have been reported to have antihyperlipidemic and antioxidant activity in several studies. This study aimed to examine the effect of the combination of purple sweet potato leaves extract and red yeast rice on cholesterol and triglyceride levels as well as MDA levels and GPx activity on rats induced by a high-fat diet. Experimental animals were randomly divided into 6 groups of 5 mice each: group 1 being the normal group; group 2 positive control; group 3 negative control; group 4 purple sweet potato leaf extract 400 mg/kg BW; group 5 red yeast rice 40 mg/kg BW; group 6 combination of purple sweet potato leaf extract 360 mg/kg BW and red yeast rice 40 mg/kg BW. Rats were treated with high-fat feed for 28 days, on day 15-28 were given oral preparations. At the end of the study, all rats were blood drawn to measure cholesterol and triglyceride levels, then rats were sacrificed and the liver was taken to measure MDA and glutathione peroxidase levels. The administration of purple sweet potato leaf extract, red yeast rice, and their combination significantly (p<0,05) reduced cholesterol, triglyceride, and MDA levels, and increased GPx activity, with the best effect in the combination group. This finding showed that the combination of purple sweet potato leaf extract and red yeast rice had antihyperlipidemic and antioxidant activity in hypercholesterol rats
Application of Ftir-Atr Spectroscopy in Combination With Multivariate Analysis to Analyse Synthetic Drugs Adulterant in Ternary Mixtures of Herbal Medicine Products
Get PDFTo against the increasing number of adulteration reports in herbal medicine products in Indonesia, specifically Jamu in powder dosage form, a rapid, efficient, inexpensive method is required. This study was aimed to develop an approach for quantification and classification of an unadulterated herbal medicine product with synthetic drug (prednisone and metamizole) by combining FTIR Spectroscopy and multivariate calibration (PLSR and PCR) as well as discriminant analysis (DA). The spectra data of three individual types of reducing herbal pain products were scanned and collected by FTIR-ATR in the mid-infrared region and further analyzed by two multivariate calibrations to exhibit the optimum mode for quantification analysis of each sample reducing herbal pain product. Based on statistical parameter value, PCR analysis of each model demonstrated the highest value of R2 in both calibration and validation and the lowest value of root mean square of calibration (RMSEC) and root mean square of prediction (RMSEP). The discriminant analysis (DA) was also performed in this study to classify pure reducing pain herbal medicine products without any drugs contaminant and adulterated with synthetic drugs. The outcome of DA was shown by Cooman’s plot and DA could discriminate adulterated and unadulterated reducing pain herbal medicine products with 100% accuracy level. FTIR-ATR spectroscopy in the mid-infrared region coupled with chemometrics could be a potential analytical technique to detect synthetic drugs contaminant in herbal products
Apoptotic Induction Mechanism of Artonin E in 3D Ovarian Cancer Cell Lines
Get PDFArtonin E is a naturally isolated compound from Artocarpus elasticus and was evaluated for their anticancer property in the present study. This study aimed to develop a 3D ovarian cell culture model and to examine the cytotoxicity of artonin E in 2D and 3D cell culture models. The 3D cell culture was performed using BD™ Puramatrix™ Peptide Hydrogel. Alamar blue assay, selectivity index analysis, morphological apoptotic double staining and immunofluorescence study were conducted to study the antiproliferative and apoptotic induction mechanism of artonin E in 3D SKOV-3 spheroid culture. SKOV-3 cells encapsulated in BD™ Puramatrix™ Peptide Hydrogel clearly demonstrated 3D-spheroid formation. The Alamar blue assay result showed that artonin E inhibited the growth of SKOV-3 cells in 2D and 3D culture with the IC50 values at 72 h treatment of 6.0 ± 0.8 µg/mL and 25.0 ± 0.8 µg/mL, respectively. This compound was found to be less toxic to the normal human ovarian cell lines, T1074, with IC50 values at 72 h of 28.0 ± 0.8 µg/mL in 2D culture and 85.0 ± 0.5 µg/mL in 3D culture, respectively. The selectivity index analysis more than 2 indicated that artonin E was selective against cancer cells compared to normal cells. Artonin E treatment caused apoptotic morphological changes in 3D SKOV-3 spheroids. In a 3D immunofluorescence study, elevated levels of cleaved caspase-3, cleaved caspase-9, apoptotic proteins bax, and decreased levels of antiapoptotic proteins bcl-2, Hsp70, and survivin were observed. In conclusion, artonin E increases chemoresistance and induces cell death in a 3D SKOV-3 spheroids culture via a pro- and anti-apoptotic protein pathway. These findings demonstrate that 3D spheroid culture is an effective platform for testing artonin E therapeutic candidates in an in vivo mimic microenvironment
Evaluation of Current Practice of Antibiotic Use and Clinical Outcomes of Community-Acquired Pneumonia Patients with Type 2 Diabetes Mellitus in Indonesia
Get PDFImpaired immunity in diabetes mellitus (DM) causes reduced lung function, which increases the incidence of various types of infections, including community-acquired pneumonia (CAP). The main principle of CAP therapy is the administration of antibiotics. This study aims to assess the appropriate use of antibiotics according to existing clinical practice guidelines using the Gyssen algorithm, and to determine its effect on clinical outcomest in hospitalized patients. It is an observational study with a retrospective cohort design and total sampling technique. The research was conducted at Dr. Cipto Mangunkusumo Hospital Jakarta, with the research subjects being 98 hospitalized CAP patients with type 2 DM (T2DM) over the period January 2018 - December 2019. The collection of data on patient characteristics and clinical outcomes was made through patient medical records. 28.6% of the subjects were in the severe category of CAP. The results of the evaluation using the Gyssen algorithm showed that 59.2% of the subjects receive the appropriate antibiotics, while 40.8% receive non appropriate antibiotics. The clinical outcomes in the group receiving appropriate antibiotics (70.7%) was significantly higher than the non-appropriate group (42.5%). The results of the multivariate analysis show that the group receiving appropriate antibiotics experienced 2.7 times greater clinical outcomes (RR 2.683, 95% CI: 1.102-6.592), after controlling for the degree of CAP and the onset of antibiotic administration. The use of appropriate antibiotics in CAP patients with T2DM significantly enhanced clinical outcomes
Polyphenols as Tyrosine Kinase Inhibitors for the Treatment of Metastatic Cancers: Current and Future Perspective
Get PDFCancer is the world's biggest cause of death as a whole. The higher cancer mortality rate is related to metastasis, which is a major stumbling block in cancer treatment. Polyphenols are a diverse set of antioxidant-rich natural compounds that are often used in cancer treatments as chemopreventives and adjuvants. To find publications that highlight the topic of this review paper, a thorough literature search was conducted in several electronic databases such as PubMed Central, Google Scholar, Scopus, and Medline. Many signaling pathways are involved in the metastatic cascade, including the tyrosine kinase pathway. Tyrosine kinases are a group of enzymes involved in the control of cancer spread. Polyphenols' true role in cancer metastasis remains unappreciated, despite a large body of research proving their antimetastatic effects. As a result, the current work lays out cancer metastasis signaling pathways, stressing the importance of tyrosine kinases in the metastatic process. Polyphenols can suppress tyrosine kinase activity, which contributes to their antimetastatic characteristics. The importance of polyphenols in preventing cancer metastasis by interfering with the tyrosine kinase signaling cascade is highlighted in this work, which could lead to the development of future antimetastatic drugs
In vitro Transdermal Transport of Domperidone by Compartmental Modeling Approach
Get PDFTransdermal delivery can be alternatively chosen for domperidone to improve its low oral bioavailability. The development of drugs into transdermal formulation needs information about the transport mechanism of the drug. This study aimed to develop models of domperidone transdermal transport in vitro based on compartmental modeling for understanding the domperidone transport mechanism. Domperidone solution (0.5g/L in a citric buffer, pH 5) was filled into the donor compartment. A comparative study was also conducted to examine the effect of different pH on domperidone transdermal transport in pH 1 (4g/L in 0.1M HCl). The shed snake-skin and cellophane membrane were pretreated for 1h with a chemical enhancer (oleic acid in propylene glycol) and assembled between the donor and the vertical diffusion cell's receptor compartment. The receptor compartment was filled in with phosphate-buffered saline at a pH of 6.8. The permeation study was performed for 8h. Samples concentration was assayed by UV-spectrophotometry. The cumulative permeation profiles of domperidone were analyzed using WinSAAM. Three and four-compartmental models were proposed with one lag compartment. The evaluation of the appropriate number of compartments in the transport model was examined based on the visual goodness of fit (GOF) and the corrected Akaike's information criterion (AICc) values. The four-compartmental model with one lag compartment was the best model describing percutaneous domperidone transport either in pH donor of 5 or pH 1. The model indicates domperidone transport follows into two parallel routes, including a lag compartment
Myrmecodia platytyrea Methanol Tuber Extract Ameliorates Hyperglycemia In STZ-Induced Diabetic Sprague-Dawley Male Rats
Get PDFType 2 diabetes mellitus (T2DM) is one of the main non-communicable chronic diseases that has many complications that compromise the quality of life. Hence, the need to find alternatives to replace the current therapy or as an adjuvant. Tubers of Myrmecodia platytytrea (Rubiaceae) has been used traditionally as an alternative therapy for the management of cancer and other inflammatory-related disorders. The aim of this study was to investigate the potency of M. platytytrea methanolic tuber extract (MPMTE) as an antihyperglycemic agent, in vivo. :The streptozotocin (STZ)-induced diabetic rats were treated orally with MPMTE (100, 200 and 400 mg/kg) and metformin (positive control, 100 mg/kg) daily for 14 days. Blood glucose level and other biochemistry analysis were conducted including histological examination on liver, kidney and pancreas. The STZ-induced diabetic rats treated with MPMTE (200 and 400 mg/kg) had significant decreased (p<0.05) in fasting blood glucose, total cholesterol, triglycerides and low-density lipoprotein (LDL) with no significant changes in high-density lipoprotein (HDL) compared to STZ-induced untreated diabetic rats. Liver, kidney and pancreas were devoid of any damage caused by STZ. MPMTE had strong antihyperglycaemic activity and was protective against any STZ-induced organ damage. Thus, MPMTE can be further developed into an adjuvant therapy for diabetic patients