Indonesian Journal of Pharmacology and Therapy

Topical gel preparation from Staphylococcus epidermidis isolate extract accelerated healing on incision wound model in rats

Wed, 27 Mar 2024 09:36:54 +0700

A wound is a disorder of skin integrity caused by physical trauma or disease. Wound healing is a natural restorative response to tissue injury. It is a complex dynamic physiological process involving several overlapping phases. Although wound management has been applied, however, some time it is associated with
major drawbak including invasiveness, antibiotic resistance, and high costs. Natural medicines are being developed for wound management to resolve the drawback. Commensal Staphylococcus epidermidis was proven to play a role in natural wound healing process. This study aimed to investigate the wound healing
activity of a topical gel preparation containing S. epidermidis isolate extract on an incision wound model in rats. The methanol extract of S. epidermidis isolate was prepared by maceration and used as an active ingredient of the topical gel using NaCMC as a gelling agent. A physical stability test was carried out by assessing
organoleptic properties, pH value, homogeneity, dispersion, and viscosity of the gel preparation. The gel preparation was then topically applied once-daily for 11 d on incision wound model of male white rats (Rattus norvegicus). The wound healing was observed daily and calculated using Morton’s formula. No
significant change in the physical stability parameters of the gel preparation was observed during observation on day 1, 7, and 14 (p>0.05). A significant increase in wound healing after the application of the gel preparation compared to negative control was observed (p<0.05). In contrast, no significant difference in
wound healing between the gel preparation and the positive control group was observed (p>0.05). In conclusion, the topical gel preparation from S. epidermidis isolate extract accelerates healing on incision wound models in rats.

The safety of fondaparinux, enoxaparin, and unfractionated heparin in COVID-19 patients

Siti Aulia Musyrifah, Agung Endro Nugroho, Fita Rahmawati — Fri, 05 Jan 2024 11:09:36 +0700

The coagulopathy, a hematological disorder affecting blood clotting, carries an elevated risk of thrombosis and mortality in COVID-19 patients. Fondaparinux, enoxaparin, and unfractionated heparin (UFH) are potential treatments for reducing coagulopathy in COVID-19 patients. Nonetheless, anticoagulant administration increases the risk of bleeding-related adverse effects. This study aimed to evaluate the safety profile of fondaparinux, enoxaparin, and UFH in COVID-19 patients. The safety was evaluated based on the prevalence of major and minor bleeding events from the data of medical records collected retrospectively from October 2022 to December 2021 at Kediri District Hospital. The Chi-square analysis and multiple logistic regression were employed to establish associations between variables. Out of the 315 patients who meet the inclusion criteria, 35 patients (11.1%) exhibited bleeding, 11 patients (3.5%) experienced major bleeding, while 24 patients (7.6%) encountered minor bleeding. No significantly different in bleeding events both major and minor bleeding among the groups receiving fondaparinux, enoxaparin, and UFH were observed (p> 0.05). The UFH emerged as the most common anticoagulant associated with bleeding incidents. The multivariate analysis revealed that age ≥ 60 yr and concomitant medication with ketorolac influenced bleeding incidence. The monitoring of bleeding events on the use of anticoagulants is necessary.

Cytotoxicity of quercetin and curcumin combination against HeLa cells line

Tue, 19 Mar 2024 13:20:54 +0700

Curcumin and quercetin combination are potential candidates for anticancer. Previous studies reported this combination active against several cancer cells including breast cancer, myeloid leukemia, and melanoma. However, the activity of this combination against cervical cancer has not been reported, yet. This study aimed to evaluate the cytotoxicity of the combination of curcumin and quercetin against HeLa and Vero cells. MTT assay was applied to evaluate cell growth inhibition. The inhibitory 50% concentration (IC₅₀) of curcumin and quercetin on HeLa and Vero cells was determined and the selectivity index (SI) was then calculated. Combination index (CI) was calculated after evaluation of the cytotoxicity of the curcumin and quercetin combination at various concentration of 1 IC_50, ½ IC_50,and ¼ IC₅₀. The IC₅₀ of the curcumin against the HeLa and Vero cells were 26.57 ± 2.00 μM and 73.89 ± 12.93 μM with a SI of 2.78. Whereas the IC₅₀ of the quercetin against the HeLa and Vero cells were 149.52 ± 21.09 μM and 1094.47 ± 15.68 μM with a SI of 7.32. The CI of combinations of curcumin and quercetin at concentrations of ¼ IC₅₀ was 0.78 indicating a mild-moderate synergistic effect, whereas the combination at a concentration of 1 IC₅₀ or ½ IC₅₀, the CI value was >0.9 indicating an antagonistic effect.

The use of antihypertension in hypertension patients with chronic kidney failure at the Universitas Gadjah Mada (UGM) Academic Hospital, Yogyakarta

Syifa Indi Wijaya, Anggraini Citra Ryshang Bathari, Chairun Wiedyaningsih — Wed, 27 Dec 2023 14:20:00 +0700

According to the 2018 Indonesian Basic Health Research data, the prevalence of hypertension in the Yogyakarta Special Region (11.0%) is higher than the national average of 8.8%. Hypertension with chronic kidney failure is currently a prevalent and increasing issue. This study aimed to investigate the pattern and rationality of antihypertensive use in hypertension patients with chronic kidney failure (CKF) participating in the National Health Insurance (Jaminan Kesehatan Nasional/JKN) program at Universitas Gadjah Mada (UGM) Academic Hospital period of 2020 to 2022. The study was conducted using quantitative descriptive non-experimental methods. Data collection was carried out retrospectively through medical records of patients diagnosed with hypertension with CKF (ICD I12.0). Samples were selected using purposive techniques and analyzed by comparing the suitability of drug selection with standard hypertension therapy with CKF based on JNC 8 and NKF-K/DOQI, including the rationality of their use. A total of 68 patients over the age of 18 were used as samples. The The majority of drug groupsresults showed that a combination of 2 drugs is more dominant (52.9%) compared to monotherapy (29.4%) and a combination of 3 drugs (17.6%). The majority of drug groups used were angiotensin receptor blockers (ARBs), especially candesartan (45%). ARB and calcium channel blockers (CCB), especially candesartan+amlodipin (50%), and ARB +CCB+diuretic, especially andesartan +amlodipine + furosemide (33%).. The rationality of drug use showed that 66.2% in the right indications, 89.7% the right drugs, 100% in the right patients and 85% the right doses. Therefore, health workers still need to make efforts to encourage rational drug use.

Development of the smartphone application for patients with dementia: a literature review

Pinasti Utami, Fita Rahmawati, Astuti, Zullies Ikawati — Fri, 19 Jan 2024 11:30:48 +0700

Primary technological developments are advancing rapidly, and dementia patients and caregivers are becoming more open to online interactions for enhancing dementia care. However, most existing applications only focus on patients, and there is a need to expand their scope to include caregivers. Ideally, the application should be designed with the caregiver in mind, and considering the impact they experience while caring for dementia patients. Families are specifically targeting caregivers who are at the highest risk of experiencing caregiver burnout, such as those caring for patients. This literature review described the necessary functions and content for dementia caregivers, serving as a reference for designing, developing, and implementing smartphone solutions that meet user needs. This review utilized articles from three databases i.e. PubMed NCBI, ScienceDirect, and Tandfonline. The Boolean approach method was used to generate the exact keywords. The inclusion criteria for this study encompassed smartphone applications for dementia patients, focusing on function and content, published in English-language journals within five last years, with an emphasis on original research and free full access. In this review, six articles were obtained. From these six articles, four findings related to functions and content were identified i.e. education, interactive health promotion, interaction stakeholder, and referencing information sources. These four aspects could serve as references for developing comprehensive smartphone applications for caregivers, and facilitating integrated health care.

Efficacy and safety of clozapine combination with different antipsychotics in schizophrenia: a systematic review

Maria Sri Ayu Mustikawati, Bambang Hastha Yoga Legowo Budiman, Zullies Ikawati — Mon, 08 Jan 2024 07:48:45 +0700

Schizophrenia is a severe and chronic mental disorder, where antipsychotics are used as the main therapy. Antipsychotics are commonly used in combination, especially in refractory patients. Clozapine is one of antipsychotics that is often used in combination with other antipsychotic to achieve more effective treatment. However, the effectiveness and safety of the clozapine combination are still inconclusive. This review aimed to evaluate the efficacy and safety evidence of clozapine combination therapy with different other antipsychotics. Relevant articles were collected from Google Scholar, Scopus, and PubMed, and published in 2000-2020. Five studies concerning the effectiveness and safety of clozapine in combination with different other antipsychotics were evaluated. No significant difference in the effectiveness of clozapine in combination with other antipsychotics was observed in 4 studies. No significant difference in the safety of all clozapine combinations was observed in 3 studies. Only 2 studies reported that the clozapine-atypical antipsychotic combination (clozapine-aripiprazole) is more tolerable compared to the clozapine-typical antipsychotic. In conclusion, the efficacy and safety of clozapine in combination with different other antipsychotics have not been definitively conclusive, yet.

Antipsychotic-associated neuroleptic malignant syndrome (NMS) in schizophrenia patients: a narrative review

Okta Puspita, Bambang Hastha Yoga, Zullies Ikawati — Wed, 20 Mar 2024 12:49:02 +0700

Neuroleptic malignant syndrome (NMS) is a neurological disorder with an high mortality rate among schizophrenia patients who receive antipsychotics as the primary long-term therapy. Appropriate selection of antipsychotics in NMS should be carefully considered to obtain maximal effectiveness with minimal side effects. An evaluation of the safety profile of the antipsychotics is important due to their different treatment patterns and rapid onset of symptoms. This review article aimed to compare the safety profile of antipsychotics in relation to NMS in schizophrenia patients. It was a narrative review using multiple search engines included PubMed, Google Scholar, and Springer to collect publications from 2007 to 2023. Of the total 14 articles reviewed, 7 articles explained the role of antipsychotics in NMS, 5 articles about the onset of NMS, and 7 articles about mortality rate. The incidence of NMS was less then 0.11%, typical antipsychotics were the most common cause of NMS, especially high-potency antipsychotics compared with atypical antipsychotics. Meanwhile, the onset of NMS consistently occured within 30 d of antipsychotic initiation with a symptom duration of 1 to 30 d, and the mortality rate was also higher for typical antipsychotics. In conclusion, the choice of antipsychotics must be carefully considered and its use must be monitored due to the rapid onset and high mortality. The use of antipsychotics is not free from the risk of NMS. The heterogeneous symptoms of NMS require earlier detection to reduce disease progression.

Effectiveness evaluation of antibiotic use in patients with Methicillin-resistant Staphylococcus aureus (MRSA) infection: a review

Musdalifa As, Ika Puspitasari, Titik Nuryastuti — Fri, 19 Jan 2024 11:17:45 +0700

Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogen that become a public health problem due to its ability to be resistant to more than three classes of antibiotics. Evaluation of the effectiveness of antibiotic use in patients with MRSA is important to optimize antibiotic use and to control antibiotic resistance. This article review attempted to evaluate the effectiveness of antibiotics in patients with MRSA. This review explored the results of previous research from PubMed as a literature source and the PRISMA flow diagram as a protocol for the article selection process. Eight studies reviewed the evaluation of the effectiveness of antibiotic use in MRSA patients with various clinical conditions, such as uncomplicated wound infections, cellulitis and no wound, purulent drainage or abscess, cSSSI infections caused by MRSA, infections caused by MRSA bacteremia and nosocomial infections caused by MRSA. In conclusion, the effectiveness of antibiotics in patients with MRSA infection depends on the clinical condition of each patient. Therefore, the use of antibiotics is adjusted based on the type of infection and the efficacy of the antibiotics. Combination therapy is recommended for MRSA patients considering its life-threatening ability.

Comparison of the effectiveness and safety between gabapentin and amitriptyline in pain improvement in peripheral diabetic neuropathy patients: a review

Nindita Rachmania, Probosuseno, Fita Rahmawati — Fri, 19 Jan 2024 11:18:48 +0700

Neuropathy pain is one chronic pain that is difficult to treat and has not had an ideal curative therapy, yet. Gabapentin and amitriptyline are widely used as diabetic neuropathy therapies. However, their effectiveness is still debatable and their side effect has been reported. Several factors affect the efficacy and morbidity of gabapentin and amitriptyline in diabetic neuropathy patients. Some treatment options for diabetic neuropathy are available in clinical setting, therefore evaluation the effectiveness of the treatment options is needed to choose the best treatment. This review article evaluated the effectiveness and safety between gabapentin and amitriptyline as pain relief in peripheral diabetic neuropathy (PDN) patients. It was a narrative review using electronic databases such as Science Direct, Scopus and PubMed. The results showed that effectiveness and safety of gabapentin is better than amitriptyline in relief pain on PDN.