Medical Sains : Jurnal Ilmiah Kefarmasian

REVIEW: INTERACTION OF GLIMEPIRIDE WITH HERBAL PLANTS

Jajang Nurjaman — 2025-04-29

Glimepiride is a commonly prescribed oral antidiabetic drug for the management of type 2 diabetes mellitus (T2DM). However, extensive simultaneous use of herbal plants increases the risk of notable interactions between herbs and drugs. This systematic review analyzed the pharmacokinetic and pharmacodynamic interactions between glimepiride and various medicinal plants, based on 20 selected studies published between 2014 and 2024. The results show that several herbs including Berberine hydrochloride, Licorice, Quercetin, Aloe vera, Ocimum sanctum, and Fenugreek can alter glimepiride’s metabolism, enhance its bioavailability, and increase insulin secretion, potentially amplifying its hypoglycemic effect. Although these interactions may improve therapeutic outcomes, they also increase the risk of hypoglycemia, indicating that careful monitoring and professional supervision are essential when using herbal supplements alongside glimepiride.

Keywords: Pharmacokinetic pharmacodynamics, glimepiride interaction, herbal plants.

FORMULATION AND EVALUATION OF GOLDEN SEA CUCUMBER (STICHOPUS HERRMANNI) ORAL SUSPENSION

Ahmad Fauzi — 2025-04-29

The Golden Sea Cucumber (Stichopus herrmanni) is widely recognized for its high protein and collagen content, making it valuable for medicinal applications, such as wound healing and tissue regeneration. The present study focused on formulating an oral suspension of sea cucumber extract, assessing its stability, and determining its protein content. Extraction was performed using a boiling method with distilled water to yield a protein-rich extract, which was then formulated into four suspension formulas (Formula 1, 2, 3, and 4) using pharmaceutical-grade excipients, including sorbitol, sodium CMC, and sodium benzoate. Protein quantification was conducted using the Biuret method with Bovine Serum Albumin (BSA) as a standard and analyzed using UV-Vis spectrophotometry. Stability testing over 1, 3, and 6 months was used to evaluate pH, viscosity, and sensory characteristics (odor, color, and taste). Among the four formulations, formula 4 demonstrated the highest stability, maintaining optimal homogeneity, sensory attributes, and pH, along with the highest protein concentration (8.10 mg/mL. These results highlight Formula 4 as the most promising because of its superior stability and protein content. This study underscores the challenges of long-term stability in protein-based suspensions, suggesting the need for further research into advanced excipient selection and encapsulation techniques to protect sensitive proteins. Overall, this research supports the potential use of marine-derived bioactive compounds in pharmaceutical applications, paving the way for sustainable healthcare and cosmetic products.

Keywords: golden sea cucumber, Stichopus herrmanni, oral suspension formulation, stability test

SYNTHESIS OF DIHYDROPYRIMIDINONE DERIVATIVES AND CYTOTOXIC ACTIVITY TEST AGAINST T47D CANCER CELLS

Wafiq Kholifatul Hakimah — 2025-04-29

Dihydropyrimidinone (DHPM) derivatives are heterocyclic compounds known for a variety of biological activities including anticancer properties. The Mitsunobu reaction was used in this study to synthesize a new DHPM derivative, ethyl 4-(4-isopropoxy-3,5-dimethylphenyl)-6-methyl-2-oxo-1,2,3,4-tetrahydropyrimidine-5-carboxylate (compound B2), and assess its cytotoxic activity against T47D breast cancer cells. Compound B2 was synthesized from ethyl 4-(4-hydroxy-3,5-dimethylphenyl)-6-methyl-2-oxo-1,2,3,4-tetrahydropyrimidine-5-carboxylate (compound M1) using multicomponent reactions (MCR) and the Mitsunobu reaction with isopropyl alcohol as the pronucleophile. Compound B2 was characterized using melting point test, FTIR and LC-MS spectroscopy, which confirmed its structure, functional groups, and molecular weight of 334.13 g/mol. MTT assay was used to evaluate cytotoxic activity. Compound B2 had an IC50 value of 205.71 µg/mL, indicating weak cytotoxicity, whereas doxorubicin had an IC₅₀ value of 3.33 µg/mL. Despite the low cytotoxicity of compound B2, this synthesis sheds light on the development of DHPM derivatives with potential anticancer properties. The results showed that the Mitsunobu reaction is useful for modifying DHPM derivatives and highlights the need for further optimization to improve cytotoxic potency.

Keywords: Dihydropyrimidinone, Mitsunobu, Cytotoxicity, T47D

OPTIMIZING STRESS ULCER PROPHYLAXIS: A CLINICAL AND COST EVALUATION IN RSUD WATES INTERNAL MEDICINE WARD

Mega Octavia — 2025-05-01

The American Society of Health-System Pharmacists (ASHP) 1999 listed guidelines for providing stress ulcer prophylaxis (SUP) therapy as the standard of care for critical patients in the ICU. However, numerous studies have shown that most patients admitted to non-intensive care units continue to receive acid suppressant prescriptions, without appropriate indications or risk factors. This can lead to increased morbidity and increased patient care costs. This study aimed to determine the utilization profile of stress ulcer prophylaxis, its appropriateness, and the costs incurred by patients for SUP. This was an observational study with a cross-sectional design based on medical records. The study participants were inpatients from the Internal Medicine Polyclinic at Wates Hospital who met the inclusion criteria from January to December 2021. The study revealed that the H2 receptor antagonist (H2RA), proton pump inhibitor (PPI), sucralfate, and antacid groups received 57.9 %, 35.7%, 6.1%, and 0.3% of preventive drugs, respectively. Of the 215 patients, 76 received appropriate indications, whereas 139 received inappropriate indications based on the guidelines. During the study period, the cost of using stress ulcer prophylaxis for patients with appropriate indications was IDR 15,344,812 (76%), whereas the cost of using inappropriate stress ulcer prophylaxis was IDR 5,965,572 (28%) of the total cost. Factors such as the length of stay (LOS), type and cost of each medication, and frequency of medication administration can influence the high cost of inappropriately indicated patients.

Keywords: Stress ulcer prophylaxis (SUP), inpatients at Wates Hospital, therapy evaluation, cost analysis

ARTICLE REVIEW: EFFECTIVENESS OF COMBINATION OF PLANT EXTRACTS AS ALTERNATIVE HYPERTENSION THERAPY

Royan Almasih — 2025-05-09

Hypertension is a global health problem requiring effective and safe management. Conventional therapies often face challenges, such as drug resistance, side effects, and patient non-compliance, increasing the need for alternative therapies. This article aims to review the effectiveness of plant extract combinations as antihypertensive therapies. This study used a literature review approach to studies published in the last 10 years, focusing on the mechanism of action, effectiveness, and synergistic potential of plant combinations. The results showed that combinations such as Anredera cordifolia (ten.) v. Steenis and Sonchus arvensis L. provided a decrease in systolic blood pressure (SBP) by 27.95 mmHg and diastolic blood pressure (DBP) by 33.89 mmHg, approaching the effectiveness of standard drugs such as valsartan. The main mechanisms include the inhibition of angiotensin-converting enzyme (ACE), vasodilation through the release of nitric oxide (NO), and diuretic effects. The combination of plant extracts shows potential as a safe and effective alternative; however, further clinical trials are needed to strengthen these findings.

Keywords: Combination of Plant Extracts, Antihypertensive, Alternative Therapy.

ANTIOXIDANT ACTIVITY OF COMBINATION OF WHITE-PURPLE Orthosiphon aristatus (Blume) Miq HERB EXTRACT AND Stevia rebaudiana Bertoni USING FRAP METHOD

Fahrauk Faramayuda — 2025-05-14

Oxidative stress is caused by an increase or decrease in the antioxidant defense activity. Orthosiphon aristatus (Blume) Miq and Stevia are two plants that contain antioxidant compounds and can bind free radical compounds. The combination of Orthosiphon aristatus (Blume) Miq and Stevia was expected to increase antioxidant activity. This study aimed to determine the antioxidant activity of a combination of the Orthosiphon aristatus (Blume) Miq white-purple variety and Stevia rebaudiana Bertoni extract. Antioxidant activity was tested using the FRAP method with a UV-visible spectrophotometer at a wavelength of 710 nm. The results of phytochemical screening showed that both plant extracts and dry material contained secondary metabolite compounds, including flavonoids, polyphenols, saponins, quinones, steroid-triterpenoids, and monoterpenes-sesquiterpenes. A qualitative test relating to antioxidants using TLC showed positive antioxidant activity, which was proven by the presence of green or blue light on the TLC plates. This was due to electron transfer in the compound, which reduced Fe³⁺ to Fe²⁺. On the other hand, quantitative measurements using the FRAP method showed the antioxidant capacity values consecutively, F1 combination extract (1:1) of 43.725 mg of QE/g extract, F2 combination extract (2:1) of 57.963 mg of QE/g extract, and combination extract of F3 (3:1) of 64.849 mg of QE/g extract. The extract combination of F3 showed the best formula, with a value of 64.849 mg QE/g extract.

Keywords: Orthosiphon aristatus (Blume) Miq, Stevia, antioxidants, FRAP

REVIEW: ADVERSE DRUG REACTIONS AND PHARMACOKINETIC CHARACTERISTICS OF LINEZOLID AS A THERAPY FOR DRUG RESISTANT TUBERCULOSIS

Ririn Retnaningsih — 2025-05-23

Introduction: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis that remains a global health challenge. One of the main problems in TB treatment is the emergence of drug resistance, such as in multidrug-resistant tuberculosis (MDR-TB). Linezolid is a class of oxazolidinones used as second-line therapy in the treatment of drug-resistant TB. However, its use is not free from serious adverse drug reactions such as peripheral neuropathy, myelosuppression, and lactic acidosis. Therefore, understanding the pharmacokinetic profile and adverse drug reactions of linezolid is important to increase the effectiveness of therapy and minimize the risk of toxicity. Objective: This study aimed to evaluate the adverse drug reactions caused by linezolid and analyze its pharmacokinetic characteristics in the treatment of drug-resistant tuberculosis (TB). Methods: This article is a literature review that collects data from national and international scientific sources over the past 10 years (2015-2025), including the addition of comparative studies or meta-analyses, as well as inclusion criteria, such as articles that discuss the pharmacokinetics, adverse drug reactions, and use of linezolid in drug-resistant tuberculosis therapy, either in clinical trials, observational studies, or relevant therapeutic guidelines. Results: Based on the results of various studies, linezolid has an oral bioavailability approaching 100%, which allows oral and intravenous administration with almost equivalent doses. Its pharmacokinetic profile shows an elimination half-life of approximately 5-7 hours, with primary metabolism via nonenzymatic oxidation in the liver and excretion in the urine as inactive metabolites. These characteristics make linezolid a flexible option for drug-resistant tuberculosis therapy..

ANALYSIS OF CUSTOMER SATISFACTION WITH DELIVERY SERVICE AT APOTEK HABIBI KUNINGAN

Juju Jumiati — 2025-05-26

Improving service quality in the pharmacy business is crucial to attracting customer interest and maintaining customer loyalty. Customer satisfaction is one of the indicators that can be used to measure the success of service quality. This study aimed to determine the effect of delivery service quality on customer satisfaction in Apotek Habibi. This study used a descriptive observational method and a cross-sectional design. Purposive sampling was used, with the Slovin formula used to obtain 83 respondents from a total population of 497 people. Data were collected through a survey of customers who had used the delivery service at least thrice. Service quality was measured using five dimensions of the Servqual method: Tangibles, Reliability, Responsiveness, Assurance, and Empathy. The results show that customers are highly satisfied with delivery service quality, with the highest scores in the Tangibles dimension (92%), Reliability (90%), Responsiveness (90%), Assurance (91%), and Empathy (89%). The Pearson's correlation analysis revealed a significant relationship between service quality and customer satisfaction (r = 0.537, p < 0.05). The Assurance variable emerged as the dominant factor influencing customer satisfaction with a regression coefficient of 10.810. Although customer satisfaction is high, developing a more flexible delivery system and improving promotional information transparency are necessary to maintain and enhance customer satisfaction in the future. This study provides valuable insights for Apotek Habibi to continuously improve service quality to meet customer expectations.

Keywords: Pharmacy, Customer Satisfaction, Delivery Service, Service Quality

SYNTHESIS OF n-OCTYL CINNAMATE USING DCC COUPLING REAGENT ASSISTED BY ULTRASONIC WAVE AND ANTIOXIDANT ACTIVITY TESTS

Ananda Endah Devianti — 2025-06-11

n-Octyl cinnamate is a cinnamic acid derivative that can be synthesized by an esterification reaction between cinnamic acid and n-octanol with the addition of a DCC coupling reagent (N,N'-dicyclohexylcarbodiimide), which is varied into three concentrations equivalent to 1:0.5, 1:0.75, and 1:1 moles of cinnamic acid. Ultrasonic waves assisted in the synthesis of n-octyl cinnamate at 2-8°C for 4 hours. The obtained n-octyl cinnamate was characterized by its organoleptic properties, solubility, melting point, TLC, FTIR-ATR, GC-MS, and antioxidant activity was measured using the DPPH assay. In the results, n-octyl cinnamate was obtained using DCC coupling reagent in 11.85; 14.83; and 35.83 % yields, respectively. This ester dissolves in methanol, ethanol, chloroform, ether, and n-hexane but is insoluble in water. It had a melting point range of 151.4-157.8 ºC. TLC shows that this ester has a different Rf value from that of the reactant. The FTIR spectrum showed suitable bonds with n-octyl cinnamate, as can be seen from its aromatic bands (C=C and C-H), which are characterized by the stretching of C=O and C-O bonds, aliphatic C=C, and aliphatic C-H absorptions. The results from the GC-MS analysis of the targeted compound appeared at 17.184 minutes with a 44.74% purity rate using synthesized n-ocytl cinnamate with the addition of 0,75 equivalent of DCC. The antioxidant activity test using the DPPH assay showed an IC50 value of 93.3375 ppm, indicating strong antioxidant activity.

Keywords : antioxidant, esterification, ultrasonic wave, N,N?-dicyclohexylcarbodiimide, n-octyl cinnamate

ESTERIFICATION OF CINNAMIC ACID WITH OCTANOL USING ULTRASONIC WAVE ASSISTED BY COUPLING REAGENT AS ANTIERYTHEMA

Daninda Jeconiah — 2025-06-14

The n-octyl cinnamate compound, a cinnamate ester, is believed to have antierythema activity. This compound is naturally present in certain plant species; however, its quantity is limited. Steglich esterification can be used to produce n-octyl cinnamate, which involves the reaction of cinnamic acid with n-octanol using n,n'-dicyclohexylcarbodiimide (DCC) as a coupling reagent. Ultrasonic wave-assisted synthesis was performed to reduce the synthesis time and increase the yield of n-octyl cinnamate with time variations of 3, 4, and 5 hours at ± 2°C. The synthesized compounds were characterized by organoleptic properties, solubility, melting point, TLC, FTIR, and GC-MS tests. The synthetic compound occurred as a white powder, yielding 10.1% after an optimal duration of 4 hours. The compound was insoluble in distilled water but soluble in methanol, ethanol, chloroform, ether, and n-hexane. The compound has a melting range of 135.1-145.4°C, and the TLC results obtained different Rf values than the initial compound. FTIR test analysis showed the presence of C=C aromatic, C-H aromatic, C=O ester, C-O ester, C=C aliphatic, and C-H aliphatic group absorption by the n-octyl cinnamate compound. GC-MS analysis revealed a synthetic retention time of 17.193 minutes and an abundance of 35.40%. The antierythema activity of the synthesized n-octyl cinnamate compound was optimal at 100 ppm with a %TE of 1.661, classifying it as an extra protection category.

Keywords: anti-erythema, esterification, ultrasonic waves, n-octyl cinnamate, time.

INVENTORY OF MEDICINAL PLANTS AND THEIR UTILISATION BY THE COMMUNITY OF RENGEL SUB-DISTRICT, TUBAN DISTRICT

Ivan Charles Seran Klau — 2025-06-23

Plant inventory is an activity aimed at documenting and classifying plant species within a specific area. This study investigated the utilization of traditional medicines in the Lengger District, Tuvan Province, focusing on the types of medicinal plants, their properties, uses, and the specific plant parts employed. A qualitative descriptive method was applied, and data were collected through observations and interviews. The sampling technique followed a snowball sampling approach, where key informants were identified based on predefined criteria, and additional informants were selected through recommendations. The findings revealed that the community in the Lengger District utilizes 54 types of medicinal plants for traditional healing practices. The conclusion of this research is that preserving traditional medicinal knowledge is very important to prevent the loss of information about the benefits and uses of medicinal plants that have been passed down from generation to generation. Further research is needed to reveal the bioactive content, effectiveness, and safety of medicinal plants so that they can be developed into scientifically based therapies. Given the community's dependence on medicinal plants, conservation efforts through sustainable cultivation and protection of natural habitats must be implemented to ensure their availability in the future and maintain ecosystem balance.

Keywords: Inventory, Types of medicinal plants, Rengel District, Tuban Regency

RATIONALITY AND COST COMPARISON OF OUTPATIENT TYPE 2 DM THERAPY UNDER INA-CBGS: A LITERATURE REVIEW

Nurani Eka Gumilang — 2025-06-30

This literature review evaluates the rationality of Type 2 Diabetes Mellitus (T2DM) therapy and analyzes the cost comparison between treatment expenses and Indonesian Case-Based Groups (INA-CBGs) tariffs for outpatient hospital care. The findings indicate that evidence-based therapy is essential for improving clinical effectiveness and cost efficiency. Several studies have highlighted significant discrepancies between actual outpatient treatment costs and INA-CBGs tariffs, with pharmaceutical expenses being the primary factor contributing to hospital cost deficits. A review was conducted using 11 peer-reviewed studies from 2019 to 2024, selected based on inclusion criteria such as relevance to outpatient T2DM therapy under INA-CBGs, full-text availability, and publication in Indonesian or English language. This review recommends policy adjustments to strengthen a transparent claims system, optimize an evidence-based national formulary, and enhance complication prevention strategies to improve the efficiency of DM management in Indonesia.

Keywords: rationality of therapy, Type 2 Diabetes Mellitus, treatment cost, INA-CBGs, hospital, outpatient

A LITERATURE REVIEW: THE IMPACT OF PHARMACIST COUNSELING ON MEDICATION ADHERENCE IN TYPE 2 DIABETES MELLITUS OUTPATIENTS

Agus Sulaeman — 2025-06-30

Type 2 diabetes mellitus (T2DM) is a chronic disease with a high prevalence that requires long-term therapeutic management. One of the biggest challenges in managing T2DM is the low level of patient adherence to medication, which can trigger serious complications and increase the economic burden on the healthcare system. Pharmacist counseling plays an important role in improving patient adherence through education, motivation, and support. This study aimed to analyze the effect of pharmacist counseling on medication adherence in T2DM outpatients using data from scientific journals published between 2019 and 2024, sourced from PubMed, ScienceDirect, and Google Scholar. A total of 10 articles were reviewed and selected based on the following inclusion criteria: studies focusing on pharmacist counseling and medication adherence in T2DM outpatients, published in English or Indonesian, and accessible in full text. The study found that various counseling interventions, such as face-to-face education, reminders via short message (SMS), and the use of informational guidance, significantly improved patient adherence, as measured by clinical parameters such as decreased HbA1c levels and improved quality of life. These findings suggest that pharmacist counseling can be an effective approach to improve the success of T2DM therapy while having a positive impact on patients' quality of life.

Keywords: Diabetes mellitus, pharmacist counseling, patient compliance, HbA1c, Quality of life, pharmacy education.