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Background:

Increasing number of chronic renal failure (CRF) patients had reflected an increase in the number of patients with diabetes and hypertension. Therefore, health practitioners would be faced with management of complicated medical problems for the patients of chronic renal disease. In this way, various complications of chronic renal failure would lead to polypharmacy, where the patients receive three to five drugs in a dose. Development of polypharmacy had made the potential of drug interaction greater.

Objective:

To determine whether CRF patients admitted to hospital with specific adverse drug reactions were likely to have been prescribed with interacting drugs

Design

Retrospective study

Setting

The study was conducted at the General Practice Rooms Floor 1 – Floor VI of Central Army Hospital Gatot Soebroto Jakarta. The study was conducted from December 2011 – February 2012. The data were collected in a retrospective way for a year (January – December 2011).

Patients

End-stage CRF patients who were having hemodialysis therapy and receiving ACE Inhibitor drugs or Angiotensin II Receptor Antagonist (AIIRA) and receiving treatment at the General Practice Rooms at Central Army Hospital Gatot Soebroto Jakarta

Results

During the period of January – December 2011, 84 patients were treated with end-stage CRF at the Central Army Hospital and having routine hemodialysis and 44 patients were receiving therapy with ACE Inhibitor and AIIRA. Other drugs simultaneously given with ACE Inhibitor and AIIRA were captopril-spironolactone, captopril-aspirin, captopril-allopurinol, captopril-KSR, captopril-furosemide, lisinopril-furosemide and valsartan-mefenemic acid. An increase in adverse effects of the drugs was found based on the clinical evaluation and laboratory examination. The adverse effects included hyperkalemia (9,09%), decrease in anti-hypertension effect (6,8%), acute hypotension (40%), and declining renal function (11,36%).

Conclusion

The study identifies drug interaction in end-stage CRF patients who received ACE Inhibitor or AIIRA. This study highlights the need for screening prescriptions of for pDDIs and proactive monitoring of patients who have identified risk factors; this helps in detection and prevention of possible adverse drug interactions 

Abstract: The antimycobacterial and antiplasmodial activities of ethanolic extracts of propolis were
evaluated after a preliminary phytochemical screening of extract. The antimycobacterium activity
assay employed the disc-paper method, while the in-vitro antiplasmodial activity assay used the SYBR
green methods. The result of the disc-paper method is the propolis extract, starting from 10 mg, has
antimicrobial activity against Mycobacterium tuberculosis and the strongest one is from propolis of
Sukabumi (West Java) which has hindrance zone of 22.01 mm when the dose is 20 mg. The in-vitro
antiplasmodial activity assay shows that the propolis extract of from Lawang (IC50 37.34 ±1.23 μg/mL
for P. falciparum strain D6 and 89.45 ± 2.13 μg/mL for strain W2) is better than the ones from
Sukabumi (IC50 215.23 ± 2.32 μg/mL P. falciparum strain D6 and 453.23 ± 3.45 μg/mL for strain
W2) and Batang (IC50 189.98 ± 1.34 μg/mL P. falciparum strain D6 and 356.89 ± 2.34 μg/mL for
strain W2) tested by SYBR Green I methods. The conclusion: The propolis extracts from several areas
in Java has antimycobacterial and antiplasmodial activities

OBJECTIVES. To investigate the anti-cancer properties of the ethylacetate fraction of Indonesian propolis in mouse mammary tumor induced by transplantation.
METHODS. Thirty two C3H mice divided into Thirty two C3H mice were randomly assignedinto 3 groups i.e. control and 2 groups of mice orally treated
with ethylacetate fraction of propolis, Dl (500mg/kgBW) and D2 (1000mg/kgBW) for 30 consecutive days, after tumor transplantation. Body weight and tumor
volume were periodically measured every week. Tumor weight was measured after the animal was sacrificed, fixed in formaldehyde and embedded in paraffin for
histological preparation. The proliferation activity of tumor cell was examined by counting the AgNOR deposits detected after colloidal AgNOR staining. Index
apoptosis was assessed by mean of Tunel method, and the width of necrotic area was identified by hematoxyllen eosin of the histological specimen. RESULTS. The
result of analysis of variants showed that there were statistical differences in tumor volume, tumor weights, AgNOR values and in the necrotic area among control
and the three treated groups (p>0,05), except in the index apoptosis between control and D3 groups (p<0,05). CONCLUSION. It can be concluded that oral
administration of 2 doses of ethylcetate fraction dose for 30 consecutive days prevents the C3H mouse mammary tumor growth induced by transplantation
(p>0,05) but there was increased apoptosis in the group receiving the ethylacetate fraction of propolis dose 500mg/kgBW (p<0,05).

Propolis from Indonesia is widely used in traditional medicine and is reported to have a broad spectrum of pharmacological activities. However nothing is known
about its toxicity. The objective of this study was to evaluate the acute and subchronic toxicity of the potential ethylacetate extract of Indonesian propolis in mice.
The acute toxicity LD50 was estimated to be 14,8597g/kgBW. In the subchronic toxicity, there was no mortality recorded among the animals when varyng doses
of the fraction (500 and 1000mg/kg-1body weight) were administered orally for 36 days consecutively. The weekly body weight of the mice showed no significant
differences between the control and the mice treated with the fraction except on the last week (day 36). There was neither any gros lession nor histopathological
changes observed in organs examined. These finding suggest that the fraction of propolis could be relatively safe when administered orally in mice.

Uji Toksisitas Subkronik Ekstrak Eatanol Kulit Batang Jaloh (Salix tetrasperma Roxb) Terhadap Parameter Fungsi dan Gambaran Histopatologi Organ Ginjal Tikus

Ros Sumarny, Sugito, Eko, Andri

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