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Within this study, the influence of particle size and zeta potential of hydroxyethyl cellulose–cysteamine particles on
permeation enhancing properties was investigated. Particles were prepared by four different methods namely ionic
gelation, spray drying, air jet milling and grinding. Particles prepared by grinding were additionally air jet milled. All
particles were characterized in terms of particle size and zeta potential. The transport of fluorescein isothiocyanate-dextran 4 (FD4) across Caco-2 cell monolayers in the presence of these particles and the decrease in transepithelial
electrical resistance (TEER) was evaluated. The cytotoxic effect of the particles was investigated using resazurin assay.
Nanoparticles displaying a zeta potential of 3.3 ± 1.3 mV showed the highest enhancement of FD4 transport among
all particles with a 5.83-fold improvement compared to buffer only. Due to the larger particle size, particles generated
by grinding exhibited a lower capability in opening of tight junctions compared to smaller particles generated by air
jet milling. In addition, the results of the transport studies were supported by the decrease in the TEER. All particle
formulations tested were comparatively non-cytotoxic. Accordingly, the zeta potential and particle size showed
a significant impact on the opening of tight junctions and hence could play an important role in the design of
hydroxyethyl cellulose (HEC)-cysteamine-based nano- and micro-particles as drug delivery systems.

The purpose of this study was to design and characterize a novel cationic thiolated polymer. In this regard a
hydroxyethylcellulose-cysteamine conjugate (HEC-cysteamine) was synthesized. Oxidative ring opening
with periodate and reductive amination with cysteamine were performed in order to immobilize free
thiol groups to HEC. The resulting HEC-cysteamine displayed 2035 ± 162  mol immobilized free thiol
groups and 185 ± 64 mol disulfide bonds per gram of polymer being soluble in both acidic and basic
conditions. Unlike the unmodified HEC, in case of HEC-cysteamine, a three-fold increase in the viscosity
was observed when equal volumes of the polymer were mixed with mucin solution. Tablets based on
HEC-cysteamine remained attached on freshly excised porcine mucosa for 80 h and displayed increased
disintegration time of 2 h. Swelling behavior of HEC-cysteamine tablets in 0.1 M phosphate buffer pH 6.8
indicated swelling ratio of 19 within 8 h. In contrast, tablets comprising unmodified HEC detached from
the mucosa within few seconds and immediately disintegrated. In addition, they did not exhibit swelling
behavior. The transport of rhodamine 123 across freshly excised rat intestine enhanced by a value of
approximately 1.6-fold (p -value = 0.0024) in the presence of 0.5% (m/v) HEC-cysteamine as compared to
buffer control. Result from cytotoxicity test of HEC-cysteamine applied to Caco-2 cells in concentration
of 0.5% (m/v) revealed 82.4 ± 4.60% cell viability. According to these results, HEC-cysteamine seems to be
a promising polymer for various pharmaceutical applications especially for intestinal drug delivery

Evaluation of Antibiotic Usage in HCU and  ICU Wards in “Dharmais” Cancer Hospital February to March 2012           

Yusi Anggriani¹, Agusdini Banun², Erliana¹

¹ Fakultas Farmasi Universitas Pancasila, ²Rumah Sakit Kanker Dharmais.

Abstrak: Penggunaan antibiotika yang tinggi dapat memicu penggunaan antibiotika yang tidak rasional. Penelitian bertujuan untuk mengevaluasi penggunaan antibiotika secara kuantitatif dan kualitatif selama bulan Februari-Maret 2012. Pengambilan data dilakukan secara prospektif dengan mengambil data dari rekam medis dan pengamatan langsung pasien yang sedang dirawat. Parameter evaluasi kuantitatif menggunakan indikator WHO tentang evaluasi penggunaan antibiotika di rumah sakit dan Defined Daily Dose. Evaluasi kualitatif menggunakan kriteria Gyssens. Hasil studi menunjukkan, antibiotika paling banyak digunakan pada bulan Februari adalah seftriakson, yaitu 54,5 DDD/100 hari rawat di ruang HCU dan 52,5 DDD/100 hari rawat di ruang ICU. Penggunaan antibiotika terbanyak di bulan Maret adalah meropenem (Ruang HCU 36,0 DDD/100 dan ruang ICU 122,73 DDD/100 hari rawat). Penggunaan antibiotika kombinasi sebesar  32,9% di HCU sebesar dan pada pasien ICU 40%. Tes sensitivitas antibiotika hanya dilakukan pada 11,1% pasien yang menerima antibiotika. Tes kultur kuman hanya dilakukan pada 18 dari 153 pasien (11,8%). Pasien ADE (Antimicrobial Documented Empirical) sebanyak 98,7%, ADT (Antimicrobial Documented Therapy)  sebanyak 1,3% dan ADET (Antimicrobial Documented Empirical Therapy) sebanyak 8,6%. Kategori VI paling banyak ditemukan yaitu sebanyak 88,2%. Penggunaan antibiotika sesuai dengan formularium 93,9%. 

Kata kunci:  Evaluasi, antibiotika, ATC/DDD, pola kuman, kriteria Gyssens

Cincau merupakan salah satu tumbuhan yang banyak dimanfaatkan oleh masyarakat secara tradisional sebagai penurun panas dalam, obat sakit perut, juga sebagai antikanker, karena cincau diduga mengandung senyawa yang mempunyai aktivitas antioksidan yang mampu mematikan sel kanker. Telah dilakukan penelitian untuk membandingkan aktivitas antioksidan dari tiga macam cincau, yaitu cincau hitam, cincau hijau dan cincau perdu dengan metode peredaman radikal bebas DPPH. Masing-masing daun cincau di ekstraksi berturut-turut menggunakan n-heksana, etil asetat dan metanol. Hasil uji menunjukkan dari ekstrak n-heksana  tidak mempunyai aktivitas antioksidan. Hasil uji terhadap ekstrak etil asetat yang paling aktif berdasarkan nilai IC₅₀ adalah cincau hitam (IC₅₀ = 35,99 bpj), cincau perdu (IC₅₀ = 80,94 bpj) dan cincau hijau (IC₅₀ = 92,85 bpj). Hasil uji terhadap ekstrak metanol  yang paling aktif berdasarkan nilai IC₅₀ adalah cincau hitam (IC₅₀ = 32,59 bpj), cincau perdu (IC₅₀ = 39,82 bpj) dan cincau hijau ((IC₅₀ = 79,23 bpj). Dari ketiga jenis cincau dapat disimpulkan tanaman cincau memiliki aktivitas antioksidan dan cincau hitam mempunyai aktivitas antioksidan yang paling tinggi.