PCJN: Pharmaceutical and Clinical Journal of Nusantara

Comparison of Extraction Methods on Medicinal Plants from the Lauraceae, Myristicaceae, Myrtaceace, Piperaceace, Rubiaceace, Solanaceace, and Zingiberaceae Families

Julia Susanti — 2025-07-24

Indonesia is recognized as the second most biodiverse country in the world after Brazil. The use of medicinal plants in traditional medicine is gaining popularity due to their proven health benefits and fewer side effects compared to synthetic drugs. Several plant families, such as Myrtaceae, Rubiaceae, and Solanaceae, are known to include species widely utilized in traditional therapies. This study aims to compare the extract yields obtained through maceration, percolation, and Soxhlet extraction methods from various medicinal plants. The extraction process used 96% ethanol as a solvent. The results revealed that extract yields varied significantly depending on the extraction method applied. In conclusion, this study demonstrates that the choice of extraction method—maceration, percolation, or Soxhlet—significantly influences the extract yield obtained from different plant families.

Effect of Garlic (Allium sativum) and Turmeric (Curcuma domestica Val.) Extract Combination in Type 2 Diabetic Rats.

Titi Marlina Ndruru — 2025-07-01

Type 2 diabetes mellitus (T2DM) often leads to kidney damage due to chronic hyperglycemia and oxidative stress. Garlic (Allium sativum) and turmeric (Curcuma domestica Val.) are traditional medicinal plants with known antioxidant and anti-inflammatory properties. This study evaluated the nephroprotective effect of their combined extracts in streptozotocin (STZ)-induced diabetic rats. Twenty-five male rats were divided into five groups: negative control, positive control (metformin 500 mg/kg BW), and three treatment groups receiving extract combinations at doses of 100, 200, and 300 mg/kg BW. Blood glucose, urea, and creatinine levels were measured, followed by histopathological examination. Phytochemical analysis confirmed the presence of alkaloids, flavonoids, and other secondary metabolites. Although statistical analysis showed no significant difference in glucose, urea, and creatinine levels among groups (p > 0.05), the 200 mg/kg BW group exhibited the most favorable trends in reduced blood glucose (226.70 ± 89.70 mg/dL) and kidney biomarkers. These results suggest the combination extract may offer protective effects on kidney function in diabetic conditions, warranting further investigation.

Study of Administrative, Pharmaceutical, and Clinical Aspects of Hypertension Patient Prescriptions at Advent Hospital, Medan

Maria Lady Saragih — 2025-07-03

Hypertension is a common chronic disease requiring precise pharmacological management to prevent complications. Inappropriate prescriptions may lead to treatment failure or adverse events. This study aimed to evaluate the completeness of prescriptions for hypertensive outpatients at Advent Hospital Medan based on administrative, pharmaceutical, and clinical aspects. This descriptive retrospective study analyzed 303 prescriptions collected from January to March 2024. Evaluation criteria included patient and prescriber identity, dosage form, drug strength, usage instructions, indication accuracy, dosage accuracy, and potential drug interactions. Results showed administrative completeness was high, with 100% inclusion of most identity elements, but 0% for weight and height. Pharmaceutical completeness was suboptimal, with only 25.08% including dosage form. Clinically, all prescriptions were appropriate in terms of indication, dose, and timing, and showed no duplication. However, 88.11% of prescriptions contained potential drug interactions, with 68 major interactions identified. The most frequent were Amlodipine–Simvastatin and Spironolactone–Candesartan combinations. These findings indicate that while clinical accuracy was excellent, pharmaceutical documentation and interaction screening need improvement. Collaboration between prescribers and pharmacists is essential to enhance medication safety.

Evaluation of Antidiabetic Drug Selection and Dosage Appropriateness in Hospitalized Type 2 Diabetes Mellitus Patients at RSU Royal Prima Medan. January-June 2024

Helprida GM Purba — 2025-07-07

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease that requires appropriate drug management to achieve optimal blood glucose control. Appropriateness of drug and dose is essential to ensure the effectiveness of therapy. while cost-effectiveness analysis is needed to assess the efficiency of resource use in its management. This study aims to assess the appropriateness of the use of drugs and doses of type 2 antidiabetics based on PERKENI 2021 clinical guidelines and analyze the cost-effectiveness of therapy in hospitalized patients. This study used a retrospective descriptive method with a cross-sectional approach. The research was conducted in January-February 2025 using purposive sampling technique.The result of the 43 patients. the majority were female (55.8%) and aged 56-65 years (48.8%). The suitability of drug use in accordance with PERKENI 2021 reached 100%. but there was a dose discrepancy of 1.36%. namely the drug sitagliptin. Based on ACER and ICER parameters. the most cost-effective monotherapy is Glimepirid with an effectiveness value of 100%. an ACER value of IDR 83.886.43. while the most cost-effective combination therapy is Pioglitazon + metformin with an effectiveness value of 100%. an ACER value of IDR 100.639.21 and an ICER value of IDR 76.734.39 and IDR 13.317.37. Most of the therapies are in accordance with the PERKENI 2021 guidelines. but dosage accuracy still needs to be improved.

Formulation and Evaluation of Avocado Leaf Extract Cream Preparation (Persea americana Mill.)

Titin Krisdayanti Sitanggang — 2025-07-07

As the outermost organ of the body, the skin is vulnerable to disorders such as inflammation, infection, and irritation, necessitating the use of effective and safe topical preparations. Avocado leaves (Persea americana Mill.) contain bioactive compounds such as flavonoids and polyphenols with known antioxidant and anti-inflammatory properties. This study aimed to formulate and evaluate a cream preparation containing ethanolic extract of avocado leaves as a natural active ingredient. The extract was obtained by maceration using 96% ethanol and formulated into three concentrations: 10% (F1), 15% (F2), and 20% (F3). Evaluations included organoleptic properties, homogeneity, pH, spreadability, and physical stability. The results showed that all formulations had a homogeneous appearance, characteristic color according to extract concentration, were odorless and tasteless. The pH values ranged within a safe range for skin application (4.83–4.90), and the best spreadability was observed in formulation F2. Increasing extract concentration tended to decrease spreadability due to increased viscosity. All formulations demonstrated good physical stability during cyclic stability testing. Based on these findings, it can be concluded that avocado leaf ethanolic extract can be effectively formulated into a stable, safe, and physically acceptable cream suitable for topical use.

Evaluation of Antibiotic Use in Typhoid Fever Patients at Mitra Sejati General Hospital Using the ATC/DDD Method

Masiria Ndruru — 2025-07-08

The inappropriate use of antibiotics can lead to negative consequences, including the development of resistance, worsening of patient conditions, and an increased burden on healthcare services. Therefore, evaluating antibiotic use through the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) method is essential to assess the rationality of therapy, particularly for typhoid fever cases, which remain highly prevalent in Indonesia. This study aimed to evaluate the use of antibiotics in typhoid fever patients at Mitra Sejati General Hospital using the ATC/DDD method. This research was a descriptive study with a cross-sectional design, utilizing patient health records of typhoid fever cases hospitalized from January to March 2024. A total of 72 patients were selected using purposive sampling and compared to WHO standards. The results showed that ceftriaxone (34.7%), levofloxacin (19.4%), and cefixime (16.7%) were the most frequently prescribed antibiotics. Based on the ATC/DDD method, only ciprofloxacin, cefotaxime, and cefadroxil met the WHO DDD standard, while the other seven antibiotics deviated from it. In conclusion, the majority of antibiotic use for typhoid fever patients at Mitra Sejati General Hospital did not comply with WHO standards, indicating the need to strengthen monitoring systems and promote education regarding the prudent and rational use of antibiotics in healthcare facilities

Analysis of the Relationship Between Attitude and Motivation and Medication Adherence Among Hypertensive Patients at Royal Prima General Hospital Medan

Desi Natalia — 2025-07-08

Hypertension remains one of the leading causes of morbidity and mortality globally, with poor medication adherence being a key barrier to effective management. This study aimed to analyze the relationship between attitude and motivation with medication adherence in hypertensive patients at Royal Prima General Hospital Medan. A quantitative, cross-sectional approach was employed, involving 150 respondents selected via purposive sampling. Primary data were collected using validated questionnaires covering demographics, attitude, motivation, and medication adherence. Data were analyzed using SPSS version 25 through univariate and bivariate (Chi-square) methods. Results showed that 59.3% of respondents had a fair attitude, 44.0% had moderate motivation, and 75.3% adhered to their medication. Bivariate analysis revealed a significant relationship between attitude and adherence (p = 0.000), and between motivation and adherence (p = 0.016). Patients with better attitudes and higher motivation demonstrated higher compliance with antihypertensive therapy. These findings highlight that psychosocial factors like attitude and motivation play critical roles in influencing patient behavior. Interventions targeting these behavioral dimensions could substantially improve treatment adherence and long-term health outcomes in hypertensive patients. Healthcare professionals should incorporate patient education and motivational strategies into hypertension management to foster sustained adherence.

Pharmacogenomic and Bioinformatic Insights into ACE Gene Variants and Their Influence on ACE Inhibitor Response in Hypertension

Danang Prasetyaning Amukti — 2025-07-09

Response to angiotensin-converting enzyme inhibitors (ACEIs)-based antihypertensive therapy varies between individuals, which is largely influenced by genetic factors. The ACE gene has several polymorphisms that can affect enzyme levels and therapeutic efficacy. This study aims to explore the relationship between genetic variations in the ACE gene and response to captopril, lisinopril, ramipril, and enalapril in hypertensive patients. This study used a bioinformatics and pharmacogenomics approach by analyzing data from PharmGKB, Ensembl, and GTEx Portal. Genetic polymorphisms were analyzed to evaluate their association with ACEI efficacy using a descriptive statistical approach. Results: Four single nucleotide polymorphisms (SNPs) in the ACE gene were found to be associated with response to ACEI. Variants rs4291 and rs1799752 were associated with captopril efficacy, where the AA genotype showed a decrease in the severity of renal failure. The rs1799752 variant was also associated with lisinopril and enalapril, with the DD genotype providing greater blood pressure reduction. In addition, rs4359 and rs4344 were correlated with the efficacy of ramipril, especially in the CC+TT and AA+GG genotypes. Genetic variation in the ACE gene plays a role in determining the response to ACEI therapy. Pharmacogenetic approaches have the potential to improve the efficacy and safety of antihypertensive treatment.