Sciences of Pharmacy

Oki Nugraha Putra, Sylvia Rizki Ramadhani, Yulistiani Yulistiani, Julaeha Julaeha, Affan Yuniar Nur Hidayatullah

The distribution of N-acetyltransferase-2 (NAT2) genetic polymorphisms varies across ethnic groups among Indonesian TB patients. This review aimed to provide a comprehensive understanding of the prevalence of NAT2 genetic polymorphisms and their association with DILI and isoniazid pharmacokinetics in Indonesian TB patients. A scoping review was conducted by searching Google Scholar, Scopus, and PubMed in accordance with PRISMA guidelines for scoping review (PRISMA-ScR). We retrieved 668 studies from three databases and we enrolled 12 studies for final analysis. Eleven studies reported on adult TB patients and one study on pediatric TB patients. Overall, the available evidence suggests that the slow acetylator phenotype is relatively common among TB patients in Indonesia, although its distribution varies across regions and ethnic groups. The NAT2*6 polymorphism was frequently observed among TB patients with a slow acetylator phenotype. TB patients with slow acetylation exhibited higher serum concentrations of isoniazid, which were significantly associated with an increased risk of DILI. No studies reported an association between NAT2 genetic polymorphisms or acetylation status and treatment outcomes among TB patients. This review confirms substantial variation in NAT2 genetic polymorphisms across studies in Indonesia. TB patients with a slow acetylator phenotype appear to have a greater risk of developing DILI compared with those with intermediate or fast acetylator phenotypes.  Information on acetylator status may identify patients at higher risk of hepatotoxicity, particularly those with the slow acetylator phenotype. Therefore, integrating NAT2 pharmacogenetics into clinical practice may predict hepatotoxicity and optimize tuberculosis therapy.

Sciences of Pharmacy

Indri Maharini, Karen Putri Utami, Lilis Rachmawati, Fitrianingsih Fitrianingsih, Puspa Dwi Pratiwi

The high prevalence of acne and increasing antibiotic resistance necessitate the development of sustainable antimicrobial agents. This study investigated the green synthesis of silver nanoparticles (AgNPs) using Erythrina subumbrans (Hassk.) Merr. leaf extract as a natural bioreductant and stabilizer. The primary objective was to optimize the synthesis process and evaluate the antibacterial efficacy of the resulting nanoparticles specifically against Propionibacterium acnes. Physicochemical and structural characterization were performed using spectroscopic and microscopic techniques to confirm the formation and stability of the nanoparticles. The results successfully demonstrated the synthesis of crystalline, nanoscale AgNPs with plant-derived functional groups facilitating their stabilization. Analytical data indicated a relatively uniform particle size distribution, spherical morphology, and favorable surface characteristics, suggesting high suitability for biomedical integration. Significantly, the synthesized AgNPs exhibited potent antibacterial activity against P. acnes. The underlying mechanism of action is attributed to the disruption of bacterial cell membranes, induction of intracellular reactive oxygen species, and subsequent interference with vital cellular functions. Utilizing E. subumbrans extract offers an eco-friendly, cost-effective, and sustainable alternative to conventional chemical synthesis, reducing the reliance on toxic reagents. These findings highlight the significant potential of plant-mediated AgNPs as innovative antimicrobial agents for dermatological applications. This research provides a robust foundation for the advancement of nanotechnology-based topical treatments. Consequently, further investigation into pharmaceutical formulation development, comprehensive safety assessments, and clinical efficacy trials is highly recommended to establish E. subumbrans-mediated silver nanoparticles as viable therapeutic solutions for managing acne and other skin-related infections in the future.

Sciences of Pharmacy

Yuliawati Yuliawati, Indah Sri Wulan Sofyan, Nurul Kamilah Sadli, Fathnur Sani Kasmadi

Organic mental disorders are psychiatric conditions caused by identifiable brain pathology or specific systemic diseases, characterized by psychotic, affective, anxiety, and cognitive symptoms that can impair daily functioning. Psychotropic medications play a central role in their management; however, data on utilization patterns, particularly among outpatients in regional psychiatric hospitals, remain limited. This study aimed to quantitatively evaluate the use of psychotropic drugs using the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) method recommended by the World Health Organization, and to identify drugs within the Drug Utilization 90% (DU90%) segment to support rational drug use. This retrospective descriptive study utilized secondary data from medical records of outpatients diagnosed with organic mental disorders at Kolonel H. M. Syukur Regional Psychiatric Hospital, Jambi, in 2024, with a total sampling of 100 patients. The results showed that the total psychotropic drug utilization was 9.89 DDD per patient per day. Antipsychotics were the most frequently used class, followed by antidepressants and anxiolytics. The DU90% segment consisted of eleven drugs, predominantly atypical antipsychotics, selective serotonin reuptake inhibitors (SSRIs), and benzodiazepines, with olanzapine, escitalopram, fluoxetine, and alprazolam being the most commonly prescribed. Most patients were male, in the productive age group, and diagnosed with unspecified organic mental disorders. Overall, the pattern of psychotropic drug utilization reflects the complexity of clinical manifestations in organic mental disorders and underscores the importance of monitoring drug use to promote rational prescribing practices in clinical settings.

Sciences of Pharmacy

Wawang Anwarudin , Salwa Diana Hanum, Liska Marlindasari, Anna Khalida Sya'bany, Nur Azizah

Tuberculosis (TB) remains a major global health concern, particularly in high-burden countries such as Indonesia. Although TB is curable, prolonged therapy, potential adverse effects, and social stigma may affect medication adherence and patients’ quality of life (QoL). Evaluating the association between adherence and QoL is important to support patient-centered TB management. This study aimed to examine the association between medication adherence and quality of life among tuberculosis patients at Permata Kuningan Hospital. A cross-sectional analytic study was conducted involving 62 TB patients selected through purposive sampling. Medication adherence was assessed using the Morisky Medication Adherence Scale (MMAS-8), and quality of life was measured using the EQ-5D-5L instrument. Data were analyzed using Spearman rank correlation. Most patients demonstrated high adherence (95.2%) and reported good quality of life (96.8%). Statistical analysis showed a significant positive correlation between medication adherence and quality of life (r = 0.384; p = 0.002), indicating that higher adherence was associated with better quality of life. These findings suggest a significant association between medication adherence and quality of life among TB patients. Strategies to support adherence, including education, counseling, and monitoring, may be considered as part of comprehensive TB care to optimize patient-centered outcomes.

Sciences of Pharmacy

Theodorus Rexa Handoyo, Juniar Kalpika Resmi, Rahmi Hutabarat, Yovi Guanse

Red apple (Malus domestica) extract, rich in hydrophobic quercetin, was formulated into oil-in-water (O/W) emulsion using a 22 factorial design to evaluate Tween 80 (8-10 g) and Span 80 (2-4 g) concentrations, targeting pH (4.5-6.0), transmittance (90-100%), and viscosity (10-2000 cPs). Design-Expert® 13 analysis identified formulations F1, FA, and FAB within acceptable physical property ranges, with all red apple emulsions exhibiting O/W type, skin-compatible pH (5.20-5.48), high transmittance, and suitable viscosity. Freeze-thaw cycling (3 cycles, -15/25°C) and centrifugation showed physical stability with non-significant changes for F1 (p > 0.05). The agar well diffusion assay was performed on F1 (n = 3), which exhibited optimal physical parameters and met stability criteria, revealing Cutibacterium acnes inhibition zones up to 22.7 ± 0.577 mm. Thus, F1 emerges as a promising nanoemulsion candidate demonstrating antibacterial activity against acne-causing bacteria.

Sciences of Pharmacy