Sciences of Pharmacy

ED. Yunisa Mega Pasha, Lutfiani Az-Zahro, Siti Saidah, Mia Nisrina Anbar Fatin

Type 2 diabetes mellitus is a metabolic disease that commonly occurs in geriatric patients and is generally accompanied by comorbidities. This condition can increase medication use and potentially lead to drug interactions that may affect therapeutic effectiveness and cause adverse effects. This study aimed to identify potential antidiabetic drug interactions and analyze the association between length of hospitalization, number of medications used, and potential drug interactions. This was an analytical observational study with a cross-sectional approach and retrospective data collection using a total sampling technique on 41 medical records of geriatric patients with type 2 diabetes mellitus in the inpatient unit from January to December 2024. Potential drug interactions were identified using Medscape and Drugs. com. with severity levels classified as minor, moderate, and major. The results showed 95 potential antidiabetic drug interactions. Moderate interactions were the most common category, accounting for 88 cases (92.6%), while pharmacodynamic interactions were the most dominant mechanism, with 84 cases (88.4%). Of the 41 patients, 73.2% experienced potential drug interactions. Bivariate analysis using Fisher’s exact test showed a significant association between length of hospitalization, number of medications used, and potential drug interactions (p< 0.05). Potential antidiabetic drug interactions in geriatric patients with type 2 diabetes mellitus may be considered in monitoring medication use, especially in patients with polypharmacy and longer hospital stays. However, this study only evaluated potential drug interactions based on a drug interaction database therefore, further studies are needed to assess the clinical manifestations of drug interactions.

Sciences of Pharmacy

Nindita Sari Nastiti, Dayyana Rizkya Hanum, Shelomita Risti Oktavia, Rissa Maharani Dewi

Bronchopneumonia is a respiratory tract infection affecting the bronchi and lungs and remains one of the leading causes of mortality among children worldwide. Antibiotics are the mainstay of therapy; however, their high utilization necessitates evaluation to ensure rational use. At K. R. M. T. Wongsonegoro Hospital, Semarang, bronchopneumonia was the leading infectious disease among pediatric patients in 2023, highlighting the need for a comprehensive assessment of antibiotic prescribing practices. This study aimed to determine the profile of antibiotic use and evaluate both qualitative and quantitative appropriateness of antibiotic therapy among pediatric inpatients with bronchopneumonia. A descriptive, retrospective, cross-sectional study was conducted involving 281 pediatric inpatients aged 0–18 years hospitalized with bronchopneumonia throughout 2023. Qualitative antibiotic appropriateness was evaluated using the Gyssens method, while quantitative utilization was analyzed via the Defined Daily Dose (DDD)/100 inpatient-days system. Ceftriaxone was the predominant therapy, both as monotherapy and in combination with azithromycin. Qualitative analysis revealed notable irrationalities, characterized primarily by incorrect dosing intervals and inappropriate dosages, alongside truncated treatment durations. Quantitatively, ceftriaxone exhibited the highest consumption rate, dominating the Drug Utilization 90% (DU90%) segment. These findings reveal suboptimal antibiotic utilization patterns, underscoring an urgent need for institutional prescription audits and targeted educational interventions to mitigate the risk of localized antimicrobial resistance.

Sciences of Pharmacy

Abdul Mulki Irpani, Anne Yuliantini, Muhammad Ilham Bintang, Arinda Tri Pramay Sella, Jajang Japar Sodik

Breast cancer is a major cause of mortality among women and requires the development of alternative therapies derived from natural products. This study aimed to profile bioactive compounds in the ethanol extract of gras jelly leaves (Cyclea barbata Miers) and evaluate their predicted interactions with estrogen receptor alpha (ERα), a key regulator of proliferation in ER-positive MCF-7 breast cancer cells using an in silico approach. LC–HRMS analysis followed by database matching tentatively annotataed 44 major compounds based on peak intensity after data filtering. Molecular docking and simulation results indicated that several compounds exhibited favorable predicted binding affinity toward estrogen receptor targets. Among them, (3β, 24R, 24′R)-fucosterol epoxide demonstrated the most stable interaction. These findings suggest that the compound showed promising interaction stability toward the estrogen receptor in computational analysis. However, further in vitro and in vivo studies are required to validate its biological activity

Sciences of Pharmacy

Nurul Kamilah Sadli, Santi Perawati, Vina Neldi, Novia Tri Astuti, Marizki Pondawinata, Syaza Putri Humaira

Digoxin has a narrow therapeutic index, requiring close monitoring to prevent toxicity, particularly in patients with heart failure, polypharmacy, and impaired renal function. Due to limitations in therapeutic drug monitoring (TDM), we estimated digoxin serum levels using pharmacokinetic formulas based on creatinine clearance. This retrospective observational study aimed to conduct an initial risk screening by estimating digoxin concentrations, evaluating drug interactions, and assessing heart rate in 17 heart failure patients at a regional general hospital in Jambi (January–August 2025). Descriptive analysis revealed that 76% of patients were within the therapeutic range, while 24% exceeded it, with elevated levels correlating with higher creatinine serum and lower creatinine clearance. Common drug interactions involved furosemide, bisoprolol, and proton pump inhibitors, with spironolactone posing a severe risk. Clinically, bisoprolol combined with hypokalemia appeared associated with lower heart rates in patients with predicted toxic concentrations. While the formula-based pharmacokinetic approach serves as a useful exploratory initial screening tool, these findings require further validation through laboratory-based TDM and larger studies.

Sciences of Pharmacy

Cut Intan Annisa Puteri, Ziza Putri Aisyia Fauzi, Rahmadani Rahmadani, Febia Sari, Putri Tri Hartini

Amoxicillin is widely used to treat gastric infections; however, conventional oral dosage forms often exhibit rapid gastric emptying and short gastric residence time, which may reduce therapeutic effectiveness. Gastroretentive floating drug delivery systems can prolong gastric retention and provide sustained drug release. This study aimed to develop gastroretentive floating beads of amoxicillin using pectin extracted from breadfruit peel (Artocarpus altilis) and compare their characteristics with those prepared using commercial pectin. Floating beads were prepared by ionotropic gelation using calcium chloride as a crosslinking agent and sodium bicarbonate as a gas-forming agent. The beads were characterized for morphology, floating behavior, entrapment efficiency, and drug release. All evaluations were performed in triplicate (n = 3). The prepared beads exhibited spherical morphology with diameters of 0.24–0.42 mm and weights of 9.26–11.38 mg. Floating lag time ranged from 10–22 seconds, and all formulations remained buoyant for up to 8 hours. Entrapment efficiency ranged from 31–47%, with formulations prepared using commercial pectin showing values of 34–47% and breadfruit peel-derived pectin showing values of 31–43%, with formulation F3 containing 3.5% commercial pectin showing the highest value. In vitro drug release studies demonstrated sustained release of amoxicillin for up to 8 hours, whereas conventional tablets released 64.77% of the drug within 2 hours. Drug release followed the Higuchi model (R² = 0.989–0.996), indicating diffusion-controlled release. These findings demonstrate that breadfruit peel-derived pectin is a promising natural polymer for gastroretentive floating bead formulations and exhibits performance comparable to commercial pectin.

Sciences of Pharmacy

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

Sucralfate is a medicine for peptic ulcers that is practically insoluble in water and might to be developed into a suspension. The choice of suspending agents is essential for formula development. This study aimed to determine the physical characteristics and physical stability of xanthan gum, CMC-Na, and Avicel RC-591 in a sucralfate suspension by conducting a characterization and stability study and analyzing the formulations. Suspensions were prepared with 0.3% w/v xanthan gum (XG), 1% w/v CMC-Na (SCMC), and 1% w/v Avicel RC-591 (ARC) and then evaluated for physical appearance, pH, density, viscosity, sedimentation, and redispersibility in a six-month stability study conducted under various storage conditions. The pH results ranged between 5.113 ± 0.001 and 4.622 ± 0.033 (p > 0.05). The density of the SCMC formula (1.1459 ± 0.0003) is greater than the density of the ARC formula (1.1396 ± 0.0002) and XG (1.1162 ± 0.0002), but statistically, the three formulas are not significantly different (p > 0.05). The viscosity of XG is greater than SCMC and ARC. The formulas indicated that XG had greater sedimentation than SCMC and ARC (p > 0.05). The redispersibility of all formulations is ARC > SCMC > XG. In conclusion, ARC and SCMC exhibit acceptable suspension characteristics and robust physical stability. Conversely, formulations utilizing XG fail to meet the required quality standards for sucralfate suspensions regarding redispersibility.

Sciences of Pharmacy

Norhidayah Norhidayah, Safira Maza, Novita Anggraeni, Taufik Qurrahman, Rizki Rahmadi Pratama, Yulistia Budianti Soemarie

Traditionally, menginang (a mixture of betel leaf, areca nut, gambir, and lime) has been used as a natural antibacterial agent. This study aimed to compare the antibacterial activity of single betel leaf extract and menginang extract against four oral pathogenic bacteria in vitro. This study compared the antibacterial activity of traditional menginang extract and single betel leaf extract against multiple oral pathogenic bacteria to evaluate their potential synergistic antibacterial effects. The experimental method used a disk diffusion technique at three concentrations (12.5%, 25%, and 50%), and the data were analyzed using one-way ANOVA and Bonferroni post hoc tests. Chlorhexidine 0.2% was used as the positive control, while distilled water was used as the negative control. The 50% menginang extract showed the strongest antibacterial activity against all tested bacteria, with inhibition zones ranging from 22.76 ± 1.38 mm to 28.22 ± 0.14 mm, and the differences were statistically significant (p < 0.05). The inhibition zones produced by the 50% menginang extract were close to those of 0.2% chlorhexidine. The superiority antibacterial activity of menginang extract may be associated with synergistic interactions among alkaloids, phenolics, flavonoids, tannins, saponins, triterpenoids, and steroids identified during phytochemical screening. The menginang extract has high potential to be developed as an innovative natural product for oral health.

Sciences of Pharmacy

Stefani Alya Swasa Wuryanto, Ida Ayu Manik Damayanti, Putu Indrayoni

Cutibacterium acnes is a cause of acne. Conventional treatments often lead to side effects and bacterial resistance, necessitating natural alternatives. Globe Amaranth (Gomphrena globosa L. ) shows potential as an anti-acne agent. This study employed an in vitro experimental laboratory design to evaluate the anti-acne activity of G. globosa L. flower extract formulated cream against C. acnes using the well diffusion method. Antibacterial activity was tested using KN (base cream), KP (1% clindamycin cream), F1 (10%), F2 (15%), and F3 (20%), and the data were analyzed using SPSS statistical analysis. Results indicated that the ethanolic extract of GA flowers has an IC₅₀ of 85.483 ppm, TPC of 60.456 ± 0.589 mg GAE/g, and TFC of 34.390 ± 0.989 mg QE/g. It exhibited antibacterial activity against C. acnes, with inhibition zone diameters of 6.693 ± 0.2 mm for the 15% formula and 7.382 ± 0.22 mm for the 20% formula. The antibacterial activity is believed to be driven by the presence of secondary metabolites, particularly phenols and flavonoids identified in the extract.

Sciences of Pharmacy

Venni Melinda, Yusi Anggriani, Sondang Khairani, Fitri Nurhayati

Platinum-based chemotherapy remains an important treatment option for patients with advanced non-small cell lung cancer (NSCLC), particularly in settings where reimbursement and resource allocation are major considerations. A retrospective observational cost-effectiveness study was conducted using medical records and billing data from adult patients with NSCLC who received carboplatin–paclitaxel, cisplatin–pemetrexed, or carboplatin–gemcitabine in 2023. Effectiveness outcomes included the one-year survival rate (%) and median progression-free survival (PFS). Costs were calculated based on direct medical expenses over six chemotherapy cycles. Cost-effectiveness was assessed using ACER, ICER, and dominance analysis. A total of 101 patients were included: 81 received carboplatin and paclitaxel, 14 received cisplatin and pemetrexed, and 6 received carboplatin and gemcitabine. Mean direct medical costs were IDR 27, 588, 547, IDR 41, 214, 281, and IDR 47, 471, 752, respectively. No statistically significant differences were observed in one-year survival rate or median PFS among the regimens, although interpretation should consider the unequal sample sizes (81 vs. 14 vs. 6), which limit statistical power. Based on one-year survival, carboplatin–paclitaxel had the lowest ACER and dominated the other regimens by providing higher observed survival at lower cost. Based on median PFS, cisplatin–pemetrexed provided longer PFS than carboplatin–paclitaxel but at a higher cost, requiring ICER-based interpretation. Carboplatin–paclitaxel was associated with the lowest direct medical cost and the most favorable cost-effectiveness profile based on one-year survival among the evaluated regimens. However, conclusions should be interpreted cautiously because of the retrospective design, small and unequal group sizes, and potential confounding by baseline clinical characteristics.

Sciences of Pharmacy

Purwaniati Purwaniati, Emy Susanti

Type 2 diabetes mellitus (T2DM) is a metabolic disorder with complex pathophysiological pathways involving multiple physiological factors. Therefore, multitarget therapy has become one of the most rational therapeutic approaches for the management of T2DM. Ginggiang (Leea aequata L.) is a medicinal plant reported to contain various bioactive compounds with potential antidiabetic activity. This study aimed to explore the multitarget antidiabetic potential of the ethanolic extract of Ginggiang leaves through liquid chromatography–high-resolution mass spectrometry (LC-HRMS) analysis followed by molecular docking studies. LC-HRMS analysis was performed to identify compounds in the extract, while molecular docking studies were conducted to evaluate potential interactions between the identified compounds and multiple antidiabetic targets. The concentrated extract obtained by maceration using 96% ethanol was analyzed using LC-HRMS. The annotated compounds were subsequently used as test ligands in molecular docking studies. Molecular docking was performed using AutoDock 4.2.3 against α-glucosidase (PDB ID: 5NN8), SGLT2 transporter protein (PDB ID: 8HEZ), and DPP-4 enzyme (PDB ID: 5T4B). LC-HRMS analysis successfully annotated 31 compounds in the ethanolic extract of Ginggiang leaves. Molecular docking results suggested that catechin gallate and 2-amino-1, 3, 4-octadecanetriol exhibited favorable docking scores against all three target proteins and may be considered potential multitarget antidiabetic compounds. Several other compounds also showed favorable interactions with one or more targets. The results indicate that Ginggiang leaf ethanol extract may serve as a potential source of bioactive compounds for antidiabetic drug discovery. Nevertheless, further studies, including molecular dynamics simulations and experimental validation, are required to confirm these findings.

Sciences of Pharmacy

Samad Ali

Diabetes mellitus remains a global health crisis, with pancreatic β-cell dysfunction as a key pathological feature that current therapies address only palliatively. This narrative review examines an emerging paradigm: the convergence of CRISPR-based epigenome editing, nanotechnology, and artificial intelligence for targeted modulation of the β-cell epigenome. We synthesize evidence on epigenetic dysregulation in diabetic β-cells, critically evaluate preclinical developments in CRISPR epigenome editors and smart nanocarriers for pancreatic delivery, and discuss artificial intelligence applications in guide RNA design and multi-omics integration. Although proof-of-concept studies demonstrate promising synergy, clinical translation remains in its earliest stages. Major challenges including delivery specificity, biosafety, immunogenicity, and regulatory hurdles must be overcome before a precision reversal of diabetes can be realistically contemplated. This review provides a balanced assessment of both the transformative potential and the substantial obstacles facing nanogenomic approaches to diabetes therapy.

Sciences of Pharmacy