Background Micronutrients, an umbrella term used to collectively describe vitamins and trace elements, are essential components of nutrition. Those requiring alternative forms of nutrition support are dependent on the prescribed nutrition regimen for their micronutrient provision. The purpose of this paper is to assist clinicians to bridge the gap between the available guidelines’ recommendations and their practical application in the provision of micronutrients via the parenteral route to adult patients. Methods Based on the available evidenced‐based literature and existing guidelines, a panel of multidisciplinary healthcare professionals with significant experience in the provision of parenteral nutrition (PN) and intravenous micronutrients developed this international consensus paper. Results The paper addresses 14 clinically relevant questions regarding the importance and use of micronutrients in various clinical conditions. Practical orientation on how micronutrients should be prescribed, administered, and monitored is provided. Conclusion Micronutrients are a critical component to nutrition provision and PN provided without them pose a considerable risk to nutrition status. Obstacles to their daily provision—including voluntary omission, partial provision, and supply issues—must be overcome to allow safe and responsible nutrition practice.
Organisasi Kesehatan Dunia (WHO) menyatakan bahwa lima besar kanker di dunia adalah kanker paru-paru, kanker payudara, kanker usus besar dan kanker lambung dan kanker hati. Sementara data dari pemeriksaan patologi di Indonesia menyatakan bahwa urutan lima besar kanker adalah kanker leher rahim, kanker payudara, kelenjar getah bening, kulit dan kanker nasofaring (Anaonim, 2004). Saat ini belum ditemukan data yang pasti yang menjadi faktor penyebab utama penyakit kanker payudara. Sampai saat ini terjadinya
Sistem perencanaan dan pengadaan obat merupakan faktor penentu ketersediaan obat dan kebutuhan anggaran. Metode yang baik dapat diterapkan untuk menciptakan sistem perencanaan dan pengadaan obat yang baik, salah satunya dengan metode ABC Indeks Kritis. Dengan metode ini maka dapat dikelompokkan obat prioritas yang memiliki nilai investasi besar. RSJ dr. Soeharto Heerdjan belum pernah melakukan analisis ABC Indeks Kritis dan masalah yang sering terjadi adalah stok obat kosong. Tujuan penelitian ini adalah menganalisis sistem perencanaan dan pengadaan obat di RSJ dr. Soeharto Heerdjan Jakarta. Jenis penelitian ini yaitu deskriptif kualitatif, menggunakan data pemakaian obat periode Januari 2020 sampai dengan Juni 2021 dan pengisian kuesioner VEN oleh 15 orang dokter. Analisis dilakukan dengan metode ABC Indeks Kritis. Hasil analisis menunjukkan bahwa dari 351 jenis obat yang termasuk dalam kelompok A indeks kritis ada 6 jenis (2%), kelompok B indeks kritis ada 119 jenis (33,6%) dan kelompok C indeks kritis ada 226 jenis (64,4%). Obat yang masuk dalam kelompok A indeks kritis adalah obat-obatan psikotropika, yaitu Clozapine 100 mg, Clozapine 25 mg, Trihexyphenidil 2 mg, Risperidone 2 mg, Depakote 500 mg ER, Abilify 10 mg Discmelt. Obat kelompok A indeks kritis menjadi prioritas untuk direncanakan dan diadakan, sehingga pada keenam jenis obat tersebut dilakukan perhitungan perkiraan kebutuhan tahun 2022, EOQ, SS dan ROP dengan hasil sebagai berikut: Clozapine 100 mg kebutuhan 194.844 tablet, EOQ 5.401 tablet, SS 16.953 tablet, ROP 17.654 tablet; Clozapine 25 mg kebutuhan 407.080 tablet, EOQ 21.338 tablet, SS 25.892 tablet, ROP 27.194 tablet; Trihexyphenidil 2 mg kebutuhan 1.695.404 tablet, EOQ 93.399 tablet, SS 29.544 tablet, ROP 33.387 tablet; Risperidone 2 mg kebutuhan 1.073.301 tablet, EOQ 42.897 tablet, SS 12.963 tablet, ROP 14.967 tablet; Depakote 500 mg ER kebutuhan 107.971 tablet, EOQ 3.068 tablet, SS 1.980 tablet, ROP 2.110 tablet; Abilify 10 mg discmelt kebutuhan 99.737 tablet, EOQ 1.426 tablet, SS 587 tablet, ROP 680 tablet. Penerapan model perencanaan dan pengadaan obat dengan metode ABC Indeks Kritis dalam penelitian dapat membantu menentukan prioritas obat, menyesuaikan dengan ketersediaan anggaran tanpa mengganggu kelancaran pelayanan, dan meningkatkan efisiensi pemakaian obat
Oncology pharmacists, pharmacy technicians and assistants are key members of the multidisciplinary health care team (MHT) caring for patients receiving immunotherapy with immune checkpoint inhibitors. The International Society of Oncology Pharmacy Practitioners (ISOPP) developed this position statement to provide guidance on the role of oncology pharmacy practitioners in caring for patients receiving immune checkpoint inhibitors. Four key recommendations were identified: 1) participation as an integrated, collaborative member of the MHT; 2) provision of education and training for patients, students, residents, fellows and other members of the MHT; 3) involvement in clinical governance to optimise the use of immune checkpoint inhibitors and 4) involvement in research and development in the field of immunotherapy. In summary, oncology pharmacy practitioners play essential roles within the MHT in caring for patients receiving immune checkpoint inhibitors.
Infectious diseases are still one of the important public health problems, especially in developing countries. The high incidence of Antibiotic resistance due to the irrational use of antibiotics is a special concern at this time. The government is also trying to control it through the Antimicrobial Resistance Control Program, including the rational administration of prophylactic antibiotics in surgery. Prophylactic antibiotics are antibiotics given before, during, and after surgical procedures to prevent complications of infection or infection of the surgical site (IDO). A retrospective and observational (non-experimental) study to know Patient characteristics, surgical characteristics, characteristics of the use of prophylactic antibiotics, rationality and cost analysis of using prophylactic antibiotics in Sectio Caesarea surgery and Appendectomy of patients at Hospital X Type B Jakarta in the period January 1 2021 – September 30 2021. The results of the study found that the selection of prophylactic antibiotics was not right (55.8%), the timing difference for prophylactic antibiotics was not right (84.5%), the prophylactic Antibiotic dose was not right (85.3%), all were correct the route of administration of prophylactic antibiotics by intravenous drip (100%), all of which are not appropriate for giving prophylactic Antibiotic intervals (100%) and entirely irrational in the use of prophylactic antibiotics in hospitals (100%). Hospitals can save costs, reduce the rate of Antibiotic resistance and reduce the incidence of surgical site infections by increasing physician compliance in using prophylactic antibiotics under hospital guidelines.
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