Category Archives: Obat

Obat Jantung Koroner

Penyakit jantung koroner ( PJK ) merupakan problema kesehatan utama di negara maju. Di Indonesia telah terjadi pergeseran kejadian Penyakit Jantung dan pembuluh darah dari urutan ke-l0 tahun 1980 menjadi urutan ke-8 tahun 1986. Di Indonesia penyakit jantung koroner saat ini menempati posisi pertama sebagai penyebab kematian di Indonesia. Sebanyak 40% orang yang meninggal karena serangan jantung tidak mengetahui kalau dirinya mengidap penyakit jantung koroner. Banyak faktor yang mempengaruhi terjadinya Penyakit Jantung Koroner sehingga usaha pencegahan harus bentuk multifaktorial juga. Pencegahan harus diusahakan sedapat mungkin dengan cara pengendalian faktor faktor resiko Penyakit Jantung Koroner dan merupakan hal yang cukup penting dalam usaha pencegahan PJK, baik primer maupun sekunder. Pencegahan primer lebih ditujukan pada mereka yang sehat tetapi mempunyai resiko tinggi, sedangkan sekunder merupakan upaya memburuknya penyakit yang secara klinis telah diderita. Berbagai Penelitian telah dilakukan selama 50 tahun lebih dimana didapatlah variasi insidens PJK yang berbeda pada geografis dan keadaan sosial tertentu yang makin meningkat sejak tahun 1930 dan mulai tahun 1960 merupakan Penyebab Kematian utama di negara Industri. Mengapa didapatkan variasi insidens yang berbeda saat itu belum diketahui dengan pasti, akan tetapi didapatkan jelas terjadi pada keadaan keadaan tertentu. Penelitian epidemiologis akhirnya mendapatkan hubungan yang jelas antara kematian dengan pengaruh keadaan sosial, kebiasaan merokok, pola diet, exercise, dsb yang dapat dibuktikan faktor-faktor yang dapat mempengaruhi terjadinya PJK antara lain: umur, kelamin ras, geografis, keadaan sosial, perubahan masa, kolesterol, hipertensi, merokok, diabetes, obesitas, exercise, diet, perilaku dan kebiasaan lainnya, stress serta keturunan.

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Stroberi Cegah Tukak Lambung

Stroberi adalah buah warna merah dengan tampilan cantik menggoda. Rasanya yang manis dan sedikit asam membuat buah ini banyak penggemarnya.

Sebuah penelitian menemukan, mengonsumsi stroberi secara teratur dapat mengurangi dan mencegah tukak lambung yang seringkali disebabkan minuman beralkohol. Studi yang diterbitkan dalam jurnal PLoS ONE meneliti tikus untuk melihat bagaimana ekstrak stroberi memengaruhi kesehatan perut.

Para peneliti menemukan, tikus yang diberi ekstrak stroberi selama 10 hari sebelum diberi alkohol mengalami luka di lambung lebih sedikit daripada tikus yang tak diberi stroberi sama sekali. Para peneliti percaya bahwa efek positif stroberi terkait jumlah antioksidan tinggi dan senyawa fenolik yang bersifat anti-inflamasi dan anti-pembekuan. Stroberi dipercaya mengaktifkan enzim yang penting untuk melindungi tubuh.
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Sirgunggu bukan hanya obat gurah tetapi juga sebagai imunomodulator

Tindakan pencegahan dari kemungkinan sakit dapat dilakukan dengan meningkatkan daya tahan tubuh melalui pemberian suatu bahan yang disebut dengan imunomodulator. Imunomodulator adalah suatu senyawa atau bahan yang dapat meningkatkan sistem imun. Meningkatnya sistem imun akan meningkatkan ketahanan tubuh terhadap berbagai pathogen yang masuk kedalam tubuh seperti infeksi berbagai mikroorganisme misalnya oleh bakteri, pirogenik dan virus.

obat gurah

imunomodulator

Bahan alam yang sering digunakan untuk meningkatkan daya tahan tubuh antara lain dengan tanaman sirgunggu (C. serratum (L) Moon). Secara turun-temurun tanaman sirgunggu (C. serratum(L) Moon) sudah banyak dipakai oleh masyarakat Giriloyo (Imogiri) khususnya untuk gurah. Gurah merupakan pengobatan tradisional yang pada umumnya dilakukan dengan meneteskan ramuan kedalam lubang hidung dengan tujuan mengeluarkan kotoran-kotoran yang ada diseluruh tubuh bersamaan dengan keluarnya lendir melalui lubang hidung (Djawadi, 2000).

imunomodulator

gurah

Kandungan sirgunggu (C. serratum (L) Moon) diduga sebagai imunomodulator yaitu kemampuan suatu zat untuk memodulasi (meningkatkan/menurunkan) imunitas (Anonim,2003). Tanaman ini mengandung senyawa flavonoid dan polifenol pada daunnya, dimana kedua senyawa tersebut sebagai imunomodulator yang dapat mengeluarkan lendir yang dibantu oleh makrofag maka akan memacu keluarnya sitokin sebagai akibat inflamasi, mencegah detoksifikasi (keracunan dalam sel) dengan cara mengeluarkan lendir dari dalam tubuh. Sedangkan pada kulit akarnya mengandung glikosida fenol, manitol, dan sitoserol serta polifenol (Anonim, 2003). Flavonoid dan polifenol pada tanaman lain terbukti memiliki efek sebagai imunostimulansia.

Makrofag sebagai efektor pada sistem imun, berperan memusnahkan kuman atau patogen yang akan merusak tubuh (Harijanto, 2000), baik melalui mekanisme fagositosis langsung maupun melalui mekanisme tak langsung dengan melepaskan Reaktive Oxygen Intermediates (ROI) dan sitokin (Wijayanti, 2000). Hal ini ditandai dengan perubahan bentuk, perubahan biokimiawi, serta perubahan fungsi dari makrofag (Baratawidjaya, 2000 ; Harijanto, 2000). Aktivitas fagositosis makrofag dapat ditingkatkan oleh zat-zat imunogen termasuk imunogen dari tanaman. Telah dibuktikan bahwa pemberian ekstrak etanol sirgunggu meningkatkan aktivitas fagositosis makrofag. Ini berarti bahwa ekstrak etanol sirgunggu dapat berlaku sebagai imunomodulator yaitu meningkatkan aktivitas fagositosis atau kemampuan membunuh sel pembunuh. Selamat mencoba

FDA merelease obat baru lagi, Vismodegib, obat ca sel basalis metastasis

Vismodegib merupakan obat untuk karsinoma sel basal metastasis atau kanker kulit sel basal fase lanjut yang tidak memungkinkan untu pembedahan atau kekambuhan pasca terapi pembedahan.

Prinsip kerja dari kerja obat baru ini adalah mempengaruhi signaling pada bagian subseluler yang disebut sistem signaling “hedgehog pathway”. Sebagaimana tampak pada gambar

hedgehog pathway

Berita lengkap tentang obat baru ini silakan baca pada paparan berikut:

On January 30, 2012, the U. S. Food and Drug Administration approved vismodegib (ERIVEDGE Capsule, Genentech, Inc.) for the treatment of adults with metastatic basal cell carcinoma or with locally advanced basal cell carcinoma that has recurred following surgery or who are not candidates for surgery, and who are not candidates for radiation.

obat kanker sel basalis

vismodegip

Efficacy was demonstrated in a single-arm, parallel cohort trial enrolling 104 patients. Patients received 150 mg of vismodegib daily. Central pathologic review of archival or baseline tissue confirmed the diagnosis of basal cell carcinoma (BCC) in 96 patients: 33 patients with metastatic basal cell carcinoma (mBCC) and 63 patients with locally advanced basal cell carcinoma (laBCC).

Efficacy was evaluated in these 96 patients with confirmed BCC. The median age of this population was 62 years, 61% were male, and 97% had an ECOG performance status of 0 or 1. Twenty‑one percent of patients carried a diagnosis of Gorlin syndrome. Sixty-six percent had locally advanced disease; 34% had metastatic disease. Among those with mBCC, 97% were previously treated. Prior therapy included surgery (97%), radiotherapy (58%), and systemic therapies (30%). Among laBCC patients, 94% were previously treated. Prior therapies included surgery (89%), radiotherapy (27%), and systemic/topical therapies (11%).

The trial’s primary endpoint was objective response rate (ORR) assessed by an independent review facility. Tumor response criteria for laBCC included assessment of tumor size, the presence or absence of ulceration, and biopsy of local disease sites. The criteria for complete response in localized disease required tumor biopsy (ies) demonstrating no pathologic evidence of BCC. RECIST version 1.0 criteria were used to assess responses in the mBCC population.

The ORRs were 30.3% (95% CI: 15.6, 48.2) and 42.9% (95% CI: 30.5, 56.0) in patients with mBCC and laBCC, respectively. All responses in the mBCC cohort were partial responses. For the 63 evaluable patients with laBCC, 13 (20.6%) patients had complete responses and 14 (22.2%) had partial responses. The median response duration was 7.6 months (95% CI: 5.6, not estimable) and 7.6 months (95% CI: 5.6, 9.7) for patients with mBCC and laBCC, respectively.

Safety was evaluated in 138 patients who received vismodegib as monotherapy for laBCC or mBCC. Adverse reactions occurring in more than 10% of patients were muscle spasms, alopecia, dysgeusia, weight loss, fatigue, nausea, diarrhea, decreased appetite, constipation, arthralgias, vomiting, and ageusia. In clinical trials, a total of 3 of 10 pre-menopausal women developed amenorrhea. Grade 3 adverse reactions occurring in more than 1% of patients were weight loss, fatigue, muscle spasms, and decreased appetite.

Healthcare professionals should verify pregnancy status prior to the initiation of vismodegib, counsel pregnant women on the potential risks to the embryo/fetus, and advise non-pregnant women to use highly effective contraception during treatment with vismodegib and for up to 7 months after the last dose. To avoid exposing an embryo/fetus to vismodegib that may be contained in semen, male patients should use condoms with spermicide during treatment with vismodegib, and for 2 months after the last dose. Healthcare providers should report to Genentech any cases of exposure during pregnancy (either direct exposure in female patients or through seminal fluid from male patients), and should encourage pregnant women to participate in the Erivedge pregnancy pharmacogvigilance program to collect information on pregnancy outcomes.

Vismodegib inhibits the Hedgehog pathway, an important embryonic developmental pathway. Reproductive toxicology studies in rats demonstrated that vismodegib exposure during organogensis results in embryo-fetal death at higher exposures and severe birth defects at exposures within the range achieved with the recommended human dose.

The recommended dose and schedule for vismodegib is 150 mg orally daily. Vismodegib may be taken with or without food.

Full prescribing information, including clinical trial information, safety, dosing, drug-drug interactions and contraindications is available at: http://www.accessdata.fda.gov/drugsatfda_docs/label/2012/203388lbl.pdf[download id=”1″]

Healthcare professionals should report all serious adverse events suspected to be associated with the use of any medicine and device to FDA’s MedWatch Reporting System by completing a form online at http://www.fda.gov/medwatch/report.htm, by faxing (1-800-FDA-0178) or mailing the postage-paid address form provided online, or by telephone (1-800-FDA-1088).

apakah bevacizumab itu? avastin adalah contoh produk paten bevacizumab

Avastin is a cancer medicine that interferes with the growth of cancer cells by blocking the formation and growth of new blood vessels in the tumor which slows their growth.

obat biologis anti ca mamae

Avastin is used to treat a certain type of brain tumor as well as cancers of the kidney, colon, rectum, lung, or breast. It is usually given as part of a combination of cancer medicines.

Avastin may also be used for purposes other than those listed here.

Most important: Avoid having surgery while you are being treated with Avastin. You may have problems with wound healing, which could result in bleeding or infection.

monoklonal antibodi anti VEGF

obat biologis

If you need to have any type of surgery, you will need to stop receiving Avastin for at least 4 weeks while your surgical incision heals.

Before being treated with Avastin, tell your doctor if you have liver disease, kidney disease, heart disease, high blood pressure, a history of stroke or blood clots, or an open wound.

Some people receiving a Avastin injection have had a reaction to the infusion (when the medicine is injected into the vein). Tell your caregiver right away if you feel dizzy, nauseated, light-headed, sweaty, itchy, or have a fast heartbeat, chills, wheezing, or chest pain during the injection.

Call your doctor at once if you have serious side effects such as blood in your stools or vomit, sudden numbness or weakness (especially on one side of the body), sudden headache or confusion, problems with vision or speech, chest pain spreading to the arm or shoulder, shortness of breath, swelling, rapid weight gain, or flu symptoms.

Avastin can cause a rare but serious neurologic disorder affecting the brain. Symptoms include headache, confusion, vision problems, feeling light-headed, fainting, and seizure (blackout or convulsions). These rare symptoms may occur within hours of your first dose of Avastin, or they may not appear for up to a year after your treatment started. Call your doctor at once if you have any of these side effects.

To be sure Avastin is not causing harmful effects, your blood pressure will need to be tested on a regular basis. Your urine may also need to be tested. Do not miss any scheduled visits to your doctor.

 

 

 

 

 

 

 

struktur antibodi

Avastin can affect a woman’s fertility (ability to have children). Talk to your doctor about your specific risks.

AXITINIB, ANTI CARCINOMA GINJAL YANG KEBAL DENGAN TERAPI SISTEMIK LAINNYA

Axitinib

Pada 27/1/2012 FDA telah memberikan ijin edar obat baru untuk kanker ginjal lanjut yang sudah kebal dengan terapi sistemik lainnya. Tentu ini suatu kabar gembira bagi penderita kanker ginjal lanjut yang sudah hampir putus harapan. Kata Allah, setiap penyakit ada obatnya. Masalahnya kita tahu tidak obat tersebut?
Berita selengkapnya tentang axitinib silakan dibaca pada artikel berikut.
Masih ada harapan On January 27, 2012, the U. S. Food and Drug Administration approved axitinib tablets (Inlyta, Pfizer, Inc.) for the treatment of advanced renal cell carcinoma after failure of one prior systemic therapy.

The approval is based on an international, randomized, open-label trial in patients with advanced renal cell carcinoma after failure of one prior systemic regimen. The primary efficacy endpoint was progression-free survival (PFS).

The trial enrolled 723 patients: 361 patients were assigned to receive axitinib 5 mg orally twice daily, and 362 patients were assigned to receive sorafenib 400 mg orally twice daily. Treatment continued until disease progression, unacceptable toxicity, and/or consent withdrawal. All enrolled patients had an ECOG performance status of 0 or 1 and all patients had received one prior systemic therapy that contained one of the following treatments: sunitinib, temsirolimus, bevacizumab or cytokine(s). The trial excluded patients who had uncontrolled hypertension.

The PFS analysis demonstrated a statistically significant improvement in PFS in patients receiving axitinib compared to patients receiving sorafenib (HR=0.67; 95% CI: 0.54, 0.81; p< 0.0001, log-rank test). The median PFS of patients receiving axitinib was 6.7 months (95% CI: 6.3, 8.6) compared to a median PFS of 4.7 months (95% CI: 4.6, 5.6) for patients receiving sorafenib. This improvement in PFS was greater in the cytokine-pretreated subgroup compared to the sunitinib-pretreated subgroup.

The most common (≥20%) adverse reactions in patients treated with axitinib were diarrhea, hypertension, fatigue, decreased appetite, nausea, dysphonia, palmar-plantar erythrodysesthesia (hand-foot) syndrome, weight decreased, vomiting, asthenia, and constipation. Other severe adverse reactions reported in axitinib-treated patients included hypertensive crisis, arterial and venous thrombotic events, hemorrhage, gastrointestinal perforation and fistula formation, and reversible posterior leukoencephalopathy syndrome.

The recommended dose schedule of axitinib is 5 mg orally twice daily, administered approximately 12 hours apart with or without a meal.

Full prescribing information, including clinical trial information, safety, dosing, drug-drug interactions and contraindications is available at: http://www.accessdata.fda.gov/drugsatfda_docs/label/2012/202324lbl.pdf

Healthcare professionals should report all serious adverse events suspected to be associated with the use of any medicine and device to FDA’s MedWatch Reporting System by completing a form online at http://www.fda.gov/medwatch/report.htm, by faxing (1-800-FDA-0178) or mailing the postage-paid address form provided online, or by telephone (1-800-FDA-1088).

Rempah-rempah Penurun Trigliserida

KOMPAS.com – Rempah-rempah tidak hanya bermanfaat untuk membuat makanan menjadi lebih enak untuk disantap, tetapi juga berkhasiat mengikis lemak jahat di dalam tubuh.

Menurut riset terbaru yang dipublikasikan dalam The Journal of Nutrition, menambahkan beberapa jenis rempah ke dalam makanan dapat membantu mengurangi  efek buruk makanan berlemak, terutama menurunkan kadar trigliserida.

“Antioksidan dalam bumbu rempah berperan penting mengurangi stres oksidatif sekaligus menekan risiko penyakit kronis. Biasanya, ketika Continue reading

Mana yang lebih menguntungkan Rivaroxaban atau Warfarin pada Nonvalvular Atrial Fibrillation

Non valvular atrial fibrilasis merupakan salah satu faktor risiko stroke iskemia dan embolisme pada pembuluh darah. Selama ini warfarin merupakan salah satu obat pilihan untuk pencegahan strok iskemia maupun pembentukan emboli pada pasien dengan fibrilasis termasuk pasien dengan nonvalvular atrial fibrilasis. Hasil Uji klinis untuk membandingkan kemanjuran rivaroxaban dengan warfarin pada nonvalvular atrial fibrilasis telah dilaporkan oleh NEJM.

rivaroxaban

faktior risiko cvd

Original Article

Rivaroxaban versus Warfarin in Nonvalvular Atrial Fibrillation

Manesh R. Patel, M.D., Kenneth W. Mahaffey, M.D., Jyotsna Garg, M.S., Guohua Pan, Ph.D., Daniel E. Singer, M.D., Werner Hacke, M.D., Ph.D., Günter Breithardt, M.D., Jonathan L. Halperin, M.D., Graeme J. Hankey, M.D., Jonathan P. Piccini, M.D., Richard C. Becker, M.D., Christopher C. Nessel, M.D., John F. Paolini, M.D., Ph.D., Scott D. Berkowitz, M.D., Keith A.A. Fox, M.B., Ch.B., Robert M. Califf, M.D., and the ROCKET AF Steering Committee for the ROCKET AF Investigators

N Engl J Med 2011; 365:883-891September 8, 2011

Comments open through September 14, 2011

Abstract
Article
References
Citing Articles (1)
Comments (3)

Background

The use of warfarin reduces the rate of ischemic stroke in patients with atrial fibrillation but requires frequent monitoring and dose adjustment. Rivaroxaban, an oral factor Xa inhibitor, may provide more consistent and predictable anticoagulation than warfarin.

Full Text of Background…

Methods

In a double-blind trial, we randomly assigned 14,264 patients with nonvalvular atrial fibrillation who were at increased risk for stroke to receive either rivaroxaban (at a daily dose of 20 mg) or dose-adjusted warfarin. The per-protocol, as-treated primary analysis was designed to determine whether rivaroxaban was noninferior to warfarin for the primary end point of stroke or systemic embolism.

Full Text of Methods…

Results

In the primary analysis, the primary end point occurred in 188 patients in the rivaroxaban group (1.7% per year) and in 241 in the warfarin group (2.2% per year) (hazard ratio in the rivaroxaban group, 0.79; 95% confidence interval [CI], 0.66 to 0.96; P<0.001 for noninferiority). In the intention-to-treat analysis, the primary end point occurred in 269 patients in the rivaroxaban group (2.1% per year) and in 306 patients in the warfarin group (2.4% per year) (hazard ratio, 0.88; 95% CI, 0.74 to 1.03; P<0.001 for noninferiority; P=0.12 for superiority). Major and nonmajor clinically relevant bleeding occurred in 1475 patients in the rivaroxaban group (14.9% per year) and in 1449 in the warfarin group (14.5% per year) (hazard ratio, 1.03; 95% CI, 0.96 to 1.11; P=0.44), with significant reductions in intracranial hemorrhage (0.5% vs. 0.7%, P=0.02) and fatal bleeding (0.2% vs. 0.5%, P=0.003) in the rivaroxaban group.

Full Text of Results…

Conclusions

In patients with atrial fibrillation, rivaroxaban was noninferior to warfarin for the prevention of stroke or systemic embolism. There was no significant between-group difference in the risk of major bleeding, although intracranial and fatal bleeding occurred less frequently in the rivaroxaban group. (Funded by Johnson & Johnson and Bayer; ROCKET AF ClinicalTrials.gov number, NCT00403767.)