NAMA : ADINDA VIDYA LESTARI

NIM : 051611133049
KELAS :D
Instruction
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1. Some tourists would like to visit Labuan Bajo, what is chemoprophylaxis that will be
recommended to them? One of them is a breastfeeding mother, her child is 1.5 y.o. and
10kg.
Penelusuran Pustaka : (Pustaka termasuk Primary Literature dan Secondary Resource)
1. Google.com pencarian mengenai penggunaan obat pada ibu menyusui.
2. Website https://wwwnc.cdc.gov/travel/page/yellowbook-home-2014 (Center for
Disease Control and Prevention)
3. Pencarian di Table of Content
4. Chapter 7 Family Travel bagian Travel & Breastfeeding (Erica H. Anstey, Katherine
R. Shealy)
5. Pada bibliography terdapat beberapa sitasi terkait :
World Health Organization. Vaccines and vaccination against yellow fever. WHO
position paper—June 2013. Wkly Epidemiol Rec. 2013 Jul 5;88(27):269–83.
Answer : Because in Labuan Bajo, East Nusa Tenggara (NTT) as an endemic area of
dengue fever (DB) mostly in rainy season, since early January 2020. Some vaccine may
have more advantages but breastfeeding mother and infants (6-8months) is a precaution
for yellow fever vaccine administration because 3 infants were diagnosed with
encephalitis and aged <1 month at the time of exposure.
Specific research data are available, yellow fever vaccine should be avoided in
breastfeeding women. However, when they must travel to a yellow fever–endemic area,
they should be vaccinated. Although there are no data, some experts recommend that
breastfeeding women who receive yellow fever vaccine should temporarily suspend
breastfeeding, pump, and discard milk for at least 2 weeks after vaccination before
resuming breastfeeding.

2. What is recommendation for pain experienced by patient with hemophilia?

Penelusuran Pustaka : (Pustaka termasuk Tertiary Resources)
1. Akses melalui penelusuran di Google.com
2. REVIEW ARTICLE : “Assessment and management of pain in haemophilia patients”
3. Mengcopy ID DOI dari review article dan mencari pada link : https://www.sci-
hub.tw/
Answer :
Patients with haemophilia utilize a wide variety of pharmacologic treatments from over-
the-counter and prescription sources. These therapies may be part of a stepped-care
progression from topical anaesthetics to mild analgesics to opioids—although no
 evidence-based guidelines or protocols are available that establish a stepwise treatment of
pain with haemophilia. Some haemophilia patients may be reluctant to use analgesics. In
one study, only 36% of haemophilia patients with pain were taking analgesics. Initial
steps in pain management include the use of over-the-counter analgesics such as
acetaminophen, ibuprofen or non-steroidal anti-inflammatory drugs
(NSAIDs). A survey of European haemophilia treatment centres found that acute and
chronic pain was most often managed with acetaminophen or NSAIDs.

3. You are a pharmacist got a prescription contained metoclopramide. The patient is a

woman who is in first trimester of pregnancy. What is your decision?
Penelusuran Pustaka : (Pustaka termasuk Primary Literature)
1. Review article : “The Safety of Metoclopramide Use in the First Trimester of
Pregnancy” dan “Metoclopramide in Pregnancy and Risk of Major Congenital
Malformations and Fetal Death”
Answer :
In the analyses of individual malformation categories, there were no significant
associations between metoclopramide use in the first trimester and any of the 20
malformations. So, if pharmacist got the prescription that contained metoclopramide we
still give them because there was not associated with significantly increased risks of any
of several adverse outcomes. These findings provide reassurance regarding the safety of
metoclopramide for the fetus when the drug is given to women to relieve nausea and
vomiting during pregnancy.

4. A prescriber needs your recommendation for treating a 7 y.o child who is suffering from
Lyme disease?
Penelusuran Pustaka : (Pustaka termasuk Primary Literature)
1. Pencarian di Google.com dengan keyword “Child or Infant” and “Lyme Disease”
2. Membuka laman https://www.cdc.gov/lyme/treatment/index.html
3. Melakukan penelusuran pustaka terkait pada Index
4. Membaca abstraksi yang tersedia melalui https://pubmed.ncbi.nlm.nih.gov/
5. Mencopy DOI pada sci-hub.tw dan penelusuran artikel “Kowalski TJ, Tata S,
Berth W, Mathiason MA, Agger WA. Antibiotic treatment duration and long-term
outcomes of patients with early Lyme disease from a Lyme disease-hyperendemic
area”
Answer : Lyme disease is most often treated with antibiotics, such as doxycycline,
amoxicillin or cefuroxime. If your child has been diagnosed early, he or she will probably
take antibiotics by mouth for two to three weeks.

5. What is recommendation for diabetic patient who is elderly and has hypertension?
Penelusuran Pustaka : (Pustaka termasuk Tertiary Resource)
1. Review article “Management of diabetic hypertensives”
 Answer : While treating diabetic hypertensives, first-line agents used must be an ACEI
or ARB (if intolerant to ACEI) or a combination of both or a thiazide diuretic

6. A mother asks a pharmacist to recommend a cold preparation that is sugar free and
alcohol free for her 12-years old son who is diabetic. What is your recommendation?
Penelusuran Pustaka : (Pustaka termasuk Tertiary Resource)
1. Textbook Pharmacy Practice for Technicians 5th edition. Durgin & Hanan. Chapter 24
Nonprescription Medications : Dosage Forms page 503
Answer : The alternative dosage form is available, the pharmacist should make a
recommendation that the patient take that rather than effervescent tablet, there is some
sugar-free and alcohol-free formulations are also more appropriate for certain patients,
such as the children and people with diabetes. For example Robitussin syrup

7. On a recent trip to the United states, a patient purchased Aleve for migraine. He returns
home and asks the pharmacist whether an equivalent product is available in Indonesia.
Penelusuran Pustaka : (Pustaka termasuk Web-based Resource)
http://pionas.pom.go.id/
Answer :
While the patient has been stayed in Indonesia, pharmacist considered to make a
recommendation other than Aleve that’s contain Naproxen, perhaps the best known of the
NSAIDs that are often used for this purpose are ibuprofen (for example, Advil, Motrin).

8. A doctor asked you as a pharmacist, which one is safer, estrogens or SERMS?

Penelusuran Pustaka : (Pustaka termasuk Secondary Resource)
1. Penelusuran Abstrak dari “Selective estrogen receptor modulators in clinical practice:
A safety overview”
Answer :
This review describes the safety profile of SERMs (tamoxifen, raloxifene, toremifene,
bazedoxifene, lasofoxifene, and ospemifene) and fulvestrant (a pure ER antagonist) from
Phase III trials, long-term extension studies, and active comparator studies. Toremifene,
raloxifene, bazedoxifene, lasofoxifene, and ospemifene present generally improved,
though distinctly different, safety profiles compared with tamoxifen, especially with
endometrial cancer and stroke.
This novel approach is currently being evaluated with bazodoxifene which could yield
the beneficial effects of estrogens and SERMS, while potentially being more tolerable
and safer than either therapy alone.

9. What do you think about consuming aspirin in primary prevention of CHD?

Penelusuran Pustaka : (Pustaka termasuk Primary Literature)
1. Journal review
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4669607/pdf/12959_2015_Article_6
8.pdf “Aspirin for primary prevention of cardiovascular disease”
 Answer : The widespread and “appropriate” use of aspirin in prevention of CVD is
particularly attractive because the drug is generally widely available and, more
importantly for developing countries where CVD is becoming the leading cause of death,
is extremely inexpensive. But there is risk must be calculated, based on accurate and cost-
benefit locally developed risk assessment tools, and adequate thresholds be defined.

10. What is the best prophylaxis to prevent corono virus infection?

Penelusuran Pustaka : (Pustaka termasuk Primary Literature)
1. Pencarian di Google.com dengan keyword Prophylaxis and Corona Virus Infection
2. Membuka laman https://www.cdc.gov/coronavirus/2019-ncov/publications.html
3. Menelusuri pustaka atau publikasi terkait, mengcopy DOI dan membuka dengan sci-
hub.tw
4. Penelusuran artikel terkait “Clinical features of patients infected with 2019 novel
coronavirus in Wuhan, China”
Answer : combination of lopinavir and ritonavir was already available in the designated
hospital, a randomised controlled trial has been initiated quickly to assess the efficacy
and safety of combined use of lopinavir and ritonavir in patients hospitalised with 2019-
nCoV infection.

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