Risk of Post-Myocardial Infarction Pneumonia with Proton Pump Inhibitors, H2 Receptor Antagonists and Mucoprotective Agents: A Retrospective Nationwide Cohort Study

Patients with myocardial infarction (MI) are at high risk of developing pneumonia. Proton pump inhibitors (PPI) and H2-receptor antagonists (H2RA) are commonly used acid-suppressive medications to the patients with MI for gastrointestinal (GI) protection, which may increase the risk for pneumonia. We evaluated whether PPI, H2RA, and mucoprotective agents without anti-acid properties increase the risk of post-MI pneumonia. We performed a retrospective cohort study based on the National Health Insurance Service—National Sample Cohort in Korea. The study included 3701 patients discharged with MI without prior history of pneumonia. During follow-up, treatments with PPI, H2RA, and mucoprotective agents were collected as time-dependent variables based on the prescription records. We performed multivariate time-dependent Cox regression analyses for the development of post-MI pneumonia. During the mean 4.85 ± 3.75 years follow-up, 999 participants developed pneumonia. In the multivariate analyses (adjusted hazard ratio; 95% confidence interval), the risk for pneumonia was significantly increased in treatment with PPI (2.25; 1.57–3.21) and H2RA (1.50; 1.16–1.93). Meanwhile, the risk for pneumonia was not increased in treatment with mucoprotective agents. When we evaluated GI bleeding event according to the medications as a secondary outcome analysis, mucoprotective agents were associated with increased GI bleeding risk, but PPI and H2RA were not. In the use of the GI medications in the treatment of patients with MI, the influence of these drugs on bleeding and pneumonia should be considered.

SKRINING SENYAWA INHIBITOR H2 DARI KAYU MANIS (Cinnamomum verum J.Presl)

Digestive tract disorders, especially gastric disorders, are often experienced by people. One drug to treat this disorder has a mechanism of blocking the H2 receptor. This research was conducted to find compounds from C.verum which have the stability of bind to H2 receptors. The method used is protein modeling with swiss-model, docking with PLANTS (CHEMPLP) and activity prediction. The test results obtained that the docking score was ?- amorphene (-65,79), ?-bergamotene (-65,48), ?-copaene (-66,62), ?-cubebene (-66,46), Cadinene (-64 , 79), Camphor (-52.15), Caryophyllene (-62.61), Cinnamaldehyde (-68.17), Epicatechin (-80.43), Ergosterol (-85.24), Eugenol (-67.35), Hydrocinnamaldehyde (-65,53), Quercetin (-74,38), Protocatechuic acid (-71,49), Stigmasterol (-88,88), 4- (2,3-dihydro-3- (hydroxymethyl) - 5- (3-hydroxypropyl) -7- (methoxy) benzofuranyl] -2-methoxyphenyl (-85,29). Combined with the probability activity of compounds that have the potential to be further developed are Epicatechin and urolignoside.

Evaluasi Penggunaan Obat Gangguan Saluran Cerna pada Pasien Rawat Inap berdasarkan Formularium Nasional di Faskes Tingkat Pertama

Gangguan pencernaan merupakan masalah yang terjadi pada salah satu organ sistem pencernaan, atau lebih dari satu organ pencernaan secara bersamaan. Gangguan saluran cerna yang sering dijumpai di sekitar masyarakat adalah gastroenteritis, dispepsia, gerd dan diare. Penelitian ini menggunakan metode kualitatif deskriptif. Peneliti menggunakan Indikator penggunaan obat yaitu tepat diagnosa, tepat indikasi, tepat dalam pemilihan obat, tepat dosis, efek samping, interval pemerian, dan tepat waktu. Penggunaan obat yang tepat harus disesuaikan dengan formularium yang disusun oleh petugas fasilitas kesehatan untuk memaksimalkan pelayanan kesehatan kepada masyarakat. Hasil penelitian menunjukan bahwa Terdapat 52,5% tenaga medis yang merasa kurang paham terhadap formularium nasional karena berbagai faktor dari mulai rasa ingin tahu yang kurang atau petugas kefarmasian yang tidak melakukan sosialisasi kepada nakes lainya, dan 30% nakes menjawab paham terhadap formularium nasional dan 17,5% menjawab tidak paham. Pengawasan terhadap pasien rawat inap dengan gangguan saluran cerna di faskes tingkat pertama sangat baik, petugas kefarmasian menggunakan form ceklis untuk melihat tingkat kerasionalan penggunaan obat dan indikator peresapan fornas. Tersedianya obat golongan PPI (proton pump inhibitor) yaitu omeprazole 40mg cap dan golongan Histamin H2-receptor antagonist yaitu ranitidin tablet dan ranitidin sediaan injeksi juga antiemetika sediaan tablet dan sirup yaitu domperidon dan obat tersebut merupakan obat-obat yang harus ada di faskes tingkat pertama.

Author Correction: NanoBRET binding assay for histamine H2 receptor ligands using live recombinant HEK293T cells

An amendment to this paper has been published and can be accessed via a link at the top of the paper.