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"This is the first comprehensive handbook entirely dedicated to all the aspects of antiplatelet therapy. The book is divided into three main sections, pathophysiology, pharmacology and therapy, for a total of 23 chapters. A large group of leading experts from different European countries and from the USA, both from academia and industry, have contributed to the book. Besides a detailed overview on the pharmacology and clinical applications of all the currently used or of the novel antiplatelet agents, innovative approaches (e.g. intracellular signalling as an antiplatelet target, small RNAs as platelet therapeutics, etc.) or unconventional aspects (e.g. pharmacologic modulation of the inflammatory action of platelets are also treated. "

"ABSTRAKPenelitian ini bertujuan untuk mengisolasi dan memurnikan enzim bromelain dari bonggol nanas (Ananas comosus [L] Merr.) disertai pengujian aktivitasnya sebagai agen antiplatelet. Tahap pemurnian dimulai dari isolasi, fraksinasi bertingkat menggunakan etanol, kromatografi penukar ion dengan DEAE-Selulosa, dan kromatografi filtrasi gel dengan Sephadex G-50. Tiap tahap pemurnian menghasilkan peningkatan aktivitas spesifik pada fraksi enzim, mulai dari ekstrak kasar berturut-turut sebesar 0,0052 Unit/mg; 4,6480 Unit/mg; 9,0306 Unit/mg; dan 11,8421 Unit/mg. Fraksi enzim yang telah melewati tahap kromatografi penukar ion dan filtrasi gel menunjukkan tingkat kemurnian tertinggi, yaitu 2277 kali dibanding ekstrak kasarnya. Hasil uji aktivitas antiplatelet terhadap seluruh fraksi enzim membuktikan bahwa bromelain berpengaruh pada proses agregasi platelet. Fraksi enzim hasil pemurnian pun menunjukkan aktivitas terbesar sebagai agen antiplatelet, yaitu memberikan nilai persentase agregasi platelet sebesar 64,04% dan nilai persentase inhibisi sebesar 31,25%. Uji stabilitas enzim menunjukkan bahwa enzim bromelain dari bonggol nanas mengalami penurunan aktivitas proteolitik sebesar 0,2315 Unit/mL per hari selama proses penyimpanan, dan dapat mengalami inaktivasi pada pemanasan suhu 80°C.

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ABSTRAKThis study aimed to isolate and purify the bromelain enzyme from pineapple core (Ananas comosus [L] Merr.), accompanied by testing that activity as a antiplatelet agents. Purification stages starting from the isolation, fractionation storied using ethanol, ion exchange chromatography with DEAE-Cellulose and gel filtration chromatography with Sephadex G-50. Each stages of purification succeed increasing value of specific activity in an enzyme fraction, start from crude extract enzyme, respectively: 0.0052 Unit/mg; 4.6480 Unit/mg; 9.0306 Unit/mg; and 11.8421 Unit/mg. Enzyme fractions have passed the stage of ion chromatography and gel filtration show the highest level of purify (2277 fold compared to the crude extract). The results of antiplatelet activity on all factions proved that the enzyme bromelain giving effect on platelet aggregation process. The fraction was purified also show greatest activity as an antiplatelet agent, with the percentage of platelet aggregation values of 64.04% and a percentage inhibition value of 31.25%. Enzyme stability test showed that the enzyme bromelain from pineapple core decreased proteolytic activity of 0.2315 units / mL per day during the storage process, and can be inactivated on heating temperature of 80°C."

"Bromelain merupakan kelompok enzim protease yang terus dikembangkan untuk dimanfaatkan dalam bidang medis sebagai agen antiplatelet, antiinflamasi, antioksidan, dan antikanker. Oleh sebab itu, diperlukan bentuk sediaan enzim terkontrol yang dapat mempertahankan aktivitas enzim dalam lambung sehingga dapat meningkatkan absorbsi saat mencapai usus. Penelitian ini bertujuan untuk mempertahankan aktivitas antiplatelet bromelain hasil isolasi bonggol buah nanas dengan mengenkapsulasinya pada kitosan terikat silang glutaraldehid. Bromelin yang diisolasi dimurnikan melalui fraksinasi dengan garam amonium sulfat dan dialisis. Aktivitas spesifik dari tiap fraksi menunjukkan adanya peningkatan, dimulai dari enzim kasar (71,10 U/mg), fraksi ammonium sulfat(151,70 U/mg) dan dialisis (226,8 U/mg). Hasil dialisis selanjutnya dienkapsulasi secara post loading dalam mikrosfer kitosan terikat silang glutaraldehid 2,5% (v/v), dengan derajat ikat silang sebesar 94,87% dan rasio swelling sebesar 41,45% pada pH 1,2; 20,97% pada pH 7,4; dan efisiensi sebesar 84,75%. Hasil uji disolusi menunjukan tingkat pelepasan bromelain yang relatif lebih kecil di cairan lambung artifisial (13,43%) dibandingkan lingkungan pH usus (60,52%). Aktivitas proteolitik dari bromelain dapat dipertahankan hingga mencapai 0,35 U/mL pada lingkungan pH usus artifisial.

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Bromelain is a group of protease enzymes that continue to be developed to be used in the medical field as an antiplatelet agent, anti-inflammatory, antioxidant, and anticancer. Therefore, a controlled enzyme dosage form is needed that can maintain enzyme activity in the stomach so that it can increase absorption when it reaches the intestine. The aim of this study was to maintain the antiplatelet bromelain activity resulting from pineapple hump isolation by encapsulating it with glutaraldehyde cross-linked chitosan. Isolated bromelin was purified by fractionation with ammonium sulfate salt and dialysis. Specific activities of each fraction showed an increase, starting from crude enzymes (71.10 U/mg), ammonium sulfate fraction (151.70 U/mg) and dialysis (226.8 U/mg). The dialysis results were then encapsulated post loading in 2.5% (v/v) glutaraldehyde crosslinked chitosan microspheres, with crosslinking degrees of 94.87% and swelling ratio of 41.45% at pH 1.2; 20.79% at pH 7.4; and efficiency of 84.75%. The dissolution test results showed a relatively smaller release rate of bromelain in artificial gastric fluid (13.43%) compared to the intestinal pH environment (60.52%). The proteolytic activity of bromelain can be maintained up to 0.35 U/mL in an artificial intestinal pH environment."

"ABSTRAKTujuan dari penelitian ini adalah untuk mempertahankan aktivitas antiplatelet inti nanas bromelain dari degradasi dalam cairan lambung dengan merangkum enzim dalam permen karet alginat-guar yang dihubungkan silang dengan glutaraldehyde. Isolasi bromelain diikuti oleh proses pemurnian seperti ammonium sulfat dan pengendapan dan dialisis natrium benzoat. Aktivitas spesifik yang diperoleh menunjukkan peningkatan yang dimulai untuk enzim kasar (51,32 U / mg), fraksi natrium benzoat (115,63 U / mg), fraksi ammonium sulfat (267,70 U / mg) dan fraksi dialisis (332,22 U / mg). Fraksi dialisis dienkapsulasi dengan metode post loading pada hidrogel alginat-guar gum dengan konsentrasi glutaraldehida 0,75% (v / v). Rasio pembengkakan hidrogel adalah 188,43% dalam keasaman 1,2; 563,83% dalam keasaman 7,4; dan jumlah efisiensi enkapsulasi adalah 72,2%. Selain itu, konsentrasi maksimum bromelain yang dilepaskan dalam uji disolusi lebih tinggi di lingkungan usus buatan (1,97 mg / l) dibandingkan dalam cairan lambung buatan (0,18 mg / l), dengan aktivitas proteolitik maksimum 1,3 U / mL dan 0,15 U / mL masing-masing. Data uji disolusi dimasukkan ke dalam model orde-pertama, orde-pertama, Higuchi dan Korsmeyer-Peppas untuk menentukan kinetik dan mekanisme disolusi obat. Semua konsentrasi enzim 70 ppm, 140 ppm dan 210 ppm mengikuti model Korsmeyer-Peppas, mekanisme disolusi adalah kombinasi dari difusi dan erosi. Studi in vitro aktivitas antiplatelet menunjukkan penghambatan yang baik untuk fraksi dialisis (56,59%) dan produk disolusi (47,45%).

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ABSTRACTThe aim of this study is to maintain the antiplatelet activity of pineapple bromelain nucleus from degradation in gastric fluid by encapsulating enzymes in alginate-guar gum which is crosslinked with glutaraldehyde. Isolation of bromelain is followed by purification processes such as ammonium sulfate and precipitation and dialysis of sodium benzoate. Specific activity obtained showed an initial increase in crude enzymes (51.32 U / mg), sodium benzoate fraction (115.63 U / mg), ammonium sulfate fraction (267.70 U / mg) and dialysis fraction (332.22 U / mg). The dialysis fraction was encapsulated by the post loading method in alginate-guar gum hydrogel with a glutaraldehyde concentration of 0.75% (v / v). The swelling ratio of the hydrogel is 188.43% in acidity 1.2; 563.83% in acidity 7.4; and the amount of encapsulation efficiency is 72.2%. In addition, the maximum concentration of bromelain released in the dissolution test was higher in the artificial intestinal environment (1.97 mg / l) than in artificial gastric fluid (0.18 mg / l), with a maximum proteolytic activity of 1.3 U / mL and 0.15 U / mL each. Dissolution test data is entered into first-order, first-order, Higuchi and Korsmeyer-Peppas models to determine the kinetic and mechanism of drug dissolution. All enzyme concentrations of 70 ppm, 140 ppm and 210 ppm follow the Korsmeyer-Peppas model, the dissolution mechanism is a combination of diffusion and erosion. In vitro studies of antiplatelet activity showed good inhibition for dialysis fractions (56.59%) and dissolution products (47.45%)."

"A renaissance of virus research is taking centre stage in biology. Empirical data from the last decade indicate the important roles of viruses, both in the evolution of all life and as symbionts of host organisms. There is increasing evidence that all cellular life is colonized by exogenous and/or endogenous viruses in a non-lytic but persistent lifestyle. Viruses and viral parts form the most numerous genetic matter on this planet."

"Manajemen pemberian terapi yang tepat adalah aspek penting dari peran apoteker dalam sistem perawatan kesehatan. Pemberian terapi yang tepat mengacu pada aspek kebijakan, praktik, dan sistem yang mendukung penggunaan obat dengan aman, efektif, dan rasional untuk meningkatkan hasil pasien. Dengan memastikan pemberian obat yang aman, apoteker dapat berperan dalam mencegah kesalahan dalam peberian obat. Infark Miokard Akut (IMA) merupakan tanda bahwa telah terjadi oklusi pembuluh darah total sehingga diharapkan semua rumah sakit dengan fasilitas intervensi dapat memberikan terapi reperfusi berupa Intervensi Koroner Perkutan Primer (IKPP) secara cepat dan efektif. DAPT lebih dapat menurunkan risiko trombosis stent dan kejadian kardiovaskular dibandingkan dengan penggunaan aspirin tanpa kombinasi. Rumah sakit Universitas Indonesia merupakan salah satu rumah sakit yang mempunyai banyak pasien dengan tindakan IKPP. Oleh karena itu, penting untuk mengetahui manajemen pemberian terapi dual antiplatelet (DAPT) untuk meminimalisir resiko yang terjadi akibat pemberian obat yang kurang sesuai khususnya di Rumah Sakit Universitas Indonesia.Metode yang dilakukan yaitu dengan melihat kumpulan tinjauan pustaka maupun guildline yang kemudian disajikan dalam booklet yang berisi tentang informasi manajemen pemberian terapi obat dual antiplatelet (DAPT).Booklet Manajemen Pemberian Obat Dual Antiplatelet Therapy (DAPT) dibuat dalam bentuk softfile berupa PDF yang berjumlah 17 halaman. Desain booklet dapat dilihat pada Lampiran 1. Halaman pertama merupakan cover berisi judul booklet “Manajemen Pemberian Obat Dual Antiplatelet Therapy (DAPT)”, halaman kedua memuat daftar isi, halaman ke 3 memuat latar belakang, halaman ke 4 hingga 15 memuat isi booklet, halaman 14 dan 15 memuat daftar pustaka dan halaman ke 16 memuat kontak Rumah Sakit Universitas Indonesia. Isi buklet dibagi menjadi 5 pembahasan. Booklet adalah salah satu sarana untuk menyampaikan informasi secara terstruktur dan komprehensif sehingga diharapkan dengan adanya booklet ini dapat menjadikan pengetahuan tambahan yang dapat bermanfaat. Dengan memanfaatkan booklet manajemen terapi obat antiplatelet (DAPT), Apoteker diharapkan dapat meningkatkan kualitas pelayanan farmasi, mengoptimalkan pemberian terapi obat, dan memberikan kontribusi positif terhadap keselamatan pasien.

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Management of appropriate therapy administration is an important aspect of the pharmacist's role in the health care system. Appropriate therapy delivery refers to aspects of policy, practice, and systems that support the safe, effective, and rational use of medications to improve patient outcomes. By ensuring safe medication administration, pharmacists can play a role in preventing errors in medication administration. Acute Myocardial Infarction (AMI) is a sign that total blood vessel occlusion has occurred so it is hoped that all hospitals with intervention facilities can provide reperfusion therapy in the form of Primary Percutaneous Coronary Intervention (IKPP) quickly and effectively. DAPT can reduce the risk of stent thrombosis and cardiovascular events more than the use of aspirin without the combination. The University of Indonesia Hospital is one of the hospitals that has many patients with IKPP procedures. Therefore, it is important to know the management of administering dual antiplatelet therapy (DAPT) to minimize the risks that occur due to inappropriate drug administration, especially at the University of Indonesia Hospital. The method used is by looking at a collection of literature reviews and guildlines which are then presented in a booklet provided. contains information on the management of administering dual antiplatelet drug therapy (DAPT). The Management of Dual Antiplatelet Therapy (DAPT) drug administration booklet is made in PDF softfile form, totaling 17 pages. The booklet design can be seen in Appendix 1. The first page is the cover containing the title of the booklet "Management of Dual Antiplatelet Therapy (DAPT) Medication Administration", the second page contains the table of contents, the 3rd page contains the background, pages 4 to 15 contain the contents of the booklet, pages 14 and 15 contain a bibliography and page 16 contains contacts for the University of Indonesia Hospital. The contents of the booklet are divided into 5 discussions. Booklets are a means of conveying information in a structured and comprehensive manner so it is hoped that this booklet can provide additional knowledge that can be useful. By utilizing the antiplatelet drug therapy (DAPT) management booklet, pharmacists are expected to be able to improve the quality of pharmaceutical services, optimize the delivery of drug therapy, and make a positive contribution to patient safety."