journal reading: etifoxine versus alprazolam for the treatment of adjusment

7/25/2019 Journal Reading: Etifoxine Versus Alprazolam for the Treatment of Adjusment

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Etifoxine Versus Alprazolam for the

Treatment of Adjustment Disorder with

Anxiety: a Randomized Controlled TrialStein, Dan J*

Oleh: Yuzana Tiarasia, S.Ked

Pembimbing: dr. Sheno Almes

SMF/ Bagian Ilmu Kesehaan !i"a

FKIK #$IB % &SK! Soe'ra'o Beng(ulu


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Etifoxine) *eri+a benzoazinee-e( aniansieas

ani(on+ulsan dengan e-e( sedai- ringan

) 0i-oine se1ara langsung s'esi-i( berinera(si dgn(anal (lorida 'd (om'le( rese'or 2ABAAmenginhibisi ransmisi sina'i( 2ABAergi1

) 0-e( a( langsung: be(er3a 'd rese'or

benzodiaze'in 'eri-erme neuroseroid oa(dengan e-e( aniansieas


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) 4igand 'roein ranslo(aormenurun(an a(i+iasma(ro-ag 'eradangan seelah 1edera sara-

merangsang regrowth a(son) Tida( men5ebab(an (eerganungan withdrawal

) 0-e( sam'ing:6 SSP, e-e( (anu( ringan

6 &ea(si alergi: ruam (uli, angioedema, uri(aria


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) T 7 8 3am dengan 9ma di dalam darah ; 3am

) *osis

6 Oral: 1a's


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Alprazolam)Aniansieas golongan benzodiaze'in

) Me(anisme (er3a: 'oensiasi inhibisi neuron dengan

2ABA sebagai mediaorn5abe(er3amem'erlamba 'er'indahan za (imia di oa( 5angmung(in men3adi ida( seimbang

) Indi(asi: gangguan ansieas, gangguan 'ani(

ansieas a(iba de'resi


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) Konraindi(asi: (ehamilan, alergi, asma, glau(oma,'en5a(i li+er/ gin3al, (onsumsi al(ohol,

(eerganungan oba/al(ohol) 0-e( sam'ing:

6 *e'resi SSP(anu( aa(sia % !aundi1e

6 Mood de'resi, ide bunuh diri % Tremor

6 ?i'era(+ias, agiasi, halusinasi % Oliguria6 $5eri dada


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) *osis

Initial dose: =,< % =,< mg ; /hari @PO

*osis da'a diing(a(an beraha' seia' ;%> hari3i(a dibuuh(an da'a dioleransi

*osis 'emeliharaan: da'a diing(a(an sam'aidosis ma(s > mg dgn dosis erbagi


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AbstrakLatar belakang:

2angguan 'en5esuaian dengan ansieas @A*A

're+alensi inggi*aa mengenai 'redi(or res'on era'isedi(i

0i-oine sbg agen inso-ar 5g men3an3i(an d(

men5ebab(an (eerganungan(en5aaan:

'enggunaan benzodiaze'ine CC


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Abstrakdila(u(an u3i (onrol a1a( ei-oine +s al'razolam

'ada A*A -o(us 'ada e-i(asi dan (eamanan,

ermasu( in+esigasi 'redi(or res'on (linis


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Abstrak

Metode:#3i a1a( double blinded, multicenter (om'arai-

'ada (elom'o( 'aralel 'asien ra"a 3alan dgn

A*A.Kelom'o( 'erama: D minggu E D minggu seelah era'i

diberheni(an


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Abstrak) Primary outcome: diu(ur denganHamilton

Anxiety Rating Scale @?AMA

) Secondary outcome:Sheehan Disability Scale@S*S, the linical !lobal Impression"hange Scale#!I"$ % Sel& Report &or the Assesment o&Ad'ustment Disorder

)Analisis non"in&eriority: menilai Prim.ou1ome) &egresi logisi( muli+aria: 'redi(or res'on


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AbstrakHasil:

) = 'asien de"asa ra"a 3alan dengan A*A

dii(u(an dlm 'eneliian 'd D la5anan 'rimer.) D 'asien 5ang berhasil men5elesai(an

'eneliian @nGH ei-oine, nG= al'razolam

0i-oine Al'razolam: 'enurunan s(or

?AMA 'ada hari (eH dgn 'erbedaan s(orD.H @9I =J u( al'razolam.


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AbstrakSeelah era'i diheni(an, s(or ?AMA membai(

'ada (elom'o( ei-oine, ea'i me 'd

(elom'o( al'razolam) Perbedaan anar (elom'o( dalam 'erubahan reraa

anara hari (eH dan (e;


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Abstrak) 0-e( sam'ing er(ai era'i dila'or(an 'd 'asien5ang menda'a(an al'razolam @0S er(ai SSP,

eruama slh h/ diheni(an.) Tida( diemu(an 'redi(or res'on era'i 5gsigni-i(an


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AbstrakKesimpulan

) #3i (onrol a1a( mendu(ung e-i(asi (eamanan

ei-oine dlm 'enaala(sanaan A*A, eruama(ei(a h/ diheni(an.

) 0i-oine memili(i (eunungan dalam e-e( aniansieas an'a (eerganungan.

) Farma(oera'i 'd 'asien dengan ge3ala ansieasbera 3uga sama se1ara e-i(asi


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Introduction) 2angguan 'en5esuaian diandai dgn 'er(embangan

s1r (linis ge3ala emosi/ 'erila(u sbg res'on hd'

stressor) Pada *SM


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) 2angguan 'en5esuaian er(ai dengan morbidias erganggun5a (ualias hidu'

) Iner+ensi 9BT menun3u((an d( signi-i(an dalammengurangi "a(u sam'ai 'asien da'a (embali(er3a 3( dibanding(an dgn an'a h/

) Benzodiaze'ine sanga sering direse'(an mes(i'un

0S CC ermasu( dis-ungsi (ognii- risi(o 'oensial(eerganungan


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) 0i-oine:benzoazin, non ben(odia(epine

) Per1obaan sebelumn5a: ei-oine, bus'irone

loraze'ame-i(asi sama 'ada A*A. 0i-oinememili(i 0S minimal dlm (ognii- 'si(omoor, d(er(ai (eerganungan

) Ob3e(i- 'eneliian: membanding(an e-i(asi

(eamanan ei-oine dgn al'razolam, e+aluasi e-e((linis 'ersisen slh h/ berheni sera menenu(an'redi(or res'on -arma(oera'i


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Material & MethodsStudy design

) Peneliian 'ros'e(i- di A-ri(a Selaan, 5aiu u3i

a1a(, double blinded, multicenter % (om'arai-.) Parisi'asi D centresdi 9a'e To"n!ohannesburg

) $onin-eriori5 design: membanding(an ei-oinedengan agen anxiolytic5g sering diberi(an

dari'ada 'enggunaan 'lasebo) Perhaian uama 'ada (un3ungan slh h/ berheni


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) Penggunaan ?AMA u(primary outcome E'enenuan 'redi(or res'on h/

) Semua 'rosedur dila(u(an dengan sandar ei( dari(omie ei( sera 'emeri(sa sudah dila(u(an'elaihan (husus sebelumn5a

) Oba diberi D 1a's 'agi, siang malam @D


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Pasien

Krieria In(lusi

D.4a(ila(i aau 'erem'uan 'asien ra"a 3alan usia DH8< ahun 5ang ermasu( (edalam (rieria A*Aberdasar(an *SMI

.Tambahan:

s(or ?AMA L= @wor), &amily % social$" S*S L < hari (eH,pG=.=D hari (e;


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Discussion) Temuan uama 'eneliian mendu(ung al'razolam3i(a dibanding(an dgn ei-oine 'ada hari (e H.#3i non"in&eriority ei-oine d( d' diun3u((an'ada hari (eH.

) S(or ?AMA sedi(i mening(a 'd al'razolamseelah era'i diheni(anbeda signi-i(an

)0-e( sam'ing (elom'o( al'razolamCC) Tida( ada 'redi(or res'on era'i 5g signi-i(an


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)Al'razolam dalam A*A(onsisen6 0-i(asi dalam era'i 'd (ondisi ini

6 +nset o& action 1e'a

6 0-e(i- unu( ge3ala somai( ansieas

6 Poensial unu( (eerganungan


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) 0i-oine 'ada A*A 3uga (onsisen dalam:6 Indi(asi non"in&eriority unu( agen ini 3i(a

dibanding(an dengan bus'irone loraze'am

6 Peneliian sebelumn5a: &es'on 'erbai(an (linis lebih bai( dengan ei-oine

Tida( erda'a 'erbedaan (e1.onse

Ke(ambuhan ansieas lebih besar 'ada loraze'am


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)Al'razolam am'a( (onsisen men5ebab(an e-e(sam'ing emergensi er(ai era'i CCC

@er(ai SSPmes(i'un s1r saisi( d( signi-i(an,namun (onsisen dengan (onsensus hd' 0S (ognii- 'oensial (eerganungan

) Teruama 0S mun1ul saa h/ diheni(an.


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!onclusion) #3i (onrol a1a( mendu(ung e-i(asi (eamanan

ei-oine dlm 'enaala(sanaan A*A, eruama(ei(a h/ diheni(an.

) 0i-oine memili(i (eunungan dalam e-e( aniansieas an'a (eerganungan.

) 0-i(asi sama 'd 'asien dengan ge3ala ansieas bera@-arma(oera'i


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Terima(asih


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journal reading: etifoxine versus alprazolam for the treatment of adjusment

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