Makalah Pengelolaan Nyeri Persalinan Secara Farmakologi Dan Non Farmakologi
farmakologi
-
Upload
shanaz-alvikha -
Category
Documents
-
view
20 -
download
9
description
Transcript of farmakologi
![Page 1: farmakologi](https://reader036.fdocuments.net/reader036/viewer/2022082501/545e71d3b1af9fc8058b4883/html5/thumbnails/1.jpg)
Current strategies
Anti-malaria for pregnant women
![Page 2: farmakologi](https://reader036.fdocuments.net/reader036/viewer/2022082501/545e71d3b1af9fc8058b4883/html5/thumbnails/2.jpg)
Options for malaria control during pregnancy
• Drugs– Chemoprophylaxis
– Intermittent preventive treatment during pregnancy (IPTp)
– Febrile case management• Insecticide Treated Nets (ITNs)• Prevention and treatment of anemia
– Hematinic supplementation– Nutritional counseling
• Vaccines?
![Page 3: farmakologi](https://reader036.fdocuments.net/reader036/viewer/2022082501/545e71d3b1af9fc8058b4883/html5/thumbnails/3.jpg)
Intermittent preventive treatment (IPTp): an alternative strategy
• Most studied regimen: Sulfadoxine-pyrimethamine (SP) 2 curative courses (3 tablets)– One course during second trimester– One course during third trimester
• Inexpensive• Easily deliverable (can be given under direct
observation)• Safe• Efficacious
![Page 4: farmakologi](https://reader036.fdocuments.net/reader036/viewer/2022082501/545e71d3b1af9fc8058b4883/html5/thumbnails/4.jpg)
Intermittent preventive treatment-- the two dose SP strategy
Weeks of gestation
Conception Birth
20 3010
Course 124-28 wks
Course 230-36 wks
Fetal growth velocity
![Page 5: farmakologi](https://reader036.fdocuments.net/reader036/viewer/2022082501/545e71d3b1af9fc8058b4883/html5/thumbnails/5.jpg)
IPTp with SP: summary of evidence and benefits
• 2 doses of IPT with SP is associated with: – Reduction in 3rd trimester maternal
anemia – Reduction in placental malaria
parasitemia– Reduction in low birth weight
• At least 2 doses required for optimal benefit
• Regimen is safe and well tolerated
![Page 6: farmakologi](https://reader036.fdocuments.net/reader036/viewer/2022082501/545e71d3b1af9fc8058b4883/html5/thumbnails/6.jpg)
Case management of malaria in pregnancy
Safe drugs
• Chloroquine• Quinine / quinidine • Proguanil, chlorproguanil• Pyrimethamine• Sulfonamides• Dapsone (+pyrimethamine=
Maloprim)• Mefloquine (prophylaxis)• Clindamycin (300 mg qid, 5-7
days)• Artemisinins (2nd and 3rd)
Drugs with questionable safety or insufficient data
• Mefloquine (treatment dose)• Artemisinins (1st)• Amodiaquine• Azithromycin• Lumefantrine (component of
coartem/Riamet)• Combination therapy
– Artemisinin derivative with other drugs
– Lapdap (chlorproguanil-dapsone)
– Atovaquone-proguanil (Malarone)
– Amodiaquine-SP
![Page 7: farmakologi](https://reader036.fdocuments.net/reader036/viewer/2022082501/545e71d3b1af9fc8058b4883/html5/thumbnails/7.jpg)
Anti-malarials contra-indicated in pregnancy
• Tetracycline• Doxycycline• Halofantrine• Primaquine• Tafenoquine• Note: if serious illness, and where limited
number of drugs are available, it is necessary to balance the risk of maternal death with the hypothetical risks to the infant
![Page 8: farmakologi](https://reader036.fdocuments.net/reader036/viewer/2022082501/545e71d3b1af9fc8058b4883/html5/thumbnails/8.jpg)
Drugs that should not be used during pregnancy
• Tetracycline– Cause abnormalities of skeletal and muscular growth,
tooth development, lens/cornea• Doxycycline
– Risk of cosmetic staining of primary teeth is undetermined
– Excreted into breast milk• Primaquine
– Harmful to newborns who are relatively Glucose-6-Phosphatase-Dehydrogenase (G6PD) deficient
• Halofantrine– No conclusive studies in pregnant women– Has been shown to cause unwanted effects, including
death of the fetus, in animals