i. Farmakoterapi Rasional
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Transcript of i. Farmakoterapi Rasional
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PENDAHULUAN FARMAKOTERAPI
Oleh :
Aulia Wati
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FARMAKOTERAPI
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DEFENISI
Cabang ilmu yang berhubungan
dengan penggunaan obat dalam
pencegahan dan pengobatanpenyakit
Ilmu yang mempelajari obat dengan
fokus terapi penyakit.
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PERAN FARMASIS
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prevent the occurrence of medication
errorsin order to achieve the goal of
treatment. Pharmacists will be the health care
professionals responsible for providing
patient care that ensures optimal medicationtherapy outcomes.
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PENGENALAN METODE ASSESMENT
FARMASI
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SOAP
Subjective
ObjectiveAssesment
Plan
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Objective
Observable/factual information obtained
from or verified by a healthcare provider
Vital signs (BP, HR, RR, temp, weight,height)
Physical Exam (GP Diagnose)
Labs (blood tests, urine tests, microbiology,etc)
Diagnostic tests (x-rays, CT/MRI, EKG,
EEG)
Medications (from Medical Record)
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Assesment
Yourclinical judgment of the patients
drug-related problems
Problem list (numbered)
Each item should include
problem, solution, evidence/reason for your
solution
Prioritize problems
start with most urgent (usually relates to CC)
end with least urgent
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Plan
Specific solution for each problem
outlined in the assessment
Numbered list to match theAssessment
Recommendations for drug dose,
frequency, duration
Monitoring
Follow-up
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Home work..Use SOAP method to resolve this case
Tn E 46th, 65kg, 162cm, MRS dengan keluhan mual,
pusing, muntah, lemas. Menurut pengakuan keluargapasien memiliki riwayat DM sekitar 5 tahun. Obat terakhir
sebelum MRS adalah insulatard 0-0-10U s.c., glucodex 1-
0-0, neurodex 2x1tab, namun tidak digunakan selama 1
bulan karena pasien berobat alternative.Hasil
pemeriksaan lab sbb: GDA 421mg/dl, Cr 2,3 mg/dl, BUN
21mg/dl, SGOT/SGPT (N), Na 123meq/l, K 3,0 meq/l.
Hasil observasi: TD 150/90 mmHg, temperature 37,8oC.
Pasien didiagnosa DM Hiperglikemi.
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PENGENALAN DRUG RELATED PROBLEMS(DRPS)
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1. Drug Choice:
Wrong Drug
Innapropriate Drug
2. DoseOver dose
Sub Dose
3. Disease
Indication Without therapyDrug Without Indication
4. Adverse Effects
5. Drug interactions
6. Patient Compliance
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PRINSIP FARMAKOTERAPI RASIONAL
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1. Tepat obat- indikasi
Problem list (diagnosis : clue) penegakandiagnosis
clue berupa kumpulan gejala syndrome(sign & symptom)
Ex : Asma : aminofilin, salbutamol
Hipertensi : kaptopril, propanolol2. Penggunaan obat dimulai dengan dosis rendah
3. Monoterapi
Diutamakan kecuali TBC , DM
4. Penggunaan obat baru
Efikasi , Keamanan dan price
Ex. Rofexocib, sibutramin, rosiglitazone
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5. Regimen obat berdasarkan evidence based
6. Pertimbangan efikasi, ES, dan IO
7. Regimen obat yang sederhana
Ex : antibiotik
8. Persepsi pasien terhadap penyakit dan
untung-rugi obat hasil terapi9. Observasi respon pasien terhadap obat
Konfirmasi efikasi, pencegahan,
penatalaksanaan efek samping Penyesuaian dosis obat atau
menghentikan terapi obat
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10. Pengobatan tidak secara parenteral jika oralmemadai
Ex injeksi : asma, syok anafilaktik, postoperasi, obat yang tidak diabsorbsi di GIT(Penicillin G)
10. Modifikasi gaya hidup11. Gagal terapi
Seleksi obat tidak cukup
Tidak tepat dosis
Penyakit lain, IO
Faktor genetik dan faktor lingkungan
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MATERI-MATERI
FARMAKOTERAPI
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MID test FINAL TEST
Penatalaksanaan Nyeri Hipertensi
Rheumatoid Arthritis Hiperlipidemia
Gout dan Hiperurisemia Diabetes Mellitus
Asma Kanker dan Kemoterapi
PPOK Kanker Payudara
Diare dan Konstipasi
Tukak Lambung
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Nama penyakit
Defenisi penyakit
Etiologi
Epidemiologi (penyebaran/Insiden-Prevalensi :Negara, JK, Genetik, Ras)
Patofisiologi Klasifikasi
Manifestasi Klinik
penata laksanaan nonfarmakologi dan farmakologi
KIE
Monitoring
Studi Kasus
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DAFTAR PUSTAKA
Chisolm, Marie.,el. (2008) : PharmacotherapyPrinciples & Practice., The McGraww-HillCompanies., United State Of America
T. R. Harrison. (2005): Harrisons Principles of
Internal Medicine 16th
. MGH Medical. London. S ilbernagl,S., Lang,F,. (2000) : Color Atlas of
Pathophysiology, Germany
Stockley I.H., (2006) : Drug Interaction, 4thed,B.Scientific Publications, London.
Dipiro, J.T., et.al., 2008. Pharmacotherapy : APatophysiologic Approach, Mc.Graw Hill. 7thed.United States of America.
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Dipiro, J.T., et al., 2008, Pharmacotherapy apathophysiologic Approach, 7thedition.
Tatro, D.S., 2009, Drug Interaction Facts.
1. http://www.nice.org.uk/
2. http://www.cebm.net/index.aspx?o=1900
3. http://www.tripdatabase.com/
4. Dan lain-lain
1. http://www.ncbi.nlm.nih.gov/pubmed
2. http://scholar.google.com/schhp?hl=en
http://www.nice.org.uk/http://www.cebm.net/index.aspx?o=1900http://www.tripdatabase.com/http://www.ncbi.nlm.nih.gov/pubmedhttp://scholar.google.com/schhp?hl=enhttp://scholar.google.com/schhp?hl=enhttp://www.ncbi.nlm.nih.gov/pubmedhttp://www.tripdatabase.com/http://www.cebm.net/index.aspx?o=1900http://www.nice.org.uk/ -
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