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    GUIDE OF PRACTICAL WORK

    PHARMACOLOGY AND THERAPY DEPARTMENT

    BLOCK 22

    MODUL NAME

    1. Nosocomial Infection

    2. Tropical Medicine

    3. TB Control ro!ram

    ". #$%stances A%$se

    1

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    PHARMACOLOGY AND THERAPY DEPARTMENT

    FACULTY OF MEDICINE

    UNIVERSITAS GADJAH MADA

    RULES AND REGULATIONS GOVERNING LABORATORY WORK

    IN THE DEPARTMENT OF PHARMACOLOGY AND THERAPY, FACULTY OF

    MEDICINE, UNIVERSITAS GADJAH MADA

    1. In t&e la%orator' of &armacolo!' dnd T&erap' Department( t&e st$dents &a)e to

    *ear la%orator' coats and s&oes( and are not allo*ed to *ear sandals.

    2. It is imperati)e t&at st$dents %e in t&e la%orator' in time. T&ose *&o arri)e 1+

    min$tes after t&e d$e time are denied permission into t&e la%orator'

    3. Before a session( t&e st$dents *ill recei)e assi!nments to %e prepared for t&e

    follo*in! session.

    ". After ta,in! part in t&e t&ree sessions( t&e st$dents *ill &a)e to sit for an e-am( t&e

    time for *&ic& *ill %e anno$nced later.

    +. T&e total !rade a st$dent *ill !et comprises +/ for t&e e-am and +/ for

    la%orator' report.

    2

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    WRITING PRESCRIPTION

    AimsT&e aims of t&is session are st$dent *ill %e a%le to0

    Calc$late dr$! dose

    Determine t&e proper medication dosa!e re!imen( incl$din! dose( ro$te of

    administration( fre$enc' of administration( time of administration( and d$ration of

    t&erap'

    rite a prescription

    BACKGROUND

    One of t&e processes in an inte!rated patient mana!ement is prescri%in!. After t&e

    doctors e-amine t&e patient( ma,e a dia!nosis( and determine t&e treatment plan( t&e ne-t

    step often done %' a p&'sician is *ritin! a prescription. rescri%in! process is as important

    as t&e pre)io$s processes. T&ro$!& t&is prescription s&eet( doctors *ill indirectl'

    comm$nicate *it& patients t&ro$!& a p&armacist.

    To *rite a !ood and ri!&t prescription( st$dents need to $nderstand &o* to calc$late

    dr$! dosa!es( ro$tes of administration( fre$enc' of administration( time of administration(

    and d$ration of t&erap'. In addition( t&ere are ot&er t&in!s t&at need to %e o%ser)ed *&en

    prescri%in!( *&ic& is dr$! dosa!e form a)aila%le in t&e mar,et.

    TOOLS AND MATERIALS

    #cenarios

    rescription paper

    " paper

    PROCEDURES

    Ten cases of scenario %elo* s&o$ld %e done %' eac& st$dent. Eac& case t&en *ill %e

    disc$ssed and presented to t&e ot&er st$dents. T&e follo*in! s&o$ld %e considered in t&e

    disc$ssion of eac& case

    1. Determine t&e proper medication dosa!e re!imen incl$de0 dose( ro$te of

    administration( fre$enc' of administration( time of administration( and

    d$ration of t&erap'

    2. rite a prescription medicine

    T&e follo*in! are t&e case0

    3

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    1. A &'sician *ants to prescri%e paracetamol ta%lets for Aldi( a 12 'ear4old %o'( "

    ,!( s$fferin! from common cold.

    Genei! n"me D#$ D%s"$e Genei! &%m

    aracetamol 141+ m!5,!5dose( e)er' "46 &o$rs Ta%let + m!#'r$p 76 ml8 12

    m!5+ml

    9a* material

    2. A &'sician *ants to prescri%e antacid c&e*a%le ta%let to Mrs. Dede( a 3 'ear4old

    *oman( + ,!( s$fferin! from ac$te !astritis.

    Genei! n"me D#$ D%s"$e Genei! &%m

    Mi-t$re ofAl7O:83and

    M!7O:83

    Al7O:83 can %e !i)en $p to 1!ram55administration

    M!7O:83 can %e !i)en $p to

    1 !ram55administration

    Antasida DOEN c&e*a%leta%let contains Al7O:832

    m! and M!7O:83 2 m!

    Antasida DOEN s$spension

    76ml8( eac& + ml contains0

    Al7O:832 m! and

    M!7O:83 2 m!

    3. &'sicians *ant to prescri%e Cotrimo-a;ol s'r$p for Clara( 3 'ears 1+ ,!( s$fferin!

    from d'senter' %asiler.

    Genei! n"me D#$ D%s"$e Genei! &%m

    Cotrimo-a;ol "

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    6. A &'sician *ants to prescri%e Anti&emorroid DOEN s$ppositor' to Mr. Dian( +"

    'ears old @ ,! s$fferin! from internal &emorr&oids.

    Genei! n"me D#$ D%s"$e Genei! &%m

    Anti&emorroidDOEN

    Once a da'( 1 s$ppositor'%efore sleep

    Eac& 1 rectal s$ppositor' ofAnti&emoroid DOEN

    contains0

    Bism$t& s$%!alat 1+ m!

    :e-ac&lorofen 2.+ m!

    Lido,ain 1 m!

    #en! o,sida 12 m!

    #$pp ad 2 !

    @. Mrs #$san 36 'ears old came to t&e doctor *it& complaints of itc&in! after $sin! acertain %rand of talc$m po*der. &'sical e-amination fo$nd er't&ematosa

    pap$lo)esic$la in t&e armpit( c&est and el%o*s. Doctor dia!nosed t&at s&e &as

    aller!ic contact dermatitis. T&e doctor t&en prescri%ed &'drocortisone cream.

    Genei! n"me D#$ D%s"$e Genei! &%m

    :'drocortisone Dosa!e .+41/.

    Topicall' $sed e)er' 6412 &o$rs

    :'drocortison cream 1/ or

    2.+/ in t$%e + !

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    1. Dino( 1+ 'ears old( came to a doctor a%o$t &is %lood' diarr&ea and &ad defecated

    t&ree times a da' for t*o da's. &'sical e-amination indicated t&at t&ere *ere no

    si!ns of de&'dration. T&e faeces e-amination infested *it& trop&o;oit of

    Entamoeba hystolitica. T&e dia!nose *as Amoe%iasis *it&o$t de&'dration and t&e

    doctor prescri%ed metronida;ol and oral re&'dration li$id.

    Genei! n"me D#$ D%s"$e Genei! &%m

    Metronida;ole Ad$lt0 +4@+ m!5dose( e)er'

    < &o$rs

    Ta%let 2+ m! and + m!

    Oralit Ad$lts0 2 to " mL for e)er'

    diarr&eaOralit 2 ml5sac&et

    L%!"'i%n 0 &armacolo!' and T&erap' Department( ac$lt' of Medicine( Uni)ersitas

    ?ad>a& Mada

    D#"'i%n0 1 - 12 min$tes

    EALUATION

    Assi!nment d$rin! la%orator' practice.

    9EE9ENCE#

    9oac&( #. 2".Introductory Clinical Pharmacology. @t&ed.I#I( 2@. ISO Indonesia7Informasi #pesialite O%at Indonesia8(

    #ri #$&armi( 22(Resep Dokter dan Proses Preskripsi yang Benar dan Rasional( Ba!ian

    armasi =edo,teran a,$ltas =edo,teran U?M( o!'a,arta

    #'arif( 9.A( M$rini( T.( dan a&'$nin!si&( M.#.:. 212. Pedoman Dasar Penulisan

    Resep Dokter untuk Pasien nak. Ba!ian arma,olo!i dan Terapi a,$ltas =edo,teran

    U?M.

    Faman4Goenoes( N. 21. rs Prescribendi Resep !ang Rasional. Edisi 1. Airlan!!a

    Uni)ersit' ress.

    6

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    9E#C9ITION ANAL#I#

    AIM0

    After doin! t&e acti)it' it is e-pected t&at st$dentHs ,no*led!e a%o$t prescription

    *ritin! increases and st$dent are a%le to t&in, criticall' to an' prescription *&ic& t&e' read

    and anal';e.

    9E#UME O T:EO9

    Until no* it is still fo$nd t&at a prescription is ille!i%le and not *ritten completel'.

    :ealt& Ministerial 9e!$lation No 2651

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    9OCEDU9E

    Me'(%)

    #t$dents are di)ided into some !ro$ps 734" persons5!ro$p8. One *ee, %efore t&is

    session( eac& !ro$p *ill recei)e assi!nments to %e prepared for t&is session. T&e

    assi!nment is a doctorHs prescription to %e anal';ed %' $sin! t&e follo*in! criteria %elo*.

    T&e st$dents &a)e to ma,e a repot of t&e assi!nment and s$%mit it one da' %efore t&e

    practical *or,. On D4da' t&e st$dent present t&e s&ort report *ritten on transparent plastic

    and disc$ss it *it& ot&er !ro$ps.

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    O9M O 9E#C9ITION ANAL#I#

    A. Completeness of a prescription

    Complete

    7'es5no8

    9i!&t5le!i%le

    7'es5no8

    E-planation

    DoctorHs Identit'

    Superscription 915.

    925.

    935.

    etc.

    Inscription 915.

    925.

    935.

    etc.

    Subscription 915.925.

    935.

    etc.

    Signa "Signatura# 915.

    925.

    935.

    etc.

    DoctorHs si!nat$re 915.

    925.

    935.etc.

    atientHs Identit'

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    B. rescription form

    1. T'pe of prescriptions

    915.

    925.

    935. etc.

    2. Ma!istral form 7present5none8

    If t&ere is ma!istral form( e-plain $sin! t&e criteria0

    In!redients T&e name of acti)e

    medicinal a!ent

    Effects5$nctions

    Remedium Cardinale7principal dr$!s8

    Remedium d$u%ant

    7ad>$)ant8

    Corrigens

    Constituents&%ehicle

    3. Official form 7present5none8

    If t&ere is official form( e-plain composition and effects of t&e medicine

    ". #pecial form 7present5none8

    If t&ere is special form( e-plain t&e content and effect of t&e medicine

    +. Narcotic dr$!s 7present5none8

    Name 0

    rite t&e dr$! in a prescription.

    B. 1 Dosa!e re!imen 7dosa!e( ro$te of administration( fre$enc'( time of

    administration( and d$ration of treatment8

    2. Dr$! Interaction 7present5none8

    C. &armace$tical dosa!e form selected %' t&e doctor

    7E-plain specification of a)aila%le dosa!e form( ad)anta!es and disad)anta!es of

    t&e p&armace$tical dosa!e form8

    1

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    D. Dia!nose

    Base on t&e medicines *ritten in t&e prescription( *&at is5are t&e possi%ilit' of

    patientHs dia!nose

    E. 1. Concl$sion and ad)ice 7ad)ices *&ic& &a)e to %e !i)en to t&e patient relatin! to

    t&e disease8

    2. rite t&e ri!&t and rational prescri%in! in a prescription form.

    After t&e st$dents anal';e and ma,e a report a%o$t t&e prescriptions( on D4Da' t&e'

    present and disc$ss t&em *it& ot&er !ro$ps.

    Eac& !ro$p presents0

    1. Ori!inal doctorHs prescription

    2. T&e calc$lation of dr$! doses for t&is patient

    3. T&e ri!&t and rational prescri%in! accordin! to st$dentsHs opinion

    E-ample0

    1. Loo, at t&e ori!inal doctorHs prescription %elo*

    dr. Mric&i Mar'

    #ip 0 @52

    :ome0 ratice site 0

    Gl.An!sa 2 Gl.An!!re, @

    o!'a,arta o!'a,arta

    o!'a,arta( 1 G$ni 2@

    95. Er't&rom'cin m! 2 #acc&.lactis .s.

    m.f.l.a.p$l).d.t.d.No II

    #.3.d.d.p$l).

    ro 0 Nila

    A!e 0 1 'ear old

    11

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    2. In t&at prescription( *e do not find %od' *ei!&t of t&e patient( so *e loo, for it

    from *ei!&t for a!e ta%le. rom it( *e o%tain t&at t&e %od' *ei!&t of a4'ear4old

    c&ild is < ,ilo!rams. 9eferences s&o* t&at er't&rom'cin dosa!e is 34+ m!5,!

    %od' *ei!&t5da' in fo$r4di)ided dose. #o(

    Doses of er't&rom'cin for Nila is < - 73 +8 m!5da'

    or 2"4" m!5da'

    or 6 1 m!5dose

    In prescription a%o)e *e also find t&at 'signa(is not complete. T&e doctor didnHt

    *rite &o* man' pac,a!e or medicine and *&en t&e medicine m$st %e ta,en %' t&e patient.

    #o( 'o$ &a)e to complete t&esignaas prescription %elo*.

    3. T&e ri!&t and rational prescri%in! for Nila is 0

    dr. Mric&i Mar'

    #I 0 @52

    :ome0 ractice site 0

    Gl.An!sa 2 Gl.An!!re, @o!'a,arta o!'a,arta

    o!'a,arta( 1 G$ni 2@

    95. Er't&rom'cin m! 1

    #acc&.lactis .s.

    m.f.l.a.p$l).d.t.d.No II

    #.3.d.d.p$l).I p.c.

    ro 0 Nila

    A!e 0 1 'ear old 71 ,!8

    L%!"'i%n 0 &armacolo!' and T&erap' Department( ac$lt' of Medicine( Uni)ersitas

    ?ad>a& Mada

    D#"'i%n0 1 - 12 min$tes

    12

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    9EO9T

    T&e st$dents &a)e to s$%mit t&e report to la%orator' of Medical &armac' one da' %efore

    t&e practical *or,.

    EALUATION

    resentation and report

    9EE9ENCE#

    ?oodman and ?ilman( 21( )he Pharmaceutical Basis of )herapeutics( Ed.

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    CA#E 9E#ENTATION0

    #TE# O 9E#C9ITION 9ITIN?

    AIM 0

    To pro)ide a st$d'in! e-perience for t&e st$dents a%o$t &o* to appl' t&e steps of

    prescription *ritin! to reali;e a rational prescription *ritin!

    9E#UME O T:EO9

    A st$d' o%tained t&at t&e fres&4!rad$ated4doctor prescri%ed *ron! dr$! or %enefit

    of dr$! *as &esitated on a &alf of cases a t&ird prescri%in! *as *ron! and t*o t&irds

    prescri%er did not !i)e important dr$! information to patient 7:O( 1"8.

    rescri%in! is p&armacot&erap' creation t&at it &as to %e ri!&t and rational. To

    create rational p&armacot&erap' in prescription *ritin! it is necessar' to $nderstand steps

    of prescription *ritin! t&at &a)e %een p$%lis&ed %' :O. T&e steps are to c&oose t&e

    p&armace$tical dosa!e form s$ita%le to patient condition( determine dosa!e re!imen

    7doses( ro$te of administration( fre$enc'( time of administration( and d$ration of

    treatment8( *rite prescription( and !i)e important information a%o$t dosa!e re!imen(

    ad)erse effect t&at s&o$ld %e ,no*n %' patient.

    TOOL AND MATE9IAL

    4 T&e ficti)e cases

    4 LCD pro>ector

    4 Note%oo,5comp$ter

    9OCEDU9EMe'(%)

    Eac& !ro$p of st$dents are di)ided into some s$%!ro$ps 734" persons5s$%!ro$p8.

    One *ee, %efore t&is session( eac& s$%!ro$p *ill recei)e an assi!nment to %e prepared for

    t&is session. T&e assi!nment contains a ficti)e case and steps of prescription *ritin!. Eac&

    s$%!ro$p of st$dents &as to ma,e a report of t&e assi!nment and s$%mit it one da' %efore

    practical *or,. On D4da' t&e st$dents present t&e s&ort report *ritten on po*er point and

    disc$ss it *it& ot&er !ro$ps.

    1"

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    E-ample of case to %e presented0

    Mrs. oni( a t&irt' fi)e4'ear4old *oman( comes a doctor in primar' &ealt& care %eca$se of

    co$!& and %reat&lessness. #&e co$!&s fre$entl' t&ro$!&o$t t&e da' and *ill &a)e

    s'mptoms 2 or 3 ni!&ts a mont& as *ell. It seems to %e *orse in cold *eat&er. :er

    e-amination is normal e-cept for &er l$n!s( *&ic& re)eal e-pirator' *&ee;in!. T&e doctor

    dia!nose &er *it& ac$te ast&ma and considered to !i)e P24adrenoceptor a!onist

    7sal%$tamol or salmeterol8. T&e doctor t&in,s a%o$t *&ic& dr$! of t&ose s$ita%le to t&e

    patient. :e remem%ers t&at $sin! steps of prescription *ritin!( t&e appropriate dr$! can %e

    determined.

    T&e steps of prescription *ritin! 0

    1. &ic& of t&e t*o are 'o$ !oin! to c&oose for t&e patient E-plain 'o$r ans*er

    7!i)e reasons8

    2. Descri%e t&e )ario$s ,ind of p&armace$tical dosa!e form and t&e stren!t& of t&ose

    dr$!s 7%ot& !eneric and %rand8( t&en determine one s$ita%le to patient condition

    3. Esta%lis& t&e proper dosa!e re!imen 7dosa!e( fre$enc' of administration( ro$te of

    administration( time of administration( and d$ration of t&e treatment8 of t&ose dr$!s

    ". rite all of t&e possi%le prescription forms 7ma!istral( official( and special8 t&en

    select *&ic& is t&e most s$ita%le for t&e patientQ

    +. ?i)e information a%o$t t&e medicines to t&e patient 7effects( side effects(

    instr$ctions( *arnin!s8

    Ans*er0

    1. S"*+#'"m%* 7INN8 or "*+#'e%* 7U#AN8 is one of s&ort4actin! P24adrenoceptor

    a!onists $sed for pre)ention and treatment of %ronc&oconstriction. T&e a!ents

    %inds specificall' to t&e P24adrener!ic receptor and a)oid t&e cardio)asc$lar effects

    of P14acti)ation. Acti)ation of P24receptors ca$ses %ronc&odilation. Onset of action

    occ$rs in min$tes and lasts for "6 &o$rs. It is t&e treatment of first c&oice to

    relie)e ac$te ast&ma. T&e preparation a)aila%le in oral( in&aler( and sol$tion *it& a

    ne%$li;er. It &as a fe* side effects. E-cessi)e $se or t&e oral preparations ma'

    res$lt in cardio)asc$lar effects s$c& as tac&'cardia.

    1+

    http://en.wikipedia.org/wiki/International_Nonproprietary_Namehttp://en.wikipedia.org/wiki/United_States_Adopted_Namehttp://en.wikipedia.org/wiki/International_Nonproprietary_Namehttp://en.wikipedia.org/wiki/United_States_Adopted_Name
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    S"*me'e%* is one of lon!4actin! P24adrenoceptor a!onists $sed onl' for

    prophyla+is of ac$te %ronc&oconstriction. T&e' are not effecti)e in ac$te attac,s

    %eca$se t&e' &a)e a slo*er onset of action t&an t&e s&ortactin! dr$!s 7$p to 2

    min$tes for salmeterol8. It &as a m$c& lon!er &alf4life 7$p to 12 &o$rs8. T&e a!ents

    are a)aila%le in metered4dose in&alers t&at prod$ce fe*er side effects t&an s'stemic

    administration. Use of lon!4actin! a!ents prod$ces t&e same rela-ation in air*a'

    smoot& m$scles and also appears to decrease t&e release of mediators from mast

    cells and l'mp&oc'tes. T&e lon!4actin! a!ents s&o$ld not %e $sed to re)erse an

    ac$te attac,.

    #o( dr$! c&oosed is sal%$tamol %eca$se it can pre)ent %ronc&oconstriction and

    s$ita%le for relie)e ac$te ast&ma.

    2. &armace$tical dosa!e form a)aila%le in mar,et0

    #al%$tamol0

    ?eneric 0 ta%let 2 m! and " m!.

    Brand name 0

    entolin ta%let 0 sal%$tamol 2 m!(

    entolin s'r$p 0 sal%$tamol 2 m!5+ ml 71 ml5%ottle8entolin ne%$les 0 2(+ m! sal%$tamol 52(+ ml NaCL( $sed *it& ne%$li;er

    entolin dis,&aler 0 2 R!5in&alation and " R!5in&alation

    Lasal in>ection 0 (+ m!5ml of sal%$tamol 72 ml5amp$le8

    ?lisend in&alation aerosol0 1 R! 5spra' sal%$tamol 71@ !5can8

    or Mrs. oni( ta%let is prescri%ed on t&e ass$mption t&at s&e a%le to s*allo*

    ta%let( t&e dosa!e form is eas' to carr' e)er'*&ere and a)aila%le in primar' &ealt&

    care( and t&e price is lo*er t&an ot&er forms 7ne%$les and dis,&aler8.

    T&e components of a sal%$tamol in&aler #al%$tamol s$lfate 2 m! #al%$tamol 2 m!5+ ml

    16

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    3. Dosa!e of sal%$tamol for ad$lt0 orall' 24" m!( dosa!e c&oosed is " m!

    re$enc' of administration0 orall' e)er' 6 &o$rs

    9o$te of administration0 orall'

    Time of administration0 e)er' 6 &o$rs 7mornin!( noon( e)enin!( at %edtime8(

    D$ration of t&e treatment0 @ da's

    ". rescription

    T&e possi%ilit' of prescription forms *&ic& ma' %e *ritten0

    A. Official prescription

    dr. B$diman#I 0 @52

    :ome0 ractice site 0

    Gl.An!sa 2 Gl.An!!re, @

    o!'a,arta o!'a,arta

    o!'a,arta( 1 No)em%er 21

    95. Ta%.#al%$tamol m! " No III

    #.p.r.n.o.6.&.Ta%.I.p.c.

    ro 0 N'. oni

    A!e 0 3+ '.o.

    1@

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    B. #pecial prescription

    dr. B$diman

    #I 0 @52

    :ome0 ractice site 0

    Gl.An!sa 2 Gl.An!!re, @

    o!'a,arta o!'a,arta

    o!'a,arta( 1 No)em%er 21

    95. Ta%.entolin m! 2 No LI

    #.p.r.n.o.6.&.Ta%.II.p.c.

    ro 0 N'. oni

    A!e 0 3+ '.o.

    Ma!istral prescription isnHt *ritten for t&e case %eca$se dose of sal%$tamol for N'.

    oni is a)aila%le in !eneric and %rand dosa!e form.

    T'pe of prescription c&oosed0 official prescription %eca$se t&e price of !eneric is

    lo*er t&an %rand dr$!.

    +. rite effects( side effects( instr$ctions( *arnin!s *&ic& *ill %e informed and

    s&o$ld %e o%e'ed %' patient

    L%!"'i%n &armacolo!' and T&erap' Department( 2ndfloor of 9adiopoetro B$ildin!(

    ac$lt' of Medicine( Uni)ersitas ?ad>a& Mada

    D#"'i%n0 1 - 12 min$tes

    Re-%'

    T&e st$dents &a)e to s$%mit t&e report to la%orator' of &armacolo!' and T&erap' one da'

    %efore t&e practical *or,.

    1

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    E."*#"'i%n

    resentation and report

    Re&een!es

    ?oodman and ?ilman( 21( )he Pharmaceutical basis of )herapeutics( Ed.

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    CODE0 A1

    BLOC= 22

    :A9MACOLO? AND T:E9A DEA9T.

    ACULT O MEDICINE U?M

    Case resentation0

    #teps of rescription ritin!

    I%$ a,$ni( " ta&$n( "< ,!( per!i ,e do,ter den!an ,el$&an %at$, %erda&a,( tida, ada

    nafs$ ma,an dan pen$r$nan %erat %adan. #e>a, 2 &ari 'an! lal$ %at$, disertai dara&.

    emeri,saan sp$t$m0 BTA positif. oto 9on!ent t&ora- men$n>$,,an =oc& $lmon$m

    a,tif. Do,ter mendia!nose se%a!ai t$%erc$losis par$ dan merencana,an pem%erian o%atantit$%erc$losis 7OAT8 ,ate!ori I fase intensif. Do,ter merencana,an pem%erian OAT

    selama 2 min!!$ pertama $nt$, memonitor toleransi pasien ter&adap o%at. O%at

    antit$%erc$losis 'an! a,an diresep,an melip$ti 2:9FE S7isonia;id( et&am%$tol(

    rifampicine dan p'ra;inamide8 ata$ OAT =DT fase intensif de*asa 79imstar DC8 serta

    )itamin 7m$lti)itamin( )it C ata$ )it B6 8.

    ertan'aan 0

    1. Bila anda se%a!ai do,ter( o%at mana 'an! anda pili&5resep,an dari o%at4o%at dalam

    ,las terapi it$ Gelas,an >a*a%an anda 7farma,o,ineti, dan farma,odinami, sem$a

    o%at terse%$t8Q

    2. #e%$t,an macam %ent$, sediaan o%at terse%$t 'an! ada di pasaran 7!eneri, danmere, da!an!8 dan tent$,an %ent$, sediaan o%at 7B#O8 'an! coco,5tepat %a!i

    pasien terse%$tQ

    3. Tent$,an >ad*al dosis $nt$, o%at 'an! anda pili& 7dosis( fre,$ensi( cara

    pem%erian( *a,t$ pem%erian( dan lama pen!o%atan8Q

    ". T$lis sem$a >enis pres,ripsi 'an! mem$n!,in,an $nt$, pasien terse%$t

    7ma!istralis( offisinalis( spesialitis8 dan tent$,an >enis mana 'an! palin! tepat %a!i

    pasien it$Q

    +. Beri,an informasi %er,aitan den!an o%at 'an! anda %eri,an 7efe,( efe, sampin!(

    instr$,si( perin!atan8Q

    2

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    CODE0 B1

    BLOC= 22

    :A9MACOLO? AND T:E9A DEA9T.

    ACULT O MEDICINE U?M

    Case resentation0

    #teps of rescription ritin!

    Bapa, Andi( 63 ta&$n( peri,sa ,e do,ter ,arena demam( %at$,( pile,( n'eri ten!!oro,an(

    dan Jpe!al4pe!alK di sel$r$& t$%$&. #etela& dila,$,an pemeri,saan do,ter mendia!nose

    common cold dan meresep,an antip'retic 7acetaminop&en ata$ i%$prop&en8( e-pectorant

    7!$ap&enesine ata$ %rom&e-in8( decon!estant 7pse$doep&edrine ata$p&en'lpropanolamine8 padan'a.

    ertan'aan 0

    1. Bila anda se%a!ai do,ter( o%at mana 'an! anda pili&5resep,an dari o%at4o%at dalam

    ,las terapi it$ Gelas,an >a*a%an anda 7farma,o,ineti, dan farma,odinami, sem$a

    o%at terse%$t8Q

    2. #e%$t,an macam %ent$, sediaan o%at terse%$t 'an! ada di pasaran 7!eneri, dan

    mere, da!an!8 dan tent$,an %ent$, sediaan o%at 'an! coco,5tepat %a!i pasien

    terse%$tQ

    3. Tent$,an >ad*al dosis $nt$, o%at 'an! anda pili& 7dosis( fre,$ensi( carapem%erian( *a,t$ pem%erian( dan lama pen!o%atan8Q

    ". T$lis sem$a >enis pres,ripsi 'an! mem$n!,in,an $nt$, pasien terse%$t

    7ma!istralis( offisinalis( spesialitis8 dan tent$,an >enis mana 'an! palin! tepat %a!i

    pasien it$Q

    +. Beri,an informasi %er,aitan den!an o%at 'an! anda %eri,an 7efe,( efe, sampin! (

    instr$,si( perin!atan8Q

    21

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    CODE0 D2

    BLOC= 22

    :A9MACOLO? AND T:E9A DEA9T.

    ACULT O MEDICINE U?M

    Case resentation0

    #teps of rescription ritin!

    Bimo( + ta&$n( 2 ,!( di%a*a i%$n'a ,e do,ter ,arena sesa, nafas. #esa, nafas ,adan!

    m$nc$l setela& %ermain. Bimo men!alami asma 142 ,ali dalam semin!!$. emeri,saan

    fisi, didapat,an e,spirasi diperpan>an! dan *&ee;in!. Do,ter mendia!nose ast&ma mild

    persistent dan meresep,an %ronc&odilator 7-ant&ine ata$ #ABA ata$ LABA8 dan steroid.#&ort actin! P2 a!onist 7#ABA80

    #al%$tamol( ter%$taline( metaproterenol

    ant&ine

    Aminop&'lline( teop&'lline

    Lon! actin! P2 a!onist 7LABA80

    salmeterol( formoterol

    #teroid

    De-amet&asone( metil prednisolone( prednisone( %eclomet&asone( &'drocortisone(

    fl$ticasone( %$desonide

    ertan'aan 0

    1. Bila anda se%a!ai do,ter( o%at mana 'an! anda pili&5resep,an dari o%at4o%at dalam

    ,las terapi it$ Gelas,an >a*a%an anda 7farma,o,ineti, dan farma,odinami, sem$a

    o%at terse%$t8Q

    2. #e%$t,an macam %ent$, sediaan o%at terse%$t 'an! ada di pasaran 7!eneri, dan

    mere, da!an!8 dan tent$,an %ent$, sediaan o%at 'an! coco,5tepat %a!i pasien

    terse%$tQ

    3. Tent$,an >ad*al dosis $nt$, o%at 'an! anda pili& 7dosis( fre,$ensi( cara

    pem%erian( *a,t$ pem%erian( dan lama pen!o%atan8Q

    ". T$lis sem$a >enis pres,ripsi 'an! mem$n!,in,an $nt$, pasien terse%$t

    7ma!istralis( offisinalis( spesialitis8 dan tent$,an >enis mana 'an! palin! tepat %a!i

    pasien it$Q

    +. Beri,an informasi %er,aitan den!an o%at 'an! anda %eri,an 7efe,( efe, sampin!(

    instr$,si( perin!atan8Q

    22

  • 8/12/2019 2014 Petunjuk Prakt Blok 22 Tadulako

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    CODE0 E2

    BLOC= 22

    :A9MACOLO? AND T:E9A DEA9T.

    ACULT O MEDICINE U?M

    Case resentation0

    #teps of rescription ritin!

    I%$ G$mira&( 6 ta&$n den!an n'eri dada 'an! men>alar ,e len!an ,irin'a selama 1

    menit mendatan!i U?D r$ma& sa,it. Dia men!ata,an %a&*a dia tela& men!alami !e>ala

    ini selama 3 ta&$n dan ,adan!4,adan! min$m ta%let s$%lin!$al nitro!liserin mili,

    s$amin'a $nt$, men!atasin'a. N'eri serin! tim%$l mes,ip$n a,ti)itas minimal. Daripemeri,saan E=? tida, ditem$,an adan'a ,enai,an se!men #T . Dia >$!a menderita

    %acterial con>$ncti)itis. Do,ter U?D mendia!onosis $nsta%le an!ina dan meresep,an

    antian!ina 7Nitrat0 Isosor%id dinitrat( isosor%id mononitrat( nitro!l'cerin ATAU

    Trom%o-ane In&i%itor0 aspirin8 dan anti%acteri 7c&loramp&enicol ata$ o-'tetrac'cline ata$

    c'proflo-acine8.

    ertan'aan0

    1. Bila anda se%a!ai do,ter( o%at mana 'an! anda pili&5resep,an dari o%at4o%at dalam

    ,las terapi it$ Gelas,an >a*a%an andaQ

    2. #e%$t,an macam %ent$, sediaan o%at terse%$t 'an! ada di pasaran 7!eneri, dan

    mere, da!an!8 dan tent$,an %ent$, sediaan o%at 'an! coco,5tepat %a!i pasien

    terse%$tQ

    3. Tent$,an >ad*al dosis $nt$, o%at 'an! anda pili& 7dosis( fre,$ensi( cara

    pem%erian( *a,t$ pem%erian( dan lama pen!o%atan8Q

    ". T$lis sem$a >enis pres,ripsi 'an! mem$n!,in,an $nt$, pasien terse%$t

    7ma!istralis( offisinalis( spesialitis8 dan tent$,an >enis mana 'an! palin! tepat %a!i

    pasien it$Q

    +. Beri,an informasi %er,aitan den!an o%at 'an! anda %eri,an 7efe,( efe, sampin! (

    instr$,si( perin!atan8Q

    23

  • 8/12/2019 2014 Petunjuk Prakt Blok 22 Tadulako

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    CODE0 1

    BLOC= 22

    :A9MACOLO? AND T:E9A DEA9T.

    ACULT O MEDICINE U?M

    Case resentation0

    #teps of rescription ritin!

    Bp. Ba>$ri( +" datan! ,e ,lini, anda ,arena &ipertensi dan !atal4!atal di p$n!!$n!n'a.

    Dia >$!a mendertia dia%etes melit$s. Te,anan dara&n'a 1651 mm:!. ada p$n!!$n!

    tampa, pla, t$n!!al %erdiameter " cm den!an s,$ama( er't&ema di pin!!irn'a dan %a!ian

    ten!a& men'em%$&. Anda se%a!ai do,tern'a mendia!nosis &ipertensi den!an Tineacorporis dan meresep,an anti&ipertensi 7Di$reti, T&ia;id0 &'droc&lorotia;id(

    %endrofl$a;id( ,lortalidon( indapamid( metola;on( -ipamid ATAU di$retic &emat ,ali$m0

    spironolactone( amilorid4:Cl ATAU di$reti, ,$at0 f$rosemid( %$metanid( torasemid8 dan

    antif$n!i 7*it&field ointment( ATAU imida;ol0 ,etocona;ole( ATAU Tria;ol0 itra,ona;ol(

    fl$,ona;ol( ATAU olien0 amp&otericine B( nistatin ATAU !olon!an lain0 !riseo)$l)in8

    $nt$,n'a.

    ertan'aan0

    1. Bila anda se%a!ai do,ter( o%at mana 'an! anda pili&5resep,an dari o%at4o%at dalam

    ,las terapi it$ Gelas,an >a*a%an anda 7farma,o,ineti,( farma,odinami,8Q

    2. #e%$t,an macam %ent$, sediaan o%at terse%$t 'an! ada di pasaran 7!eneri, dan

    mere, da!an!8 dan tent$,an %ent$, sediaan o%at 'an! coco,5tepat %a!i pasien

    terse%$tQ

    3. Tent$,an >ad*al dosis $nt$, o%at 'an! anda pili& 7dosis( fre,$ensi( cara

    pem%erian( *a,t$ pem%erian( dan lama pen!o%atan8Q

    ". T$lis sem$a >enis pres,ripsi 'an! mem$n!,in,an $nt$, pasien terse%$t

    7ma!istralis( offisinalis( spesialitis8 dan tent$,an >enis mana 'an! palin! tepat %a!i

    pasien it$Q

    +. Beri,an informasi %er,aitan den!an o%at 'an! anda %eri,an 7efe,( efe, sampin! (instr$,si( perin!atan8Q

    2"

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    CODE0 3

    BLOC= 22

    :A9MACOLO? AND T:E9A DEA9T.

    ACULT O MEDICINE U?M

    Case resentation0

    #teps of rescription ritin!

    Bp. #$!ito( +3 ta&$n( seoran! ,ar'a*an s*asta men!el$& sa,it ,epala di %a!ian %ela,an!(

    ten!,$, dan s$lit tid$r se>a, se%$lan 'an! lal$. =el$&an dirasa,an ter$tama %ila sedan!

    t$!as di ,antor. Te,anan dara& 1+51+ mm:! sama den!an te,anan dara& semin!!$ 'an!

    lal$. 9i*a'at &ipertensi se%el$mn'a disan!,al. 9i*a'at :ipertensi dalam ,el$ar!a0 positif.#elain it$ dia men!el$& mata mera& dan %erair. Do,ter mendia!nosis &ipertensi dan

    %a,terial con>$n!ti)itis dan meresep,an anti&ipertensi 7Di$reti, T&ia;id0

    &'droc&lorotia;id( ,lortalidon( indapamid( metola;on ATAU Di$reti, ,$at0 f$rosemid(

    %$metanid( torasemid ATAU %eta %lo,er0 propanolol ATAU anta!onis ,alsi$m0 nifedipin(

    amlodipin8 dan anti%a,teri 7c&loramp&enicol ata$ o-'tetrac'cline ata$ c'proflo-acine8.

    ertan'aan0

    1. Bila anda se%a!ai do,ter( o%at mana 'an! anda pili&5resep,an dari o%at4o%at dalam

    ,las terapi it$ Gelas,an >a*a%an anda 7farma,o,ineti, dan farma,odinami, sem$a

    o%at terse%$t8Q

    2. #e%$t,an macam %ent$, sediaan o%at terse%$t 'an! ada di pasaran 7!eneri, danmere, da!an!8 dan tent$,an %ent$, sediaan o%at 'an! coco,5tepat %a!i pasien

    terse%$tQ

    3. Tent$,an >ad*al dosis $nt$, o%at 'an! anda pili& 7dosis( fre,$ensi( cara

    pem%erian( *a,t$ pem%erian( dan lama pen!o%atan8Q

    ". T$lis sem$a >enis pres,ripsi 'an! mem$n!,in,an $nt$, pasien terse%$t

    7ma!istralis( offisinalis( spesialitis8 dan tent$,an >enis mana 'an! palin! tepat %a!i

    pasien it$Q

    +. Beri,an informasi %er,aitan den!an o%at 'an! anda %eri,an 7efe,( efe, sampin! (

    instr$,si( perin!atan8Q

    2+

  • 8/12/2019 2014 Petunjuk Prakt Blok 22 Tadulako

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    CODE0 ?"

    BLOC= 22

    :A9MACOLO? AND T:E9A DEA9T.

    ACULT O MEDICINE U?M

    Case resentation0

    #teps of rescription ritin!

    Bp.O!a& + ta&$n peri,sa ,e do,ter ,arena >ari4>ari ,a,i dan l$t$t ,a,$ dan n'eri se>a, +

    &ari 'an! lal$. Dia s$da& min$m parasetamol tetapi n'eri tida, %er,$ran!. emeri,saan

    fisi, tida, ditem$,an ,elainan. Do,ter mendia!nose s$spe, osteoart&ritis dan meresep,an

    N#AID oral 7indometasin ata$ melo-icam ata$ i%$profen ata$ asetosal ata$ ,etoprofenata$ fenil%$tasone8 dan N#AID topical 7napro-en ata$ di,lofena,8

    ertan'aan 0

    1. Bila anda se%a!ai do,ter( o%at mana 'an! anda pili&5resep,an dari o%at4o%at dalam

    ,las terapi it$ Gelas,an >a*a%an anda 7farma,o,ineti, dan farma,odinami, sem$a

    o%at terse%$t8Q

    2. #e%$t,an macam %ent$, sediaan o%at terse%$t 'an! ada di pasaran 7!eneri, dan

    mere, da!an!8 dan tent$,an %ent$, sediaan o%at 'an! coco,5tepat %a!i pasien

    terse%$tQ

    3. Tent$,an >ad*al dosis $nt$, o%at 'an! anda pili& 7dosis( fre,$ensi( carapem%erian( *a,t$ pem%erian( dan lama pen!o%atan8Q

    ". T$lis sem$a >enis pres,ripsi 'an! mem$n!,in,an $nt$, pasien terse%$t

    7ma!istralis( offisinalis( spesialitis8 dan tent$,an >enis mana 'an! palin! tepat %a!i

    pasien it$Q

    +. Beri,an informasi %er,aitan den!an o%at 'an! anda %eri,an 7efe,( efe, sampin! (

    instr$,si( perin!atan8Q

    26

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  • 8/12/2019 2014 Petunjuk Prakt Blok 22 Tadulako

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    CODE0 G1

    BLOC= 22

    :A9MACOLO? AND T:E9A DEA9T.

    ACULT O MEDICINE U?M

    Case resentation0

    #teps of rescription ritin!

    Bapa, Dan$ ++ ta&$n datan! ,e $s,esmas ,arena sesa, nafas sampai mem%an!$n,an

    tid$r malamn'a. Dia memp$n'ai ri*a'at &ipertensi nam$n tida, r$tin min$m o%at.

    emeri,saan fisi, didapat,an m$rm$r sistoli, di ape- cordis dan edema di ,ed$a t$n!,ai.

    #am%il men'aran,an pemeri,saan E=? dan 9ont!en( do,ter mendia!nose &eart fail$resta!e C dan meresep,an di$reti, dan o%at anti &ipertensi 7An!iotensin II 9eseptor Bloc,er

    7A9B8 ata$ Beta Bloc,er ata$ ACE in&i%itor ata$ ,om%inasi8

    Di$reti,

    :'droc&lorot&ia;ide( f$rosemide( spironolactone( amiloride

    An!iotensin II 9eseptor Bloc,er

    Losartan( )alsartan( ir%esartan( candesartan

    Beta %loc,er

    La%etolol( ( car)edilol( %eta-olol( %isoprolol( metoprolol s$ccinate( ace%$tolol(

    propanolol

    ACE In&i%itor

    captopril(%ena;epril(delapril( enalapril( fosinopril( lisinopril(perindopril( $inapril(

    ramipril( cila;april

    ertan'aan 0

    1. Bila anda se%a!ai do,ter( o%at mana 'an! anda pili&5resep,an dari o%at4o%at dalam

    ,las terapi it$ Gelas,an >a*a%an anda 7farma,o,ineti, dan farma,odinami, sem$a

    o%at terse%$t8Q

    2. #e%$t,an macam %ent$, sediaan o%at terse%$t 'an! ada di pasaran 7!eneri, danmere, da!an!8 dan tent$,an %ent$, sediaan o%at 'an! coco,5tepat %a!i pasien

    terse%$tQ

    3. Tent$,an >ad*al dosis $nt$, o%at 'an! anda pili& 7dosis( fre,$ensi( cara

    pem%erian( *a,t$ pem%erian( dan lama pen!o%atan8Q

    ". T$lis sem$a >enis pres,ripsi 'an! mem$n!,in,an $nt$, pasien terse%$t

    7ma!istralis( offisinalis( spesialitis8 dan tent$,an >enis mana 'an! palin! tepat %a!i

    pasien it$Q

    +. Beri,an informasi %er,aitan den!an o%at 'an! anda %eri,an 7efe,( efe, sampin! (

    instr$,si( perin!atan8Q

    2

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    Unt$, 6 ,elompo, 'an! ter%a!i dalam 3 sesi 2 ,elompo,=arena tiap !r$p mendapat 3 soal dan ada 3 sesi ma,a ada soal 'an! di%eri,an( Masin!4

    masin! soal di print 2 ,ali.

    %eri,$t pem%a!ian ,ode soal

    #esi 10 D2( B1( 3

    sesi 20 A1( E2( 1

    #esi 30 G1( I1( ?"