Download - FARMAKOLOGI Endokrin
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 1/67
FARMAKOLOGIGANGGUANSISTEMENDOKRINBy : Ns. Maria Diah
Ciptaning Tyas, M!p,SpMB
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 2/67
"ang p!r#$ %ip!rhatian• In%iasi• K&ntrain%iasi
• K!r'a &(at• Fa)a&in!ti• E*! sa)ping• Int!rasi &(at
• R&t! %an %&sis• S!%iaan• +at$ !r'a &(at
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 3/67
!rti)(angan %&sish$s$s-. K#i!n p!%iatri
. K#i!n g!riatri
/. K#i!n &(st!tri
0. !nyait gin'a#
1. !nyait hati
2. Gaga# 'ant$ng &ng!sti*
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 4/67
!rti)(angan %&sish$s$s3. U$ran t$($h
4. !ngiri)an ! t!)pat !r'a &(at5r$t!6
7. Int!rasi &(at
-8. B!nt$ s!%iaan
--. Fat&r #ing$ngan-. Fat&r n$trisi
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 5/67
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 6/67
9ip&tir&i%#!&thyr&;in! < most common
Synth!ti= thyr&i% h&r)&n! T0 #i&thyr&nin!
Synth!ti= thyr&i% h&r)&n! T/
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 7/67
#!&thyr&;in!
In%iasi
• T!rapi p!ngganti pa%a *$ngsi tir&i% yang$rang>ti%a a%a
K&ntrain%iasi
•
9ip!rs!nsiti?tas• IMA
• Tir&t&si&sis
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 8/67
9ati@hati p!ngg$naan pa%a:
!ny ar%i&as$#!r
Ins$?si!nsi gin'a#
Lansia
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 9/67
K!r'a &(at• M!ningatan #a'$ )!ta(&#is)! 'aringan
t$($h• M!ningatan g#$&n!&g!n!sis,
)!ningatan p!ngg$naan %anp!nyi)panan g#i&g!n
• Sti)$#asi sint!sis pr&t!in• M!ningatan p!rt$)($han• M!)(ant$ p!r!)(angan &ta
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 10/67
E*! t!rap!$ti
!nggantian pa%a stat$s %!?si!nsi
!)$#ihan !s!i)(angan h&r)&na#
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 11/67
Far)a&in!ti
A(s&rpsi : 18@48 %ari sa#$ran GI
Distri($si : s!(agian (!sar ! %a#a) 'aringan t$($h
M!ta(&#is)! %an !sr!si : )!ta(&#is!)%i hati. Esr!si %a#a) *!s!s
+at$ par$h : 2 3 hari
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 12/67
E*! sa)ping• SS : irita(i#itas, ins&)nia,g$g$p, sait !pa#a
• K : taiar%ia, arit)ia, p!ningatan =$rah 'ant$ng, p!ningatan TD, angina p!t&ris
• GI : %iar!, ra), )$ntah• K$#it : (!r!ringat• En%&rin : )!nstr$asi ti%a t!rat$r• M!ta(&#is)! : p!n$r$nan BB• )$s$#&s!#!ta# : p!r=!patan )at$rasi t$#ang
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 13/67
R$t! %an %&sis O 5%!asa6 : -,1 18 )=g %&sis
t$ngga# aa#>hari IM 5%!asa6 : 18 -88 )=g>hari %&sis
t$ngga#
S!%iaan
Ta(#!t : 8,81 8,81 8,831 8,844 8,-8,-- 8,-1 8,-1 8,-31 8, 8,/ 5)=g6
In'!si : 18 )=g 88 )=g 188 )=g
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 14/67
I)p#iasi !p!raatan• Ka'i na%i %an TD s!=ara p!ri&%! s!#a)a
p!)!(rian t!rapi. Ka'i arit)ia %an ny!ri %a%a
• Ana@ana:panta$ tinggi (a%an, (!rat (a%an%an p!r!)(angan psi&)&t&r
• !)!risaan *$nsgi tir&i%
• anta$ g#$&sa %arah pa%a %ia(!t!s.
• Unt$ p!)(!rian I, !n=!ran s!tiap 188 )=g%a#a) 1 )# NaC# 8,7 apa(i#a p!)(!rian -88)=g>)#.
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 15/67
B!rian !%$asi :
)!#a$an p!ng&(atan t!rat$r
B!ritah$ %an a'ran t!ni )!)!risana%i
An'$ran #i!n $t )!)(!ritah$ %&t!rapa(i#a a%a !#$han
Ea#$asi !!*!ti*an t!rapi
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 16/67
Li&tir&nin5=yt&)!#, L@trii%&thyr&nin!,
Tri&stat6 In%iasi
s.%.a
K&ntrain%iasi
s.%.a
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 17/67
K!r'a &(at
S.%.a
E*! t!rap!$ti
s.%.a
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 18/67
Far)a&in!ti
A(s&rpsi : 71 %ia(s&rpsi s!t!#ahp!)(!rian &ra#
Distri($si : s!(agian (!sar ! %a#a) 'aringan t$($h
M!ta(&#is)! %an !sr!si : )!ta(&#is!)%i hati. Esr!si %a#a) *!s!s
+at$ par$h : - hari
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 19/67
E*! sa)ping• SS : irita(i#itas, ins&)nia,g$g$p, sait !pa#a
• K : taiar%ia, arit)ia, p!ningatan =$rah 'ant$ng, p!ningatan TD, angina p!t&ris
• GI : %iar!, ra), )$ntah• K$#it : (!r!ringat• En%&rin : )!nstr$asi ti%a t!rat$r
• M!ta(&#is)! : p!n$r$nan BB• )$s$#&s!#!ta# : p!r=!patan )at$rasi t$#ang
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 20/67
R$t! %an %&sis
O 5%!asa6 : 1 1>18 )=g %&sist$ngga# aa#>hari
I 5%!asa6 : 1 18 )=g &)a)is!%!)a
S!%iaan
Ta(#!t : 1 1 18 5)=g6
In'!si : -8 )=g>)#
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 21/67
I)p#iasi !p!raatan Ka'i na%i %an TD s!=ara p!ri&%! s!#a)a
p!)!(rian t!rapi. Ka'i arit)ia %an ny!ri
%a%a !)!risaan *$nsgi tir&i% anta$ g#$&sa %arah pa%a %ia(!t!s. B!rian s!(!#$) sarapan
$nt$)!n=!gah ins&)nia In'!si #i&tir&nin hanya $nt$
p!ngg$naan I
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 22/67
• B!rian !%$asi :
)!#a$an p!ng&(atan t!rat$r
B!ritah$ %an a'ran t!ni )!)!risa na%iAn'$ran #i!n $t )!)(!ritah$ %&t!rapa(i#a a%a !#$han
aspa%a p!)(!rian (!rsa)a #!&tir&sin
• Ea#$asi r!sp&n #inis t!rapi
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 23/67
9IERTIROID
)!thi)a&#! 5Tapa&#!6
pr&py#thi&$ra=i# 5TU, r&py#@Thyra=i#6
&(at anti tir&i% )!ngha)(at pr&%$si T9.
)!thi)a&#! %apat %i(!rian -;>haripr&py#thi&$ra=i# %i(!rian /;>hari ti%a(isa %i(!rian s!#a)a !ha)i#an.
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 24/67
9ip!rtir&i% In%iasi
@ 9ip!rtir&i%
@ !rsiapan tir&i%!t&)i p!ng!n%a#ianhip!rtir&i%
K&ntrain%iasi :@ 9ip!rs!nsiti?tas
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 25/67
Fa)a&in!ti
A(s&rpsi : %ia(s&rpsi %gn =!pat s!t!#ahp!)(!rian
Distri($si : )!n!)($s p#as!nta %an)!)as$i ASI %a#a) &ns!ntarsi tinggi
M!ta(&#is)! %an !sr!si : )!ta(&#is)!%i hati. E#i)inasi %i gin'a#
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 26/67
E*! sa)ping
SS : Sait !pa#a, )!ngant$, !rtig&
GI : Diar!,)$a#,)$ntah
K$#it : R$a) pa%a $#it,$rtiaria
D!)a)
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 27/67
R$t! %an %&sis
O 5%!asa6 : -1 28 )g>hari %&sis
t$ngga# ata$ %&sis
O 5ana@ana6 : 088 )=g>g>hari ata$ %&sis t!r(agi
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 28/67
9IERTIROID I)p#iasi !p!raatan M&nit&r !*! sa)ping: agran$#&sit&sis,
hip&tir&i%, pr$rit$s, p!ningatan s$h$,!%!)a p!ri&r(ita#, an&r!sia, hi#ang rasa,p!r$(ahan )!nstr$asi.
B!rian &(at pa%a at$ yang sa)as!tiap hari $nt$ )!)p!rtahanan!sta(i#an a%ar %arah
M&nit&r g!'a#a hip&tir&i% : !#!#ahan,p!na)(ahan (!rat (a%an, ti%a t&#!ranth% %ingin
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 29/67
9IERTIROID !n%i%ian !s!hatan pa%a #i!n %an
!#$arga
!rhatian p!r%arahan, !)!rahan,(!nga, )$a#, hi#angnya s!#!ra, ata$ny!ri !pigastri.
ia )!n%apatan t!rapi ar*arin,
#apr&an tan%a p!r%arahan Ea#$asi r!sp&n t!rapi
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 30/67
Dia(!t!s M!##it$s
T& typ!s Typ! -
Typ! 9yp!rg#y=!)ia
Fasting p#as)a g#$=&s! H3 ))&#>L
9yp&g#y=!)ia
B#&&% g#$=&s! #!!# .4 ))&#>L G!stati&na# %ia(!t!s DM tip! #ain
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 31/67
Signs J Sy)pt&)s &* DM
&#y%ipsia
&#y$ria
&#yphagia
+!ight #&ss
Fatig$!
B#$rr!% isi&n
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 32/67
Typ! - Dia(!t!s M!##it$sIDDM
=hara=t!ri!% (y #&ss &* th! ins$#in@
pr&%$=ing (!ta =!##s &* th! is#!ts &*Lang!rhans &* th! pan=r!as #!a%ing t& a%!?=i!n=y &* ins$#in.
A!=t!% =#i!nts n!!% !;&g!n&$s ins$#in C&)p#i=ati&ns
R!tin&pathy, n!phr&pathy, n!$r&pathy Dia(!ti= !t&a=i%&sis 5DKA6 Ora# antihyp!rg#y=!)i= ag!nts n&t !!=ti!
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 33/67
Typ! Dia(!t!s M!##it$s
• M&st =&))&n typ!• Ca$s!% (y ins$#in %!?=i!n=y an% ins$#in
r!sistan=!, ($t th!r! is n&t an a(s&#$t!&* ins$#in pr&%$=ti&n
• Many tiss$!s ar! r!sistant t& ins$#in – R!%$=!% n$)(!r ins$#in r!=!pt&rs
– Ins$#in r!=!pt&rs #!ss r!sp&nsi!↑Obesity among children and adolescent is
increasing the incidence
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 34/67
Typ! Dia(!t!s M!##it$s5=&nt%6• S!!ra# =&)&r(i% =&n%iti&ns
– G#$=&s! int&#!ran=!
– O(!sity – Dys#ipi%!)ia – 9yp!rt!nsi&n – Ins$#in r!sistan=! – 9yp!rins$#in!)ia – Mi=r&a#($)in!)ia 5pr&t!in in th! $rin!6 – Enhan=!% =&n%iti&ns *&r !)(&#i= !!nts
5(#&&% =#&ts6 – 9!art %is!as!
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 35/67
Typ!s &* Anti%ia(!ti= Ag!nts
Ins$#ins
Ora# antihyp!rg#y=!)i= ag!nts
B&th ai) t& pr&%$=! n&r)a# (#&&%g#$=&s! stat!s
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 36/67
9$)an@Bas!% Ins$#ins
• Rapi% a=ting,5aspart, lispro)• Sh&rt a=ting (regular, humulinR, Toronto)
• Int!r)!%iat! a=ting (Humulin N, NPH)• L&ng a=ting (glargine, detemir)• C&)(inati&n Ins$#in pr&%$=ts (humulog,
humulin 30!0 "0#0)
– Regular insulin• The only insulin product that can be gi$en
by %& bolus, %& in'usion, or e$en %
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 37/67
In%iasi !ng&(atan DM tip! -
!nata#asanaan DM tip! yang ti%a
(!r!sp&n %!ngan p!ng&(atan %!ngan%i!t ata$ OAD
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 38/67
K!r'a O(at M!n$r$nan g#$&sa %arah %gn
)!ningatan transp&r ! %a#a) s!#
M!ningatan &n!rsi g#$&sa)!n'a%i g#i&g!n
M!ngha)(at p!#!pasan asa) #!)a(!(as
M!ng!n%a#ian a%ar g#$&sa %arah
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 39/67
Far)a&in!ti A(s&rpsi : %ia(s&rpsi %!ngan =!pat
s!t!#ah p!)(!rian SC. K!=!patan
a(s&rpsi %ip!ngar$hi '!nis ins$#in,t!)pat in'!si, %&sis.
Distri($si : %istri($si s!=ara #$as M!ta(&#is)! %an !sr!si :
%i)!ta(&#is)! %i hati, gin'a# %an &t&t +at$ par$h : 7 )!nit 5)!)an'ang
pa%a p!n%!rita6
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 40/67
E*! sa)ping K$#it : $rtiatis
En%&rin : hip&g#i!)i
L&a#: #ip&%istr&phy
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 41/67
R$t! %an %&sis• D&sis t!rgant$ng %ari g$#a %arah.
• K!t&asi%&sis hanya ins$#in r!g$#!r
I 5%!asa6 :8,- $nit>g>'a)
• T!rapi r$)atan :SC 5D!asa %an ana@ana6 : 8,1 -$nit>g>$nit
• S!%iaan
In'!si ins$#in : -88 $nit>)#, 088$nit>)#, 188 $nit>)#
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 42/67
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 43/67
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 44/67
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 45/67
I)p#iasi !p!raatan• Ka'i tan%a@tan%a hip&g#i!)i %an
hip!rg#i!)i
• anta$ BB• anta$ hasi# #a( :g#$&sa %arah, a#i$) %an
)agn!si$)• G$naan hanya %!ngan sp$it ins$#in• K!tia )!n=a)p$r ins$#in, hisap t!r#!(ih
%ah$#$ ins$#in r!g$#!r ! %a#a) sp$it.• Ins$#in har$s %isi)pan %i t!)pat yang
%ingin %an !ring
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 46/67
angan %ig$naan (i#a s%$ah !r$h,(!r$(ah arna ata$ !nta#
Bi#a %i(!rian s!(agai in*$s, !=!patan%iinstr$sian &#!h %&t!r
A'aran %an an'$ran #i!n %an !#$argat!ni p!)(!rian trapi ins$#in yang (!nar
!#asan (ahaa &(at ini hanya)!ng!n%a#ian hip!rg#i!)i
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 47/67
!#asan tan%a hip&g#i!)i %anhip!rg#i!)i
Instr$si !pa%a #i!n ata$ !#$arga $nt$#ap&r ! %&t!r apa(i#a a%a !#$han
an'$ran )!)(aa s$)(!r g$#a 5p!r)!n,g$#a6
Ea#$asi !!*!ti*an t!rapi
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 48/67
Ora# Anti%ia(!ti= Ag!nts
Us!% *&r typ! %ia(!t!s
Tr!at)!nt *&r typ! %ia(!t!s in=#$%!s
#i*!sty#! )&%i?=ati&ns Di!t, !;!r=is!, s)&ing =!ssati&n, !ight
#&ss
Ora# antihyp!rg#=!)i= ag!nts )ay n&t
(! !!=ti! $n#!ss th! =#i!nt a#s& )a!s(!hai&$ra# &r #i*!sty#! =hang!s
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 49/67
Ora# Anti%ia(!ti= Ag!nts5=&nt%6 Ins$#in s!=r!tag&g$!s: =#ass!s &* %r$gs
a(#! t& sti)$#at! ins$#in s!=r!ti&n:
S$#*&ny#$r!as =h#&rpr&pa)i%!, t&#($ta)i%!
g#i)!piri%!, g#i=#ai%!, glyburide
N&ns$#*&n$r!as 5G#ini%6
r!pag#ini%!, nat!g#ini%!
Big$ani%!s 5p!na)(ah s!nsiti?tas th% ins$#in6 Big$ani% 5)!t*&r)in6
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 50/67
Ora# Anti%ia(!ti= Ag!nts5=&nt%6 A#pha@g#$=&si%as! inhi(it&rs
a=ar(&s!
Thia&#i%in!%i&n!s 5A=t&s6 pi&g#ita&n!, r&sig#ita&n!
A#s& n&n as g#ita&n!s
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 51/67
Ag!nts:M!=hanis) &* A=ti&n
• S$#*&ny#$r!as 5G#y($ri%!6
– Sti)$#at! ins$#in s!=r!ti&n *r&) th! (!ta =!##s
&* th! pan=r!as, th$s in=r!asing ins$#in #!!#s – Kh#&rpr&pa)i% : %i!sr!si %i gin'a#. La)a
!r'a H 0 'a), %i(!rian %&sis t$ngga#
– G#i(!n#a)i% : !*! hip&g#i!)i (!rat, har$s%ip!rhatian 'a%a# )aan
– G#iasi% : !*! hip&g#i!)i s!%ang. Dapat%i(!rian pa%a gangg$an *$ngsi gin'a# %anhati yang ringan
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 52/67
G#i$i%&n : !*! hip&g#i!)i s!%ang.Esr!si )!#a#$i !)p!%$ %an $s$s.
G#ipisi% : !*! hip&g#i!)i #!(ih #a)a %arig#i(!n#a)i% tapi #!(ih p!n%! %arih#&rpr&pa)i%!.)!n!an pr&%$sig#$&sa hati
G#i)!piri%: aa# !r'a #!(ih =!pat %an
#a)a !r'a pan'ang. E*!*ar)a&%ina)i)!ns!r!si ins$#in (i#at!r%apat as$pan )aanan
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 53/67
G#ini% R!pag#ini% : !*! hip&g#i!)i ringan
sa)pai s!%ang. Di!sr!si )!#a#$i hati.E*! sa)ping a%anya !#$hangastr&int!stina#
Nat!g#ini%: %i!sr!si )!#a#$i $rin. E*!sa)ping in*!si sa#$ran p!rna*asan atas
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 54/67
!na)(ah s!nsiti?tas ins$#in
Big$ani% M!ng$rangi hepatic glucose ouput
ti%a )!ny!(a(an hip&g#i!)i C&nt&h : )!t*&r)in E*! sa)ping : )$a#, )$ntah, a%ang@
a%ang %iar! K&ntrain%iasi : gangg$an *$ngsi gin'a#,
%!hi%rasi, gg *$ngsi hati, gaga# 'ant$ng Di(!rian (!rsa)aan )aan
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 55/67
Thia&#in%i&n>g#ita&n B!riatan pa%a peroisome proli'erattor
gamma s$at$ r!s!pt&r inti %i s!# &t&t %an s!##!)a.
M!)p!r(aii s!nsiti?tas t!rha%ap ins$#in %an)!)p!r(aii transp&r g#$&sa
C&nt&h : pi&g#ita&n 5A=t&6 %an r&sig#ita&n5aan%ia6
M!ny!(a(an p!na)(ahan (!rat (a%an %an!%!)a t$ngai,(i#a %&sis (!sar %an %ig$naan(!rsa)aan %gn ins$#in
K&ntrain%iasi gaga# 'ant$ng *= III@I
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 56/67
!ngha)(at a#*a g#$&si%as!5a=ar(&s!6 Eni) a#*a g#$&si%as! 5)a#tas!,
is&)a#tas!, g#$&)a#tas!, %an s$ras!6
t!r#!ta %i %in%ing $s$s ha#$s. Cara !r'a : )!ng$rangi %ig!sti
ar(&hi%rat &)p#! %an a(s&r(sinya.
D&sis : -18@/88 )g>hari
E*! sa)ping : p!r$t $rang !na,s!ring at$s, a%ang@a%ang %iar!
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 57/67
Antihyp!rg#y=!)i= Ag!nts:N$rsing I)p#i=ati&ns S!(!#$) )!)(!rian &(at yang
)!ng$(ah a%ar g#$&sa, a'i %an
%&$)!ntasi : Riayat !s!hatan
Tan%a@tan%a ita#
Ka%ar g$#a %arah
&t!nsi &)p#iasi %an int!rasi &(at
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 58/67
N$rsing I)p#i=ati&ns
• S!(!#$) )!)(!rian &(at yang)!ng$(ah a%ar g#$&sa :
-. Ka'i !)a)p$an #i!n $nt$ )!ng&ns$)si)aanan
. Ka'i )$a# ata$ )$ntah/. 9ip&g#i!)ia %apat )!n'a%i )asa#ah 'ia
ag!n antihyp!rg#y=!)i= %i(!rian %an #i!nti%a )aan
0. ia #i!n a%a#ah NO $nt$ t!s ata$pr&s!%$r, (!r&ns$#tasi#ah %!ngan %&t!r$nt$ )!)p!r'!#as p!rintah $nt$ t!rapi&(at antihyp!rg#y=!)i=
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 59/67
N$rsing I)p#i=ati&ns 5=&nt%6
• !n%i%ian #i!n )!ny!#$r$h sangatp!nting )!ng!nai:
pr&s!s p!nyait Di!t %an &#ahraga r!&)!n%asi
S!#*@p!)(!rian ins$#in ata$ &(at &ra#
p&t!nsi &)p#iasi
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 60/67
N$rsing I)p#i=ati&ns 5=&nt%6 Ag!n antihyp!rg#y=!)i= Ora#
S!#a#$ p!risa a%ar g#$&sa %arah
s!(!#$) )!)(!rian Biasanya %i(!rian /8 )!nit s!(!#$)
)aan Inhi(it&r a#pha@g#$=&si%as! %i(!rian
%!ngan gigitan p!rta)a %ari s!tiap
)aanan $ta)a )!t*&r)in %i)in$) (!ra)a %!ngan
)aan $nt$ )!ng$rangi !*! GI
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 61/67
Symptoms of hypoglycemia
include:
!#aparan
g$g$p %an !g&yahan !ringat p$sing ata$ p$sing ant$
!(ing$ngan !s$#itan (!r(i=ara )!rasa =!)as ata$ #!)ah
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 62/67
N$rsing I)p#i=ati&ns 5=&nt%6 Ka'i tan%a@tan%a hip&g#i!)ia ia t!r'a%i hip&g#i!)ia :
B!rian g#$ag&n Apaah #i!n )aan ta(#!t g#$&sa ata$
g!#, sir$p 'ag$ng, )a%$, '$s ($ah ata$)in$)an ringan n&n%i!t
Ata$ apaah #i!n )aan )aanan !=i#
s!p!rti !r$p$ ata$ s!t!ngah san%i=h M!)anta$ a%ar g#$&sa %arah
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 63/67
N$rsing I)p#i=ati&ns 5=&nt%6 anta$ r!sp&ns t!rap!$ti
!n$r$nan a%ar g#$&sa %arah pa%a
a%ar yang %it!nt$an &#!h %&t!r M!ng$$r h!)&g#&(in A-= $nt$
)!)anta$ !pat$han 'anga pan'ang$nt$ %i!t %an t!rapi &(at
!rhatian hip&g#i!)ia %an hip!rg#i!)ia
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 64/67
S$)(!r D!g#in, 9 J a##!ran%, A9.58806.
!%&)an O(at $nt$ !raat. aarta.
EGC S&!g&n%&, S&!&n%& J S$(!ti. 58876.
!nata#asanaan Dia(!t!s M!#it$s T!rpa%$. E% . aarta. Ba#ai !n!r(it FK
UI
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 65/67
DIABETES MELITUS
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 66/67
L&asi p!ny$ntian ins$#in s$( $tan
American Pharmacists Association,Handbook of Nonprescription Drugs5ins$#in in'!=ti&n sit!6.
7/17/2019 FARMAKOLOGI Endokrin
http://slidepdf.com/reader/full/farmakologi-endokrin-568c19b42476a 67/67