i. farmakoterapi rasional

8/10/2019 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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