6. Obat Dispepsia - dr. Qathrunnada.pptx
Transcript of 6. Obat Dispepsia - dr. Qathrunnada.pptx
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FARMAKOLOGIK
OBAT-OBAT DISPEPSIA
Dispepsia = gangguan pencernaan
I. Obat-bat !"ser #an GastritisII. Anti Spas$#i%III. Anti DiareI&. Anti Munta'&. P e n c a ' a r
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. Obat-bat !"ser #an Gastritis
Pat(isi"gi #asar #ari !"%us pepti%u$
#an Gastritis a#a"a' gangguan %esei$bangan (a%tr agresi( #an (a%tr #e(ensi( ) %eta'anan $u%sa pa#a
"a$bung #an #u#enu$
Fa%tr Agresi( * Asa$ "a$bung #anPepsin
Fa%tr De(ensi( * - $u%us + bi%arbnas - resistensi $u%sa - a"iran #ara' $u%sa
- p r s t a g " a n # i n
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Obat-bat ,ang #ipa%ai #a"a$
Pengbatan !"%us Pepti%u$
. A n t a s i # a. Obat ,ang $eng'a$bat se%resi asa$/. Anti K"inergi%
0. P r s t a g " a n # i n1. S u % r a " ( a t
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. A n t a s i # a
Preparat * - A"2O34/ - Mg2O34 - 5a36O/
- 6a6O/ Me%anis$e * - Basa "e$a' $enetra"%an asa$ "a$bung
- Sti$u"asi $e%anis$e perbai%an$u%sa se%itar u"%us $e"a"ui
perangsangan pe"epasan prstag"an#in "%a"
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Far$a%%ineti% * Sebagian besar Antasi# ti#a% #iabsrbsi
Intera%si * Mengurangi absrbi bat "ain #ari usus $is * - Dig%sin - Fentia7in
- Tetrasi%"in 8e#a $ini$u$ 9a$
E(e% Sa$ping *
A" Knstipasi Mg Diare 5a36O/ A"%a"sis $etab"i%:
$e$percepat pe$bentu%an batu gin9a" (s(at
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5a36O/
Se%arang su#a' ti#a% #ian9ur%an
5etra"isasi ter"a"u cepat
6O ban,a% %e$bung
Absrbsi 5a; se$purna
A"%a"sis siste$i%
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6a6O/ 6O ,g terbentu% "ebi' se#i%it.
Pe$a%aian 9ang%a pan9ang
$en,ebab%an 'iper%a"se$ia#an ne(r%a"sinsis. Dapat $en,ebab%an acidrebound %arena $ening%at%an
gastrin #an sti$u"asi se"parieta" "e' 6a;
Se#i%it $en,ebab%an bstipasi.
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Mg2O34/ 6u%up bai% sebagai antasi#a.
Ti#a% #ian9ur%an untu% terapi 9ang%a pan9ang pa#a pasien#engan gangguan (ungsi gin9a"
#apat 'iper$agnesia. Pun,a e(e% "a%san 2"a
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A"2O34/ Menetra"%an + $enga#srpsi 36". Me$bentu% A"2PO04/ ,ang ti#a% "arut
#a"a$ usus 'a"us.
Menguntung%an untu% pasien
insu(isiensi gin9a" %arena ti#a%
'iper(s(ate$i.
Pa#a pasien #engan gin9a" se'at
9ustru $en9a#i %e%urangan PO0 Intera%si bat * $enurun%an absrbsi
gara$ besi: tetrasi%"in + asa$ e$pe#u%arena a#srpsi)pe$bentu%an %$p"e%.
Sebab%an %nstipasi.
Ob t b t ' b t
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. Obat-bat ,ang $eng'a$bat se%resi asa$
a. Antagnis reseptr 3 * - Si$eti#in - Raniti#in - 5i7ati#in
- Fa$ti#in
Me%anis$e * Mengurangi se%resi asa$ #ari se" parieta" $e"a"ui %$petisi #engan 'ista$in pa#a reseptr 3: %'ususn,a pa#a $a"a$ 'ari #an %ea#aan puasa.
Mengurangi se%resi asa$ a%ibatran san an $a%anan
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Far$a%%ineti% * Absrbsi bai% p
E%s%resi "e>at gin9a" #a"a$ bentu% utu' Pe$berian pa#a $a"a$ 'ari
E(e% Sa$ping * 8arang Si$eti#in bersi(at anti an#rgeni% "e$a' pa#a pria - i$ptensi
- gine%$astia Meng'a$bat en7i$ sit%r$ P-01?
$e$perpan9ang %er9a anti%agu"an:"i#%ain: (enitin: te(i"in
29arang4
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b. Meng'a$bat p$pa prtn
- O$epra7" - Lanspra7" - Pantpra7"
Me%anis$e * Meng'a$bat p$pa prtn se" parieta" secara irreersib"e
P$pa prtn 23;)K; -ATPase4 a#a"a' en7i$ ,ang secara a%ti( $ense%resi in 3; %e"u$en "a$bung
F % %i ti%
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Far$a%%ineti% * Absrbsi p sangat #ipengaru'i $a%anan #i$inu$ #a"a$ perut %sng atau
9a$ sebe"u$ $a%an T) pen#e%: tapi #urasi pan9ang: "e'%arena i%atan antara bat #engan
reseptr bersi(at irreersib"e #an tubu'per"u >a%tu @ 9a$ untu% $ensintesisen7i$ ,ang baru.
Be#a #engan 3 antagnis: bat ini #apat$eng'a$bat se%resi asa$ "a$bung saatpuasa atau sesu#a' $a%an
Obat ini sangat a$an
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O$epra7"
Mengin'ibisi 3;
)K;
-ATPase: #engancara #enaturasi en7i$ tersebut Me$b"% p$pa 3;)K;: se'inggater9a#i anasi#itas.
Ter9a#i 'a$batan se%resi asa$"a$bung sa$pai #isintesis en7i$ baru
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/. Antagnis K"inergi%
A%si se"e%ti( pa#a reseptr $us%arini%
#i se" parieta" se%resi asa$ .
2#a,a in'ibisi se%resi asa$ "ebi' %eci" #ari
3 antagnis4. Parasi$pat"iti% "ain seperti atrpin
2antagnis nn se"e%ti(4 ti#a%% e(e%ti(
pa#a #sis ,ang #iperb"e'%an. E(e% Sa$ping *
9arang * - $u"ut %ering
- $ata %abur
- gangguan buang air seni.
Piren7epin
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- Be%er9a $e$perbai%i (a%tr prte%ti( #engancara * sti$u"asi pe$bentu%an $u%us:
$e$perta'an%an)$ening%at%an a"iran#ara' $u%sa "a$bung: $e$perta'an%anbarier $u%sa ter'a#ap #i(usi %e$ba"i 3 $e$percepat pen,e$bu'an u"%us.
- Meng'a$bat (a%tr agresi(
$engurangi se%resi asa$.- 6nt' * Misprst" e(e%ti( #a"a$ pencega'an
u"%us ,ang #isebab%an
OAI5S)5SAID
E(e% Sa$ping * - Kra$ perut - #iare - %ntra%si uterus abrtus
0. Prstag"an#in
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Merupa%an basa A"-sa%arsa-su"(at Me$percepat pen,e$bu'an u"%us #engan
$e$bentu% %$p"e% #engan prtein #iper$u%aan u"%us $e$bentu% "apisanpe"in#ung #ari (a%tr agresi(.
Ti#a% $e$pengaru'i se%resi asa$ Merangsang pe"epasan prstag"an#in "%a" Be%er9a "%a" Mengurangi absrbsi bat * Fenitin: Tetrasi%"in
E(e% Sa$ping * bstipasi Kntra In#i%asi * gangguan (ungsi gin9a" ,ang
berat ba'a,a siste$i%
%arena A" ,ang
#iabsrbsi.
1. Su%ra"(at 2Su%rsa A" %ta su"(at4
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Bis$ut %e"at
A%sin,a sa$a #engansu%ra"(at.Diberi%an sebe"u$ $a%an
2"a$bung %sng4.
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Be%er9a $e$perbai%i (a%tr prte%ti(
#engan cara * sti$u"asi pe$bentu%an$u%us: $e$perpan9angu$ur se" $u%sa "a$bung $e$percepat
pen,e$bu'an u"%us.
Karben%s"n
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E(e% Sa$ping *
Seperti $inera"%rti%i# retensi air+ 5a; 'ipertensi: 'ip%a"e$i:$e$perburu% insu(isiensi $i%ar#.
Kntra In#i%asi *
- insu(isiensi 'ati - insu(esiensi 9antung
- insu(usuensi gin9a"
- 'ipertensi. Intera%si #engan #iureti%a pena'an K; $eng'enti%an a%si %arben%s"n.
Bi th d
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Bismuth compounds
efects :1. anti-microbial activity against
Helicobacter pylori 2. stimulation o prostaglandin synthesis
increasing mucosal protection3. chelation with exposed ulcer proteins
and protecting the ulcer base. . onotherapy not very efective in
eradicating H. pylori . . !ombined with other agents "anti-
microbials# $$%&s or '2 antagonists()*+ eradicated.
. ,lso used to treat nausea# diarrhea# andindigestion.
.
arening the tongue and stool .
' l i t t t
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'. pylori treatment
Helicobacter pylori etiologic agent o peptic ulcers and gastritis ma/or ris actor or gastric adenocarcinoma and
mucosa-associated lymphoid tissue lymphoma",0(.
1 days regimens triple therapy regimens: 1( a proton pump inhibitor "$$%( 2( two anti-microbial "clarithromycin and
amoxycillin )
1 days regimens uadruple therapy:1) proton pump inhibitor (PPI)
2) bismuth subcitrate
3) tetracycline
4) metronidazol
http://www.cvzkompassen.nl/fk/Preparaatteksten/C/claritromycine.asphttp://www.cvzkompassen.nl/fk/Preparaatteksten/A/amoxicilline.asphttp://www.cvzkompassen.nl/fk/Inleidendeteksten/I/inl%20protonpompremmers.asphttp://www.cvzkompassen.nl/fk/Preparaatteksten/B/bismutsubnitraat_antacida_rhamnus%20frangula.asphttp://www.cvzkompassen.nl/fk/Preparaatteksten/T/tetracycline%20(systemisch).asphttp://www.cvzkompassen.nl/fk/Preparaatteksten/M/metronidazol%20(overige%20antimicrobiele%20middelen).asphttp://www.cvzkompassen.nl/fk/Preparaatteksten/M/metronidazol%20(overige%20antimicrobiele%20middelen).asphttp://www.cvzkompassen.nl/fk/Preparaatteksten/T/tetracycline%20(systemisch).asphttp://www.cvzkompassen.nl/fk/Preparaatteksten/B/bismutsubnitraat_antacida_rhamnus%20frangula.asphttp://www.cvzkompassen.nl/fk/Preparaatteksten/B/bismutsubnitraat_antacida_rhamnus%20frangula.asphttp://www.cvzkompassen.nl/fk/Inleidendeteksten/I/inl%20protonpompremmers.asphttp://www.cvzkompassen.nl/fk/Preparaatteksten/A/amoxicilline.asphttp://www.cvzkompassen.nl/fk/Preparaatteksten/C/claritromycine.asp
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II. A5TISPASMODIK
Antispas$#i% #apat $ere"a%sasi
tt p"s pa#a sa"uran cerna: antara "ain- G" Anti%"inergi%- G" Antagnis reseptr Dpa$in * $isa" * - A"%a"i# be""a#na
- Atrpin su"(at - Prpanta"in br$i#a - 3isin buti" br$i#In#i%asi *
- Gangguan sa"uran cerna ,ang #itan#ai spas$e tt p"s Sering #iguna%an untu% n,eri TGI:
%arena %ntra%si ,ang ber"ebi'an
- Dis$enre