RENCANA PROGRAM DAN KEGIATAN PEMBELAJARAN
SEMESTER
MATA KULIAH
SPESIALIT DAN ALKES
Oleh
Hansen Nasif, S.Si., Apt., Sp.FRS
Najmiatul Fitria, M.Farm, Apt.
FAKULTAS FARMASI
UNIVERSITAS ANDALAS
2014
A. PERENCANAAN PEMBELAJARAN
1. Nama Mata Kuliah
: Spesialit dan Alkes
2. Kode Mata kuliah
: FAR 363
3. SKS
:2
4. Sifat
: Wajib
5. Prasyarat
: Farmakologi
6. Semester
:V
7. Perkiraan banyaknya peserta
: 120 mhs
8. Deskripsi singkat mata kuliah Spesialit dan Alkes :
Mata Kuliah ini merupakan mata kuliah yang diberikan setelah mahasiswa mendalami
farmakologi dengan baik. Pada Spesialit dan Alkes diberikan materi pokok pengenalan dan
penggunaan rasional obat-obatan bebas, bebas terbatas, dan obat wajib apotik serta
pengenalan dan penggunaan alat kesehatan baik yang habis pakai maupun yang tidak habis
pakai.
9. Tujuan Pembelajaran:
Tujuan pembelajaran Spesialit dan Alkes adalah mahasiswa memahami dan menguasai
Setelah menyelesaikan kuliah ini, diharapkan mahasiswa penggunaan
rasional obat obat bebas, bebas terbatas dan obat wajib apotik serta penggunaan alat
kesehatan agar nantinya mampu melakukan tugas sebagai seorang farmasis.
10. Tujuan Pembelajaran khusus
Setelah mengikuti perkuliahan ini, mahasiswa diharapkan dapat :
1. Mengetahui dan memahami penggunaan rasional obat – obat yang tidak diresepkan.
2. Memahami macam-macam jenis dan penggunaan alat kesehatan
B. PELAKSANAAN PEMBELAJARAN
Minggu ke
(1)
Topik
(Pokok Bahasan)
(2)
Pendahuluan dan
ruang
lingkup
Spesialit
dan
alkes
1
Substansi Materi





Penggunaan
antasida
pada
tukak peptik
2
3
Penggunaan DMP,








(3)
Batasan Spesialit dan Alkes
Ruang lingkup
Spesialit dan
alkes
Perkembangan spesialit dan
alkes
Konsep obat rasional pada obat
bebas, bebas terbatas dan
wajib apotik.
Manfaat ilmu
Spesialit dan
alkes
Antasida dan sediaanya
Keadaan tukak peptik
Keluhan yang biasanya terjadi
Penggolongan antasida
Pilihan penggunaan antasida
Keadaan
yang
membatasi
penggunaan antasida
Keamanan penggunaan antasida
Obat batuk dan sediaanya
Metode
Pembelajaran
(4)

Ceramah,
Tanya jawab
Fasilitas
(5)
Laptop,
LCD
viewer

Persentasi,
diskusi
Laptop,
LCD
viewer

Persentasi,
Laptop,
Ket
(6)
GG
dan
Bromhexine
sebagai
antitusive
dan
ekspektoran
pada batuk






Penggunaan oralit
dan
atapulgit
pada diare
4







Penggunaan
Bisakodil,
dan
laktulosa
pada
konstipasi
5








Penggunaan
theophilin pada
asma
6








Penggunaan
Chlorpheniramin
dan
Brompheniramina
ntihistamin pada
alergi






7


8
Penggunaan
Etinilestradiol


Keadaan batuk dan jenisnya
Keluhan yang biasanya terjadi
Penggolongan obat batuk
Profil DMP, GG, Bromhexine
Pilihan penggunaan
antitusive
dan ekspektoran
Keamanan
penggunaan
antitusive dan ekspektoran
Oralit, atapulgit dan sediaanya
Keadaan diare
Keluhan yang biasanya terjadi
Profil Oralit dan Attapulgit
Pilihan penggunaan oralit dan
atapulgit
Keadaan
yang
membatasi
penggunaan oralit dan atapulgit
Keamanan penggunaan
oralit
dan atapulgit
Obat konstipasi dan sediaanya
Keadaan konstipasi
Keluhan yang biasanya terjadi
Penggolongan obat konstipasi
Profil Bisakodil dan Laktulosa.
Pilihan
penggunaan
obat
konstipasi
Keadaan
yang
membatasi
penggunaan obat konstipasi
Keamanan penggunaan
obat
konstipasi
Theophilin dan sediaanya
Keadaan Asma
Keluhan yang biasanya terjadi
Penggolongan obat asma
Profil Theophilin
Pilihan penggunaan theophilin
Keadaan
yang
membatasi
penggunaan theophilin
Keamanan
penggunaan
theophilin
Antihistamin dan sediaanya
Keadaan alergi
Keluhan yang biasanya terjadi
Penggolongan antihistamin
Profil
Chlorpheniramin dan
Brompheniramin
Pilihan
penggunaan
Chlorpheniramin
dan
Brompheniramin
Keadaan
yang
membatasi
penggunaan
Chlorpheniramin
dan Brompheniramin
Keamanan
penggunaan
Chlorpheniramin
dan
Brompheniramin
Kontrasepsi oral dan sediaanya
Penggolongan kontrasepsi oral
diskusi
LCD
viewer

Persentasi,
diskusi
Laptop,
LCD
viewer

Persentasi,
diskusi
Laptop,
LCD
viewer

Persentasi,
diskusi
Laptop,
LCD
viewer

Persentasi,
diskusi
Laptop,
LCD
viewer

Persentasi,
diskusi
Laptop,
LCD
dan
progestin
sebagai
kontrasepsi oral




Penggunaan
Preparat
sebagai
antianemia
besi
9







Penggunaan alat
kesehatan habis
pakai.




10



Penggunaan alat
kesehatan tidak
habis pakai



11

Peralatan
infus
dan
penggunaanya.
12





13
Peralatan
operasi,
ortopaedi
dan
penggunaanya



Profil
Etinilestradiol dan
progestin
Pilihan
penggunaan
Etinilestradiol dan progestin
Keadaan
yang
membatasi
penggunaan Etinilestradiol dan
progestin
Keamanan
penggunaan
Etinilestradiol dan progestin
Antianemia dan sediaanya
Keadaan anemia
Keluhan yang biasanya terjadi
Penggolongan antianemia
Profil Fe
Pilihan penggunaan Fe sebagai
antianemia
Keadaan
yang
membatasi
penggunaan
Fe
sebagai
antianemia
Keamanan penggunaan Fe
Pembagian alat kesehatan
Penggunaaan alat kesehatan
habis pakai
Peran alat kesehatan habis
pakai dalam diagnosa
Macam” Spiut dan iv kateter,
mask dan nebulizer
Pilihan
penggunaan
dan
permasalahannya
Keamanan penggunaan spuit dan
iv keteter
Macam-macam alat kesehatan
tidak habis pakai
Peran alat kesehatan habis
pakai dalam diagnosa
Macam” alat kesehatan habis
pakai dari linen maupun bahan
lainnya
Pilihan
penggunaan
dan
permasalahannya
Keamanan penggunaanya
Macam –macam peralatan infus,
infus set dan pompa infus.
Peran peralatan infus dalam
suatu terapi
Pilihan
penggunaan
dan
permasaalahannya.
Keamanan penggunaan peralatan
infus
Macam-macam peralatan pisau
operasi, alat ortopaedi untuk
operasi dan sesudah operasi
Pilihan
penggunaan
macammacam peralatan operasi.
Keamanan penggunaan peralatan
operasi
viewer

Persentasi,
diskusi
Laptop,
LCD
viewer

Persentasi,
diskusi
Laptop,
LCD
viewer

Persentasi,
diskusi
Laptop,
LCD
viewer

Persentasi,
diskusi
Laptop,
LCD
viewer

Persentasi,
diskusi
Laptop,
LCD
viewer
14
Peralatan
radiodiagnostik
dan
penggunaannya



15
Peralatan
kesehatan lainnya



Macam-macam
peralatan
Rontgen, USG, Endoskopi untuk
radiodiagnostik
Pilihan
penggunaan
macammacam
peralatan
peralatan
radiodiagnostik
Keamanan penggunaan peralatan
radiodiagnostik

Persentasi,
diskusi
Laptop,
LCD
viewer
Macam” benang bedah dan
kegunaannya
Alat kesehatan lainnya
penyimpanan alat kesehatan di
gudang farmasi

Persentasi,
diskusi
Laptop,
LCD
viewer
2. Metode pembelajaran dan bentuk kegiatan
Perkuliahan diberikan dalam bentuk penjelasan oleh dosen di depan kelas dengan
berbagai alat bantu seperti LCD viewer, Laptop, dan white board. Selain itu juga diterapkan
casebased learning di mana dipresentasikan berbagai contoh kasus untuk dibahas di dalam
kelas.
C. PERENCANAAN EVALUASI PEMBELAJARAN
1. Hasil pembelajaran
Kriteria penilaian mengacu pada beberapa kriteria berikut ini :
- mahasiswa dapat memahami prinsip-prinsip dalam materi perkuliahan Spesialit dan Alkes,
Serta menjelaskan kembali materi perkuliahan tersebut,
- Kemampuan mahasiswa menganalisis dan mempresentasikan kasusnya di depan kelas
Penilaian tersebut akan dilakukan melalui ujian tertulis dan aktivitas diskusi. Ujian tertulis
dilakukan pada akhir semester. Adapun prosentase unsur penilaian dan kriterianya adalah
sbb:
Unsur - unsur
Tugas
Quiz
Ujian tengah Semester
Ujian Semester
Total
Persentase ( %)
15
15
20
50
100
- Kriteria penilaian untuk mata kuliah ini sesuai dengan yang berlaku pada universitas andalas
yaitu dari yang terendah nilai E sampai yang tertinggi nilai A+
2. Evalusi Proses pembelajaran dari mahasiswa
Untuk mendapatkan masukan dari mahasiwa mengenai keseluruhan proses pembelajaran,
akan dibagikan kuesioner yang berupa SKALA KEPUASAN MENGAJAR.
D. DAFTAR PUSTAKA
1) AHFS Drugs Informations 2008
2) BNF, 57 editions, 2009
3) USPDI, Drugs Information for health care proffesionals, in Harisson Principles of
Internal Medicines, 15 th edition CD-ROM, Micromedex, ( www. Harissononline.com)
4) Dipiro, JT, et all, Pharmacotherapy : a pathophisiologic approach, 7 th ed,McGrawHill Company, USA 2008
5) MIMS terbaru
KONTRAK PERKULIAHAN
Nama Mata Kuliah
Kode Mata kuliah
Pengajar
SKS
Semester
Hari Pertemuan/Jam
Ruang Kuliah
: Spesialit dan Alkes
: FAR 363
: Hansen Nasif, S.Si., Apt., Sp.FRS
Najmiatul Fitria, M.Farm, Apt
:2
: VII
: Kamis/ 08.00-09.40 WIB
: Lokal C
1.Manfaat Mata Kuliah
Mata kuliah ini diberikan pada mahasiswa agar dapat memahami dan menguasai penggunaan
rasional obat obat bebas, bebas terbatas dan obat wajib apotik serta penggunaan alat
kesehatan agar nantinya mampu melakukan tugas sebagai seorang farmasis.
2. Deskripsi Perkuliahan
Mata Kuliah ini merupakan mata kuliah yang diberikan setelah mahasiswa mendalami
farmakologi dengan baik. Pada Spesialit dan Alkes diberikan materi pokok pengenalan dan
penggunaan rasional obat-obatan bebas, bebas terbatas, dan obat wajib apotik serta
pengenalan dan penggunaan alat kesehatan baik yang habis pakai maupun yang tidak habis
pakai.
3. Tujuan Instruksional
Setelah mengikuti perkuliahan ini, mahasiswa diharapkan dapat Mengetahui dan memahami
penggunaan rasional obat – obat yang tidak diresepkan dan Memahami macam-macam jenis
dan penggunaan alat kesehatan
4. Organisasi Materi
Organisasi materi dapat dilihat pada jadwal perkuliahan
5. Strategi Perkuliahan
Strategi Instruksional yang digunakan pada mata kuliah ini terdiri dari :
a. Urutan kegiatan instruksional berupa : Pendahuluan (TIU dan TIK, cakupan
materi pokok bahasan, dan relevansi ), penyajian ( uraian,contoh, diskusi , evaluasi
) dan penutup ( umpan balik, ringkasan materi, petunjuk tindak lanjut, pemberian
tugas di rumah, gambaran singkat tetang materi berikutnya )
b. Metode Instruksional menggunakan : metode ceramah, demonstrasi, tanya-jawab,
diskusi kasus dan penugasan
1. Ceramah berupa penyampaian bahan ajar oleh dosen pengajar dan
penekanan-penekanan pada hal-hal yang penting dan bermanfaat untuk
diterapkan
2. Tanya jawab dilakukan sepanjang tatap muka dengan memberikan
kesempatan mahasiswa untuk memberikan pendapat atau pertanyaan
tentang hal-hal yang tidak mereka mengerti atau bertentangan dengan
yang mereka pahami sebelumnya.
3. Diskusi kasus dilakukan dengan memberikan contoh kasus/kondisi pada
akhir pokok bahasan, mengambil tema yang sedang aktual di masyarakat
dan mengajak mahasiswa menganalisisnya
4. Penugasan diberikan untuk membantu mahasiswa memahami bahan ajar,
membuka wawasan, dan memberikan pendalaman materi
c. Media Instruksionalnya berupa LCD Projector, Laptop, spidol, Whiteboard,artikel
ilmiah di surat kabar/ internet, jurnal ilmiah, handout, dan kontrak perkuliahan.
D Waktu : 5 menit pada tahap pendahuluan, 40 menit pada tahap penyajian, dan 5
menit pada tahap penutup.
6. Materi/ Bacaan Perkuliahan
1.
AHFS Drugs Informations 2008
2. BNF, 57 editions, 2009
3. USPDI, Drugs Information for health care proffesionals, in Harisson Principles of
Internal Medicines, 15 th edition CD-ROM, Micromedex, ( www. Harissononline.com)
4. Dipiro, JT, et all, Pharmacotherapy : a pathophisiologic approach, 7 th ed,McGrawHill Company, USA 2008
5. MIMS terbaru
7. Tugas
Dalam perkuliahan, diberikan beberapa tugas sebagai berikut :
1.
Materi perkuliahan sebagaimana disebutkan dalam jadwal perkuliahan harus sudah
dibaca sebelum mengikutitatap muka. Apabila ada, handout sudah akan diserahkan
pada mahasiswa sbelum hari kuloiah
2. Evaluasi mahasiswa dilakukan dengan mengadakan quis dengan waktu yang tidak
ditentukan, ujian mid semester dan ujian semester dengan format soal essay
3. Penugasan, jika ada yang sesuai dengan pokok bahasan harus sudah diselesaikan
sebelum ujian semester dimulai
8. Kriteria Penilaian
Nilai Akhir
Nilai Mutu
Angka Mutu
Sebutan Mutu
Sangat
cemerlang
≥85-100
A
4,00
≥80<85
A-
3,50
Cemerlang
≥75<80
B+
3,25
Sangat baik
≥70<75
B
3,00
Baik
≥65<70
B-
2,75
Hampir baik
≥60<65
C+
2,25
Lebih dari cukup
≥55<60
C
2,00
Cukup
≥50<55
C-
1,75
Hampir cukup
≥40<50
D
1,00
Kurang
<40
E
0,00
Gagal
1. Pembobotan nilai adalah sebagai berikut :
Unsur - unsur
Tugas
Quiz
Ujian tengah Semester
Ujian Semester
Total
Persentase ( %)
15
15
20
50
100
2. Bagi mahasiswa yang sudah pernah mengikuti mata kuliah ini sebelumnya namun
mengambil mata kuliah ini selanjutnya harus mengikuti perkuliahan ini seluruhnya
3. Untuk memacu kreativitas mahasiswa dan mendapatkan update dalam keilmuan ini maka
semua quiz dan ujian pada mata kuliah ini, adalah open book dan dibolehkan melakukan
koneksi internet.
BAHAN AJAR
Dyspepsia
Dyspepsia covers pain, fullness, early satiety, bloating, and nausea. It can occur with gastric
and duodenal ulceration and gastric cancer but most commonly it is of uncertain origin.
Urgent endoscopic investigation is required if dyspepsia is accompanied by ‘alarm features’
(e.g. bleeding, dysphagia, recurrent vomiting, or weight loss). Urgent investigation should
also be considered for patients over 55 years with unexplained dyspepsia that has not
responded to treatment. Patients with dyspepsia should be advised about lifestyle
changes (see Gastro-oesophageal reflux disease, below). Some medications may cause
dyspepsia—these should be stopped, if possible. Antacids may provide some symptomatic
relief.
Histamine H -receptor antagonists heal gastric and duodenal ulcers by reducing gastric acid
output as a result of histamine H -receptor blockade; they are also used to relieve
symptoms of gastro-oesophageal reflux disease. H -receptor antagonists should not
normally be used for Zollinger-Ellison syndrome because proton pump inhibitors are more
effective. Maintenance treatment with low doses for the prevention of peptic ulcer disease
has largely been replaced in Helicobacter pylori positive patients by eradication regimens
H -receptor antagonists are used for the treatment of functional dyspepsia . Treatment of
uninvestigated dyspepsia with H -receptor antagonists used regularly or on an intermittent
basis, may be acceptable in younger patients but care is required in older people
because of the possibility of gastric cancer in these patients. H -receptor antagonist
therapy can promote healing of NSAID-associated ulcers (particularly duodenal)
Treatment with a H -receptor antagonist has not been shown to be beneficial in
haematemesis and melaena, but prophylactic use reduces the frequency of bleeding
from gastroduodenal erosions in hepatic coma, and possibly in other conditions requiring
intensive care. H - receptor antagonists also reduce the risk of acid aspiration
in obstetric patients at delivery
Antacids (usually containing aluminium or magnesium compounds) can often relieve symptoms
in ulcer dyspepsia and in non-erosive gastro-oesophageal reflux; they are also sometimes
used in functional (non-ulcer) dyspepsia but the evidence of benefit is uncertain. Antacids
are best given when symptoms occur or are expected, usually between meals and at bedtime,
4 or more times daily; additional doses may be required up to once an hour. Conventional
doses e.g. 10 mL 3 or 4 times daily of liquid magnesium– aluminium antacids promote ulcer
healing, but less well than antisecretory drugs ; proof of a relationship between healing and
neutralising capacity is lacking. Liquid preparations are more effective than tablet
preparations. Aluminium- and magnesium-containing antacids (e.g. aluminium hydroxide, and
magnesium carbonate, hydroxide and trisilicate), being relatively insoluble in water, are
long-acting if retained in the stomach. They are suitable for most antacid purposes.
Magnesiumcontaining antacids tend to be laxative whereas aluminium- containing antacids
may be constipating; antacids containing both magnesium and aluminium may reduce these
colonic side-effects. Aluminium accumulation does not appear to be a risk if renal function is
normal The acid-neutralising capacity of preparations that contain more than one antacid
may be the same as simpler preparations. Complexes such as hydrotalcite confer no special
advantage. Sodium bicarbonate should no longer be prescribed alone for the relief of
dyspepsia but it is present as an ingredient in many indigestion remedies. However, it
retains a place in the management of urinary-tract disorders
and acidosis . Sodium
bicarbonate should be avoided in patients on salt-restricted diets.
Simeticone (activated dimeticone) is added to an antacid as an antifoaming agent to relieve
flatulence. These preparations may be useful for the relief of hiccup in palliative care.
Alginates, added as protectants, may be useful in gastro-oesophageal reflux disease
. The amount of additional ingredient or antacid in individual preparations varies widely, as
does their sodium content, so that preparations may not be freely interchangeable.
See also section 1.3 for drugs used in the treatment of peptic ulceration. Interactions
Antacids should preferably not be taken at the same time as other drugs since they may
impair absorption. Antacids may also damage enteric coatings designed to prevent
dissolution in the stomach
ALUMINIUM HYDROXIDE
Indications dyspepsia; hyperphosphataemia , Cautions see notes above; renal impairment
Contra-indications hypophosphataemia; neonates and infants
Aluminium-only preparations
Aluminium Hydroxide (Non-proprietary)
Tablets, dried aluminium hydroxide 500 mg. Net price
20 = 28p
Dose 1–2 tablets chewed 4 times daily and at bedtime or as
required
Alu-Capc (3M)
Capsules, green/red, dried aluminium hydroxide
475 mg (low Na+). Net price 120-cap pack = £3.75
Dose antacid, 1 capsule 4 times daily and at bedtime; CHILD not
recommended for antacid therapy
Co-magaldrox
Co-magaldrox is a mixture of aluminium hydroxide and
magnesium hydroxide; the proportions are expressed in the
form x/y where x and y are the strengths in milligrams per unit
dose of magnesium hydroxide and aluminium hydroxide
respectively
Maaloxc (Sanofi-Aventis)
Suspension, sugar-free, co-magaldrox 195/220
(magnesium hydroxide 195 mg, dried aluminium
hydroxide 220 mg/5 mL (low Na+)). Net price 500 mL
Dose ADULT and CHILD over 14 years, 10–20 mL 20–60 minutes
after meals and at bedtime or when required
CIMETIDINE
Indications benign gastric and duodenal ulceration, stomal ulcer, reflux oesophagitis,
Zollinger–Ellison syndrome, other conditions where gastric acid reduction is beneficial (see
notes above and section
Cautions see notes above; also hepatic impairment ;Side-effects see notes above; also
alopecia; very rarely tachycardia, interstitial nephritis
Dose
400 mg twice daily (with breakfast and at night) or
800 mg at night (benign gastric and duodenal ulceration)
for at least 4 weeks (6 weeks in gastric ulceration,
8 weeks in NSAID-associated ulceration); when
necessary the dose may be increased to 400 mg 4
times daily; INFANT under 1 year 20 mg/kg daily in
divided doses has been used; CHILD 1–12 years, 25–
30 mg/kg daily in divided doses; max. 400 mg 4 times
daily
Maintenance, 400 mg at night or 400 mg morning and
night
. Reflux oesophagitis, 400 mg 4 times daily for 4–8
weeks
. Zollinger–Ellison syndrome (but see notes above),
400 mg 4 times daily or occasionally more (max. 2.4 g
daily)
. Prophylaxis of stress ulceration, 200–400 mg every 4–
6 hours
. Gastric acid reduction (prophylaxis of acid aspiration;
do not use syrup), obstetrics 400 mg at start of labour,
then up to 400 mg every 4 hours if required (max.
2.4 g daily); surgical procedures 400 mg 90–120 minutes
before induction of general anaesthesia
. Short-bowel syndrome, 400 mg twice daily (with
breakfast and at bedtime) adjusted according to
response
. To reduce degradation of pancreatic enzyme supplements,
0.8–1.6 g daily in 4 divided doses 1–1½ hours
before meals
1Cimetidine (Non-proprietary)A
Tablets, cimetidine 200 mg, net price 60-tab pack =
£1.48; 400 mg, 60-tab pack = £1.61; 800 mg, 30-tab
pack = £1.88
Oral solution, cimetidine 200 mg/5 mL, net price
300 mL = £14.24
Excipients may include propylene glycol (see Excipients, p. 2)
1. Cimetidine can be sold to the public for adults and children
over 16 years (provided packs do not contain more than 2
weeks’ supply) for the short-term symptomatic relief of
heartburn, dyspepsia, and hyperacidity (max. single dose
200 mg, max. daily dose 800 mg), and for the prophylactic
management of nocturnal heartburn (single night-time dose
100 mg)
Tagametc (Chemidex)A
Tablets, all green, f/c, cimetidine 200 mg, net price
120-tab pack = £19.58; 400 mg, 60-tab pack = £22.62;
800 mg, 30-tab pack = £22.62
Syrup, orange, cimetidine 200 mg/5 mL. Net price
600 mL = £28.49
Adsorbents and bulk-forming drugs
The priority in acute diarrhoea, as in gastro-enteritis, is the prevention or reversal of fluid
and electrolyte depletion. This is particularly important in infants and in frail and elderly
patients. For details of oral rehydration preparations, . Severe depletion of fluid and
electrolytes requires immediate admission to hospital and urgent replacement. Antimotility
drugs
relieve symptoms of acute diarrhoea. They are used in the management of
uncomplicated acute diarrhoea in adults; fluid and electrolyte replacement may be necessary
in case of dehydration. However, antimotility drugs are not recommended for acute
diarrhoea in young children. Antispasmodics are occasionally of value in treating abdominal
cramp associated with diarrhoea but they should not be used for primary treatment.
Antispasmodics and antiemetics should be avoided in young children with gastro-enteritis
because they are rarely effective and have troublesome side-effects.
Adsorbents such as kaolin are not recommended for acute diarrhoeas. Bulk-forming drugs,
such as ispaghula, methylcellulose, and sterculia (section 1.6.1) are useful in controlling
diarrhoea associated with diverticular disease.
KAOLIN, LIGHTU
Indications diarrhoea but see notes above
Cautions interactions: Appendix 1 (kaolin)
Kaolin Mixture, BPU
(Kaolin Oral Suspension)
Oral suspension, light kaolin or light kaolin (natural)
20%, light magnesium carbonate 5%, sodium bicarbonate
5% in a suitable vehicle with a peppermint
flavour.
Dose 10–20 mL every 4 hours
Laxatives
Before prescribing laxatives it is important to be sure that the patient is constipated and
that the constipation is not secondary to an underlying undiagnosed complaint.
It is also important for those who complain of constipation to understand that bowel habit
can vary considerably in frequency without doing harm. Some people tend to consider
themselves constipated if they do not have a bowel movement each day. A useful definition
of constipation is the passage of hard stools less frequently than the patient’s own normal
pattern and this can be explained to the patient. Misconceptions about bowel habits have
led to excessive laxative use. Abuse may lead to hypokalaemia. Thus, laxatives should
generally be avoided except where straining will exacerbate a condition (such as
angina) or increase the risk of rectal bleeding as in haemorrhoids. Laxatives are also of
value in druginduced constipation, for the expulsion of parasites after anthelmintic
treatment, and to clear the alimentary tract before surgery and radiological procedures.
Prolonged treatment of constipation is sometimes necessary.
Children
Laxatives should be prescribed by a healthcare professional experienced in the management
of constipation in children. Delays of greater than 3 days between stools may increase the
likelihood of pain on passing hard stools leading to anal fissure, anal spasm and eventually to
a learned response to avoid defaecation.
If increased fluid and fibre intake is insufficient, an osmotic laxative containing macrogols
or lactulose can be used. If there is evidence of minor faecal retention, the addition of a
stimulant laxative may overcome withholding but may lead to colic or, in the presence of
faecal impaction in the rectum, an increase of faecal overflow. In children with faecal
impaction, an oral preparation containing macrogols is used to clear faecal mass and to
establish and maintain soft well-formed stools. Rectal administration of laxatives may be
effective but this route is frequently distressing for the child and may lead to persistent
withholding. If the impacted mass is not expelled following treatment with macrogols,
referral to hospital may be necessary. Enemas may be administered under heavy sedation in
hospital or alternatively, a bowel cleansing solution may be tried. In severe cases or where
the child is afraid, a manual evacuation under anaesthetic may be appropriate.
Long-term regular use of laxatives is essential to maintain well-formed stools and prevent
recurrence of faecal impaction; intermittent use may provoke relapses.
For children with chronic constipation, it may be necessary to exceed the licensed doses of
some laxatives. Parents and carers of children should be advised to adjust the dose of
laxative in order to establish a regular pattern of bowel movements in which stools are soft,
well-formed, and passed without discomfort.
Pregnancy
If dietary and lifestyle changes fail to control constipation in pregnancy, moderate doses of
poorly absorbed laxatives may be used. A bulk-forming laxative should be tried first. An
osmotic laxative, such as lactulose, can also be used. Bisacodyl or senna may
be suitable, if a stimulant effect is necessary. The laxatives that follow have been divided
into 5 main groups. This simple classification disguises the fact that some laxatives have
a complex action.
Bulk-forming laxatives
Bulk-forming laxatives relieve constipation by increasing faecal mass which stimulates
peristalsis; patients should be advised that the full effect may take some days to develop.
Bulk-forming laxatives are of particular value in those with small hard stools, but should not
be required unless fibre cannot be increased in the diet. A balanced diet, including adequate
fluid intake and fibre is of value in preventing constipation. Bulk-forming laxatives are
useful in the management of patients with colostomy, ileostomy, haemorrhoids, anal fissure,
chronic diarrhoea associated with diverticular disease, irritable bowel syndrome, and as
adjuncts in ulcerative colitis . Adequate fluid intake must be maintained to avoid intestinal
obstruction. Unprocessed wheat bran, taken with food or fruit juice, is a most effective
bulk-forming preparation. Finely ground bran, though more palatable, has poorer waterretaining properties, but can be taken as bran bread or biscuits in appropriately increased
quantities. Oat bran is alsoused. Methylcellulose, ispaghula, and sterculia are useful in
patients who cannot tolerate bran. Methylcellulose also acts as a faecal softener.
BISACODYL
Contra-indications see notes above, acute surgical
abdominal conditions, acute inflammatory bowel
disease, severe dehydration
Dose
. Constipation, by mouth, 5–10 mg at night; CHILD (but
see section 1.6) 4–10 years (on medical advice only)
5 mg at night, over 10 years, adult dose
By rectum in suppositories, 10 mg in the morning;
CHILD (but see section 1.6) under 10 years (on
medical advice only) 5 mg, over 10 years, adult dose
. Before radiological procedures and surgery, by
mouth, 10–20 mg the night before procedure and by
rectum in suppositories, 10 mg the following morning;
CHILD 4–10 years by mouth, 5 mg the night
before procedure and by rectum in suppositories,
5 mg the following morning; over 10 years, adult
dose
Note tablets act in 10–12 hours; suppositories act in 20–60
minutes
The brand names Dulcolax Liquid and Dulcolax Perles are used
for sodium picosulfate preparations
The selective beta agonists (selective beta –adrenoceptor agonists, selective beta
stimulants) such as salbutamol or terbutaline are the safest and most effective shortacting beta agonists for asthma. Less selective beta agonists such as orciprenaline
should be avoided whenever possible. Adrenaline (epinephrine) (which has both alpha- and
beta-adrenoceptor agonist properties) is used in the emergency management of allergic and
anaphylactic reactions and in the management of croup .
Selective beta2 agonists
Selective beta agonists produce bronchodilation. A short-acting beta agonist is used for
immediate relief of asthma symptoms while a long-acting beta agonist is added to an inhaled
corticosteroid in patients requiring prophylactic treatment.
Short-acting beta agonists Mild to moderate symptoms of asthma respond rapidly to the
inhalation of a selective short-acting beta agonist such as salbutamol or terbutaline. If beta
agonist inhalation is needed more often than once daily, prophylactic treatment should be
considered, using a stepped approach as outlined in the Management of Chronic Asthma
table,. Regular treatment with an inhaled short-acting beta agonist is less effective than ‘as
required’ inhalation and is not appropriate prophylactic treatment. A short-acting beta
agonist inhaled immediately before exertion reduces exercise-induced asthma; however,
frequent exercise-induced asthma probably reflects poor overall control and calls for
reassessment of asthma treatment.
Long-acting beta agonists
Formoterol (eformoterol) and salmeterol are longer-acting beta agonists which are
administered by inhalation. Added to regular inhaled corticosteroid treatment, they have a
role in the long-term control of chronic asthma and they can be useful in nocturnal asthma.
Salmeterol should not be used for the relief of an asthma attack; it has a slower onset of
action than salbutamol or terbutaline. Formoterol is licensed for short-term symptom relief
and for the prevention of exercise-induced bronchospasm; its speed of onset of action is
similar to that of salbutamol.
EPHEDRINE HYDROCHLORIDEU
Indications reversible airways obstruction, Cautions hyperthyroidism, diabetes mellitus,
ischaemic heart disease, hypertension, renal impairment, elderly; prostatic hypertrophy
(risk of acute retention); interaction with MAOIs a disadvantage;
Side-effects
tachycardia,
anxiety,
restlessness,
insomnia
common;
also
tremor,
arrhythmias, dry mouth, cold extremities
Dose
15–60 mg 3 times daily; CHILD up to 1 year 7.5 mg 3
times daily, 1–5 years 15 mg 3 times daily, 6–12 years
30 mg 3 times daily
Theophylline
Theophylline is a bronchodilator used for asthma and stable chronic obstructive pulmonary
disease; it is not generally effective in exacerbations of chronic obstructivepulmonary
disease. It may have an additive effect when used in conjunction with small doses of beta
agonists; the combination may increase the risk of side-effects, including hypokalaemia
Theophylline is metabolised in the liver; there is considerable variation in plasmatheophylline concentration particularly in smokers, in patients with hepatic impairment or
heart failure, or if certain drugs are taken concurrently. The plasma-theophylline
concentration is increased in heart failure, cirrhosis, viral infections, in the
elderly, and by drugs that inhibit its metabolism. The plasma-theophylline concentration is
decreased in smokers and in chronic alcoholism and by drugs that induce
liver metabolism. For other interactions of theophylline
Differences in the half-life of theophylline are importantbecause its toxic dose is close to
the therapeutic dose; particular care is required when introducing or withdrawing
drugs
that
interact
with
theophylline.
In
most
individuals
a
plasma-theophylline
concentration of between 10–20 mg/litre is required for satisfactory bronchodilation,
although a plasma-theophylline concentration of 10 mg/litre (or less) may be effective.
Adverse effects can occur within the range 10–20 mg/ litre and both the frequency and
severity increase at concentrations above 20 mg/litre.
Theophylline is given by injection as aminophylline, a mixture of theophylline with
ethylenediamine, which is 20 times more soluble than theophylline alone. Aminophylline
injection is needed rarely for severe attacks of asthma. It must be given by very slow
intravenous injection (over at least 20 minutes); it is too irritant for intramuscular use.
Measurement of plasma theophylline concentration may be helpful, and is essential if
aminophylline is to be given to patients who have been taking theophylline, because serious
side-effects such as convulsions and arrhythmias can occasionally precede
other symptoms of toxicity.
THEOPHYLLINE
Indications reversible airways obstruction, acute severe asthma; see also Management of
Chronic and Acute Asthma Cautions cardiac disease, hypertension, hyperthyroidism;
peptic ulcer; epilepsy; elderly; fever; CSM advice on hypokalaemia risk, ; avoid in acute
porphyria ; monitor plasma-theophylline concentration (see notes above); hepatic
impairment ; pregnancy ;
Side-effects tachycardia, palpitation, nausea and other gastro-intestinal disturbances,
headache, CNS stimulation, insomnia, arrhythmias, and convulsions especially if given rapidly
by intravenous injection; overdosage: see Emergency Treatment of Poisoning,
Note Plasma-theophylline concentration for optimum
response 10–20 mg/litre (55–110 micromol/litre); 4–6
hours after a dose and at least 5 days after starting treatment;
narrow margin between therapeutic and toxic dose, see also
notes above
Modified release
Note The rate of absorption from modified-release preparations
can vary between brands. The Council of the Royal
Pharmaceutical Society of Great Britain advises pharmacists
that if a general practitioner prescribes a modified-release oral
theophylline preparation without specifying a brand name, the
pharmacist should contact the prescriber and agree the brand
to be dispensed. Additionally, it is essential that a patient
discharged from hospital should be maintained on the brand on
which that patient was stabilised as an in-patient.
Slo-Phyllinc (Merck)
Capsules, m/r, theophylline 60 mg (white/clear,
enclosing white pellets), net price 56-cap pack =
£2.76; 125 mg (brown/clear, enclosing white pellets),
56-cap pack = £3.48; 250 mg (blue/clear, enclosing
white pellets), 56-cap pack = £4.34. Label: 25, or
counselling, see below
Dose 250–500 mg every 12 hours; CHILD 2–6 years 60–120 mg
every 12 hours, 6–12 years 125–250 mg every 12 hours
Counselling Swallow whole with fluid or swallow enclosed granules
with soft food (e.g. yoghurt)
AMINOPHYLLINE
Note Aminophylline is a stable mixture or combination of theophylline and ethylenediamine;
the ethylenediamine confers greater solubility in water
Indications reversible airways obstruction, acute severe asthma
Cautions see under Theophylline
Side-effects see under Theophylline; also allergy to ethylenediamine can cause urticaria,
erythema, and exfoliative dermatitis
Dose
See under preparations, below
Note Plasma-theophylline concentration for optimum response 10–20 mg/litre (55–110
micromol/litre); measure plasma-theophylline concentration 4–6 hours after dose by
mouth and at least 5 days after starting oral treatment; measure plasma-theophylline
concentration 4–6 hours after the start of intravenous infusion; narrow margin between
therapeutic and toxic dose, see also notes above
Antihistamines
All antihistamines are of potential value in the treatment of nasal allergies, particularly
seasonal allergic rhinitis (hay fever), and they may be of some value in vasomotor
rhinitis. They reduce rhinorrhoea and sneezing but are usually less effective for nasal
congestion. Antihistamines are used topically in the eye (section 11.4.2),
in the nose , and on the skin Oral antihistamines are also of some value in preventing
urticaria and are used to treat urticarial rashes, pruritus, and insect bites and stings; they
are also used in drug allergies. Injections of chlorphenamine (chlorpheniramine) or
promethazine are used as an adjunct to adrenaline (epinephrine) in the emergency
treatment of anaphylaxis and angioedema . For the use of antihistamines (including
cinnarizine, cyclizine, and promethazine teoclate) in nausea and vomiting, see
section 4.6. Buclizine is included as an anti-emetic in a preparation for migraine . For
reference to the use of antihistamines for occasional insomnia,
All older antihistamines cause sedation but alimemazine (trimeprazine) and promethazine
may be more sedating whereas chlorphenamine and cyclizine may be less so. This sedating
activity is sometimes used to manage the pruritus associated with some allergies. There is
little evidence that any one of the older, ‘sedating’ antihistamines is superior to another
and patients vary widely in their response. Non-sedating antihistamines such as cetirizine,
desloratadine (an active metabolite of loratadine), fexofenadine (an active metabolite of
terfenadine), levocetirizine (an isomer of cetirizine), loratadine, and mizolastine cause less
sedation and psychomotor impairment than the older antihistamines because
they penetrate the blood brain barrier only to a slight extent.
Cautions and contra-indications Sedating antihistamines have significant antimuscarinic
activity and they should therefore be used with caution in prostatic hypertrophy,
urinary retention, susceptibility to angle-closure glaucoma, and pyloroduodenal obstruction.
Antihistamines should be used with caution in hepatic disease
Caution may be required in epilepsy. Children and the elderly are more susceptible to
sideeffects. Many antihistamines should be avoided in acute porphyria but some are thought
to be safe, see section
Side-effects Drowsiness is a significant side-effect with most of the older antihistamines
although paradoxical stimulation may occur rarely, especially with high doses or in children
and the elderly. Drowsiness may diminish after a few days of treatment and is
considerably less of a problem with the newer antihistamines . Side-effects that are
more common with the older antihistamines include headache, psychomotor impairment, and
antimuscarinic effects such as urinary retention, dry
mouth, blurred vision, and gastro-intestinal disturbances.
Other rare side-effects of antihistamines include hypotension, palpitation, arrhythmias,
extrapyramidal effects, dizziness, confusion, depression, sleep disturbances,
tremor, convulsions, hypersensitivity reactions (including bronchospasm, angioedema, and
anaphylaxis, rashes, and photosensitivity reactions), blood disorders, liver dysfunction, and
angle-closure glaucoma.
Non-sedating antihistamines
Driving Although drowsiness is rare, nevertheless patients should be advised that it can
occur and may affect performance of skilled tasks (e.g. driving); excess alcohol should be
avoided.
CETIRIZINE HYDROCHLORIDE
Indications symptomatic relief of allergy such as hay fever, chronic idiopahtic urticaria
Cautions see notes above; also renal impairment
Contra-indications see notes above; also pregnancy
Dose
ADULT and CHILD over 6 years, 10 mg once daily or5mg
twice daily; CHILD 1–2 years see BNF for Children, 2–6
years, hay fever, 5 mg once daily or 2.5 mg twice daily
Cetirizine (Non-proprietary)
Tablets, cetirizine hydrochloride 10 mg, net price 30tab pack = 97p. Counselling, driving
Dental prescribing on NHS Cetirizine 10 mg tablets may be
prescribed
Oral solution, cetirizine hydrochloride 5 mg/5 mL,
net price 200 mL = £2.43. Counselling, driving
Cough suppressants
Cough may be a symptom of an underlying disorder, such as asthma , gastro-oesophageal
reflux disease, or rhinitis , which should be addressed before prescribing cough
suppressants. Cough may be a side-effect of another drug, such as an ACE inhibitor , or it
can be associated with smoking or environmental pollutants. Cough can also have a significant
habit component. When there is no identifiable cause, cough suppressants may be useful,
for example if sleep is disturbed. They may cause sputum retention and this may be harmful
in patients with chronic bronchitis and bronchiectasis.
Non-opioid analgesics
Aspirin is indicated for headache, transient musculoskeletalpain, dysmenorrhoea and
pyrexia. In inflammatory conditions, most physicians prefer anti-inflammatory
treatment with another NSAID which may be better tolerated and more convenient for the
patient.
Aspirin is used increasingly for its antiplatelet properties . Aspirin tablets or dispersible
aspirin tablets are adequate for most purposes as they act rapidly. Gastric irritation may be
a problem; it is minimised by taking the dose after food. Enteric-coated preparations
are available, but have a slow onset of action and are therefore unsuitable for single-dose
analgesic use(though their prolonged action may be useful for nightpain).
Aspirin interacts significantly with a number of other drugs and its interaction with
warfarin is a special hazard, see interactions: (aspirin). Paracetamol is similar in efficacy to
aspirin, but has no demonstrable anti-inflammatory activity; it is less irritant
to the stomach and for that reason is now generally preferred to aspirin, particularly in the
elderly. Overdosage with paracetamol is particularly dangerous as it may cause hepatic
damage which is sometimes not apparent for 4 to 6 days (see Emergency Treatment of
Poisoning, p. 29).
Nefopam may have a place in the relief of persistent pain unresponsive to other non-opioid
analgesics. It causes little or no respiratory depression, but sympathomimetic
and antimuscarinic side-effects may be troublesome. Non-steroidal anti-inflammatory
analgesics (NSAIDs, section 10.1.1) are particularly useful for the
treatment of patients with chronic disease accompanied by pain and inflammation. Some of
them are also used in the short-term treatment of mild to moderate pain including transient
musculoskeletal pain but paracetamol is now often preferred, particularly in the elderly
. They are also suitable for the relief of pain in dysmenorrhoea and to treat pain caused by
secondary bone tumours, many of which produce lysis of bone and release prostaglandins
Compound analgesic preparations
Compound analgesic preparations that contain a simple analgesic (such as aspirin or
paracetamol) with an opioid component reduce the scope for effective titration
of the individual components in the management of pain of varying intensity. Compound
analgesic preparations containing paracetamol or aspirin with a low dose of an opioid
analgesic (e.g. 8 mg of codeine phosphate per compound tablet) are commonly used, but the
advantages have not been substantiated. The low dose of the opioid may be enough to cause
opioid side-effects (in particular, constipation) and can complicate the treatment of
overdosage yet may not provide significant additional relief of pain.
A full dose of the opioid component (e.g. 60 mg codeine phosphate) in compound analgesic
preparations effectively augments the analgesic activity but is associated with the full
range of opioid side-effects (including nausea, vomiting, severe constipation, drowsiness,
respiratory depression, and risk of dependence on long-term administration). For details of
the side-effects of opioid analgesics, (important: the elderly are particularly
susceptible to opioid side-effects and should receive lower doses).
In general, when assessing pain, it is necessary to weigh up carefully whether there is a
need for a non-opioid and an opioid analgesic to be taken simultaneously.
For information on the use of combination analgesic preparations in dental and orofacial
pain, Caffeine is a weak stimulant that is often included, insmall doses, in analgesic
preparations. It is claimed that the addition of caffeine may enhance the analgesic
effect, but the alerting effect, mild habit-forming effect and possible provocation of
headache may not always be desirable. Moreover, in excessive dosage or on withdrawal
caffeine may itself induce headache.
Co-proxamol tablets (dextropropoxyphene in combination with paracetamol) are no longer
licensed because of safety concerns, particularly toxicity in overdose. Coproxamol tablets
[unlicensed] may still be prescribed for patients who find it difficult to change, because,
for example, alternatives are not effective or suitable.
ASPIRIN
(Acetylsalicylic Acid)
Indications mild to moderate pain, pyrexia; antiplatelet Cautions asthma, allergic disease,
hepatic impairment , renal impairment, dehydration; preferably avoid during fever or viral
infection in children (risk of Reye’s syndrome, see below); pregnancy; elderly; G6PDdeficiency concomitant use of drugs that increase risk of bleeding;
Contra-indications children under 16 years and in
breast-feeding (Reye’s syndrome, see below; Appendix 5); previous or active peptic
ulceration, haemophilia; not for treatment of gout
Hypersensitivity Aspirin and other NSAIDs are contraindicated in patients with a history of
hypersensitivity to aspirin or any other NSAID—which includes those in whom attacks of
asthma, angioedema, urticaria or rhinitis have been precipitated by aspirin or any other
NSAID Reye’s syndrome Owing to an association with Reye’s syndrome, the CSM has advised
that aspirin-containing preparations should not be given to children under 16 years,
unless specifically indicated, e.g. for Kawasaki syndrome
Side-effects generally mild and infrequent but high incidence of gastro-intestinal irritation
with slight asymptomatic blood loss, increased bleeding time, bronchospasm and skin
reactions in hypersensitive patients. Prolonged administration,
PARACETAMOL
(Acetaminophen)
Indications mild to moderate pain, pyrexia
Cautions hepatic impairment ; renal impairment , alcohol dependence;
Side-effects side-effects rare, but rashes, blood disorders (including thrombocytopenia,
leucopenia, neutropenia) reported; hypotension also reported on infusion; important: liver
damage (and less frequently renal damage)
SILABUS MATA KULIAH
FAR 363 Spesialit & Alat Kesehatan
Prasyarat : Farmakoogi
Mata Kuliah ini merupakan mata kuliah yang diberikan setelah mahasiswa mendalami
farmakologi dengan baik. Pada Spesialit dan Alkes diberikan materi pokok pengenalan dan
penggunaan rasional obat-obatan bebas, bebas terbatas, dan obat wajib apotik serta
pengenalan dan penggunaan alat kesehatan baik yang habis pakai maupun yang tidak habis
pakai.
Buku Pegangan
6) AHFS Drugs Informations 2008
7) BNF, 57 editions, 2009
8) USPDI, Drugs Information for health care proffesionals, in Harisson Principles of
Internal Medicines, 15 th edition CD-ROM, Micromedex, ( www. Harissononline.com)
9) Dipiro, JT, et all, Pharmacotherapy : a pathophisiologic approach, 7 th ed,McGrawHill Company, USA 2008
10) MIMS terbaru
SPESIALIT & ALKES
Contoh Soal & Jawaban
1.Seorang penderita penderita asma datang meminta informasi kepada saudara yang sedang berasda di
apotik tentang aminophilin yang sering dikonsumsinya. Saudara memberikan informasi bahwa
theophilin ternyata lebih baik dari ainophilin karena aminophilin anhydrous yang biasa digunakan
sebagai obat mengandung ;
a.
b.
c.
d.
e.
83% theophilin
86% theophilin
74% theophilin
71% theophilin
79% theophilin
2.Efedrin adalah salah satu obat yang dulunya digunakan sebagai obat asma,namunsekarang mulai
jarang digunakan lagi karena banyaknya efek samping yang timbul pada penggunaan obat ini. Efek
samping efedrin timbul adalah karena kerja obat ini pada reseptor:
a.
b.
Alfa 1, Alfa 2, Beta 1, Beta 2, CNS
Alfa 1, Alfa 2, Beta 1, Beta 2
c.
d.
e.
Alfa 1, Alfa 2, Beta 1, CNS
Alfa 1, Beta 1, Beta 2, CNS
Alfa 2, Beta 1, Beta 2, CNS
3.Antasida adalah obat yang biasa digunakan untuk mengatasi gangguan asam lambung, namun selain
itu antasida berguna juga untuk keadaan antihiperfosfatemia ( untuk mengikat kelebihan fosfat) pada
gangguan ginjal, antasida yang dipakai adalah :
a.
b.
c.
d.
e.
Magaldrad
Magnesium oxide
Magnesiun hidroxide
Natrium Bicarbonate
Calsium Carbonate
4.Seorang pasien penderita konstipasi saudara rekomendasikan untuk menggunakan dulcolax supp
untuk mengobati keluhannnya itu, maka saudara harus menerangkan cara penggunaan suppose nya
adalah saat :
a.
b.
c.
d.
e.
Berbaring mirring, kaki diangkat
Berbaring miring kaki ditekuk
Berbaring miring kaki dibuka selebar mungkin
Menelungkup dengan pinggul diangkat
Jongkok
5.Pendapat saudara jika suatu obat asma dikombinasi dengan bukan obat bronkodilator
a.
b.
c.
d.
e.
Tidak boleh karena tidak bisa dikombinasikan
Boleh karena mungkin saja bermanfaat
Seharusnya tidak dikombinasikan karena mungkin berbahaya
Harus dikombinasi kalau satu obat tdk cukup mengatasi keadaan
Semua pendapat diatas salah
6.Penderita diare sering menderita lemah tubuhnya, secara umum ini adalah karena selain kekurangan
glukosa juga kekurangan bahan/ senyawa:
a.
b.
c.
d.
e.
Sitrat
Natrium
Kalium
Magnesium
Clorida
7.Pemberian suatu obat sering dikaitkan dengan interaksi obat. Kasus yang sering kita jumpai adalah
adanya interaksi obat seperti antasida dengan bahan/ senyawa lainnnya. Pada prinsipnya interaksi obat
ini kemungkinan bisa terjadi jika pemberian obat yang diberikan bersamaan dengan :
a.
b.
c.
d.
e.
Suatu obat lain
Makanan
Minuman
a dan b benar
semua jawaba diatas benar
8.Seorang ibu dengan anak usia 1,5 tahun menderita asma meminta saran saudara tentang theohilin,
penyataan yang benar adalah :
a.
Theohilin tidak boleh digunakan untuk anak ini
b.
c.
d.
e.
Dosis theophilin untuk anak ini adalah sekitar 260 mg sekali pakai
Kalau untuk anak ini mau dipakai sebaiknya bukan theophilin, tapi aminophilin
Obat bentuk Inhalasi lebih aman untuk anak ini
Sebaiknya gunakan sediaan Sustain Releasenya.
9.Garlic ( Allium sativum ) adalah herbal medicine yang yang diyakini bersifat
a.
b.
c.
d.
e.
Memperbaiki keadaan pada gangguan jantung
Antidiabetes
antihiperkolesterolemia
Neurotonik
Antiasmatic
10.Banyaknya kasus konstipasi pada bayi berhubungan dengan beberapa statemen berikut:
a.
b.
c.
d.
e.
Bayi sebaiknya diberikan bisakodil tab saja.
Bayi sebaiknya diberi lactulosa
Bayi boleh mendapatkan sediaan untuk antikonstipasi yang diberikan via anus
Bayi tidak boleh mendapatkan sediaan antikonstipasi via anus
Semua penyataan diatas salah.
Jawaban : 1. b, 2. c, 3. e, 4. b, 5. b, 6. c, 7.e, 8. b, 9. c, 10. c.