6. obat dispepsia - dr. qathrunnada.pptx

8/17/2019 6. Obat Dispepsia - dr. Qathrunnada.pptx

1/23

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


2/23

. 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


3/23

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


4/23

. 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"


5/23

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


6/23

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%


7/23

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.


8/23

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


9/23

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


10/23

. 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


11/23

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


12/23

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%


13/23

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


14/23

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


15/23

/. 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


16/23

- 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


17/23

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


18/23

Bis$ut %e"at

A%sin,a sa$a #engansu%ra"(at.Diberi%an sebe"u$ $a%an

2"a$bung %sng4.


19/23

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


20/23

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


21/23

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


22/23

'. 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


23/23

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

6. obat dispepsia - dr. qathrunnada.pptx

Documents