daftar obat generik

Kitab Daftar Nama Obat Generik

by:

Faik Fauzi&MulachellaGenghis Khun

DAFTAR NAMA GENERIK OBAT Klik Cepat ke: Daftar Isi, Index (Sebaiknya baca Panduan dulu) Saluran Cerna Kardiovaskuler Saluran Nafas Neuromuskuler Hormon Antibakteri Saluran Kemih Metabolik Vitamin & Mineral Preparat Mata, Kulit, Telinga, Mulut Imunologi

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Nama Generik Obat, Kembali ke: Awal, Daftar Isi, Index

All high-street pharmacists are obliged by law to dispense whatever the doctor has written on the prescription. If your doctor has prescribed a medicine by its brand name, your pharmacist must dispense that brand. However, if a medicine has been prescribed by its generic name, your pharmacist can dispense whatever version of the medicine they have available, because each version will have the same therapeutic effect. There are a few exceptions to this. There are a handful of medicines that your doctor must prescribe by the brand name. These include: modified-release theophylline & aminophylline modified-release nifedipine & diltiazem the immunosuppressant ciclosporin lithium, which is a mood stabiliser fentanyl patches carbamazepine, phenytoin and Na valproate www.netdoctor.co.uk/medicines/brand_generic.htmGenghis Khun ([email protected],nafanakhun.wordpress.com)


Kitab Daftar Nama Obat Generik Ini Dibuat Untuk Kemaslahatan Orang Banyak.

Semua Boleh Mengcopy dan Menyebarluaskannya.Semoga Bermanfaat. Amin.

by:

FaiK Fauzi [email protected]: [email protected]o.com Blog: faikshare.blogspot.com faik-mulachella.blogspot.com

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DAFTAR NAMA GENERIK OBAT Bisa dibuka di semua sistem operasi: Komputer: - Windows - Linux - Macintosh HP/ PDA: - Symbian - Windows Mobile

FaiK Fauzi [email protected]: [email protected] Blog: faikshare.blogspot.com faik-mulachella.blogspot.comGenghis Khun ([email protected],nafanakhun.wordpress.com)


Sistem Penulisan Nama Generik berdasarkan nama internasional I: Indikasi BSO: Bentuk sediaan obat D: Dosis dan cara pemberian oral * Qd= 1x Bid=2x Tid=3x Hs= sebelum tidur KI: Kontra Indikasi P: Perhatian ES: Efek Samping IO: Interaksi Obat Preg: (Tingkat Keamanan untuk Ibu Hamil) A, B, C, D, X* Nama Dagang: Nama ini akan langsung diisi bila distribusi di Indonesia.hanya tersedia 1 (satu) macam nama dagang/ paten tersebut Produk, Rp. /box, Amp)Genghis Khun ([email protected],nafanakhun.wordpress.com)


Cara Pemberian Obat Oral Simbol: : Diberikan bersama makanan : Diberikan bersama atau tanpa makanan : Diberikan saat perut kosong (1 jam sebelum makan atau 2 jam sesudah makan) Tingkat Keamanan untuk Ibu Hamil A: Aman pada janin manusia B: Aman pada janin binatang percobaan. C: Efek samping pada janin binatang percobaan, pada manusia belum diketahui. D: Efek samping pada janin manusia, tetapi manfaat obat mungkin lebih besar daripada resikonya. X: Abnormalitas pada janin manusia. Resiko melebihi manfaat yang diperoleh.Genghis Khun ([email protected],nafanakhun.wordpress.com)


Cara Pencarian Data 1. Panduan Daftar Isi, atau 2. Mengaktifkan Bookmark disamping halaman PDF viewer atau 3. Melihat Index (Berdasarkan urutan abjad). 4. Fasilitas Search.. (Tekan Ctrl+F) : Tulislah dengan nama generik internasional, misalnya hydroxide, jangan ditulis hidroksida


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I. SALURAN PENCERNAAN A. ANTASIDA & ANTI ULCERASI B. REGULATOR GIT, ANTI FLATULEN & ANTI INFLAMASI C. ANTI SPASMODIK D. ANTI DIARE E. LAKSATIF & PENCAHAR F. DIGESTAN G. KOLAGOGUM, KOLELITOLITIK & HEPATIK PROTEKTOR H. PREPARAT ANOREKTAL



A. Antasida & anti ulcerasi Aluminium hydroxide/ Antacid Magnesium hydroxide Magnesium trisilicateCimetidine Ranitidine HCl Famotidine Nizatidine Omeprazole Lansoprazole Rabeprazole Pantoprazole Esomeprazole Clebropride Malate Misoprostol Sulpiride Sucralfate Teprenone Rebamipide PolymigelGenghis Khun ([email protected],nafanakhun.wordpress.com)


Aluminium hydroxide/ Antacid I: Hiperasiditas lambung, pengikat fosfat pada kasus hiperfosfatemia pada gagal ginjal. BSO: Tablet Kunyah 300mg D: 1-2 tab/ hr, 1 jam stlh makan & sebelum tidur . KI: Payah ginjal P: Insuffisiensi Ginjal ES: Jarang, konstipasi, diare. Hipofosfatemia (jangka lama, dosis tinggi) IO: Perubahan absorbsi terutama tetrasiklin dan garam Fe Preg:: C Nama Dagang:



Magnesium hydroxide I: Konstipasi & defekasi tdk teratur yg disertai ggn pencernaan. BSO: Syr 400mg/5cc D: Dws 2,4g 4,8 g sblm tidur/ ssdh bangun tidur. Anak 1,2g2,4 g. KI: P: Kerusakan ginjal ES: Mual muntah, nyeri perut IO: Mengganggu absorpsi Cimetidin/ Tetrasiklin Preg:: B Nama Dagang: Laxasium



Magnesium trisilicate I: Hiperasiditas GI BSO: Tab, Syrup D: Perut Kosong/ menjelang tidur/ timbul gejala. Tdk >7 hr KI: Anak dr 4 mgg KI: Bumil & Laktasi. P: Umur dibwh 18 th. Gangguan Liver ES: Flatulen, Vertigo IO: Mengurangi efektifitas obat anti HIV & anti fungi. Peningkatan kadar dlm darah: warfarin, phenytoin, benzodiazepines (such as diazepam, triazolam, lorazepam or flurazepam), digoxin, cilostazol, tacrolimus. Preg:: A, B, C, D, X Nama Dagang:



Lansoprazole Proton pump inhibitor I: Ulkus gaster & duoenum BSO: Kaps 30 mg D: Dws 30mg 1x/hr KI: Ggn hati berat P: Anak ES: IO: Preg:: A, B, C, D, X Nama Dagang:



Rabeprazole BSO: Tablet 10 mg, 20 mg D: Dws 1x 20 mg/hr. Tukak Duodenum aktif 1x 10 mg/hr. sembuh dlm 2-4 mgg. Pasien Tukak lambung sembuh dalam 4-6 mgg. Refluks esofagitis 1x 20 mg/hr selama 4-8 mgg. Pagi I: Tukak Duodenum, Tukak lambung, Refluks esofagitis P: Ggn fungsi ginjal, hipersensitif. Usia lanjut. Bumil & Laktasi. Anak. ES: Konstipasi, eksema, sakit kepala, peningkatan GPT, lekosit eosinofilik & GOT IO: Menurunkan kadar Ketokonazole, meningkatkan konsentrasi digoxin dlm darah. Tdk berinteraksi dg obat yg dimetabolisme scr oksidatif: Teofilin, Fenitoin, Warfarin & Diazepam. Preg:: B Nama Dagang:ParietGenghis Khun ([email protected],nafanakhun.wordpress.com)


Pantoprazole I: Terapi jangka pendek ggn gaster & intestinal yg memerlukan pengurangan sekresi as lambung; ulkus duodenum, ulkus gaster; refluks esofagitis. BSO: Tab 20 mg, 40 mg. Vial 40 mg D: Tab 40 mg/hr slm 2-8 mgg. IV 40 mg/hr slm < 8 mgg. KI: Kerusakan hati. Hamil. P: IV digunakan bila IO tidak memungkinkan. ES: sakit kepala, diare, ruam kulit, pruritus. IO: Mempengaruhi penyerapan Ketokonazole Preg:: B Nama Dagang: Pantozol


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Esomeprazole I: Refluks Gastroesofageal, Kombinasi antibakteri utk eradikasi H. pylori BSO: Tab 20 mg, 40 mg. Vial 40 mg/cc D: Tab Refluks Esofagitis Erosif 1x 40 mg/hr slm 4 mgg. Relaps esofagitis & pemeliharaan 1x 20 mg/hr. Vial Dws 40 mg iv pelan/ infus slm 10-30mnt. KI: P: Bumil Laktasi. Intoleransi fruktosa herediter. Malabsorbsi Glukosa Galaktosa. Insufisiensi sukrase isomaltase. ES: Diare, Kembung. Mual, konstipasi, dermatitis, pruritus, mulut kering. IO: Diazepam, Sitalopram, Imipramin, Klomipramin, Fenitoin Preg:: B Nama Dagang: Nexium



Clebropride Malate I: Ulkus peptikum, Gastroduodenitis BSO: Tab 0,5 mg D: Dws 3x/hr KI: Bila stimulasi lambung membahayakan (perdarahan, obstruksi, perforasi). Pasien diskinesia tardiv thd neuroleptik. P: anak, bumil trim 1, laktasi. ES: Mengantuk, pusing. IO: mempotensiasi sfek SSP Fenotiazin & antidopaminergik lain. Preg:: Nama Dagang: Clast



Misoprostol I: Mencegah ulkus krn induksi AINS BSO: Tab 200 mcg D: 4x 200 mcg/hr. KI: Bumil, Laktasi P: ES: Ggn GI: diare, nyeri perut, ggn ginekologi (kram, bercak, menoragi, dismenorre) IO: Preg:: X Nama Dagang:



Sulpiride I: Psikosomatik, ulkus peptikum, colitis ulseratif, peny Crohn, Ggn kolik fungsional, migren abdominal. BSO: Kaps 50 mg, Tab forte 200 mg. Amp 100 mg/ 2cc D: Ggn psikofungsional 2-4 kaps/ hr. Anak 5-10 mg/kgBB/hr dibagi bbrp dosis. Psikiatri pengobatan wkt serangan 3-6 amp/hr (IM). Pemeliharaan 2-4 tab/hr dibagi bbrp dosis. KI: Feokromositoma P: Insufisiensi Ginjal, epilepsy. Bumil & Laktasi. Manula: Parkinson. ES: Galaktore, ginekomastia, impotensi/ frigid, amenore, reaksi extra pyramidal, hipotensi ortostatik, diskinesia tardiv, sedasi & somnolen. IO: Obat Depresan, SSP, alcohol, Levodopa. Preg:: Nama Dagang: DogmatilGenghis Khun ([email protected],nafanakhun.wordpress.com)


Sucralfate I: Terapi jangka pendek (8 mgg) ulkus duodenum BSO: Tab 500 mg, Susp 500 mg/ 5cc D: 4x 1 g KI: P: GGK, dialysis, Bumil, laktasi, Anak. ES: Konstipasi, mulut kering, ggn GI, ruam kulit, gatal, ggn tidur, nyeri punggung. IO: Menurunkan absorbsi Cimetidine, Fluoroquinolon (Ciprofloxacin, Norfloxacin), Digoxin, Ketokonazol, Fenitoin, Ranitidine, Tetrasiklin, Quinidin, L-tiroksin, Teophylline. Preg:: B Nama Dagang:



Teprenone I: Tukak peptik BSO: Kaps 50 mg D: 3x 50 mg/hr KI: P: Bumil & anak ES: Jarang: konstipasi,rasa penuh pd perut, diare, haus, mual, muntah, ruam kulit, gatal. IO: Preg:: Nama Dagang: Purubex



Rebamipide I: Ulkus gaster, antagonis H2 BSO: Tab 100 mg D: 3x 100 mg/hr KI: P: Hamil,laktasi, lansia ES: abdomen terasa membesar, konstipasi IO: Preg:: Nama Dagang: Mucosta



Polymigel I: Mual, hiperasiditas, nyeri abdomen, kembung BSO: Tab 400 mg D: 1-2 tab 3-4x/hrDosis KI: Hipo/hipertiroidisme,dialisis P: Hiperkalsemia, diet rendah fosfat, disfungsi ginjal pd penggunaan lama ES: Konstipasi, diare, mual, muntah IO: Mengurangi absorbsi bila kombinasi dg Cimetidine, Tetrasiklin Preg:: Nama Dagang: Strocain P



B. Regulator GIT, Anti Flatulen & Anti Inflamasi Metoclopramide HCl Domperidone Cisapride Dimeticone Simeticone Sulfasalazine Mesalazine Ramosetron Otilonium bromide Lactobacillus Tegaserod



Metoclopramide HCl I: GGn GI, mual/ muntah krn obat, kembung, ulkus peptikum, stenosis pylorus (ringan), dyspepsia, epigastralgia. BSO: Tab 5 mg, 10 mg, amp 10 mg/2cc, syrup 5 mg/5cc. Supp 10 mg, 20 mg. Tetes paed. 1 mg/ 10 tts. D: Tab, Amp,Supp: Dws 3x 10 mg/ hr Anak 0,5 mg/kg/hr. KI: Jika stimulasi motilitas GI dpt membahayakan. Ex. Obstruksi intestinal, epilepsy, feokromositoma. P: Anak & remaja, kehamilan, menyusui, DM, depresi, penggunaan obat lain yg menyebabkan reaksi extrapiramidal. ES: Dosis tinggi: pusing, gelisah, lesu, gejala extrapiramidal, sakit kepala, mengantuk, ggn GI, hipertensi. IO: Efek diantagonis oleh antikolinergik & analgesic. Depresan SSP meningkatkan efek sedasi. Absorbsi digoxin & simetidin terganggu. Absorbsi parasetamol, tetrasiklin, levodopa di usus halus akan meningkat. Perubahan kebutuhan insulin. Preg:: B Nama Dagang:Genghis Khun ([email protected],nafanakhun.wordpress.com)


Domperidone I: Dispepsia disertai masa pengosongan lambung yg lambat atau refluks esophagus. Mual & muntah krn: intoleransi sal cerna akibat kemoterapi antikanker, digitalis, levodopa, radioterapi, patologi organ abdomen, GI, hepatobilier, peritoneal, ginjal. BSO: Tab 10 mg, Sirup 5mg/5c D: Dws 10-20 mg 3x/hr perut kosong (bila perlu tambah sblm tidur) , anak 0.25-0.5 mg/kgBB 3x/hr. KI: Pasien dg serangan motilitas lambung dpt membahayakan, missal perdarahan, obstruksi mekanik, perforasi GI. Prolaktinoma tumor hipofise yg mengeluarkan prolaktin. P: Tidak utk mual/ muntah kronik. Bumil laktasi, bayi < 1th. ES: Galaktorea, ginekomastia, kejang usus sementara IO: Antasida, obat anti sekresi. Preg:: Nama Dagang:Genghis Khun ([email protected],nafanakhun.wordpress.com)


Cisapride I: Ggn motilitas GI spt gastroparesis & Refluks esofagitis. BSO: Tab 5 mg D: Dws 5 mg 3-4x/hr, max 40 mg/hr. Anak 0.2-0.8 mg/kgBB 3-4x/hr,max 40 mg/hr. KI: Stimulasi GI berbahaya, perdarahan GI, obstruksi mekanik/ perforasi. P: Insufisiensi hati/ ginjal. Bumil & laktasi. Prematur dg kehamilan < 34mgg ES: Kram abdomen sementara, borborigmis & diare. IO: Peningkatan absorbsi depresan SSP & alcohol. Efek motilitas GI diturunkan oleh antikolinergik. Preg:: C Nama Dagang:



Dimeticone I: Flatulen & meteorismus. Mengurangi gas sal cerna sblm radiografi. Meringankan distensi abdomen. Dispepsia. BSO: Tab 40 mg D: 40 mg 3x/hr & sblm tidur. 4x/hr sblm pemeriksaan radiografi. KI: P: ES: IO: Preg:: Nama Dagang:



Simeticone I: Kembung & Rasa tidak enak pada perut. Distensi abdomen & dyspepsia. Sbg defoaming agent pd radiografi & endoskopi sal cerna BSO: Tab 125 mg D: 125 mg 3x/hr KI: Neonatus & prematur P: ES: IO: Preg:: C Nama Dagang:



Sulfasalazine I: Kolitis ulseratif, RA, spondilitis ankylosing, spondyloartritis seronegatif. BSO: Kaplet 500 mg D: Kolitis ulseratif: Dws 3-4 g, Anak 40-60mg/kgBB/hr dlm dosis terbagi. AR, spondilitis ankilosa: 500 mg malam hari selama 1 mggu, dilanjutkan 500 mg 2x/hr mggu selanjutnya. KI: Porfiria intermiten akut. Anak < 2th. Obstruksi GIT & UTI. P: Ggn hati/ ginjal, diskrasia darah, defisiensi G6PD. ES: Mual, anoreksia, kenaikan suhu, eritema & pruritus, sakit kepala. IO: Mengurangi absorbsi Folat & Digoxin. Preg:: B, D bila mendekati partus Nama Dagang: SulcolonGenghis Khun ([email protected],nafanakhun.wordpress.com)


Mesalazine I: Radang usus, Colitis ulseratif, pnykt Crohn, Enema. BSO: Tab 250 mg, Enema 4g, Supp 500mg D: Dws: akut 1.5- 3g 3x/hr. Maintenance 500mg 3x/hrDosis. Enema 1x/hr. Supp 2x/hr. KI: Kelainan hati & ginjal berat. Ulkus peptic aktif. Pembekuan darah abnormal.Bayi & Infant. P: manula, bumil & laktasi ES: Eksantema alergi, demam, bronkospasme. IO: Meningkatnya efek hipoglikemik Sulfonilurea. Kumarin, MTX, Probenesid, Sulfinpirazon, Furosemid & Rifampisin. Preg:: B Nama Dagang: Salofalk



Ramosetron I: Mual & muntah karena obat karsinostatik (misal Cisplatin) BSO: Tab 0.1 mg, Amp 0.3 mg/2cc D: Dws Tab 0.1 mg 1x/hr. Amp 0.3 mg 1x/hr. Max 0.6 mg/ hr. KI: P: Sebaiknya diberikan 1 jam sebelum obat karsinostatik. Manula, Bumil & laktasi. ES: syok & reaksi anafilaktik, serangan yg menyerupai epilepsy, ggn tidur, konstipasi, diare, peningkatan BUN, ggn fungsi ginjal, peningkatan SGPT/SGOT/LDH IO: Preg:: Nama Dagang: Nasea



Otilonium bromide I: Irritable Bowel syndrome & pengobatan simtomatis utk nyeri & ggn GI yg berhubungan dg spasme otot polos. BSO: Tab 40 mg D: 40 mg 2-3x/hr. KI: P: Glaukoma, hyperplasia prostate jinak, stenosis pilorik. Hamil & Laktasi. ES: Mual, lelah, nyeri epigastrium, vertigo. IO: Preg:: Nama Dagang: Spasmomen



Lactobacillus I: Pemeliharaan kesehatan fungsi GIT BSO: Tab, Kapsul D: 3x/hr. KI: P: Bumil & Laktasi ES: IO: Preg:: Nama Dagang:



Tegaserod I: Irritable bowel syndrome, predominan konstipasi, khususnya wanita. Rasa tidak enakpada perut. BSO: Tab 6 mg D: 6mg 2x/hr selama maks 12 minggu KI: Laktasi P: Kerusakan hati berat,hamil. ES: Nyeri abdomen, diare,mual, flatulensi, sakit kepala, pusing, nyeri punggung & sindr seperti flu. IO: Preg:: B Nama Dagang: Zelmac



C. Anti Spasmodik Papaverine HCl Pramiverine Mebeverine Hyoscine butylbromide Butropium Bromide Propantheline bromide Valethamate bromide Timepidium bromide Chlordiazepoxide Tiemonium methylsulphate

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Papaverine HCl I: Kolik sal empedu, ginjal & otot polos lainnya, emboli perifer & mesenteric. BSO: Tab 40 mg, amp 40 mg/cc D: Tab, SC, IM, IV 40-80 mg 3x/hr. KI: P: Pemberian IV, Glaukoma ES: IO: Preg:: A, B, C, D, X Nama Dagang:



Pramiverine I: Kolik & Kejang otot polos: sal cerna, empedu & sal kemih BSO: Tab 2 mg D: 2 mg 3x/hr . Akut 4 mg 2x/hr selama 2 hr. KI: Glaukoma sudut sempit, adenoma prostate dg tendensi terbentuknya sisa urine, takiaritmia, stenosis mekanik sl GIT, megakolon, paska bedah abdomen. P: Hipotensi, bayi, bumil. ES: Rasa kering mulut& kulit, ruam kulit, pandangan kabur, glaucoma, takikardia, ggn kencing. IO: Peningkatan efek antikholinergik dg amantadin atau antidepresan trisiklik. Preg:: Nama Dagang: Systabon Plain



Mebeverine I: Ggn spasme kolon. Sindr Irritable colon stadium awal & yg disertai luka pada GIT (divertikulosis & divertikulitis pd kolon, enteritis regional, pnykit kandung empedu, tukak lambung & usus 12 jari, disentri, inflamasi spesifik & non spesifik GIT). BSO: Tab salut gula 135 mg D: 135 mg 3x/hr, 20 menit a.c KI: P: ES: IO: Preg:: BSO: Nama Dagang: Duspatalin



Hyoscine butylbromide I: Spasme GIT & Sal kemih. Pencegahan & terapi dismenore. BSO: Tab 10 mg, ampul 20 mg/cc D: Dws 10-20 mg 4x/hr, anak 10 mg 3x/hr. KI: Hipersensitif, porfiria, glaucoma, hipertrofi prostate dg kecenderungan retensi urine, stenosis mekanis GIT, takikardia, megakolon. P: Bumil, laktasi, lansia, ggn jantung, colitis ulseratif, ileus paralitik, stenosis pilorik. Hindari minuman alcohol. ES: Kering mulut & kulit, konstipasi, palpitasi, aritmia jantung, bradikardi, takikardia, reaksi paradoksikal, ggn penglihatan. IO: Antihistamin, antidepresan, kuinidin, disopiramid, alcohol, antidepresan, analgesic narkotik, sedative/ hipnotik, kalium klorida. Preg:: C Nama Dagang:



Butropium Bromide I: Nyeri, kejang yg berhubungan dengan gastritis, enteritis, tukak peptic, kolesistitis, diskinesia bilier. BSO: Tab 5 mg. D: 10 mg 3x/hr. KI: Glaukoma, Ggn sal kemih krn hipertrofi prostate, ggn jantung berat, ileus paralitik, stenosis pylorus, hipersensitif. P: Hipertrofi prostate, gagal jantung kongestif, aritmia, colitis ulseratif, hipertiroidisme. Bumil. ES: Ggn daya akomodasi mata. Mulut kering. Mual,muntah, konstipasi, ggn miksi, sakit kepala, mengantuk, pusing, takikardia, hipotensi, muka merah, lesu, reaksi hipersensitif. IO: Antidepresan trisiklik, Fenotiazin, MAOI Preg:: C Nama Dagang: ColiopanGenghis Khun ([email protected],nafanakhun.wordpress.com)


Propantheline bromide I: Terapi tambahan ulkus peptic & colitis ulseratif, divertikulitis, divertikulitis, kolesistitis, pankreatitis & prosedur diagnostic GI. Utk pengobatan sindr usus iritabel, kolik ginjal & hiperhidrosis. BSO: Tab 15 mg D: Ulkus peptic 15 mg a.c & 30 mg sblm tidur. Kontras: 30 mg, 45 menit sblm foto. Indikasi lain 15-30 mg 4x/hr. KI: Penyakit obstruktif GI/ Sal kemih. Atoni usus. Colitis ulseratif berat atau toksikmegakolon, hiatal hernia sehubungan dg refluks esofagitis, perdarahan akut, miastenia gravis, glaucoma. P: Panyakit KV berat, lansia, neuropati otonomik, colitis ulseratif, peny hati/ ginjal, hipertiroid, peny jantung kongestif, PJK, hipotensi. ES: Mulut kering, pandangan kabur, midriasi, efek SSP, takikardia, retensi urine, heat stroke, ggn GI, dermatitis alergi, impotensi, anafilaksis, konstipasi.



IO: Meningkatkan kadar digoksin serum, potensiasi efek kolinergik dari antihistamin, antidepresan, antipsikotik, obat anti Parkinson. Preg:: C Nama Dagang:




Valethamate bromide I: GI spasm (cardiospasm, spastic constipation, ulcerative complaints), spasm of biliary & urinary tract, spasmodic dismenore, delayed dilatation of cervix in parturition. Child: Pylorospsm, spastic bronkhitis BSO: Tab 10 mg, Amp 8 mg/cc. D: Tab 10-20 mg 3x/hr. Amp 8-16 mg IV/ IM/ SC KI: Glaukoma sdt tertutup, obstruksi GIT/ UT, hipertrofi prostate, megakolon, stenosis pylorus. P: ES: Sikloplegia, mydriasis, mulut kering, flushing, takikardi, palpitasi, konstipasi, rash, muntah, fotofobia. IO: Efek antikholinergik bias ditingkatkan oleh parasimpatolitik lain. Preg:: A, B, C, D, X Nama Dagang: Epidosin



Timepidium bromide I: Spasme otot polos. BSO: Kaps 30 mg, Amp 7.5 mg/cc D: Kaps 30 mg 3x/hr Amp 7.5mg SC/IM/IV. KI: Glaukoma, disuria, gagal jantung, ileus paralitik P: hipertrofi prostate, hipertiroidisme, CHF, aritmia, colitis ulseratif idiopatik. ES: Fotofobia, mulut kering, vertigo, palpitasi, konstipasi, disuria. IO: Efek ditingkatkan oleh Trisiklik antidepresan, Phenothiazine, MAOIs Preg:: Nama Dagang: Sesden



Chlordiazepoxide I: Nyeri spastic, dismenore, tukak peptik. BSO: Tab 5 mg D: 1-2 drag 3x/hr KI: Glaukoma sudut sempit akut, miastenia gravis, syok, psikosis berat. P: Ketergantungan, amnesia & serangan grandmal, penyakit otak organic, insufisiensi kardiorespiratoris, penurunan fungsi hati/ ginjal. Gagal nafas/ PPOK. Bumil/ laktasi. Lansia. ES: Lesu, ngantuk, lemah otot. IO: Meningkatkan efek Depresan SSP pada alcohol, barbiturate, antihistamin, fenotiazin, opiate, Fenitoin (potensiasi), meningkatkan efek relaksasi otot dg benzodiazepine & relaksasi otot lainnya. Antasida mengganggu absorbsi di GI Preg:: D Nama Dagang:Genghis Khun ([email protected],nafanakhun.wordpress.com)


Tiemonium methylsulphate I: Spasme sal cerna, sal nafas, sal kemih. BSO: Sir 10 mg/5cc D: Dws 5-15cc 3x/hr Anak 15cc/5cc/kgBB/hr KI: Glaukoma, hyperplasia/ adenoma prostate. P: Bumiltrim 1 ES: IO: Preg:: Nama Dagang: Visceralgine

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D. Anti Diare Loperamide HCl Dioctahedral smectite Kaolin, Pectin Attapulgit Racecadotril Furazolidone Charcoal Bismuth salicylate Paromomycin

FaiK Fauzi MuLaCheLLaGenghis Khun ([email protected],nafanakhun.wordpress.com)

[email protected]: [email protected] Blog: faikshare.blogspot.com faik-mulachella.blogspot.com


Loperamide HCl I: Diare akut non spesifik & diare kronis BSO: Tab, Kaps 2 mg D: Awal 4 mg diikuti 2 mg tiap selesai BAB, maks 16 mg/hr. Tidaklebih dari 2 hari. KI: Anak 12 thn 3 sachet/hr, 6-12 thn 1-2 sachet/hr. < 6 th sesuai petunjuk dokter. KI: P: Dehidrasi ES: Konstipasi IO: Mengganggu absorbsi Preg:: Nama Dagang: Smecta



Kaolin, Pectin I: Diare non spesifik BSO: Tab (K 550 mg+P 20mg), Susp (K 5.832 g+ P 130 mg) per fl oz, atau (K 700 mg+ P 50 mg) D: Dws & anak >12 thn 2.5 tab/diare maks 15 tab/hr, 6-12 thn 1.5 tab/diare maks 7.5 tab/hr. KI: Obstruksi intestinal, hipersensitifitas P: Anak< 6 th. Jangan digunakan >2 hr & demam. ES: IO: Preg:: Nama Dagang:



Attapulgit I: Diare non spesifik BSO: Tab (600mg), (A 600mg/ 700mg/ 750mg+Pectin 50mg) D: Dws 2 tab/diare maks 12 tab/hr. Anak dosis dws. KI: Obstruksi usus. Anak 15thn 100mg Dosis Tunggal. Terapi selanjutnya 8jam kemudian sampai diare berhenti, maks 400mg/hr. KI: Bumil laktasi. P: Anak 12th 50-100mg, 5-12th 25-50mg, 3bln-1th 12.5mg. 4x/hr selama maks 7hr. KI: Bayi 65 or older, a blood problem or low blood counts, taking phenytoin, cyclosporine, or theophylline. stomach ulcer or bleeding, bleed easily, Avoid other aspirin-containing products, such as, ibuprofen or like products, other blood thinners (warfarin, ticlopidine, clopidogrel), garlic, ginseng, ginkgo, vitamin E, allergic to any medicine, pregnancy, breast-feeding. ES: Nausea or vomiting. Diarrhea, Belly pain, heartburn, Stomach bleeding or ulceration. Preg:: B Nama Dagang:Genghis Khun ([email protected],nafanakhun.wordpress.com)


Heparin sodium I: Prophylaxis and treatment of thromboembolic disorders Pregnancy Risk Factor BSO: Lock flush injection: Beef lung source: 10 U/mL; 100 U/mL Porcine intestinal mucosa source: 10 U/mL; 100 U/mL Multiple-dose vial injection: Beef lung source, with preservative: 1000 U/mL; 5000 U/mL; 10,000 U/mL; 20,000 U/mL; 40,000 U/mL Porcine intestinal mucosa source, with preservative: 1000 U/mL; 5000 U/mL; 10,000 U/mL; 20,000 U/mL Single-dose vial injection: Beef lung source: 1000 U/mL; 5000 U/mL; 10,000 U/mL; 20,000 U/mL; 40,000 U/mL Porcine intestinal mucosa: 1000 U/mL; 5000 U/mL; 10,000 U/mL; 20,000 U/mL; 40,000 U/mL Unit dose injection:Genghis Khun ([email protected],nafanakhun.wordpress.com)


Porcine intestinal mucosa source, with preservative: 1000 U/dose; 2500 U/dose; 5000 U/dose; 7500 U/dose; 10,000 U/dose; 15,000 U/dose; 20,000 U/dose Heparin sodium infusion, porcine intestinal mucosa source: D5W: 40 U/mL; 50 U/mL; 100 U/mL NaCl 0.45%: 2 U/mL); 50 U/mL; 100 U/mL NaCl 0.9%: 2 U/mL; 5 U/mL; 50 U/mL Heparin calcium: Unit dose injection, porcine intestinal mucosa, preservative free: 5000 U/dose; 12,500 U/dose; 20,000 U/dose D: Line flushing: When using daily flushes of heparin to maintain patency of single and double lumen central catheters, 10 U/mL is commonly used for younger infants (eg, 60 years of age, particularly women. They are also more sensitive to the dose. Some preparations contain benzyl alcohol as a preservative. In neonates, large amounts of benzyl alcohol (>100 mg/kg/day) have been associated with fatal toxicity (gasping syndrome). The use of preservative-free heparin is, therefore, recommended in neonates. Some preparations contain sulfite which may cause allergic reactions. Heparin does not possess fibrinolytic activity and, therefore, cannot lyse established thrombi; discontinue heparin if hemorrhage occurs; severe hemorrhage or overdosage may require protamine ES: bleeding is the major adverse effect of heparin. Fever, headache, chills, Unexplained bruising, urticaria, alopecia, dysesthesia pedis, purpura, eczema, HyperkalemiaGenghis Khun ([email protected],nafanakhun.wordpress.com)


(supression of aldosterone), rebound hyperlipidemia on discontinuation, Nausea, vomiting, constipation, hematemesis, Frequent or persistent erection, Hemorrhage, blood in urine, bleeding from gums, epistaxis, adrenal hemorrhage, ovarian hemorrhage, retroperitoneal hemorrhage, thrombocytopenia, Elevated liver enzymes (AST/ALT), Irritation, ulceration, cutaneous necrosis have been rarely reported with deep S.C. injections, I.M. injection (not recommended) is associated with a high incidence of these effects, Peripheral neuropathy, osteoporosis (chronic), Hemoptysis, pulmonary hemorrhage, asthma, rhinitis, Conjunctivitis, anaphylactoid reactions Note: Thrombocytopenia has been reported to occur at an incidence between 0-30%. It is often of no clinical significance. However, immunologically mediated heparin-induced thrombocytopenia has been estimated to occur in 1-2% of patients, and is marked by a progressive fall in platelet counts and, in some cases, thromboembolic complications (skin necrosis, pulmonary embolism, gangrene of the extremities, stroke or myocardial infarction); daily platelet counts for 5-7Genghis Khun ([email protected],nafanakhun.wordpress.com)


days at initiation of therapy may help detect the onset of this complication. Case reports: Bronchospasm, erythematous plaques IO: increase the risk of hemorrhage: Cephalosporins which contain the MTT side chain, aspirin, NSAIDs, dipyridamole, ticlopidine, clopidogrel. Nitroglycerin (I.V.) may decrease heparin's anticoagulant effect. This interaction has not been validated in some studies, and may only occur at high nitroglycerin dosages. Penicillins (parenteral) may prolong bleeding time via inhibition of platelet aggregation, potentially increasing the risk of hemorrhage. Warfarin: Risk of bleeding may be increased during concurrent therapy. Heparin is commonly continued during the initiation of warfarin therapy to assure anticoagulation and to protect against possible transient hypercoagulability. Other drugs reported to increase heparin's anticoagulant effect include antihistamines, tetracycline, quinine, nicotine, and cardiac glycosides (digoxin). Preg: CGenghis Khun ([email protected],nafanakhun.wordpress.com)


Warfarin Anticoagulant. Prophylaxis and treatment of venous thrombosis, pulmonary embolism, and thromboembolic disorders. D: 2-10 mg/d PO/IV qd; adjust dose to an INR of 1.5:2 or higher depending on the condition requiring anticoagulation Paed. 0.05-0.34 mg/kg/d PO/IV; adjust dose according to desired INR KI: Hipersensitif; severe liver or kidney disease; open wounds; GI ulcers IO: Griseofulvin, carbamazepine, glutethimide, estrogens, nafcillin, phenytoin, rifampin, barbiturates, cholestyramine, colestipol, vitamin K, spironolactone, oral contraceptives, and sucralfate may decrease anticoagulant effects; oral antibiotics, phenylbutazone, salicylates, sulfonamides, chloral hydrate, clofibrate, diazoxide, anabolic steroids, ketoconazole, ethacrynic acid, miconazole, nalidixic acid, sulfonylureas, allopurinol, chloramphenicol, cimetidine, disulfiram,Genghis Khun ([email protected],nafanakhun.wordpress.com)


metronidazole, phenylbutazone, phenytoin, propoxyphene, sulfonamides, gemfibrozil, acetaminophen, and sulindac may increase anticoagulant effects Preg: D P: Dose needs to be adjusted to INR; caution in bleeding tendency and hazardous active hemorrhagic conditions, malignant hypertension, patients at high risk of recurrent trauma, (eg, people with alcoholism or psychosis, unsupervised patients who are senile); warfarin anaphylaxis, hepatic, renal, thyroid, allergic, and hematologic hypocoagulable conditions and disorders; do not switch brands after achieving therapeutic response; caution in active tuberculosis or diabetes; patients with protein C or S deficiency are at risk of developing skin necrosis Nama Dagang:



Enoxaparin I: Prevention of deep vein thrombosis following hip or knee replacement surgery or abdominal surgery in patients at risk for thromboembolic complications; inpatient treatment of acute deep vein thrombosis with and without pulmonary embolism when administered in conjunction with warfarin sodium; outpatient treatment of acute deep vein thrombosis without pulmonary embolism when administered in conjunction with warfarin sodium; prevention of ischemic complications of unstable angina and non-Q wave myocardial infarction (when administered with aspirin) BSO: Injection: Graduated prefilled syringe: 60 mg/0.6 mL, 80 mg/0.8 mL, 100 mg/1.0 mL Ampul: 30 mg/0.3 mL D: S.C.: Adults: DVT prophylaxis in hip replacement: 30 mg twice daily: First dose within 12-24 hours after surgery and every 12 hours until risk of deep vein thrombosis hasGenghis Khun ([email protected],nafanakhun.wordpress.com)


diminished or the patient is adequately anticoagulated on warfarin. Average duration of therapy: 7-10 days. 40 mg once daily: First dose within 9-15 hours before surgery and daily until risk of deep vein thrombosis has diminished or the patient is adequately anticoagulated on warfarin. Average duration of therapy: 7-10 days unless warfarin is not given concurrently, then 40 mg S.C. once daily should be continued for 3 more weeks (4 weeks total). DVT prophylaxis in knee replacement: 30 mg twice daily: First dose within 12-24 hours after surgery and every 12 hours until risk of deep vein thrombosis has diminished. Average duration of therapy: 7-10 days; maximum course: 14 days. Patients who weigh 65 years of age: Some clinicians recommend 0.5 mg/kg/dose every 12 hours to reduce the risk of bleeding. DVT prophylaxis in high-risk patients undergoing abdominal surgery: 40 mg once daily, with initial dose given 2 hours priorGenghis Khun ([email protected],nafanakhun.wordpress.com)


to surgery; usual duration: 7-10 days and up to 12 days has been tolerated in clinical trials. Treatment of acute proximal DVT: Start warfarin within 72 hours and continue enoxaparin until INR is between 2.0 and 3.0 (usually 7 days). Inpatient treatment of DVT with or without pulmonary embolism: Adults: S.C. 1 mg/kg/dose every 12 hours or 1.5 mg/kg once daily. Outpatient treatment of DVT without pulmonary embolism: Adults: S.C.: 1 mg/kg/dose every 12 hours. Prevention of ischemic complications with unstable angina or non-Q-wave myocardial infarction: S.C.: 1 mg/kg twice daily in conjunction with oral aspirin therapy (100-325 mg once daily); treatment should be continued for a minimum of 2 days and continued until clinical stabilization (usually 2-8 days). Dosing adjustment in renal impairment: Total clearance is lower and elimination is delayed in patients with renal failure; adjustment may be necessary in elderly and patients with severe renal impairment.Genghis Khun ([email protected],nafanakhun.wordpress.com)


Hemodialysis: Supplemental dose is not necessary. Peritoneal dialysis: Significant drug removal is unlikely based on physiochemical characteristics. KI: Hypersensitivity to enoxaparin or thrombocytopenia associated with a + in vitro test for antiplatelet antibodies in the presence of enoxaparin; hypersensitivity to pork products; active major bleeding; not for I.M. or I.V. use P: Patients with recent or anticipated neuraxial anesthesia (epidural or spinal anesthesia) are at risk of spinal or epidural hematoma and subsequent paralysis. Consider risk versus benefit prior to neuraxial anesthesia; risk is increased by concomitant agents which may alter hemostasis, as well as traumatic or repeated epidural or spinal puncture. Patient should be observed closely for bleeding if enoxaparin is administered during or immediately following diagnostic lumbar puncture, epidural anesthesia, or spinal anesthesia. ES: As with all anticoagulants, bleeding is the major adverse effect of enoxaparin. Hemorrhage may occur at virtually any site. Risk is dependent on multiple variables. At theGenghis Khun ([email protected],nafanakhun.wordpress.com)


recommended doses, single injections of enoxaparin do not significantly influence platelet aggregation or affect global clotting time (ie, PT or APTT). Central nervous system: Fever (5% to 8%), confusion, pain Dermatologic: Erythema, bruising Gastrointestinal: Nausea (3%), increased ALT/AST (5.9% to 6.1%) Hematologic: Hemorrhage (5% to 13%), thrombocytopenia (2%), hypochromic anemia (2%) Local: Injection site hematoma (9%), local reactions (irritation, pain, ecchymosis, erythema) IO: Drugs which affect platelet function (eg, aspirin, NSAIDs, dipyridamole, ticlopidine, clopidogrel) may potentiate the risk of hemorrhage. Thrombolytic agents increase the risk of hemorrhage. Warfarin: Risk of bleeding may be increased during concurrent therapy. Enoxaparin is commonly continued during the initiation of warfarin therapy to assure anticoagulation and to protect against possible transient hypercoagulability.Genghis Khun ([email protected],nafanakhun.wordpress.com)


Standard heparin consists of components with molecular weights ranging from 4000-30,000 daltons with a mean of 16,000 daltons. Heparin acts as an anticoagulant by enhancing the inhibition rate of clotting proteases by antithrombin III impairing normal hemostasis and inhibition of factor Xa. Low molecular weight heparins have a small effect on the activated partial thromboplastin time and strongly inhibit factor Xa. Enoxaparin is derived from porcine heparin that undergoes benzylation followed by alkaline depolymerization. The average molecular weight of enoxaparin is 4500 daltons which is distributed as ( less than or equal to 20%) 2000 daltons, ( greater than or equal to 68%) 2000-8000 daltons, and ( less than or equal to 15%) >8000 daltons. Enoxaparin has a higher ratio of antifactor Xa to antifactor IIa activity than unfractionated heparin. Preg: B Nama Dagang: LovenoxGenghis Khun ([email protected],nafanakhun.wordpress.com)


Aprotinin I: Reduction or prevention of blood loss in patients undergoing coronary artery bypass surgery when a high risk of excessive bleeding exists, including open heart reoperation, pre-existing coagulopathies, operations on the great vessels, and when a patient's beliefs prohibit blood transfusions BSO: Injection: 1.4 mg/mL [10,000 U/mL] D: Test dose: All patients should receive a 1 mL I.V. test dose at least 10 minutes prior to the loading dose to assess the potential for allergic reactions Regimen A (standard dose): 2 million U (280 mg) loading dose I.V. over 20-30 minutes 2 million U (280 mg) into pump prime volume 500,000 U/hour (70 mg/hour) I.V. during operation Regimen B (low dose): 1 million U (140 mg) loading dose I.V. over 20-30 minutes 1 million U (140 mg) into pump prime volume 250,000 U/hour (35 mg/hour) I.V. during operation KI: Hypersensitivity to aprotinin or any componentGenghis Khun ([email protected],nafanakhun.wordpress.com)


P: Anaphylactic reactions are possible. Hypersensitivity reactions are more common with repeated use especially when re-exposure is within 6 months. All patients should receive a test dose at least 10 minutes before loading dose. Patients with a history of allergic reactions to drugs or other agents may be more likely to develop a reaction. ES: 1-10%: Atrial fibrillation, myocardial infarction, heart failure, atrial flutter, ventricular tachycardia, hypotension, supraventricular tachycardia, Fever, mental confusion, Phlebitis, Dyspnea, bronchoconstriction IO: Heparin and aprotinin prolong ACT. The ACT becomes a poor measure of adequate anticoagulation with the concurrent use of these drugs. Fibrinolytic drugs may have poorer activity. Aprotinin blocks this fibrinolytic activity; avoid concurrent use. Captopril's antihypertensive effects may be blocked; avoid concurrent use. Preg:B Nama Dagang:Genghis Khun ([email protected],nafanakhun.wordpress.com)


Acetylsalicyclic acid/ Aspirin Prevents platelet aggregation by irreversible cyclooxygenase inhibition with subsequent suppression of thromboxane A2. Antiplatelet effect can last as long as 7 d. BSO: D: 81-325 mg PO qd KI: Hipersensitif; liver damage; hypoprothrombinemia; vitamin K deficiency; bleeding disorders; asthma Because of association with Reye syndrome, do not use in children ( 2 g/d may potentiate glucose-lowering effect of sulfonylurea drugs Preg: DGenghis Khun ([email protected],nafanakhun.wordpress.com)


P: May cause transient decrease in renal function and aggravate chronic kidney disease; avoid use in patients with severe anemia, history of blood coagulation defects, or taking anticoagulants; adverse effects include prolonged bleeding time, rhinitis, asthma, urticaria, and exacerbation of gout; monitor BP, BUN, and uric acid level; consider discontinuing 7 d before surgery Nama Dagang:



Clopidogrel Selectively inhibits ADP binding to platelet receptor and subsequent ADP-mediated activation of GPIIb/IIIa complex, thereby inhibiting platelet aggregation. Consider in patients with contraindication to aspirin. D: 75 mg PO qd KI: Hipersensitif; active pathological bleeding IO: Naproxen associated with increased occult GI blood loss; prolongs bleeding time; safety of coadministration with warfarin not established Preg: C P: Caution in patients at increased risk of bleeding from trauma, surgery, or other pathological conditions; caution in patients with lesions with propensity to bleed (eg, ulcers); adverse effects include rash, diarrhea, purpura, GI ulcers, neutropenia, and rare cases of agranulocytosis; consider discontinuing 7 d before surgery Nama Dagang:Genghis Khun ([email protected],nafanakhun.wordpress.com)


Nadroparin calcium I: Ggn tromboembolik, mencegah pembekuan darah. BSO: Jarum suntik Prefilled 9.500 anti-Xa/cc D: 0.3 cc 1x/hr (7.500 ICU AXa) selama min 7 hari. Pre-op: 2-4 jam sebelum. Bedah ortopedi: 12 jam pre-op & 12 jam post-op BB 50-69 Kg: 0.3 cc pre-op s/d hr ke-3. 0.4 cc harike-4 dst. BB < 50 Kg: 0.2 cc pre-op s/d hr ke-3. 0.3 cc harike-4 dst. Terapi minimal 10 hari. Mencegah pembekuan darah selama hemodialisis: BB 50-69 Kg: 0.4 cc. BB < 50 Kg: 0.3 cc . KI: Trombositopeni P: ES: IO: OAINS, Aspirin, antiplatelet, Dextran Preg: B Nama Dagang: FraxiparineGenghis Khun ([email protected],nafanakhun.wordpress.com)


Iloprost I: Hipertensi pulmonal primer atau sekunder krn penyakit jaringan ikat atau krn diinduksi obat pd stadium sedang & berat. BSO: Lar inhalasi 2cc D: Dws: 2.5-5 mcg. Jika digunakan dg HaloLite atau Prodose: dosis pd mouthpiece 2.5 mcg, waktu inhalasi 8-10 mnt. Dosis harian 6-9x/hr. Ggn hati: Awal 2.5 mcg dg interval min 3 jam (max 6x/hr) KI: Ulkus peptic aktif, perdarahan intrakranial P: ES: IO: Vasodilator & obat antihipertensi, antikoagulan Preg: C Nama Dagang: Ventavis



Cilostazol I: Symptomatic management of peripheral vascular disease, primarily intermittent claudication; currently being investigated for the treatment of acute coronary syndromes BSO: Tablet: 50 mg, 100 mg D: Adults: Oral: 100 mg 2x/d 1 -2 hours ; dosage should be reduced to 50 mg 2x/d during concurrent therapy with inhibitors of CYP3A4 or CYP2C19 (see Drug Interactions) KI: Hypersensitivity, heart failure (of any severity) P: Use with caution in patients receiving platelet aggregation inhibitors, hepatic impairment. Use with caution in patients receiving inhibitors of CYP3A4 (such as ketoconazole or erythromycin) or inhibitors of CYP2C19 (such as omeprazole); use with caution in severe underlying heart disease; use is not recommended in nursing mothers ES: >10%: Headache, Abnormal stools, diarrhea, Infection.



2-10%: Peripheral edema, palpitation, tachycardia, Dizziness, Dyspepsia, nausea, abdominal pain, flatulence, Back pain, myalgia, Rhinitis, pharyngitis, cough IO: Preg: C Nama Dagang:



Fondaparinux sodium I: Mencegah tomboembolik pd pasien bedah ortopedi tungkai bawah BSO: Jarum Suntik Prefilled 2.5 mg/0.5cc D: 2.5 mg SC 6 jam post op, lalu 2.5mg/hr selama 5-9 hari KI: Perdarahan aktif P: ES: IO: Preg:: A, B, C, D, X Nama Dagang: Arixtra



Antithrombin III I: Hereditary antithrombin III deficiency BSO: Powder for injection: 500 U D: Adults: After first dose of antithrombin III, level should increase to 120% of normal; thereafter maintain at levels >80%. Generally, achieved by administration of maintenance doses once every 24 hours. Initially and until patient is stabilized, measure antithrombin III level at least twice daily, thereafter once daily and always immediately before next infusion. 1 unit = quantity of antithrombin III in 1 mL of normal pooled human plasma; administration of 1 unit/1 kg raises AT-III level by 1% to 2%; assume plasma volume of 40 mL/kg. Measure antithrombin III preceding and 30 minutes after dose to calculate in vivo recovery rate; maintain level within normal range for 2-8 days depending on type of surgery or procedure. KI: Hypersensitivity to antithrombin III or any component P: Can potentially transmit infectious diseases since it is a product of human plasma. Discuss risk versus benefits withGenghis Khun ([email protected],nafanakhun.wordpress.com)


patient. Reduce the dose of heparin to avoid bleeding when used concurrently. Administer alone by the I.V. route only. ES: 1% to 10%: Central nervous system: Dizziness (2%) IO: Drugs which affect platelet function (eg, aspirin, NSAIDs, dipyridamole, ticlopidine, clopidogrel) may potentiate the risk of hemorrhage. Heparin's anticoagulant effects are potentiated by antithrombin III. Thrombolytic agents increase the risk of hemorrhage. Warfarin (and other oral anticoagulants) may increase the risk of bleeding with antithrombin III. Preg: C Nama Dagang: Kybernin P



Anagrelide I: Agent for essential thrombocythemia (ET); treatment of thrombocytopenia secondary to myeloproliferative disorders BSO: Capsule: 0.5 mg, 1 mg D: Adults: Oral: 0.5 mg 4 times/day or 1 mg twice daily KI: Hypersensitivity P: Patients with known or suspected heart disease, and only if the potential benefits of therapy outweigh the potential risks. Thrombocytopenia appears to be the main dose-limiting side effect of anagrelide; palpitations, orthostatic hypotension, and headache have also been reported. ES: Palpitations, chest pain, tachycardia, orthostatic hypotension, CHF, cardiomyopathy, Headache, dizziness, bad dreams, impaired concentration ability IO: There is a single case report that suggests sucralfate may interfere with anagrelide absorption Preg: C Nama Dagang:Genghis Khun ([email protected],nafanakhun.wordpress.com)


Alteplase Commercially manufactured recombinant DNA fibrinolytic protein approved for treatment of AMI, AIS, and acute massive pulmonary embolism. BSO: Powder for injection, lyophilized (recombinant): 20 mg [11.6 million U]; 50 mg [29 million U]; 100 mg [58 million U] D: 0.9 mg/kg IV; max 90 mg/dose; infuse over 60 min with 10% of total dose administered as initial IV bolus over 1 min KI: Hipersensitif; active internal bleeding; stroke within last 3 mo; recent intracranial or intraspinal surgery or trauma; intracranial hemorrhage on pretreatment evaluation; suspicion of subarachnoid hemorrhage, intracranial neoplasm, arteriovenous malformation, or aneurysm; bleeding diathesis; severe uncontrolled hypertension IO: Drugs that alter platelet function (eg, aspirin, dipyridamole, clopidogrel, abciximab) may increase risk of bleeding prior to,Genghis Khun ([email protected],nafanakhun.wordpress.com)


during, or after alteplase therapy Note that criteria for use of IV t-PA preclude use of antiplatelet or antithrombotic agents for 24 h following t-PA infusion Preg: C P: Noncompressible arterial punctures and internal jugular and subclavian venous punctures must be avoided to minimize bleeding from noncompressible sites; in event of serious bleeding, immediately discontinue alteplase; monitor patients for allergic-type reactions, such as anaphylactoid reaction, laryngeal edema, rash, and urticaria Nama Dagang: Actilyse



N. Preparat Flebitis & Varises Monoxerutin Heparinoid Diosmin Anagrelide



Monoxerutin Lihat di I. Sal Cerna > Preparat Anorektal



Heparinoid Heparinoid blocks the production of a chemical called prostaglandin which the body produces in response to injury or certain diseases. Prostaglandins are responsible for causing swelling, pain and inflammation, and therefore heparinoid reduces these effects. It is also able to dissolve blood clots and improve the blood supply to the skin. I: Anal itch, Inflammation of the rectum (proctitis), Piles (haemorrhoids), Tear in the lining of the back passage (anal fissure) BSO: D: KI: Children, allergic. P: ES: IO: Preg:: A, B, C, D, X Nama Dagang: HirudoidGenghis Khun ([email protected],nafanakhun.wordpress.com)


O. Hemoreologik Pentoxyfilline Naftidrofuryl Buflomedil Bencyclane



Pentoxyfilline I: Symptomatic management of peripheral vascular disease, mainly intermittent claudication BSO: Tablet, controlled release: 400 mg D: Adults: Oral: 400 mg 3x/hr ; may reduce to 400 mg 2x/d if GI or CNS side effects occur KI: Hypersensitivity; patients with recent cerebral and/or retinal hemorrhage P: Use with caution in patients with renal impairment ES: Dizziness, headache, Dyspepsia, nausea, vomiting IO: Increased effect/toxic potential with cimetidine (increased levels) and other H2-antagonists, warfarin; increased effect of antihypertensives Increased toxicity with theophylline Preg:: C Nama Dagang:



Naftidrofuryl Naftidrofuryl oxalate works in two main ways. Firstly, it causes the blood vessels to widen. Secondly, it increases the ability of cells to remove waste products. Both these properties make it useful in the treatment of disorders caused by decreased blood supply to a particular area of the body. In peripheral vascular diseases, the blood vessels in the extremities are narrowed and the blood and oxygen supply to cells in the hands, feet or legs is reduced. Oxygen is required by cells in order for them to remove waste products, therefore in these conditions waste products can build up. This can cause damage to cells and lead to symptoms such as pain, cramps or ulceration. Similarly, where there is a disorder of blood flow to the brain, a lack of oxygen supply can cause damage to the cells in the brain, resulting in symptoms such as confusion or decreasing mental ability. Naftidrofuryl improves these symptoms by increasing blood and oxygen supply to the affected areas and also increasing theGenghis Khun ([email protected],nafanakhun.wordpress.com)


ability of the cells to remove waste products, even in low oxygen supply. I: Cerebral insufficiency, Narrowing of blood vessels in the extremities (peripheral vascular disease), cerebral atherosclerosis BSO: Tab 100 mg, 200 mg D: 100-200 mg 3x/hr KI: Rash, Nausea, Stomach pain, hepatitis P: ES: IO: Preg:: A, B, C, D, X Nama Dagang:



P. Haematopoietic agent Lenograstim Filgrastim Epoetin alfa Epoetin beta Erythropoietin



Lenograstim Lenograstim is a substance that stimulates the production of a type of white blood cell from the bone marrow, known as neutrophils. Neutrophils play a cental role in the body's immune system and defends the body from infections. Therefore a low level of neutrophils in the blood (neutropenia), leaves a person very susceptible to life threatening infections. Neutropenia can be caused by a number of factors, such as cancer chemotherapy and it often occurs in individuals who have recently had a bone marrow transplant or are suffering from AIDS. Lenograstim is commonly used after high dose chemotherapy regimes or bone marrow transplants, to correct low neutrophil levels in the blood and thereby reduces the duration and severity of the neutropenia. As a result, lenograstim minimises the need for antibiotic treatment, the risk of complications due to infections and length of time spent in hospital after bone marrow transplants.Genghis Khun ([email protected],nafanakhun.wordpress.com)


I: To increase production of stem cells (or progenitor cells), To speed up production of neutrophils following bone marrow transplants, chemotherapy induced neutropenia BSO: Vial 33.6 MIU tau 263 mcg/cc D: Dws 150 mcg/m2/hr.1 vial dpt digunakan utk pasien dg BSA s/d 1.6 m2/hr. Transplantasi sumsum tulang (BMT): mulai 24 jam setelah transplantasi, infuse IV dlm saline 100 cc selama 30 menit. Kemoterapi sitotoksik: mulai 24 jam setelah kemoterapi lengkap inj SC, biasanya selama 8-14 hari. KI: Myeloma, Children under 2 years of age P: Severely decreased kidney & liver function ES: Headache, Abdominal pain, Allergic reaction, Bone pain, Reactions at injection site, cutaneous vasculitis, adult respiratory distress syndrome (ARDS) Nama Dagang: Granocyte 34Genghis Khun ([email protected],nafanakhun.wordpress.com)


Filgrastim I: Patients with nonmyeloid malignancies receiving myelosuppressive anticancer drugs associated with a significant incidence of neutropenia (FDA-approved indication) Cancer patients receiving bone marrow transplant (BMT) (FDAapproved indication) Patients undergoing peripheral blood progenitor cell (PBPC) collection Patients with severe chronic neutropenia (SCN) (FDA-approved indication) Chronic administration in symptomatic patients with congenital neutropenia, cyclic neutropenia, or idiopathic neutropenic; filgrastim should not be started until the diagnosis of SCN is confirmed, as it may interfere with diagnostic efforts Safety and efficacy of G-CSF given simultaneously with cytotoxic chemotherapy have not been established; concurrent treatment may increase myelosuppression; G-CSF should be avoided in patients receiving concomitant chemotherapy and radiation therapyGenghis Khun ([email protected],nafanakhun.wordpress.com)


BSO: Injection, preservative free: 300 mcg/mL D: Children and Adults: Existing clinical data suggest that starting G-CSF between 24 and 72 hours subsequent to chemotherapy may provide optimal neutrophil recover; continue therapy until the occurrence of an absolute neutrophil count of 10,000 L after the neutrophil nadir The available data suggest that rounding the dose to the nearest vial size may enhance patient convenience and reduce costs without clinical detriment Neonates: 5-10 mcg/kg/day once daily for 3-5 days has been administered to neutropenic neonates with sepsis; there was a rapid and significant increase in peripheral neutrophil counts and the neutrophil storage pool Children and Adults: Myelosuppressive chemotherapy infusion: 5 mcg/kg/day IV/SC Doses may be increased in increments of 5 mcg/kg for each chemotherapy cycle, according to the duration and severity of the absolute neutrophil count (ANC) nadirGenghis Khun ([email protected],nafanakhun.wordpress.com)


Bone marrow transplant patients: 5-10 mcg/kg/day as an I.V. infusion of 4 or 24 hours or as continuous 24-hour S.C. infusion; administer first dose at least 24 hours after cytotoxic chemotherapy and at least 24 hours after bone marrow infusion; if ANC decreases 1000/mm3 for 3 consecutive days: Reduce Filgrastim dose to 5 mcg/kg/day If ANC remains >1000/mm3 for 3 more consecutive days: Discontinue filgrastim If ANC decreases to 10%: Central nervous system: CNS stimulating effects, nervousness, anxiety, apprehension, fear, tension, agitation, excitation, restlessness, irritability, insomnia, hyperactivityGenghis Khun ([email protected],nafanakhun.wordpress.com)


1% to 10%: Cardiovascular: Hypertension, tachycardia, palpitations, elevation or depression of blood pressure, unusual pallor Central nervous system: Dizziness, headache Gastrointestinal: Xerostomia, nausea, anorexia, GI upset, vomiting Genitourinary: Painful urination Neuromuscular & skeletal: Trembling, tremor (more common in the elderly), weakness Miscellaneous: Diaphoresis (increased) IO: Decreased effect: Alpha- and beta-adrenergic blocking agents decrease ephedrine vasopressor effects Increased toxicity: Additive cardiostimulation with other sympathomimetic agents; theophylline cardiostimulation; MAO inhibitors or atropine may increase blood pressure; cardiac glycosides or general anesthetics may increase cardiac stimulation Preg: C Nama Dagang:Genghis Khun ([email protected],nafanakhun.wordpress.com)


Terbutaline I: Asthma, Chronic obstructive pulmonary disease (COPD) BSO: Aerosol, oral: 0.2 mg/actuation Injection: 1 mg/mL Tablet: 2.5 mg, 5 mg D: Children 12 years and Adults: Oral: 12-15 years: 2.5 mg q6h 3 x/day; max 7.5 mg/day >15 years: 5 mg/dose every 6 hours 3 times/day; if side effects occur, reduce dose to 2.5 mg every 6 hours; max 15 mg in 24 hoursGenghis Khun ([email protected],nafanakhun.wordpress.com)


S.C.: 0.25 mg/dose repeated in 15-30 minutes for one time only; a total dose of 0.5 mg should not be exceeded within a 4hour period Nebulization: 0.01-0.03 mg/kg/dose every 4-6 hours Inhalation: 2 inhalations every 4-6 hours; wait 1 minute between inhalations Dosing adjustment/comments in renal impairment: Clcr 10-50 mL/minute: Administer at 50% of normal dose Clcr 10%: Insomnia, restlessness, Dry throat, xerostomia, discoloration of saliva (pinkish-red) 1% to 10%: Flushing of the face or skin, ventricular arrhythmias, tachycardias, profound hypotension, hypertension, Nervousness, anxiety, dizziness, headache, lightheadedness, Vomiting, nausea, Trembling, tremor, weakness, Diaphoresis IO: Increased toxicity: Sympathomimetic agents may cause headaches and elevate blood pressure; general anesthetics may cause arrhythmias Preg: C Nama Dagang:



Fenoterol HBr I: Asma BSO: Inhaler dosis terukur 100 mcg/semprot. 200 mcg/semprot. Larutan inhalasi 0.1% D: Asma akut: 1 semprot. Maks 8 semprot/hr Lar inhalasi, tunggal: 0.2-1 mg 3x/hr dg interval min 3 jam KI: Kardiomiopati obstruksi hipertrofi, takiaritmia P: ES: IO: Preg: B Nama Dagang:



Clenbuterol HCl I: PPOK (asma bronchial, bronchitis kronik & emsifema paru) BSO: Tab 10 mcg. 20 mcg. Sir 5 mcg/5cc D: Tab Dws & >12thn 40 mcg/hr. kasus berat bs 80mcg/hr. pemeliharaan 20 mcg/hr. Anak 1.2 mcg/kg/hr. Sir: 6-12thn 2x 3sdt. 4-6thn 2x 2 sdt. 2-4 thn 3x 1sdt. 10%: Hypertension, palpitations 1-10%: Insomnia, restlessness, dizziness, Xerostomia, nausea IO: Decreased effect of antihypertensivesGenghis Khun ([email protected],nafanakhun.wordpress.com)


Increased effect/toxicity with MAO inhibitors (hypertensive crisis), beta-blockers (increased pressor effects) Preg: C Nama Dagang:



Guaifenesin/ Glyceryl Guaiacolate & Dextromethorphan Treats minor cough resulting from bronchial and throat irritation. BSO: Caplet, sustained release 300 mg, 600 mg Capsule: 200 mg Liquid: 100 mg/5 mL, 200 mg/5 mL Tablet: 100 mg, 200 mg, 1200 mg Sustained release: 600 mg D: 5 mL PO q4h or 10 mL PO q6-8h; max 40 mL/24h Paed. 1-2 mg/kg/d PO divided tid/qid KI: Hipersensitif IO: Preg: C P: Do not use to treat productive cough or persistent chronic cough resulting from emphysema Nama Dagang:



Ambroxol HCl I: Penyakit sal nafas akut & kronik yg berhubungan dg sekresi abnormal bronkus. BSO: Tab 30 mg, Syr 15 mg/5cc D: D:1 tab 3x/hr atau 10 cc 3x/hr Anak 5-12 th: tab 3x/hr atau 5 cc 3x/hr Anak 2-5 th: 2.5 cc 3x/hr 12 years: Sedation/analgesia for procedures: I.V.: 3-4 mg and repeat in 5 minutes if necessary Adults: Oral: Prompt release: 10-30 mg every 4 hours as needed; controlled release: 15-30 mg every 8-12 hoursGenghis Khun ([email protected],nafanakhun.wordpress.com)


I.M., I.V., S.C.: 2.5-20 mg/dose every 2-6 hours as needed; usual: 10 mg/dose every 4 hours as needed I.V., S.C. continuous infusion: 0.8-10 mg/hour; may increase depending on pain relief/adverse effects; usual range: up to 80 mg/hour Epidural: Initial: 5 mg in lumbar region; if inadequate pain relief within 1 hour, administer 1-2 mg, maximum dose: 10 mg/24 hours Intrathecal (1/10 of epidural dose): 0.2-1 mg/dose; repeat doses not recommended Rectal: 10-20 mg every 4 hours Dosing adjustment in renal impairment: Clcr 10-50 mL/minute: Administer at 75% of normal dose Clcr 48 hours or after 34-week gestation Nama Dagang: DialonGenghis Khun ([email protected],nafanakhun.wordpress.com)


Loxoprofen I: AR, OA, nyeri punggung, periartritis skapulo-humoral & sindroma leher-bahu & lengan BSO: Tab 60 mg D: Dws 60 mg 3x/hr atau dosis tunggal 60-120 mg tgt umur & beratnya gejala. KI: Tukak peptik, ggn hematologi berat. Hamil trim akhir, laktasi P: Usia lanjut, hamil ES: syok, anemia hemolitik, sindr mukokutaneus okular, ggl ginjal akut, sindr nefrotik IO: Antikoagulan kumarin, kuinolon, antimikroba Preg:: A, B, C, D, X Nama Dagang: Loxonin



Phenylbutazone I: AR, Demam rematik, tendonitis, bursitis, sinovitis, gout akut, tromboflebitis superfisial BSO: Kapl & Kaps 100 mg, 200 mg D: Awal 300-600 mg/hr terbagi dlm 3-4 dosis KI: Edema,dekompensasi kordis, tukak lambung, riwayat diskrasia darah, anak < 14 thn, ggn hati & ginjal P: Usia lanjut, hamil & laktasi ES: Mual, muntah, ggn epigastrium, hematuria, penglihatan kabur IO: antikoagulan, insulin, hipoglikemik oral Preg: C, D hamil trim 3 Nama Dagang:



Oxyphenbutazone NSAID I: Management of inflammatory disorders, as an analgesic in the treatment of mild to moderate pain; acute gouty arthritis BSO: Tablet: 100 mg, 200 mg D: Acute gout: 1st 400 mg then 100 mg q4h. max 7day KI: Active GI bleeding; ulcer disease; hypersensitivity to oxyphenbutazone or any component P: ES: >10%: Dizziness, Skin rash, Abdominal cramps, heartburn, indigestion, nausea 1% to 10%: Headache, nervousness, Itching, Fluid retention, Vomiting, Tinnitus IO: Preg: D BSO: Nama Dagang: ReozonGenghis Khun ([email protected],nafanakhun.wordpress.com)


Dexketoprofen NSAID I: Pain in muscles, bones/ joints, dysmenorrhea, Toothache BSO: Tab salut selaput 25 mg D: 12.5 mg 3-4x/hr atau 25 mg 3x/hr. Maks 75 mg. KI: Children, allergic, asthma, peptic ulcer, Crohn's disease, Ulcerative colitis, Pregnancy, Breastfeeding. P: Elderly people, Dehydration, History of disorders affecting the stomach or intestines, hypertension, History of allergies ES: Indigestion, nausea, vomiting, constipation, diarrhoea, heartburn, abdominal pain, Headache, Dizziness, insomnia, vertigo, Palpitations, Fatigue, Flushing, Dry mouth, fluid retention, oedema, Changes in blood pressure, Ulceration of the stomach or intestine, bronchospasm, photosensitivity, Visual disturbances, tinnitus Preg:: A, B, C, D, X Nama Dagang: KetesseGenghis Khun ([email protected],nafanakhun.wordpress.com)


Fenbufen NSAID I: Rheumatoid arthritis, ankylosing spondylitis, Osteoarthritis, Painful disorders of the muscles and skeleton, such as tendinitis, sprains, strains, dislocations, fractures, back pain BSO: Kaps 300 mg D: Rematik: 600-900 mg 2-3x/hr. Max 1200 mg/hr Analgesik: 400 mg 2x/hr atau 300 mg 3x/hr KI: Allergic reactions, Active peptic ulcer or bleeding from the gut, Severe heart failure, children < 14 years of age. P: Elderly people, Inflammatory bowel disease such as Crohn's disease or ulcerative colitis, Heart failure, hypertension, History of asthma & allergies, People with blood clotting disorders or taking anticoagulant medicines, Diseases affecting connective tissue, eg SLE ES: Indigestion, diarrhoea, constipation, nausea, vomiting or abdominal pain, Rash, Headache, Dizziness, insomnia, tinnitus,Genghis Khun ([email protected],nafanakhun.wordpress.com)


vertigo, Visual disturbances, Ulceration of the stomach or intestines, Bleeding from the stomach or intestines, fluid retention, oedema, photosensitivity, Hypersensitivity reactions, Kidney, liver or blood disorders, Lung disorders IO: Preg:: A, B, C, D, X Nama Dagang: Cybufen



Nabumetone NSAID I: Inflammation of joints (arthritis) BSO: Tablet: 500 mg, 750 mg D: 500-1000 mg 1-2x/day Max 1 g/hr KI: Allergy, Peptic ulcers, Severe liver disease P: Asthma, Children, Elderly people, Heart disease, hypertension, Kidney disease, Liver disease ES: Abdominal pain, Diarrhoea, Nausea, dyspepsia, Ulceration of the stomach or intestine, Rash (allergic reaction), fluid retention, Dizziness or loss of balance, Kidney disease, pancreatitis, photosensitivity, toxic epidermal necrolysis, bronchospasm, angioedema IO: Aspirin decreases serum concentrations probably by protein-binding displacement; there is an increased bleeding potential with concomitant warfarin therapy; may increase lithium and methotrexate concentrations by decreasing renal clearance; may decrease diuretic and hypotensive effects ofGenghis Khun ([email protected],nafanakhun.wordpress.com)


thiazides, loop diuretics, ACE inhibitors, and beta-blockers; may increase nephrotoxicity of cyclosporine Preg: C, D hamil trim 3 Nama Dagang: Goflex



Celecoxib Primarily inhibits COX-2. COX-2 is considered an inducible isoenzyme, induced by pain and inflammatory stimuli. Inhibition of COX-1 may contribute to NSAID GI toxicity. At therapeutic concentrations, COX-1 isoenzyme is not inhibited, thus GI toxicity may be decreased. Seek lowest dose of celecoxib for each patient. Celecoxib has the same general class labeling as conventional NSAIDs. BSO: Kaps 100 mg, 200 mg D: 100 mg PO qd/bid (1-2x/hr) KI: Hipersensitif IO: Coadministration with fluconazole may cause increase in celecoxib plasma concentrations because of inhibition of celecoxib metabolism; coadministration of celecoxib with rifampin may decrease celecoxib plasma concentrations Preg: B P:Genghis Khun ([email protected],nafanakhun.wordpress.com)


May cause fluid retention and peripheral edema; caution in compromised cardiac function, hypertension, and conditions predisposing to fluid retention; severe heart failure and hyponatremia may occur because celecoxib may deteriorate circulatory hemodynamics; NSAIDs may mask usual signs of infection; caution in the presence of existing controlled infections; evaluate symptoms and signs suggesting liver dysfunction Nama Dagang: Celebrex



Valdecoxib NSAID I: RA, OA, dysmenorrhoea BSO: Tab salut selaput 10 mg D: OA &RA 10-20 mg 1x/hr. Max 20 mg Dismenore primer 40 mg 1x/hr. Tambahan 40 mg dpt diberikan pd hari I . KI: Allergy, Active peptic ulcer, Bleeding from the stomach or intestines, Inflammatory bowel disease such as ulcerative colitis or Crohn's disease, People who have had coronary artery bypass graft (CABG) surgery, Moderate to severe heart failure, ischaemic heart disease, cerebrovascular disease, Severely decreased liver function, Third trimester of pregnancy, Breastfeeding, P: Elderly people, Moderately decreased liver function, Decreased kidney function, fluid retention, Dehydration, History of diseases of the stomach or intestines, History of ulceration or bleeding in the stomach or intestines, hypertension,Genghis Khun ([email protected],nafanakhun.wordpress.com)


hyperlipidaemia, Diabetes, Smokers, Narrowing of the arteries in the extremities (peripheral arterial disease) ES: Abdominal pain and bloating, diarrhoea, nausea, indigestion, Dry mouth, insomnia, somnolence, hypertension, Cough, pharyngitis, sinusitis, Urinary tract infection, peripheral oedema, Rash or itching, anaemia, Dry socket following a tooth extraction, Blurred vision, Pins and needles or numb sensations, Anxiety, Confusion, Ulceration or bleeding of the stomach or intestines, heart failure, Severe skin reactions IO: If you are taking anti-blood-clotting medicines (anticoagulants) such as warfarin, you should have your blood clotting time (INR) monitored if you start or stop treatment with valdecoxib, or if your dose is changed. Valdecoxib may be taken with low-dose (75mg daily) aspirin. However, this combination may carry an increased risk of ulceration or bleeding in the stomach or intestines compared to taking valdecoxib on its own. Valdecoxib should not be taken with higher daily doses of aspirin. For more information and advice ask your doctor or pharmacist.Genghis Khun ([email protected],nafanakhun.wordpress.com)


Valdecoxib should not be taken with other non-steroidal antiinflammatory drugs (NSAIDs), eg ibuprofen, diclofenac, as using more than one NSAID together may also increase the risk of side effects on the gut. Valdecoxib may potentially decrease the effectiveness of medicines used for lowering high blood pressure (antihypertensives). There may be an increased risk of side effects on the kidney if valdecoxib is taken with any of the following medicines, and your kidney function should be monitored if you are taking any of these medicines with valdecoxib: * ACE inhibitors, eg enalapril * ciclosporin * diuretics, eg bendroflumethiazide, furosemide * tacrolimus. The following medicines may increase the blood level of valdecoxib, and your doctor may prescribe a lower dose of valdecoxib if you are taking one of these medicines:Genghis Khun ([email protected],nafanakhun.wordpress.com)


* fluconazole * ketoconazole. The following medicines may decrease the blood level of valdecoxib: * antiepileptics, eg carbamazepine, phenytoin * dexamethasone * rifampicin. Valdecoxib may increase the blood levels of the following medicines: * flecainide * propafenone * metoprolol * omeprazole * phenytoin * diazepam * imipramine * lithium (your lithium blood level should be monitored if you are starting, changing dose, or stopping valdecoxib while taking lithium).Genghis Khun ([email protected],nafanakhun.wordpress.com)


Valdecoxib may also increase the blood levels of hormones (oestrogens and progestogens) contained in combined oral contraceptive pills, and this may increase the risk of side effects from these pills. Discuss this with your doctor. Other NSAIDs can reduce the removal of the medicine methotrexate from the body. This has not been reported with valdecoxib, but people taking methotrexate should be well monitored for any side effects of methotrexate while taking valdecoxib. Preg: C Nama Dagang: Bextra



Etoricoxib NSAID I: Acute gout, RA, OA BSO: Tab salut selaput 60 mg, 90 mg, 120 mg D: 60 -120 mg 1x/hr KI: < 16 years of age, allergic reactions, Severely decreased liver function, Moderate to severely decreased kidney function, Active peptic ulcer or bleeding from the gut, Inflammatory bowel disease such as Crohn's disease or ulcerative colitis, hypertension, Heart failure, ischaemic heart disease, cerebrovascular disease, peripheral arterial disease, Pregnancy, Breastfeeding, Rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucosegalactose malsorption (Arcoxia tablets contain lactose). P: Elderly people, History of disorders affecting the stomach or intestines, such as ulceration or bleeding, Decreased liver & kidney function, Liver cirrhosis, Dehydration, History of heartGenghis Khun ([email protected],nafanakhun.wordpress.com)


failure, oedema, hypertension, hyperlipidaemia, Diabetes, Smokers ES: Headache, Dizziness, diarrhoea, constipation, nausea, vomiting, indigestion, flatulence or abdominal pain, oedema, hypertension, asthenia, Fatigue, Cold or flu-like symptoms, Skin reactions such as rash and itch, Blurred vision, insomnia, Muscle cramps, Weight gain, Anxiety, Depression, epistaxis, dyspnoea, Chest pain, Heart attack or stroke, Ulceration or bleeding of the stomach or intestine, Liver or kidney disorders IO: Preg:: A, B, C, D, X Nama Dagang: Arcoxia



Etanercept Soluble p75 TNF receptor fusion protein (sTNFR-Ig). Inhibits TNF binding to cell surface receptors, which, in turn, decreases inflammatory and immune responses. BSO: Vial 25 mg D: 25 mg SC 2x/wk with or without concomitant administration of MTX KI: Hipersensitif, sepsis, concurrent live vaccination IO: Preg: B P: Caution in impaired renal function and asthma; discontinue administration if serious infection develops; adverse effects may include injection site pain, localized erythema, rash, URI symptomology, GI upset, nausea, vomiting, rhinitis, cough, and drug-induced lupus Nama Dagang: EnbrelGenghis Khun ([email protected],nafanakhun.wordpress.com)


Parecoxib I: Terapi jangka pendek utk nyeri pasca operasi BSO: Vial 20 mg D: 40 mg IV/IM diikuti 20-40 mg 2-4x/hr. Max 80 mg/hr Lansia > 65 th: BB < 50 Kg dosis lazim. Max 40 mg/hr KI: Hipersensitif, hamil (tirm 1 & 2), laktasi, tukak peptic aktif P: ES: Hipoestesi, nyeri punggung, edema perifer, osteitis alveolar, dispepsia, kembung, peningkatan kreatinin, hipokalemia,agitasi, insomnia. IO: Warfarin, diuretik, antihipertensi, siklosporin, takrolimus, flukonazol, rifampisin, fenitoin Preg:: A, B, C, D, X Nama Dagang: Dynastat



Tinoridine I: Radang pasca bedah, cedera sal. Kemih, radang akut sal nafas atas, otitis, artritis, uretritis, epididimitis, lumbago, nyeri punggung, artralgia, nyeri setelah cabut gigi, rematik BSO: Kaps 50 mg D: 50-100 mg 2x/hr KI: P: ES: Jarang, ggn GI, vertigo, mulut kering IO: Preg:: A, B, C, D, X Nama Dagang: Nonflamin



Sodium hyaluronate/ Hyaluronic acid I: Surgical aid in cataract extraction, intraocular implantation, corneal transplant, glaucoma filtration, and retinal attachment surgery BSO: Jarum suntik 10 mg/mL, 12 mg/mL, 14 mg/mL, 16 mg/mL 20 mg/cc, 30 mg/mL D: 3 cc/ sendi lutut atau pinggang sebagai dosis tunggal KI: Hypersensitivity to hyaluronate P: Do not overfill the anterior chamber; carefully monitor intraocular pressure; risk of hypersensitivity exists ES: 1% to 10%: Ocular: Postoperative inflammatory reactions (iritis, hypopyon), corneal edema, corneal decompensation, transient postoperative increase in IOP IO: Preg: C Nama Dagang:



Nimesulide I: OA, RA, pnykit Rematik ekstra artikuler, nyeri & peradangan sesudah intervensi bedah & akibat trauma akut, dismenore. BSO: Tab 100 mg D: 100 mg 2x/hr KI: Hipersensitifitas, tukak lambung, Anak, Hamil P: Ggn fungsi ginjal dan jantung ES: Anoreksia, urin gelap,perforasi, vertigo. IO: AINS lain: meningkatkan resiko perdarahan Preg: X Nama Dagang:



Infliximab Chimeric IgG1k monoclonal antibody that neutralizes cytokine TNF-alpha and inhibits its binding to TNF-alpha receptor. Reduces infiltration of inflammatory cells and TNF-alpha production in inflamed areas. Used with MTX in patients who have inadequate response to MTX monotherapy. BSO: Vial 100 mg D: 3 mg/kg IV at weeks 0, 2, and 6; then q4-8wk, usually with MTX; some patients require higher doses (4-5 mg/kg) KI: Hipersensitif Preg: B P: TNF-alpha modulates cellular immune responses; antiTNF therapies, such as infliximab, may adversely affect normal immune responses and allow development of superinfections; may increase risk of reactivation of TB in patients with certain granulomatous infections; PPD-+ patients require TB prophylaxis; may cause anti-DNA antibodies and drug-induced lupus Nama Dagang: RemicadeGenghis Khun ([email protected],nafanakhun.wordpress.com)


Rituximab Chimeric IgG1-kappa monoclonal antibody directed against the CD20 antigen found on the surface of normal and malignant B lymphocytes. The Fab domain of rituximab binds to CD20 antigen on B lymphocytes, and Fc domain recruits immune effector functions to mediate B-cell lysis in vitro. Possible mechanisms of cell lysis include complement-dependent cytotoxicity (CDC) and antibody-dependent cell-mediated cytotoxicity (ADCC). Rituximab in combination with methotrexate is indicated to reduce signs and symptoms in adult patients with moderately to severely active RA who have had an inadequate response to one or more TNF antagonist therapies. BSO: Injection, preservative free: 100 mg/ 10cc; 500 mg/50cc D: Give two 1-g IV infusions 2 wk apart Glucocorticoids administered as methylprednisolone 100 mg IV or equivalent 30 min prior to each infusion are recommended to reduce incidence and severity of infusion reactionsGenghis Khun ([email protected],nafanakhun.wordpress.com)


Adults: I.V. (refer to individual protocols): Do not administer I.V. push or bolus (hypersensitivity reactions may occur). Consider premedication (consisting of acetaminophen and diphenhydramine) before each infusion of rituximab. Premedication may attenuate infusion-related events. Because transient hypotension may occur during infusion, give consideration to withholding antihypertensive medications 12 hours prior to rituximab infusion. KI: Known anaphylaxis or IgE-mediated hypersensitivity to murine proteins or any component of product IO: renal toxicity reported with drug in combination with cisplatin in clinical trials (in clinical trials involving patients with RA, concomitant administration of MTX or cyclophosphamide did not alter pharmacokinetics of rituximab) Preg: C P: Safety and efficacy of re-treatment not established in controlled trials; not recommended in patients with RA and no prior inadequate response to one or more TNF antagonists; has caused severe infusion reactions (in some cases, reactionsGenghis Khun ([email protected],nafanakhun.wordpress.com)


were fatal); hepatitis B virus (HBV) reactivation with fulminant hepatitis, hepatic failure, and death has been reported in some patients with hematologic malignancies treated with rituximab; hypersensitivity reactions (nonIgE-mediated reactions reported); mucocutaneous reactions, some with fatal outcome, have been reported in patients treated with rituximab; vaccination with live-virus vaccines not recommended Nama Dagang: MabThera



Glucosamine HCl, Chondroitin sulphate I: OA, membantu melindungi kerusakan rawan sendi BSO: Krim D: 2-3x/hr KI: P: ES: IO: Preg:: A, B, C, D, X Nama Dagang:



Diacerein I: Terapi oral jangka panjang spesifik utk penykt sendi degeneratif (OA & penyakit lain yg berkaitan) BSO: Kapl 50 mg D: 1 kapl 2x/hr KI: Hipersensitif P: Hamil & laktasi ES: Mual, muntah, diare, nyeri epigastrik IO: Obat yg menyebabkan perubahan transit intestinal & atau kualitas kandungan intestinal (misalnya kelebihan serat atau filtrate), Al hidroksida, Mg hidroksida Preg: B Nama Dagang: Artrodar



Leflunomide Antimetabolite First new DMARD approved in more than 10 years. Blocks autoimmune antibodies and reduces inflammation. Inhibits dihydroorotate dehydrogenase, an enzyme in the de novo pyrimidine synthesis pathway. Studies indicate that it reduces symptoms, possibly better than MTX, and may even slow progression of RA. Use with caution in renal insufficiency I: Treatment of active rheumatoid arthritis to reduce signs and symptoms and to retard structural damage as evidenced by xray erosions and joint space narrowing BSO: Tablet: 10 mg, 20 mg, 100 mg D: Initial: 100 mg/d PO for 3 d Maintenance dose: 10-20 mg/d PO KI: Hipersensitif IO: Cholestyramine and charcoal reduce effects; concomitant rifampin increases toxicity Preg: X P:Genghis Khun ([email protected],nafanakhun.wordpress.com)


Serious adverse reactions include hepatotoxicity and immunosuppression; other reactions include nausea, diarrhea, abdominal pain, rash, bronchitis, headache, hypertension, dizziness, and alopecia; caution if impaired liver or renal function or if immunodeficient; leflunomide is a prodrug and active metabolite has a very long plasma half-life (approximately 15 d); with serious toxicity, can be cleared more quickly using cholestyramine 8 mg tid. Nama Dagang: Arava



C. Preparat Gout Colchicine Allopurinol Indometacin Phenylbutazone Probenecid



Colchicine -- Inhibits microtubules and thereby may inhibit phagocytosis, neutrophil mobility, and chemotaxis. Also may inhibit generation of prostaglandins. BSO: Injection: 0.5 mg/mL Tablet: 0.5 mg, 0.6 mg D: PO for acute flares: 0.5 mg or 0.6 mg q1h until significant pain relief, adverse GI effects, or a total dose of 6 mg IV acute flares: 1 m

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