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FARMAKOLOGI TB
EVA HERENCIA PURBA - 1310211005
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ANTIMIKROBA
• Defnisi !"#$ %e&"#s&i &i'(!"# %#)# &#n*si#+#n, "e(si#$ toksitas selektif se$in,,i &*n,'in.
• T!'si$#s se/e'$i !"#$ "e(si#$ s#n,#$ $!'si' *$'
&i'(!"# $% (e/#$i $)' $!'si' *$' !s%es
• 2 enis
• A'$ii$#s bakteriostatik &en,#&"#$ %e($*&"*#n&i'(!"#
• A'$ii$#s bakterisid &e&"*n* &i'(!"#
• AM %*n+# )*# 'e/!&%!'
• %e'$(*& se&%i$ 4! "en6i/ %enisi/in 7 s$(e%$!&isin
• %e'$(*& /*#s 4! $e$(#si'/in 7 '/!(#&eni'!/
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• Me'#nis&e 'e(#
• AM )i"#,i 5 'e/!&%!'
• &en,,#n,,* &e$#"!/is&e se/ &i'(!"#
• &en,#&"#$ sin$esis )in)in, se/ &i'(!"#
• &en,,#n,,* %e(&e#"i/i$#s &e&"(#n se/ &i'(!"#
• &en,#&"#$ sin$esis %(!$ein se/ &i'(!"#
• &en,#&"#$ sin$esis &e(*s#' #s. N*'/e#$ se/ &i'(!"#
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1.
• Di%e(!/e ee' "#'$e(i!s$#$i'
• C! s*/!n#&i)8 $(i&e$!%(i&8 #s. P-#&in!s#/i$ 9PA:8s*/!n
• Mi'(!"# "*$* #s !/#$ *$' i)*% )#n #(*s
&ensin$esis #s !/#$ )( #s #&!n! "en6!#$ 9PABA: *$''e"*$*#n i)*%.
• PA #n#/!, PABA "e'e(# &en,#&"#$ sin$esis #s!/#$ %) M.$*"e('*/!sis
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2.
• Ee' "#'$e(isi)#/ %#)# '*&#n +#n, %e'#
• C! %enisi/in8 se#/!s%!(in8 "#si$(#sin8 si'/!se(in
• Din)in, se/ $e("*#$ )#(i %e%$i)!,/i'#n +#i$* s*#$*'!&%/e's %!/i&e( &*'!%e%$i)# 9,/i'!%e%$i)#:. Te'
!s$&!$i' )#/#& '*&#n /e"i $in,,i )#(i%#)# )i /*#(-; /isis )in)in, se/ '*&#n
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3.
• Ti)#' se/e'$i )en,#n ,(#& <
• C! 'e/!&%!' !"#$ %!/i&i'(in
• en+#=# #&!ni*&-'*#($ene( )#%#$ &e(*s#'&e&"(#n se/ se$e/# "e(> ),n !s#$ %) !s!/i%i)
&e&"(#n se/ &i'(!"# -; 'e(*s#'#n &e&"(#n
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?.
• e/ &i'(!"# #(*s &ensin$esis "e("#,#i %(!$ein +,)i/#'*'#n )i (i"!s!& ),n "#n$*#n &RNA 7 $RNA.P#)# "#'$e(i8 (i"!s!& $e()i(i #$#s 2 s*"*ni$ 930)#n 50: *$' *n,si %#)# %(!$ein8 'e2 '!&%!nen#(*s &en+#$* %) %#n,'# (#n$#i &RNA &en#)i(i"!s!& @0
• C! ,!/ #&in!,/i'!si)8 &#'(!/i)8 $e$(#si'/in8'/!(#&eni'!/
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5.
• C! (i#&%isin 7 ,!/. K*in!/!n
• Ni#&%isin < en6. P!/i&e(#si RNA -; &en,#&"#$sin$esis RNA 7 DNA
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REITENI AM
• O"#$ $i)#' )#%#$ &en4#%#i $e&%#$ 'e(#n+# )i)#/#& se/ &i'(!"#
• In#'$i#si !"#$
• Mi'(!"# &en,*"#$ $e&%#$ i'#$#n
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PENEBARAN AM
• M*$#si %e(*"##n ,en &i'(!"# &en,*"# "in)in,si$e AM
• T(#ns)*'si &i'(!"# (esis$en '#(en# )%$ DNA )#(i
"#'$e(i#, +, &e&"#=# DN )( '*&#n /#in +,(esis$en $e(#)#% #n$i"i!$i' $e($en$*
• T(#ns!(&#si '*&#n &en,#&"i/ DNA "e"#s +,&e&"#=# si#$ (esis$en )#(i se'i$#(n+#
• K!n*,#si $e(#)i se4#(# /#n,*sn, #n$#( )*#&i'(!"# )en,#n s*#$* e&"#$#n
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FAKTOR PEMUDAHANREITENI
• Pen,,*n##n AM +, se(in,
• Pen,,*n##n AM +, i(#si!n#/
•
Pen,,*n##n AM "#(* +, "e(/e"i#n• Pen,,*n##n AM *$' #n,'# +, /#&# &e&"e(i
'ese&%#$#n *$' (esis$en
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EFEK AMPING
• R> #/e(,i
• R> i)i!sin'(#si
•
R> $!'si'
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KEGAGALAN TERAPI
• D!sis +#n, '*(#n,
• M#s# $e(#%i '*(#n,
•A)# #'$!( &e'#ni'
• Kes#/##n )#/#& &enen$*'#n e$i!/!,i
• Pi/i#n AM +, '*(#n, $e%#$
• F#'$!( %#sie
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PENGOBATAN TB
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• T**#n &e&*sn#'#n "#si/ TB ),n 4e%#$)#n &en4e,# '#&"* se($# &en,*(#n,i
$(#ns&isi TB 'e%#)# !(#n, '#in )#n&en4e,# &e&%e(/#&"#$ $i&"*/n+#(esis$ensi TB $)% !"#$
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• 2 %(insi% %en,!"#$#n TB
• P#/in, se)i'i$ &en,,*n#'#n 2 !"#$
• Pen,!"#$#n "e(/#n,s*n, 3- "/n *$' $**#n s$e(i/is#si
)#n &en4e,# '#&"*
• Hi%!$esis '*&#n TB "e('e&"#n, )#/#& /esi)i"e)#'#n #$#s 3 'e/!&%!' "e()#s#('#n $e&%#$'*&#n
• 1. #n, "e(#)# )#/#& '#i$#s 9/esi /!n,,#(:8 #'$i&e&"e/# '(n O2 &enin,'#$ 9#e(!" !"/i,#$:8 s*#s#n#ne$(#/
• 2. K*&#n +, "e(#)# )/& /esi "e('i* $e($*$*% )#n
&e&"e/# se4#(# /#&"#$ in$e(&i$en 9"e(se/#n,:8 $e('O2 &en*(*n )#n s*#s#n# ne$(#/
• 3 "#si/ +, #)# )i )/& se/ &#'(!#, s*#s#n+# #s#& -;/#&"#$ &e&"e/#
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• Pen,!"#$#n TB #&%i( se/#/* &en,,*n#'#n 3 !"#$INH8 (i#&%isin8 %i(#6i#&i)
•
Is!ni#6i) 7 (i#&%isin s,$ '*#$8 si#$ "#'$e(isi) *$'"#si/ e's$(#se/ in$#se/ )/& &#'(!(#, 7 "#si/ )/& #(+, "e('i*
• Ri#&%isin 7 %i#6i#&i) /e"i #'$i %#)# "#si/ )#/#&
se/ &#'(!#, )#n )#/#& #( "e('i* )#(i%#)#is!ni#6i)
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REGIMEN PENGOBATAN
• Te()i(i )#(i 2 #se
• Ini$i#/ %#se
• C!n$in*e %#se
• An,'# )e%#n s#$* #se #n,'# =#'$* %en,!"#$#n9"*/#n:
• H*(* n#&# !"#$
• An,'# )i "e/#'#n,s#&%in, *(* (e'*ensi%e&"e(i#n !"#$&in,,*
• Ti)#' #)# #n,'# (e'e*nsi %e&"e(i#n se$i#% #(i
• H*(* )i )#/#& 9: !"#$ )/& '!&"in#si $e$#%
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• Is!ni#6i) 9H:8 Pi(#6i#&i) 9:8 E$#&"*$!/ 9E:8Ri#&%isin 9R:8 P#(# #&in! s#/isi' #4i) 9PA:
•
C!• 2(HR)ZE/6(HE)
Pe&"e(i#n '!&"in#si $e$#% *$' is!ni#6i) 7 (i#&%isin
se$i#% #(i8 )i$#&"# %e&"e(i#n %(i#6i#&i) 7 e$#&*$!/se/#&# #se #=#/ )*# "*/#n
Pe&"e(i#n #se /#n*$#n se/#&# "*/#n )en,#n'!&"in#si $e$#% INH 7 e$#&"*$!/ se$i#% #(i
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UI
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2HRZE/4H3R3
2HRZ/4HR2
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• DOT 9Di(e4$/+ O"se(e) T(e#$&en$ !($-4!*(se:
• Pen,#=#s &#'#n !"#$ 9PMO:
•
Resis$ensi• Pen,!"#$#n $*n,,#/
• Pen,!"#$#n /e"i )#(i )*#
• Ee' s#&%in,
• Re,i&en %en,!"#$#n %#)# %#sien )ifsiensi i&*n
• Le"i 4e%#$ "e('e&"#n, )#n s*/i$ se&"*
• Pe(/* )#%#$ %en,!"#$#n in$ensi
• Peni/#i#n #si/ %en,!"#$#n
• P> s%*$*& $i#% "*/#n s#&%#i #si/ %> BTA
• Ui (esis$ensi
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• Pen,!"#$#n */#n,
• Di/#'*'#n i'# $e(#)i 'e,#,#/#n )/& %en,!"#$#n%en+#'i$ '#&"* se$e/# %en,!"#$#n se/#&# "/n
#$#* &#si &en*n*''#n #si/ BTA < se$e/#%en,!"#$#n "/n
• P(een$i
• V#'sin#si BCG %) #n#'
• Ini)* )en,#n '!n$#' <8 *i &#n$!*>
• In)ii)* $e(ine'si $n% ,e#/# '/ini' 9*i &#n$!*> <8(#)i!/!,i n!e(&#/: