farmakologi blok muskuloskeletal
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7/23/2019 Farmakologi Blok Muskuloskeletal
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Farmakologi BlokMuskuloskeletal
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Farmakologi Blok
Muskuloskeletal• Ada 3:
1. NSAID
2. Obat Pirai
3. Obat Osteoorosis
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1. NSAID
• 3 e!ek: a"tiiretik# a"algesi$# a"ti%i"&amasi
• Masi"g%masi"g u"'a ke$e"deru"ga" ke sala( satu# sdua ba(ka" sala( tiga e!ek tersebut )seimba"g*
• Mekanisme Kerja: Menghambat terbentuknya
prostaglandin.
Prekursor: Asam arachidonat
Enzim yang dihambat: Siklooksigenase
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+e"is NSAID
• ,ambat -O%1: (ambat rostagla"di" u"tuk ker/a otubu( seerti embe"tuka" mu$us di lambu"g sadi(ambat# mu$us me"iis da" lambu"g bisa luka. asiri"# asam me!e"amat# dkk
• ,ambat -O%2 Pre!ere"tial: lebi( $e"deru"g ke -Otai gak selekti! /uga. : meloksikam# diklo!e"ak# d
• ,ambat -O%2 selekti!: selekti! (ambat -O%2. gak iritasi lambu"g tai $e"deru"g ba(a'a buat /a"tu"g
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Per(atia" u"tuk NSAID
• !ek sami"g utama -O%1 adala( lambu"g da"e"$er"aa". !ek sami"g utama -O%2 adala( 'gber(ubu"ga" kardioaskular
• Farmakoki"etik sa"gat erat de"ga" (ati da" gi"/al.
u"tuk asie" de"ga" desie"si !u"gsi (ati da" gi"/a• Beberaa obat tidak bole( u"tuk ibu (amil# me"'usu
a"ak%a"ak da" ora"g tua. -ek lagi di buku.
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2. Obat Pirai
• Meka"isme ker/a ada 3:
1. A"tii"&amasi sesik: 4olk(isi"
2. ,ambat embe"tuka" Asam urat: Alouri"ol
3. Me"i"gkatka" sekresi Asam urat: robe"esid#sul"ira5o"
•. -atata" e"ti"g: semua obat di atas 6IDA4 BO7,digu"aka" u"tuk irai akut. ,AN8A BO7, 9N6944ONIS
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A. 4olk(isi"
• A"ti%i"&amasi sesik irai
• Meka"isme ker/a: (ambat migrasi gra"ulosit se(i"gme"g(ambat mediator i"&amasi
• I"dikasi: obat irai# rolaksis irai kro"is
• S: mual# mu"ta( diaere# deresi sumsum tula"g# d
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B. Alouri"ol
• Meka"isme 4er/a: ,ambat ker/a a"ti" Oidase )ada" ,ioa"ti" tidak bisa /adi asam urat*
• !ekti! u"tuk irai kro"ik de"ga" i"susie"si gi"/al batu asam urat
• Se$ara !armakoki"etik sebe"ar"'a ker/a"'a $eat# t(asil metabolisme"'a )aloa"ti"* membuat ker/aallouri"ol /adi lebi( a"/a"g dari se(arus"'a
• S: reaksi kulit
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-. Probe"esid
• -ega( kerusaka" se"dir da" embe"tuka" toi
• 4er/a di gi"/al
• Diakai ,AN8A +I4A ltrasi glomerulus ; 30 ml<me")(ati2 'g gagal gi"/al*
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D. Sul"ira5o"
• -ega( da" kura"gi kelai"a" se"di da" toi
• Meka"ismek ker/a: (ambat reabsorbsi asam urat
• S: ga"ggua" salura" $er"a# a"emia# leukoe"ia#agra"ulositosis# dll
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=== u"tuk NSAID da" Oba
Pirai• 4etorola$ da" etodola$ diakai u"tuk a"algesi$ kuat )setara mor
tidak biki" ketagi(a". 4etorola$ selekti! -O%1# etodola$ selekti!
• Ada kelomok obat tamba(a": APP )A"tireumatik Pemodikasi P
• APP 'a"g seri"g diakai: Metotreksat )obat ka"ker# tai dosis ke$me"gura"gi lesi erosi* ada artritis /ue"ile kro"ik# artritis soria
• APP lai": a5atrioi" u"tuk r(eumatoid artritis
• 6AMBA,AN: BDA4AN >A# A# OA kare"a !armakoterai"'a /ugBa(ka" ada 'g gak erlu !armakoterai.
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3. Obat Osteoorosis
• Meka"isme ker/a:
1. ,ambat osteoklas )a"tiresorbti!*: Bi!os!o"at# Estro)estradiol*# A "tiestroge" )aloksi!e"*# K alsito"i".Disi"gkat: BEAK
2. Me"i"gkatka" absorbs kalsium: itami" D
3. Pemberia" kalsium
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1. stroge"
• Meka"isme ker/a: (ambat osteoklas# me"i"gkatka"roduksi kalsito"i"
• 6uru"a": estradiol
• 4o"trai"dikasi ba"'ak: ka"ker# erdara(a" dis!u"gs
(ierte"si# tromboemboli# i"!ark miokard# strok#('erliidemia# DM# e"t. >i"/al
• Bisa me"i"gkatka" resiko ka"ker. Pe"ggu"aa" bersarogestero"e bisa me"gura"gi resiko ka"kere"dometrium
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2. aloksi!e"
• A"tiestroge": si!at estroge" u"tuk tula"g da" lemaktidak u"tuk orga" lai" )a'udara da" uterus* se(i"gme"gura"gi resiko ka"ker
• Disebut SM )Sele$tie estroge" re$etor modulat
• S: (ot &us(es da" mastalgia )"'eri di mammae*
• 4I: ibu (amil
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3. Bi!os!o"at
• Obat ali"g reot
• Obat later"ati!# ada 'g bila"g utama /uga
• Meka"isme ker/a: osteo$last# me"gura"gi roto" da" (ambat e"5im li
• Farmakoki"etik: se$ara oral buruk# sa"gat die"garu(i maka"a" )erkoso"g*# dibare"gi de"ga" mi"um ba"'ak air biar gak iritasi eso(ag
• Ada 3 ge"erasi )Semaki" "aik ge"erasi kekuata""'a maki" besar*>e"erasi 1: etidro"at# klodro"at )4*
>e"erasi 2: amidro"at# ale"dro"ate# liludro"at )PA7*
>e"erasi 3: ?oledro"at# isedro"at )?*
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@. 4alsito"i"
• 6uru"a": kalsitriol
• Disekresika" ole( Sel - tiroid
• Diatur sekrei"'a ole( kadar kalsium dara( da" estro
• Meka"isme ker/a: (ambat ker/a osteoklas
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. it D da" 4alsium
• it D me"i"gkatka" absorbs kalsium
• 4alsium: u"tuk kalsikasi tula"g )00%100 mg<(ari
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