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GASTROPATI OBAT ANTI INFLAMASI

NON STEROID (OAINS/NSAID)

Saptino Miro, MDSub Bagian Gastroentero-Hepatologi

Bagian Ilmu Penyakit Dalam FK Unand

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Page 2

Pemakaian OAINS (Obat Anti In!ama"i Non Steroi#)

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Page

$omp!ika"i Ga"trointe"tina!

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Page !

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Page "

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Page #

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Page $

Faktor Perta%anan M&ko"a Lamb&n'

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Page %

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Page & 'etabolisme asam arakidonat dlm proses in(lamasi

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Page )*

GASTROPATI OAINS

P+,SS I.F/0'0SI /0'BU.G 10.G DISB0BK0.

,/H P.GGU.00. ,0I.S

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Page ))

ENISENIS OAINS

Inibitor 3,4 .on Selekti(

5urunan 0sam salisilat 6 0spirin7 natrium salisilat7 kolinmagnesium7 sul(asala8in7 olsala8in

5urunan para amino(el 6 0setamino(en

0sam asetat Indol dan Inden 6 Indometasin dan sulindak

0sam asetat eteroaril 6 5olmetin7 diklo(enak7 ketorolak

0sam 0rilpropionat 6 Ibupro(en7 .aproksen7 Ketopro(en7

oksapro8in

0sam 0ntranilat 9Fenamat: 6 0sam me(enamat7 asammeklo(enamat

0sam nolat 6 ,ksikam 9Piroksikam7 'eloksikam:

0lkanon 6 .abumeton

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Page )2

ENISENIS OAINS

Inibitor 3,4-2 Selekti(

Furanon tersubsitusi diaril 6 +o(ekoksib

Pira8ol tersubsitusi diaril 6 3ele;o

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Page )

PEMILI*AN OAINS

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Page )!

RISI$O $OMPLI$ASI GASTROINTESTINAL

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Page )"Patogenesis Kerusakan /ambung yang Diinduksi ,0I.S

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Page )#

Patoi"io!o'i Ga"tropati OAINS

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Page )$

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Page )%

$!a"iika"i #an Etio!o'i

A!iran #ara% M&ko"a

Sekre"i M&ko"a

Sekre"i Ion Bikarbonat

Menin'katkan Perta%anan epite!

Pro"ta'!an#in

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Page )&

FA$TOR RISI$O $OMPLI$ASI GASTROINTESTINALATAS A$IBAT OAINS

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Page 2*

Dia'no"i" Ga"tropati OAINS

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Page 2)

$e!&%an Ga"tropati OAINS

Perdarahan-Perforasi

Ulkus

Dispepsia

Tidak Bergejala

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Page 22

DI0G.,S5IK

.D,SK,PI

Kongesti 'ukosa

rosi Ke;il-Ke;il

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Page 2

P.050/0KS0.00.

G0S5+,P05I ,0I.S

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Page 2!

Men+e'a% !k&"

Lamb&n'

,0I.S 0+H2

,0I.S 0nalog Prostaglandin

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Page 2"

ANTAGONIS RESEPTOR *- (AR*-) DOSIS TINGGI

+0.I5IDI. )"* 'G=Hr

FK5IF '.I.GK05K0. pH /0'BU.G

'.U+U.K0. P+D0+0H0. /0'BU.G

F0',5IDI. !* 'g 2

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Page 2#

Pen'obatan

5eRi.aat !k&"

>Pen''&naan Obat Lain

>

eni", Lama, Do"i" OAINS

>$e!&%an Ga"trointe"tina!

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Page 2$

G,/DS5I. 92**%:P./I5I. D,UB/ B/I.D

'U/5I3.5+

U/KUS

0SPI+I.

3/3,4IB

$?

0SPI+I.

.0P+,4.

27?

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Page 2%

'IS,P+,S5,/

Prostaglandin Sintesis 0nalog

5erapi /ini pertama

(ek Samping yang @@@

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Page 2&

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Page *

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Page )

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Page 2

$ESIMPLAN

,bat anti in(lamasi non steroid komplikasigastrointestinal melalui pengambatan produksi

prostaglandin

Faktor +isiko komplikasi gastrointestinal terkait,0I.S 6 usia7 kombinasi obat lain7 kombinasi oains

lain7 gangguan keseatan lain

ndoskopi merupakan standar emas diagnostik

gastropati ,0I.S

Pengambat Pompa Proton Ulkus lambung

dan komplikasi

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Page

'anaAemen Pasien yg 'endapat aspirin