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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(&#/:

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