makalah studi kasus interaksi obat.docx

8/19/2019 MAKALAH studi kasus interaksi obat.docx

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MAKALAH

INTERAKSI OBAT

PADA PENDERITA DIABETES MELITUS TIPE 2

Disusun oleh:

Kelompok 5

Erna Erliawati !""#!"$

A%e Hikmawati ""#'

Nan(i Sitor)* 2""#&'

A%it+a Ha%i Ken(ana 2""#&2#

An,,it Dea Rama*wara 2""#&"!

T-at)r D-oko .i/owo 2""#&"

Ren,,o Sap)tra Ra0man 2""#&""

Ri1k+ Aliani 30a*ana0 2""#"

Alin Nail)l M)na 2""#'

Dosen Pembimbing :

Dra. Refdanita, MSi, Apt

INSTITUT SAINS DAN TEKNOLOGI NASIONAL

FAKULTAS MATEMATIKA DAN ILMU PENGETAHUAN ALAM

PROGRAM STUDI FARMASI

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2!"

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DA4TAR ISI

halaman

DAFTAR ISI.............................................................................................. 2

BAB I PENDAHULUAN ....................................................................... 3

BAB II TINJAUAN PUSTAKA ............................................................... 6

BAB III HASIL......................................................................................... 23

BAB IV PEMBAHASAN ........................................................................ 25

BAB VI SIMPULAN DAN SARAN ....................................................... 30

A. Sm!"lan.................................................................................. 30

B. Sa#an....................................................................................... 30

DAFTAR PUSTAKA

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BAB I

PENDAHULUAN

In$%#a&' ()a$ a*alah !%#")ahan %+%& '"a$" ()a$ a&)a$ !%ma&aan ()a$ lan

,n$%#a&' ()a$-()a$ a$a" (l%h ma&anan/ ()a$ $#a*'(nal *an '%naa &ma lan.

In$%#a&' ()a$ an 'n+&an *a!a$ $%#a* &a *"a a$a" l%)h ()a$ *"na&an

)%#'ama-'ama.

In$%#a&' ()a$ *an %+%& 'am!n ()a$ !%#l" m%n*a!a$ !%#ha$an. S%)"ah '$"*

* Am%#&a m%n"n"&&an )aha '%$a! $ah"n ham!# 100.000 (#an ha#"' ma'"&

#"mah 'a&$ a$a" ha#"' $nal * #"mah 'a&$ l%)h lama *a# !a*a '%ha#"'na/ )ah&an

hna $%#a* &a'"' &%ma$an &a#%na n$%#a&' *an4a$a" %+%& 'am!n ()a$. Pa'%n

an *#aa$ * #"mah 'a&$ '%#n m%n*a!a$ $%#a! *%nan !(l+a#ma' ,6-10 maam

()a$ &a#%na '%)aa '")%& "n$"& l%)h *a# 'a$" *(&$%#/ '%hna 'ana$ m"n&n

$%#a* n$%#a&' ()a$ $%#"$ama an *!%na#"h $n&a$ &%!a#ahan !%na&$ a$a" "'a.

In$%#a&' ()a$ '%a#a &ln' !%n$n )la )%#a&)a$ !%nn&a$an $(&''$a'

*an4a$a" !%n"#anan %+%&$$a' ()a$. Ja* !%#l" *!%#ha$&an $%#"$ama )la

m%nan&"$ ()a$ *%nan )a$a' &%amanan an '%m!$ ,n*%&' $%#a! an #%n*ah/

m'alna l&('*a an$"n/ an$&(a"lan *an ()a$-()a$ '$('$a$&. S%lan $" "a !%#l"

*!%#ha$&an ()a$-()a$ an )a'a *"na&an )%#'ama-'ama.

K%a*an n$%#a&' ()a$ *alam &ln' '"&a# *!%#&#a&an &a#%na 7

a. *(&"m%n$a'na ma'h 'ana$ &"#an

). '%#n&al l(l(' *a# !%nama$an/ &a#%na &"#anna !%n%$ah"an a&anm%&an'm% *an &%m"n&nan $%#a* n$%#a&' ()a$. Hal n m%na&)a$&an

n$%#a&' ()a$ )%#"!a !%nn&a$an $(&''$a' *ana! '%)aa #%a&'

*('na' $%#ha*a! 'alah 'a$" ()a$/ '%*an&an n$%#a&' )%#"!a !%n"#"na&n

%+%&$$a' *ana! *a&)a$&an )%#$am)ah !a#ahna !%na&$ !a'%n

. &%a*an a$a" &%!a#ahan n$%#a&' ()a$ *!%na#"h (l%h a#a' n**"al/ *

mana !(!"la' $%#$%n$" l%)h !%&a m'alna !a'%n %#a$# a$a" )%#!%na&$

!a#ah/ *an )'a "a &a#%na !%#)%*aan &a!a'$a' m%$a)(l'm% an$a# n**".

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S%lan $" +a&$(# !%na&$ $%#$%n$" $%#"$ama aal nal a$a" !%na&$ ha$

an !a#ah *an +a&$(#-+a&$(# lan ,*('' )%'a#/ ()a$ *$%lan )%#'ama-'ama/

!%m)%#an (n&.

Da)%$%' M%ll$"' ,DM m%#"!a&an !%na&$ m%$a)(l (n& an m%n%na

'%ala la!' ma'a#a&a$ *"na. P%na&$ n '%#n *'%)"$ the great imitator &a#%na

!%na&$ n *a!a$ m%n%na '%m"a (an *an m%nm)"l&an )%#)aa maam &%l"han.

P%na&$ n $*a& *a!a$ '%m)"h m%'&!"n *a!a$ *a$a'. B%#*a'a#&an &la'+&a' an

)a#" *a)%$%' *)a m%na* )%)%#a!a &%la' *an an $%#ma'"& *alam &%la' "$ama

alah *a)%$%' $!% I *an *a)%$%' $!% II. S%)ana& l%) *a# 95 : &a'"' DM a*alahDM $!% 2. DM *a!a$ m%nm)"l&an )%#)aa &(m!l&a' )a& a&"$ ma"!"n

&(m!l&a' (n&. ;l%h &a#%na $" !%#l" !%nananan '%#"' $%#ha*a! *a)%$%' an

*la&"&an m%lal" Pana U'aha P%n(lahan Da)%$%' a$" %*"&a'/ !%na$"#an

ma&an/ la$han a'man/ !%n"naan ()a$ '%#$a m%na$a' an"an *an &(m!l&a'

"a !%#")ahan !(la h*"! !%n*%#$a *a)%$%' m%ll$"'.

Dalam ma&alah n !%n"l' $%#$a#& "n$"& m%n"l' m%n%na n$%#a&' ()a$ *an

ma&anan $%#ha*a! !%n*%#$a *a)%$%' m%ll$"' $!% II.

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BAB II

TINAUAN PUSTAKA

DIABETES MELLITUS

A6 Deini*i

Da)%$%' M%ll$"' a*alah &%lanan an )%#'+a$ (n& an *$an*a

(l%h an"an m%$a)(l'm &a#)(h*#a$/ !#($%n/ *an l%ma& an *&"$ (l%h

&(m!l&a' m(a'&"l%# ma"!"n ma(a'&"l%#/ *an $%lah *&%$ah"

)%#&a$an *%nan +aa&$(# %n%$& *%nan %ala &ln& an !aln "$ama

a*alah n$(l%#an' l"&('a ,. D

In*(n%'a/ an&a &%a*an *a)%$%' )%#&'a# 1-2 : )%#a#$ 'a$" * an$a#a 50 ? 100

!%n*"*"& In*(n%'a m%n*%#$a *a)%$%'. Salah 'a$" +a$(# an **"a m%nn&a$&an

&%a*anna * A'a *an A+#&a a*alah a*ana !%#")ahan an na$a *alam !(la

ma&an/ a$" an )ana& n%#l%ma& *%nan &"#an 'a"#/ &%%m"&an/ *an h*"!

an 'ana$ 'an$a ,Ha#$a$/2002.

36 Etiolo,i %an Pato,ene*i*

A*a )"&$ an m%n"n"&&an )aha %$(l( *a)%$%' m%ll$"' )%#maam ?

maam. A&an $%$a!/ !%na&$ n '%#n *h")"n&an *%nan +a&$(# %n%$& an

a"$('(mal *(mnan * mana +a$(# ln&"nan m%ml& &(n$#)"' !a*a

man+%'$a'na $%#"$ama !a*a (#an ? (#an *%nan !#%*'!('' %n%$&. Da#

!%n%l$an *&%$ah" )aha !a*a &%m)a# m(n(@($ &%a*an DM $!% 2 m%nn&a$

hna =1 : *an $*a& )%#")ah m%'&!"n !%#)%*aan )%#a$ )a*an $%lah *h$"n.

B%'a#na #%'&( $%#&%na DM $!% 2 a*alah '%)%'a# 18 : &a $a& 'a$" !"n (#an $"a

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8/30

!%n#man 'nal4 !%'an n$#a'%l"l%# an **"a $%#&a$ *%nan

a)n(#mal$a' m%$a)(l'm &a#)(h*#a$ ,Sla/1==5.

D6 Manie*ta*i Klini*

Man+%'$a' &ln' *a)%$%' m%ll$"' *&a$&an *%nan &(n'%&"%n' m%$a)(l

*%+'%n' n'"ln. Pa'%n ? !a'%n an m%nalam *%+'%n' n'"ln $*a& *a!a$

m%m!%#$ahan&an &a*a# l"&('a !la'ma !"a'a an n(#mal/ a$a" $(l%#an' l"&('a

'%'"*ah ma&an &a#)(h*#a$. J&a h!%#l&%mana !a#ah *an m%l%)h am)an nal/

ma&a $m)"l l"&('"#a. Dl"&('"#a n a&an m%na&)a$&an *"#%'' ('m($ an

m%nn&a$&an *"#%'' ('m($ an m%nn&a$&an !%n%l"a#an &%mh ,!(l"# *an

$m)"l #a'a ha"' ,!(l*!'a. Ka#%na l"&('a hlan )%#'ama &%mh/ ma&a !a'%n

m%nalam &%'%m)anan &al(# n%a$% *an )%#a$ )a*an )%#&"#an. P(l+a a&an

$m)"l '%)aa a&)a$ &%hlanan &al(. Pa'%n m%n%l"h l%lah *an m%nan$"&. Pa*a

!a'%n NIDDM,n(n n'"ln *%!%n*%n$ *a)%$%' m%ll$"' m"n&n 'ama '%&al $*a&

m%m!%#lha$&an %ala a!a!"n/ *an *an('' hana *)"a$ )%#*a'a#&an !%m%#&'aan

*a#ah * la)(#a$(#"m *an m%la&"&an $%' $(l%#an' l"&('a. P%#$(l(nan m%*' !aln

'%#n *a# &a#%na %ala an )%#&a$an *%nan h!%#l&%ma/ $%$a! &%a*an

!%#$ama m"n&n )%#"!a *%&(m!%n'a' m%$a)(l a&"$ an m%n%)a)&an &(ma

*a)%$&. Ka*an ? &a*an !%nam!a&an aal )%#"!a !%n"l$ *%%n%#a$% '%!%#$

n%"#(!a$ $an!a h!%#l&%ma )%#%ala ,Ka!$a S%l%&$a/2001.

am)a#an &ln' an &ha' *a# NIDDM7

• Um"# a$an C80

• B%n$"& $")"h %m"& a$a" $*a& %m"&

• In'"ln !la'ma n(mal hna $n

• P%n"l$ a&"$ &(ma h!%#('m(la#

• R%'!(n'% hna #%''$%n $%#ha*a! $%#a! n'"ln

• R%'!(n'% $%#ha*a! $%#a! '"l+(nl"#%a

E6 Dia,no*i*

Dan('' &ln' DM "m"mna a&an *!&#&an )la a*a &%l"han &ha' DM )%#"!a !(l"#/

!(l*!'/ !(l+aa/ *an !%n"#"nan )%#a$ )a*an an $*a& *a!a$ *%la'&an '%)a)na.

K%l"han lan an m"n&n *&%m"&a&an !a'%n a*alah &%l%mahan/ &%'%m"$%n/ a$al/

ma$a &a)"#/ *an *'+"n' %#%&' !a*a !#a/ '%#$a !#"#$"' "la% !a*a !a'%n an$a. J&a

&%l"han &ha'/ !%m%#&'aan l"&('a *a#ah '%a&$" 200 m4*l '"*ah "&"! "n$"&

m%n%a&&an *an('' DM. "n$"& &%l(m!(& $an!a &%l"han &ha' DM/ ha'l !%m%#&'aan

l"&('a *a#ah an )a#" 'a$" &al 'aa a)n(#mal/ )%l"m "&"! &"a$ "n$"& m%n%a&&an

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*an('' DM. *!%#l"&an !%ma'$an l%)h lan"$ *%nan m%n*a!a$ '%&al la an&a

a)n(#mal/ )a& &a*a# l"&('a *a#ah !"a'a 126 m4*l/ &a*a# l"&('a *a#ah '%a&$"

200 m4*l !a*a ha# n/ a$a" *a# ha'l $%' $(l%#an' l"&('a (#al ,TT; **a!a$&an

&a*a# l"&('a *a#ah !a'a !%m)%)anan 200 m4*l ,P%#&%n/2006.

46 Komplika*i Dia/ete* Mellit)*

K(m!l&a' ? &(m!l&a' *a)%$%' m%ll$"' *a!a$ *)a m%na* *"a &a$%(#7

,1 &(m!l&a' m%$a)(l a&"$/ *an ,2 &(m!l&a' ? &(m!l&a' a'"la# an&a

!anan.

K(m!l&a' m%$a)(l *a)%$%' m%#"!a&an a&)a$ !%#")ahan an #%la$% a&"$

*a# &a*a# l"&('a !la'ma. K(m!l&a' m%$a)(l an !aln '%#"'/ a*alah

&%$(a'*('' *a)%$&. A!a)la &a*a# n'"ln 'ana$ m%n"#"n/ !a'%n m%nalam

h!%#l&%ma *an l"&('"#a )%#a$/ !%n"#"nan l!(%n%''/ !%nn&a$&an l!(l''/

*an !%nn&a$&an (&'*a' a'am l%ma& )%)a' *'%#$a !%m)%n$"&an )a*an &%$(n

,a'%$(a'%$a$/ h*#(&' )"$#a$/ *an a'%$(n. P%nn&a$&an *alam !la'ma

m%na&)a$&am &%$(''/ !%nn&a$an )%)an (n h*#(%n *an a'*('' m%$a)(l.

l"&('"#a *an &%$('"#a an %la' "a *a!a$ m%na&)a$&an *"#%'' ('m($

*%nan ha'l a&h# *%h*#a' *an &%hlanan %l%&$#(l$. Pa'%n *a!a$ m%na* h!($%n'

*an m%nalam '(&. A&h#na a&)a$ !%n""nan !%n"naan (&'%n ($a&/ !a'%n

a&an m%nalam &(ma *an m%nnal. K(ma *an &%ma$an a&)a$ &%$(a'*('' 'aa$

n a#an $%#a*/ &a#%na !a'%n ma"!"n $%naa &%'%ha$an $%lah m%na*a# !($%n'

)ahaa &(m!l&a' n *an !%n()a$an &%$(a'*('' *a!a$ *la&"&an '%*n m"n&n.

K%$(a'*('' *a)%$ *$anan *%nan ,1 !%#)a&an &%&aa"an m%$a)(l

a&)a$ &%&"#anan n'"ln/ ,2 !%m"lhan &%'%m)anan a# *an %l%&$#(l$/ *an ,3

!%n()a$an &%a*aan an m"n&n m%m!%#%!a$ &%$(a'*(''. P%n()a$an *%nan

n'"ln #%"la# ma'a &%#a 'n&a$ *)%#&an m%lal" n+"'% n$#a%na &(n$n" a$a"

'"n$&an n$#am"'"la# an '%#n *an n+"'% l"&('a *alam a# a$a" 'aln a&an

m%nn&a$&an !%n"naan l"&('a/ m%n"#an l!(l'' *an !%m)%n$"&an )a*an

&%$(n/ '%#$a !%m"lhan &%'%m)anan a'am ? )a'a. S%lan $" !a'%n "a m%m%#l"&an

!%nan$an &al"m. Ka#%na n+%&' )%#"lan *a!a$ m%nn&$&an &%)"$"han n'"ln

!a*a !%n*%#$a *a)%$%'/ ma&a $*a& m%nh%#an&an &ala" n+%&' *a!a$ m%m!%#%!a$

$%#a*na *%&(m!%n'a' *a)%$ a&"$ *an &%$(a'*(''. D%nan *%m&an/ !a'%n

*alam &%a*aan n m"n&n !%#l" *)%#&an !%n()a$an an$)($&a.

K(m!l&a' m%$a)(l lan *a# *a)%$%' an '%#n $%#a* a*alah

h!(l&%ma. %ala ? %ala h!(l&%ma *'%)a)&an (l%h !%l%!a'an %!n%+#n

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, )%#&%#na$/ %m%$a#/ 'a&$ &%!ala/ *an !al!$a' "a a&)a$ &%&"#anan l"&('a

*alam ($a&, $n&ah la&" an an%h/ '%n'(#"m an $"m!"l *an &(ma.

K(m!l&a' a'"la# an&a !anan *a# *a)%$%' m%l)a$&an !%m)"l"h ?

!%m)"l"h &%l m(an(!a$ *an !%m)"l"h ? !%m)"l"h '%*an *an )%'a#

ma(an(!a$. M(an(!a$ m%#"!a&an l%' '!%'+& *a)%$%' an m%n%#an

&a!l%# *an a#$%#(la #%$na, #%$n(!a$ *a)%$/ l(m%#"l"' nal , n%+#(!a$ *a)%$

*an 'a#a+ ? 'a#a+ !%#+%# ,n%"#(!a$ *a)%$/ ($($ ? ($($ *an &"l$. D!an*an *a#

'"*"$ h'$(&ma/ !%n%)alan n *'%#$a (l%h !%nn&a$&an !%nm)"nan l&(!#($%n.

S%lan $"/ &a#%na '%naa &ma *a# m%m)#an% *a'a# )%#a'al *a# l"&('a/ ma&a

h!%#l&%ma m%n%)a)&an )%#$am)ahna &%%!a$an !%m)%n$"&&an '%l ? '%l

m%m)#an% *a'a#. P%n"naan l"&('a *a# '%l ? '%l n $*a& m%m)"$"h&an n'"ln

,P%#&%n/2006.

4ARMAKOLO7I

A6 4armakokinetik

6 A/*orp*i

A)'(#!' a*alah !#('%' ma'"&na ()a$ *a# $%m!a$ !%m)%#an &%

*alam *a#ah. B%#an$"n *a# a#a !%m)%#anna/ $%m!a$ !%m)%#an

()a$ a*alah 'al"#an %#na , m"l"$ 'am!a *%nan #%$"m/ &"l$/ !a#"/

($($/ *an lan ? lan. an $%#!%n$n a*alah a#a !%m)%#an ()a$ !%#

(#al/ *%nan a#a n $%m!a$ a)'(#!' "$ama a*alah "'"' hal"' &a#%na

m%ml& !%#m"&aan a)'(#!' an 'ana$ l"a'.

P%m)%#a ()a$ *)aah l*ah hana "n$"& ()a$ an la#"$ *alam

l%ma&/ &a#%na l"a' a)'(#!'na &%l/ '%hna ()a$ ha#"' m%la#"$ *an

*a)'(#!' *%nan 'ana$ %!a$/ m'alna n$#(l'n.A)'(#)' '%)aan )%'a# ()a$ '%a#a *+"' !a'+/ ma&a '%)aan )a#%#

a)'(#!' a*alah m%m)#an% '%l %!$%l 'al"#an %#na/ an '%!%#$ halna

'%m"a m%m)#an% '%l $")"h &$a/ m%#"!a&an l!* )la%#. D%nan

*%m&an/ aa# *a!a$ m%ln$a' m%m)#an% '%l $%#'%)"$/ m(l%&"l ()a$

ha#"' m%ml& &%la#"$an l%ma&,'%$%lah $%#l%)h *ah"l" la#"$ *alam

a#. K%%!a$an *+"' )%#)an*n l"#"' *%nan *%#aa$ &%la#"$an l%ma&

m(l%&"l ()a$ , '%lan *%nan !%#)%*aan &a*a# ()a$ ln$a' m%m)#an%/

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an m%#"!a&an *#n +(#% !#('%' *+"'/ *an *%nan l"a'na a#%a

!%#m"&aan m%m)#an% *+"'.

K%)ana&an ()a$ m%#"!a&an %l%&$(l$ l%mah/ a&n a'am l%mah a$a"

)a'a l%mah. Dalam a#/ %l%&$(l$ l%mah n a&an $%#(n'a' m%na*

)%n$"& (nna. D%#aa$ (n'a' ()a$ $%#an$"n !a*a &(n'$an$a (n'a'

()a$ *an !H la#"$an * mana ()a$ )%#a*a.

26 Di*tri/)*i

Dalam *a#ah/ ()a$ a&an *&a$ (l%h !#($%n !la'ma *%nan

)%#)aa &a$an l%mah. A*a )%)#a!a maam !#($%n !la'ma7

• Al)"mn 7 m%n&a$ ()a$ ? ()a$ a'am *an ()a$ ? ()a$ n%$#al '%#$a

)l#")n *an a'am ? a'am l%ma&.

• G-l&(!#($%n7 m%n&a$ ()a$ ? ()a$ )a'a

• B , (#$('$%#(*-)n*n l()"ln7 &h"'"' m%n&a$

&(#$&('$%#(*

• SSB , '% '$%#(*-)n*n l()"ln7 &h"'"' m%n&a$ h(#m(n%

&%lamn.

;)a$ ? ()a$ !a*a !#($%n !la'ma a&an *)aa (l%h *a#ah &% '%l"#"h

$")"h. K(m!l%& ()a$ ? !#($%n $%#*'('a' *%nan 'ana$ %!a$. ;)a$

)%)a' a&an &%l"a# &% a#nan7 &% $%m!a$ &%#a ()a$/ &% a#nan $%m!a$

*%!($na/ &% ha$ , *mana ()a$ m%nalam m%$a)(l'm m%na*

m%$a)(l$ an *&%l"a#&an m%lal" %m!%*" a$a" ma'"& &%m)al &%

*a#ah/ *an &% nal , *mana ()a$4 m%$a)(l$na *%&'&%' &% *alam

"#n.

In$%#a&' !%#%'%#an !#($%n. ;)a$ ? ()a$ a'am a&an )%#'an "n$"& )%#&a$an *%nan al)"mn * $%m!a$ &a$an an 'ama/ *an ()a$ - ()a$

a&an )%#'an "n$"& )%#&a$an *%nan G-l&(!#($%n. Ka#%na $%m!a$

&a$an !a*a !#($%n !la'ma $%#'%)"$ $%#)a$a'/ ma&a ()a$ an !a*a

*('' $%#a! $%lah m%n%)a)&an %n"hna &a$an a&an m%n%'%# ()a$

lan an $%#&a$ !a*a $%m!a$ &a$an an 'ama '%hna ()a$ an

)%#%'%# n a&an l%)h )ana& an )%)a'. S%lan"$na ()a$ an

)%)a' n a&an &%l"a# *a# !%m)"l"h *a#ah *an m%nm)"l&an

%+%&+a#ma&(l(& a$a" *%lmna' *a# $")"h. In$%#a&' !%#%'%#an

11


12/30

!#($%n a&an )%#ma&na '%a#a &ln& &a ()a$ an *%'%# m%m%n"h

3 'a#a$ )%#&"$7

• I&a$an !#($%n $n7 95:/ '%hna &a*a# ()a$ )%)a' #%n*ah/

a&)a$na !%#%'%#an '%*&$ 'aa '"*ah m%nn&a$&an "mlah ()a$

)%)a' '%a#a )%#ma&na.

• V(l"m% *'$#)"' &%l , 0/15 L4&/ '%hna !%nn&a$an

"mlah ()a$ )%)a' $*a& ha)' $%#*'$#)"' $a! m%m)%#&an

!%nn&a$an &a*a# !la'ma an "&"! )%#ma&na

• Ma#n (+ 'a+%$ , )a$a' &%amanan '%m!$/ '%hna !%nn&a$an

&a*a# !la'ma an #%la$% &%l '"*ah )%#ma&na '%a#a &ln'.

"6 Meta/oli*meM%$a)(l'm% ()a$ $%#"$ama $%#a* * ha$/ a&n * m%m)#an%

endoplasmic reticulum ,m('(m *an * cytosol . $%m!a$

m%$a)(l'm an lan , %&'$#ah%!a$& a*alah7 *n*n "'"'/ nal/

!a#"/ *a#ah/ ($a&/ *an &"l$/ "a * l"m%n &(l(n ,(l%h +l(#a "'"'.

T""an m%$a)(l'm% ()a$ a*alah m%n")ah ()a$ an n(n!(la#

,la#"$ l%ma& m%na* !(la# , la#"$ a# aa# *a!a$ *%&'%' m%lal"

nal a$a" %m!%*". D%nan !%#")ahan n ()a$ a&$+ "m"mna ")ah

m%na* na&$+/ $a! '%)aan )%#")ah m%na* l%)h a&$+ ,&a

a'alna !#(*#"/ &"#an a&$+/ a$a" m%na* $(&'&.

Ea&' m%$a)(l'm $%#*# *a# #%a&' +a'% I *an #%a&' +a'% II.

R%a&' +a'% I $%#*# *a# (&'*a'/ #%*"&'/ *an h*#(l''/ an

m%n")ah ()a$ m%na* l%)h !(la#/ *%nan a&)a$ m%na* na&$+/

l%)h a&$+/ a$a" &"#an a&$+. S%*an&an #%a&' II m%#"!a&an #%a&'

&(n"na' *%nan '")'$#a$ %n*(%n7 a'am l"&(#(na$/ a'am '"l+a$/

a'am a'%$a$/ a$a" a'am amn(/ *an ha'lna m%na* 'ana$ !(la#/*%nan *%m&an ham!# '%lal" $*a& a&$+. ;)a$ *a!a$ m%nalam

#%a&' +a'% I 'aa/ a$a" #%a&' +a'% II 'aa/ a$a" #%a&' I an *&"$

#%a&' +a'% II. Pa*a #%a&' +a'% I/ ()a$ *)")"h ""' !(la# '%!%#$

""' h*#(&'l/ ""' amn(/ &a#)(&'l/ '"l+h*#l/ *')/ "n$"& *a!a$

)%#%a&' *%nan '")'$#a$ %n*(%n !a*a #%a&' +a'% II. Ka#%na $" ()a$

an '"*ah m%m!"na ""' ? ""' $%#'%)"$ lan'"n )%#%a&'

*%nan '")'$#a$ %n*(%n ,#%a&' +a'% II. Ha'l %a&' +a'% I *a!a$ "a

12


13/30

'"*ah "&"! !(la# "n$"& lan'"n *%&'%'&an l%a$ nal $an!a

ha#"' m%lal" #%a&' +a'% II l%)h *"l".

R%a&' m%$a)(l'm an $%#!%n$n a*alah (&'*a' (l%h %n@m

$(h#(m% P850 , P/ an *'%)"$ "a %n@m m(n( ?

(&'%na'%/ a$a" MF;, m%*- +"n$(n (*a'%/ *alalm %n*(!la'm

#%$"l"m , m('(m ha$.

In$%#a&' *alam m%$a)(l'm% ()a$ )%#"!a n*"&' a$a" nh)'

%n@m m%$a)(l'm/ $%#"$ama %n@m P. In*"&' )%#a#$ !%nn&a$an

'n$%'' %n@m m%$a)(l'm% !a*a $n&a$ $#an''!' '%hna $%#a*

!%nn&a$an &%%!a$an m%$a)(l'm% ()a$ an m%na* '")'$#a$ %n@m

an )%#'an&"$an/ a&)a$na *!%#l"&an !%nn&a$an *('' ()a$

$%#'%)"$/ )%#a#$ $%#a* $(l%#an' +a#m(&n%$&. Ka#%na m%l)a$&an'n$%'' %n@m ma&a *!%#l"&an a&$" !aanan )%)%#a!a ha# '%)%l"m

*a!a %+%& an ma&'mal. In*"&' *alam (l%h '%m"a %n@m

m('(mal. Ja* %n@m P *an UT.

Inh)' %n@m m%$a)(l'm% 7 ham)a$an $%#a* '%a#a lan'"n/

*%nan a&)a$ !%nn&a$&an &a*a# ()a$ an m%na* '")'$#a$ *a#

%n@m an *ham)a$ "a $%#a* '%a#a lan'"n. Un$"& m%n%ah

$%#a*na $(&''$a'/ *!%#l"&an !%n"#"nan *('' ()a$ an

)%#'an&"$an a$a" )ah&an $*a& )(l%h **)%#&an )%#'ama

!%nham)a$na.

M%$a)(l'm% ()a$ a&an $%#an" !a*a !a'%n !%na&$ ha$

'%!%#$ '#(''/ ha$ )%#l%ma&/ *an &an&%# ha$. Pa*a '#('' an

!a#ah/ m%$a)(l'm% ()a$ )%#&"#an an$a#a 30 ? 50 :/ n *a!a$

m%nn&a$&an )(aala)l$a' 2-8 &al !a*a ()a$ ? ()a$ an

m%nalam m%$a)(l'm% ln$a' !%#$ama. En@m ? %n@m P l%)h

$%#!%na#"h *)an*n #%a&' ? #%a&' +a'% II '%!%#$ l"&"#(n*a'.M%$a)(l'm% ()a$ "a $%#an" (l%h a*ana !%na&$ an

m%n"#an !%#+"' ha$ '%!%#$ aal an$"n *an '(&.

En@m ? %n@m m%$a)(l'm% +a'% I *an +a'% II m%na!a

&%ma$anan '%$%lah $ah"n !%#$ama &%h*"!an/ &%"al %n@m UT

"n$"& )l#")n m%na!a nla *%a'a !a*a *%a*% &%*"a &%h*"!an.

#6 Ek*kre*i

;#an $%#!%n$n "n$"& %&'%' ()a$ a*alah nal. ;)a$

*%&'%' m%lal" nal *alam )%n$"& "$"h ma"!"n )%n$"&

13


14/30

m%$a)(l$na. E&'%' *alam )%n$"& "$"h a$a" )%n$"& a&$+ m%#"!a&an

a#a %lmna' ()a$ m%lal" nal. E&'%' m%lal" nal m%l)a$&an 3

!#('%'/ a&n +l$#a' l(m%#"l"'/ '%%' a&$+ $")"l"' !#(&'mal *an

#%a)'(#)' !a'+ * '%!anan $")"l"'. F"n' nal m%nalam

&%ma$anan !a*a "'a 6-12 )"lan/ *an '%$%lah *%a'a m%n"#"n 1: !%#

$ah"n.

E&'%' m%lal" nal a&an )%#&"#an &a $%#*a!a$ an"an

+"n' nal.

E&'%' ()a$ an &%*"a !%n$n a*alah m%lal" %m!%*" &%

*alam "'"' *an &%l"a# )%#'ama +%'%'. ;)a$ *an m%$a)(l$ an la#"$

l%ma& *a!a$ *#%a)'(#)' &%m)al &% *alam $")"h *a# l"m%n "'"'.

M%$a)(l$ *alam )%n$"& l"&"#(na$ *a!a$ *!%ah *"l" (l%h %n@ml"&"#(n*a'% an *ha'l&an (l%h +l(#a "'"' m%na* )%n$"& ()a$

aalna an m"*ah *a)'('#!' &%m)al. A&an $%$a!/ )%n$"&

&(n"a$ "a *a!a$ lan'"n *a)'(#!' m%lal" $#an'!(#$%# m%m)#an%

;ATP * *n*n "'"'/ *an )a#" *!%ah *alam *a#ah (l%h %n@m

%'$%#a'%. S&l"' %n$%#(h%!a$& n *a!a$ m%m!%#!anan %+%& ()a$/

m'alna %'$#(%n *alam &(n$#a'%!' (#al.

E&'%' m%lal" !a#" $%#"$ama "n$"& %lmna' a' an%'$%$&

"m"m.

B6 4armako%inamik

Fa#ma&(*nam& alah '")*'!ln +a#ma&(l( an

m%m!%laa# %+%& )(&ma *an +'(l( ()a$/ '%#$a m%&an'm%

&%#ana. T""an m%m!%laa# m%&an'm% &%#a ()a$ a*alah "n$"& m%n%l$

%+%& "$ama ()a$/ m%n%$ah" n$%#a&' ()a$ *%nan '%l/ *an m%n%$ah"

"#"$an !%#'$a '%#$a '!%$#"m %+%& *an #%'!(n' an $%#a*. P%n%$ah"an

an )a& m%n%na hal n m%#"!a&an *a'a# $%#a! #a'(nal *an )%#"na

*alam 'n$%'' ()a$ )a#".

Mekani*me Ker-a o/at

K%)ana&an ()a$ m%nm)"l&an %+%& m%lal" n$%#a&'

*%nan #%'%!$(#na !a*a '%l (#an'm. In$%#a&' ()a$ *%nan #%'%!$(#na

n m%n%$"'&an !%#")ahan )(&ma *an +'(l( an m%#"!a&an

18


15/30

#%'!(n' &ha' "n$"& ()a$ $%#'%)"$. R%'%!$(# ()a$ m%#"!a&an &(m!(n%n

ma(m(l%&"l +"n'(nal hal n m%na&"! 2 &(n'%! !%n$n. P%#$ama/

()a$ *a!a$ m%n")ah &%%!a$an &%a$an +aal $")"h. K%*"a/ ()a$ $*a&

m%nm)"l&an +"n' )a#"/ $%$a! hana m%m(*"la' +"n' an '"*ah

a*a.


16/30

(!$mal m%m)"$"h&an !%n*%&a$an *(&$%# !a*a !a'%n *an &%l"a#ana/ aa# a*a

&((#*na' an$a#a *%$/ la$han +'&/ *an !%m)%#an n'"ln.

Eek Sampin,

6 Hipo,likemia

H!(l&%ma m%#"!a&an %+%& 'am!n !aln '%#n $%#a* *an $%#a* a&)a$

*('' n'"ln an $%#lal" )%'a#/ $*a& $%!a$na a&$" ma&an *%nan a&$"

$%#a!ana &a*a# !"na& n'"ln/ a$a" &a#%na a*ana +a$(# an *a!a$

m%nn&a$&an '%n'$$a' $%#ha*a! n'"ln/ m'alna n'"+'%n' a*#%nal a$a"

!$"a#/ a$a"!"n a&)a$ &%#a +'& an )%#l%)han.

26 Reak*i aler,i %an re*i*ten*i

P%n"naan n'"ln #%&(m)nan *an n'"ln an l%) m"#n/ $%lah *a!a$m%n"#"n&an n'*%n #%a&' al%# *an #%''$%n'. M%'& *%m&an/ &a*an ?

&a*an#%a&' $%#'%)"$ ma'h *a!a$ $%#a*a&)a$ a*ana )%&"an a$a" $%#a*na

*%na$"#a' !#%!a#a$ n'"ln/ a$a" &(n$amnan/ a$a" a&)a$ !a'%n '%n'$% $%#ha*a!

'%naa an *$am)ah&an !a*a !#('%' +(#m"la' !#%!a#a$ n'"ln. R%a&' al%#

l(al !a*a &"l$ an '%#n $%#a* a&)a$ IE a$a" #%''$%n' a&)a$ $m)"lna

an$)(* I.

Interak*i B%)%#a!a h(#m(n% )%#'+a$ an$a(n' $%#ha*a! %+%& h!(l&%ma n'"ln an$a#a

lan/ h(#m(n% !%#$"m)"han/ &(#$&($#(!n/ l"&(&(#$&(*/ $#(*/ %'$%#(%n/

!#(%'$n/ *an l"a(n. A*#%naln m%nham)a$ '%%' n'"ln *an m%#an'an

l&(%n(l''. P%nn&a$an &a*a# h(#m(n% n !%#l" *!%#h$"n&an *alam $%#a!

n'"ln. Sal'la$ m%nn&a$&an '%%' n'"ln/ m"n&n m%n%)a)&an

h!(l&%ma. H!(l&%ma %n*%#"n $%#a* !a*a !a'%n *%nan !%nham)a$

a*#%n('%!$(# a&)a$ !%nham)a$an %+%& &a$%&(lamn !a*a l"&(n%(%n%'' *an

l&(%n(l''/ ()a$ n "a m%n&a)"#&an $a&&a#* a&)a$ h!(l&%ma. P($%n'

%+%& h!(l&%ma n'"ln $%#a* *%nan !%nham)a$ MA;/ '$%#(* ana)(l *an

+%n+l"#amn ,FK UI/200>.

OBAT ANTIDIABETIK ORAL

A*a 5 (l(nan an$*a)%$& (#al , AD; an *a!a$ *"na&an "n$"& DM *an

$%lah *!a'a#&an * In*(n%'a a&n (l(nan7 '"l+(nl"#%a/ m%l$n*/ )"an*/

!%nham)a$ G-l&('*a'%/ *an $a@(l*n%'(n. K%lma (lnan n *a!a$

16


17/30

*)%#&an !a*a DM $!% II an $*a& *a!a$ *&(n$#(l hana *%nan *%$ *an

la$han +'& 'aa.

7olon,an S)lonil)rea

D&%nal 2 %n%#a' '"l+(nl"#%a/ %n%#a' 1 $%#*# *a# $(l)"$am*/ a'%$(h%&'m*

*an &l(!#(!am*. %n%#a' II an !($%n' h!(l&%m& l%)h )%'a# an$a#a lan

l)"#* , l)%n&lam*/ l!@*/ l&a@* *an lm%!#*.

Mekani*me ker-a

(l(nan ()a$ n *'%)"$ '%)aa n'"ln '%#%$a(%"'/ &%#ana m%#an'an

'%%' n'"ln *a# #an"l '%l ? '%l Lan%#han' !an%a'. Ran'anan m%lal"

n$%#a&'na *%nan ATP- '%n'$% K hann%l !a*a m%m)#an% '%l ? '%l anm%nm)"l&an *%!(la#'a' m%m)#an% *an &%a*aan n a&an m%m)"&a &anal a.

D%nan $%#)"&ana &anal a ma&a (n a a&an ma'"& '%l / m%#an'an

#an"la an )%#' n'"ln *an a&an $%#a* '%%' n'"ln *%nan "mlah an

%&"al%n *%nan !%!$*% . &%"al $"/ '"l+(#l"#%a *a!a$ m%n"#an &l#%n

n'"ln * h%!a#.

Pa*a !%n"naan an&a !anan a$a" *('' an )%'a# *a!a$ m%n%)a)&an

h!(l&%ma.

Eek *ampin,In'*%n %+%& 'am!n %n%#a' I '%&$a# 8 :/ n'*%n'na l%)h #%n*ah la "n$"&

%n%#a' II. H!(l&%ma/ )ah&an 'am!a &(ma $%n$" *a!a$ $m)"l. R%a&' n

'%#n $%#a* !a*a !a'%n "'a lan"$ *%nan an"an +"n' h%!a# *an nal/

$%#"$ama an m%n"na&an '%*aan *%nan ma'a &%#a !anan.

E+%& 'am!n lan/ #%a&' al%# a#an '%&al $%#a* / m"al/m"n$ah/ *a#%/ %ala

h%ma$(l(/ '"'"nan 'a#a+ !"'a$/ ma$a/ *an '%)aana.

Interak*i

;)a$ an *a!a$ m%nn&a$&an #'&( h!(l&%ma '%a&$" !%n"naan

'"l+(nl"#%a a*alah n'"ln/ al(h(l/ +%n+(#mn/ '"l+(nam*%/ 'al'la$ *('' )%'a#/

+%n)"$a@(n/ (&'+%n)"$a@(n/ !#()%n%@*/ *&"ma#(l/ &l(#am+%n&(l/ !%nham)a$

MA;/ "an%$*n/ ana)(l '$%#(*/ +%n+l"#amn *an &l(+)#a$.

P#(!#an(l(l *an !%nham)a$ a*#%n(#%'%!$(# lanna m%nham)a$ #%a&'

$a&&a#*a/ )%#&%#na$ *an $#%m(# !a*a h!(l&%ma (l%h )%#)aa '%)a)

$%#ma'"& (l%h AD;/ '%hna &%a*aan h!(l&%ma m%na* h%)a$ $an!a

*&%$ah". S"l+(nl"#%a $%#"$ama &l(#!#(!am* *a!a$ m%n"#"n&an $(l%#an'

$%#ha*a! al(h(l/ hal n *$"n"&&an *%nan &%m%#ahan $%#"$ama *m"&a *an

l%h%#.

1>


18/30

Me,litini%

R%!aln* *an na$%ln* m%#"!a&an (l(nan m%l$n*/ m%&an'm% &%#ana

'ama *%nan '"l+(nl"#%a $%$a! '$#"&$"# &mana 'ana$ )%#)%*a. (l(nan

A;D n m%#an'an n'"ln *%nan m%n"$"! &anal K an ATP- n*%!%n*%n$ *

'%l !an%a'.

Pa*a !%m)%#an (#al a)'(#!'na %!a$ *an &a*a# !"na&na *a!a *alam &"#"n

a&$" 1 am. Ma'a !a#"hna 1 am/ &a#%nana ha#"' *)%#&an )%)%#a!a &al

'%ha#/ '%)%l"m ma&an. M%$a)(l'm "$amaa * h%!a# *an m%$a)(l$na $*a&

a&$+. S%&$a# 10 : *m%$a)(l'm% * nal. Pa*a !a'%n *%nan an"an +"n'

ha$ a$a" nal ha#"' *)%#&an '%a#a ha$ ? ha$. E+%& 'am!n "$amana

h!(l&%ma *an an"an 'al"#an %#na. R%a&' al%# "a !%#nah *la!(#&an.

Bi,)ani%

S%)%na#na *&%nal 3 %n' AD; *a (l(nan )"an*7 +%n+(#mn/ )"+(#mn/ *an

m%$+(#mn/ $%$a! an !%#$ama $%lah *$a#& *a# !%#%*a#an &a#%na '%#n

m%n%)a)&an a'*('' la&$a$. S%&aan an )ana& *"na&an a*alah m%$+(#mn.

Mekani*me ker-a

B"an* '%)%na#na )"&an ()a$ h!(l&%ma/ $%$a! an$h!%#l&%ma/ $*a&

m%n%)a)&an #an'anan '%%' n'"ln *an "m"mna $*a& m%n%)a)&an

h!(l&%ma. M%$+(#mn m%n"#"n&an !#(*"&' l"&('a * h%!a# *an

m%nn&a$&an '%n'$a' a#nan ($($ *an a*!('% $%#ha*a! n'"ln.

Eek *ampin,

Ham!# 20: !a'%n *%nan m%$+(#mn m%nalam m"al/ m"n$ah/ *a#% '%#$a

&%a! l(am/ $%$a! *%nan m%n"#"n&an *('' &%l"han ? &%l"han $%#'%)"$ *a!a$

hlan. Pa*a )%)%#a!a !a'%n an m"$la& )%#an$"n !a*a n'"ln %&'(%n/

&a*an ? &a*an )"an* m%nm)"l&an &%$('' an $*a& *'%#$a h!%#l&%ma.

Hal n ha#"' *)%*a&an *%nan &%$('' &a#%na *%+'%n' n'"ln.

Pa*a !a'%n *%nan an"an +"n' nal a$a" ''$%m &a#*(a'&"l%#/

!%m)%#an )"an* *a!a$ m%nm)"l&an !%nn&a$an &a*a# a'am la&$a$ *alam

*a#ah/ '%hna hal n 'a!a$ m%nan" &%'%m)anan %l%&$#(l$ *alam a#an

$")"h.

7olon,an Tia1oli%ine%ion

Makani*me ker-a %an eek meta/oli(

T%lah *$%#an&an *a$a'/ n'"ln m%#an'an !%m)%n$"&an *an $#an'l(&a' LUT

&% m%m)#an% '%l (#an !%#+%#. In $%#a* &a#%na n'"ln m%#an'an Peroxisome

proliferators-activated reseptor-γ ,PPAR * n$ '%l *an m%na&$a' insulin-

responsive genes/ %n an )%#!%#an *alam m%$a)(l'm &a#)(h*#a$ *an l%ma&.

19


19/30

PPAR $%#*a!a$ * $a#%$ n'"ln/ a&n * a#nan a*!('%/ !an%a'/ h%!a#/

&%)%#a*aanna * ($($ '&%l%$ ma'h m%#a"&an.

Ta@(l*n%*(n m%#"!a&an a(n'$ !($%n$ *an '%l%&$+ PPAR m%m)%n$"&

&(m!l%&' PPAR-RR *an $%#)%n$"&lah LUT )a#". D a#nan a*!('% PPAR

m%n"#an &%l"a#na a'am l%ma& &% ($($/ *an &a#%nana *a!a$ m%n"#an

#%''$%n' n'"ln.

E+%& 'am!n an$a#a lan/ !%nn&a$&an )%#a$ )a*an / %*%ma/ m%nam)ah (l"m%

!la'ma *an m%m!%#)"#"& aal an$"n &(n%'+. E*%ma '%#n $%#a* !a*a

!%n"naanna )%#'ama n'"ln. K%"al h%a!/ $*a& *an"#&an !a*a aal nal

&%la' 3 *an 8 m%n"#"$ New York Heart Association. H!(l&%ma !a*a

!%n"naan m(n($%#a! a#an $%#a*.

Pen,0am/at En1im 897liko*i%a*e

;)a$ (l(nan !%nham)a$ %n@m G-l&('*a'% n *a!a$ m%m!%#lam)a$ a)'(#!'

!(l'a&a#*a/ *%&'$#n/ *an *'a&a#*a * n$%'$n%. D%nan m%nham)a$ &%#a

%n@m G-l&('*a'% * )#"'h )(#*%# n$%'$n%/ *a!a$ m%n%ah !%nn&a$an

l"&('a !la'ma !a*a (#an n(#mal *an !a'%n DM.

Ka#%na &%#ana $*a& m%m!%na#"h '%%' n'"ln/ ma&a $*a& a&an

m%n%)a)&an %+%& 'am!n h!(l&%ma. A&a#)('% *a!a$ *"na&an '%)aa

m(n($%#a! !a*a DM "'a $!% lan"$ a$a" DM an l"&('a !('$!#an*alna

'ana$ $n. D &ln& '%#n *"na&an )%#'ama an$*a)%$& (#al lan *an a$a"

n'"ln.

;)a$ (l(nan n *)%#&an !a*a a&$" m"la ma&an *an a)'(#'!' )"#"&.

A&a#)('% m%#"!a&an (l('a&a*a an )%#a'al *a# m()a/ *an m$(l '"a$"

*%#a$% *%'(&'n(#m'n/ '%a#a &(m!%$$+ "a m%nham)a$ l"&(amla'% *an

'"a'%/ $%$a! %+%&na !a*a G-amla'% !an%a' l%mah.

E+%& 'am!n an )%#'+a$ *('%- *%!%n*%n$ an$a#a lan mala)'(#)'/ +la$"l%n/

*a#%/ *an a)*(mnal )l(a$n. Un$"& m%n"#an %+%& 'am!n n '%)a&na

*('' *$$#a' ,FK UI/200>.

OBAT HERBAL ANTIDIABETIK

1. )a$an )#($(al 4 inosporae caulis ,m%nan*"n al&al(* / @a$ !ah$/

$n('!(#*n%/ )%#%+%& m%n"#"n&an &a*a# "la *a#ah

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2. )"ah !a#%4 !omordicae fructus ,m%nan*"n al&al(* m(m(#*n )%#%+%&

m%n"#"n&an &*a# "la *a#ah *an $%&anan *a#ah

3. Da"n 'am)l($( 4 Andrographii folium ,m%nan*"n an*#(#a!h(l*% )%#%+%&

m%n"#"n&an "la *a#ah/ $%&anan *a#ah/ m%nn&a$&an '$amna

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BAB III

HASIL

IDENTITAS PASIEN

Nama 7 N T(a'ahUm"# 7 86 $ah"n

J%n' K%lamn 7 P%#%m!"an

S$a$"' P%#&anan 7 Kan

Alama$ 7 S"#a*a* - T%al

Aama 7 I'lam

S"&" Ban'a 7 Jaa

P%n**&an 7

P%&%#aan 7

RESUME PEN:AKIT DAN PENATALAKSANAAN :AN7 SUDAH

DILAKUKANAnamne*i*

Pa'%n *a$an "n$"& &(n$#(l "la *a#ah

Riwa+at Pen+akit Sekaran,

Pa'%n *a$an *%nan "la *a#ah '%a&$" 280 m4*l

Riwa+at Pen+akit Da0)l)

• Raa$ $%&anan *a#ah $n *'an&al

• Raa$ &%nn man' '%a& > $ah"n an lal"/ &(n$#(l $%#a$"# • Raa$ 'a&$ &"nn *'an&al

• Raa$ 'a&$ an$"n *'an&al

• Raa$ a'ma *'an&al

Riwa+at Pen+akit Kel)ar,a

• Raa$ &%l"a#a 'a&$ *'an&al

• Raa$ &%l"a#a 'a&$ *a#ah $n/ a'ma/ 'a&$ &"nn/ *an an$"n

*'an&al

Pemerik*aan 4i*ik

• K%a*aan "m"n 7 )a&

• K%'a*a#an 7 )a&

• Tan*a $al7

T%n'7 1204>0 mmH

Na*7 >0 4m%n$

F#%&"%n' na+a'7 32 4m%n$

S"h"7 36/1 *%#aa$ %l"' a&'la ,&%$a&

• S$a$"' @7

BB7 58 &

TB7 160 m

BMI7 21/1

K%'an 7 n(#malDia,no*i* Ker-a

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Da)%$%' M%l$"' $!% 2

Penatalak*aan

• 4armakolo,i

l)%n&lam*

a#a &%#a m%nn&a$&an '%%' n'"ln

M%$+(#mna#a &%#a m%n%&an !#(*"&' l"&('a ha$

• Nonarmakolo,i

D%$ *a$"#7 &"#an man' ? man' *an )a$a' ma&anan an

)ana& &a#)(h*#a$.

;lah#aa $%#a$"# 3 ? 8 &al '%mn" &"#an l%)h 30 m%n$ ,

alan 'an$a/ '%!%*a 'an$a/ (n/ )%#%nan

P%mahaman $%n$an !%na&$ DM/ h!(l&%ma/ ma&na *an

!%#l"na !%n%n*alan *an !%man$a"an DM.

BAB I;

PEMBAHASAN

In$%#a&' *&la'+&a'&an )%#*a'a#&an &%$%#l)a$an *alam !#('%'

+a#ma&(&n%$& ma"!"n +a#ma&(*nam&. In$%#a&' +a#ma&(&n%$& *$an*a *%nan

!%#")ahan &a*a# !la'ma ()a$/ a#%a * )aah &"#a ,AU/ (n'%$ a&'/ a&$" !a#(

*'). In$%#a&' +a#ma&(&n%$& *a&)a$&an (l%h !%#")ahan la" a$a" $n&a$ a)'(#!'/

*'$#)"'/ m%$a)(l'm% *an %&'%'. In$%#a&' +a#ma&(*nam& )a'ana

*h")"n&an *%nan &%mam!"an '"a$" ()a$ "n$"& m%n")ah %+%& ()a$ lan $an!a

m%n")ah '+a$-'+a$ +a#ma&(&n%$&na. In$%#a&' +a#ma&(*nam& m%l!"$ a*$+

,%+%& ()a$ A 1/ %+%& ()a$ B 1/ %+%& &(m)na' &%*"ana 2/ !($%n'a' ,%+%& A

0/ %+%& B 1/ %+%& &(m)na' AB 2/ 'n%#'m% ,%+%& A 1/ %+%& B 1/ %+%&

&(m)na' AB 3 *an an$a(n'm% ,%+%& A 1/ %+%& B 1/ %+%& &(m)na' AB

0. M%&an'm% an $%#l)a$ *alam n$%#a&' +a#ma&(*nam& a*alah !%#")ahan %+%&

!a*a a#nan a$a" #%'%!$(#.

Interak*i armakokinetik

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6 A/*orp*i

;)a$-()a$ an *"na&an '%a#a (#al )'aana *'%#a! *a# 'al"#an %#na &%

*alam ''$%m '#&"la'. A*a )ana& &%m"n&nan $%#a* n$%#a&' '%lama ()a$

m%l%a$ 'al"#an %#na. A)'(#!' ()a$ *a!a$ $%#a* m%lal" $#an'!(#$ !a'+ ma"!"n

a&$+/ * mana '%)aan )%'a# ()a$ *a)'(#!' '%a#a !a'+. P#('%' n m%l)a$&an *+"'

()a$ *a# *a%#ah *%nan &a*a# $n &% *a%#ah *%nan &a*a# ()a$ an l%)h #%n*ah.

Pa*a $#an'!(#$ a&$+ $%#a* !%#!n*ahan ()a$ m%laan #a*%n &(n'%n$#a' ,(n$(hna

(n-(n *an m(l%&"l an la#"$ a# *an !#('%' n m%m)"$"h&an %n%#. A)'(#!' ()a$

'%a#a $#an'!(#$ a&$+ l%)h %!a$ *a# !a*a '%a#a $an'!(#$ !a'+. ;)a$ *alam )%n$"&

$a&-$%#(n la#"$ l%ma& *an m"*ah )%#*+"' m%l%a$ m%m)#an '%l/ '%*an&an ()a$

*alam )%n$"& $%#(n $*a& la#"$ l%ma& *an $*a& *a!a$ )%#*+"'. D )aah &(n*'

+'(l( n(#mal a)'(#!'na aa& $%#$"n*a $%$a! $n&a$ a)'(#!'na )a'ana

'%m!"#na.

Bla &%%!a$an a)'(#!' )%#")ah/ n$%#a&' ()a$ '%a#a 'n+&an a&an l%)h

m"*ah $%#a*/ $%#"$ama ()a$ *%nan a&$" !a#( an !%n*%& a$a" )la *)"$"h&an

&a*a# !"na& !la'ma an %!a$ "n$"& m%n*a!a$&an %+%&. M%&an'm% n$%#a&'

a&)a$ an"an a)'(#!' an$a#a lan 7

a. In$%#a&' lan'"n

In$%#a&' '%a#a +'&4&ma an$a# ()a$ *alam l"m%n 'al"#an %#na '%)%l"m

a)'(#!' *a!a$ m%nan" !#('%' a)'(#!'. In$%#a&' n *a!a$ *hn*a#&an a$a"

'ana$ *&"an )la ()a$ an )%#n$%#a&' *)%#&an *alam an&a a&$" mnmal

2 am.

). !%#")ahan !H 'al"#an %#na

a#an 'al"#an %#na an al&al'/ m'alna a&)a$ a*ana an$a'*/ a&an

m%nn&a$&an &%la#"$an ()a$ an )%#'+a$ a'am an '"&a# la#"$ *alam 'al"#an

%#na/ m'alna a'!#n. D%nan *%m&an *!%#%!a$na *'(l"' a'!#n (l%h )a'a

a&an m%m!%#%!a$ a)'(#!'na. A&an $%$a!/ '"a'ana al&al' * 'al"#an %#na a&an

m%n"#an &%la#"$an )%)%#a!a ()a$ an )%#'+a$ )a'a ,m'alna $%$#a'&ln

*alam a#an 'al"#an %#na/ '%hna m%n"#an a)'(#!'na. B%#&"#anna

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&%a'aman lam)"n (l%h an$a'*a a&an m%n"#an !%n#"'a&an ()a$ an $*a&

$ahan a'am '%hna m%nn&a$&an )(aala)l$a'na.

K%$(&(na@(l an *mn"m !%# (#al m%m)"$"h&an m%*"m a'am "n$"&

m%la#"$&an '%"mlah an *)"$"h&an '%hna $*a& m%m"n&n&an *)%#&an

)%#'ama an$a'*a/ ()a$ an$&(ln%#&/ !%nham)a$an H2/ a$a" nh)$(# !(m!a

!#($(n ,m'alna (m%!#a@(l. J&a m%man *)"$"h&an/ '%)a&na a)a$-()a$ n

*)%#&an '%*&$na 2 am '%$%lah !%m)%#an &%$(&(na@(l.

. !%m)%n$"&an '%naa &(m!l%&' $a& la#"$ a$a" &h%la$/ *an a*'(#'

In$%#a&' an$a#a an$)($& (l(nan +l"(#(&n(l(n ,'!#(+l(&'a'n/ %n(&'a'n/

l%(+l(&'a'n/ l(m%+l(&'a'n/ n(#+l(&'a'n/ (+l(&'a'n *an '!a#+l(&'a'n *an (n-

(n *al%n$ *an $#al%n$ ,m'alna (n a2 / M2 *an Al3 *a# an$a'*a *an ()a$

lan *a!a$ m%n%)a)&an !%n"#"nan an 'n+&an *a# a)'(#!' 'al"#an %#na/

)(aala)l$a' *an %+%& $%#a!%$&/ &a#%na $%#)%n$"&na '%naa &(m!l%&'.

In$%#a&' n "a 'ana$ m%n"#"n&an a&$$a' an$)($& +l"(#(&"n(l(n. E+%&

n$%#a&' n *a!a$ '%a#a 'n+&an *&"#an *%nan m%m)%#&an an$a'*a

)%)%#a!a am '%)%l"m a$a" '%$%lah !%m)%#an +l"(#(&"n(l(n. J&a an$a'*a )%na#-

)%na# *)"$"h&an/ !%n%'"aan $%#a!/ m'alna !%nan$an *%nan ()a$-!)a$

an$a(n' #%'%!$(# H2 a$a" nh)$(# !(m!a !#($(n *a!a$ *la&"&an.

B%)%#a!a ()a$ an$*a#% ,an m%nan*"n a$a!"l$ m%n%#a! ()a$-()a$ lan/

'%hna m%n"#"n&an a)'(#!'.


25/30

Anali*i* ka*)*

P%n*%#$a )%#nama N T(a'ah/ )%#"m"# 86 $ah"n m%n*%#$a *a)%$%' $!% 2 '%a& >

$ah"n an lal". P%n*%#$a '%lal" #"$n &(n$#(l !%n()a$an *a)%$%' m%ll$"' *an #"$n

m%la&"&an %& &a*a# "la *a#ah.

P%n*%#$a ma&an $%#a$"# *%nan m%n"#an ma&anan an man' ? man' '%'"a

!%$"n"& *(&$%# "n$"& m%naa &a*a# "la *a#ahna. Un$"& "la/ !%n*%#$a )a'a

m%n"na&an "la #%n*ah &al(#.

P%nala&'aan +a#ma&(l( an *)%#&an &%!a*a !%n*%#$a a*alah l)%n&lam* *an

m%$+(#mn.

Interak*i o/at ,li/enklami% %an metormin

Metormin

M%&an'm% &%#a m%$+(#mn m%n"#"n&an l"&('a *a#ah m%lal" !%na#"hna

$%#ha*a! &%#a n'"ln !a*a $n&a$ '%l"la#/ *'$al #%'%!$(# n'"ln *an m%n"#"n&an

!#(*"&' l"&('a ha$. M%$+(#mn m%nn&a$&an !%ma&aan l"&('a (l%h '%l "'"'

'%hna m%n"#"n&an l"&('a *a#ah *an "a **"a m%nham)a$ a)'(#)' l"&('a *

"'"' '%'"*ah a'"!an ma&an. S%$%lah *)%&an (#al/ m%$+(#mn a&an m%na!a &a*a#

$%#$n *alam *a#ah '%$%lah 2 am *an *%&'%'&an l%a$ "#n *alam &%a*aan "$"h

*anan a&$" !a#"h 2/5 am.

M%$+(#mn *a!a$ m%n"#"n&an l"&('a *a#ah $%$a! $*a& a&an m%n%)a)&an

h!(l&%ma '%hna $*a& *ana! '%)aa ()a$ h!(l&%ma. Pa*a !%ma&aan

&(m)na' *%nan '"l+(nl"#%a/ h!(l&%ma *a!a$ $%#a* a&)a$ !%na"h

'"l+(nll"#%ana. Pa*a !%ma&aan $"nal m%$+(#mn *a!a$ m%n"#"n&an l"&('a

*a#ah 'am!a 20 : *an &(n'%n$#a' n'"ln !la'ma !a*a &%a*aan )a'al "a $"#"n.

M%$+(#mn $*a& m%n%)a)&an &%na&an )%#a$ )a*an '%!%#$ !a*a !%ma&aan

'"l+(nl"#%a.

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7li/lenklami%

M%&an'm% &%#a l)%n&lam* a*alah *%nan m%#an'an &anal K an

$%#an$"n !a*a ATP *a# '%l )%$a !an%a'. Bla 'l+(nl"#%a $%#&a$ #%'%!$(# &anal

$%#'%)"$ ma&a a&an $%#a* !%n"$"!an. K%a*aan n a&an m%n%)a)&an $%#a*na

!%n"#"nan !%#m%a)l$a' K !a*a m%m)#an% '%l )%$a/ $%#a* *%!(la#'a' m%m)#an%

*an m%m)"&a &anal a $%#an$"n (l$a'%/ *an m%n%)a)&an !%nn&a$an a

n$#a'%l. I(n a a&an $%#&a$ !a*a alm(*"ln/ *an m%n%)a)&an %&'('$('' #an"l

an m%nan*"n n'"ln.

;)a$ n )%&%#a *%nan m%#an'an '%l )%$a !an%a' "n$"& m%l%!a'&an

n'"ln an $%#'m!an.

P%n"naan *alam &ln&. Pa*a !%ma&aan '"l+(nl"#%a/ "m"mna '%lal"

*m"la *%nan *('' #%n*ah/ "n$"& m%nhn*a# &%m"n&nan h!(l&%ma. Pa*a

&%a*aan $%#$%n$" * mana &a*a# l"&('a *a#ah 'ana$ $n/ *a!a$ *"na&an *alam

*('' )%'a#.

K(m)na' l)%n&lam* *an m%$+(#mn 'aa$ n m%#"!a&an &(m)na' an

#a'(nal &a#%na m%m!"na a#a &%#a 'n%#' '%hna &(m)na' n *a!a$

m%n"#"n&an l"&('a *a#ah l%)h )ana& *a#!a*a !%n()a$an $"nal ma'n ?

ma'n/ )a& !a*a *('' ma&'mal &%*"ana ma"!"n !a*a *('' #%n*ah. K(m)na'

*%nan *('' ma&'mal *a!a$ m%n"#"n&an l"&('a *a#ah an l%)h )ana&.

K(m)na' m%$+(#mn *%nan n'"ln "a *a!a$ *!%#$m)an&an !a*a !'%n

%m"& *%nan l&%m an '"&a# *&%n*al&an. K(m)na' l)l%n&lam* *%nan

m%$+(#mn l%)h )a& *a#!a*a &(m)na' m%$+(#mn *%nan n'"ln.

K(m)na' l)l%n&lam* *%nan n'"ln **a'a#&an )aha #%#a$a &a*a#

l"&('a *a#ah '%!anan ha# $%#"$ama *$%n$"&an (l%h &a*a# l"&('a *a#ah !"a'ana.

Um"mna &%na&an &a*a# l"&('a *a#ah '%'"*ah ma&an &"#an l%)h 'ama/ $*a&

$%#an$"n *a# &a*a# l"&('a *a#ah !a*a &%a*aan !"a'a. D%nan m%m)%#&an n'"ln

&%a '%*an !a*a malam ha#/ !#(*"&' l"&('a ha$ malam ha# *a!a$ *&"#an

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'%hna &a*a# l"&('a *a#ah !"a'a *a!a$ $"#"n. S%lan"$na &a*a# l"&('a *a#ah

'an ha# *a$"# *%nan !%m)%#an '"l+(nl"#%a '%!%#$ )a'ana.

K(m)na' '"+(nl"#%a *an n'"ln $%#na$a l%)h )a& *a#!a*a n'"ln '%n*#

*an *('' n'"ln an *!%#l"&an $%#na$a l%)h #%n*ah. Dan a#a &(m)na' n l%)h

*a!a$ *$%#ma !a'%n *a#!a*a !%n"naan n'"ln m"l$!l%.

BAB ;

PENUTUP

A6 Simp)lan

Da)%$%' M%ll$"' a*alah &%lanan an )%#'+a$ (n& an *$an*a (l%h

an"an m%$a)(l'm &a#)(h*#a$/ !#($%n/ *an l%ma& an *&"$ (l%h &(m!l&a'

m(a'&"l%# ma"!"n ma(a'&"l%#/ *an $%lah *&%$ah" )%#&a$an *%nan +aa&$(#

%n%$& *%nan %ala &ln& an !aln "$ama a*alah n$(l%#an' l"&('a

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28/30

*h")"n&an *%nan &%mam!"an '"a$" ()a$ "n$"& m%n")ah %+%& ()a$ lan $an!a

m%n")ah '+a$-'+a$ +a#ma&(&n%$&na

K(m)na' l)%n&lam* *an m%$+(#mn 'aa$ n m%#"!a&an &(m)na' an

#a'(nal &a#%na m%m!"na a#a &%#a 'n%#' '%hna &(m)na' n *a!a$

m%n"#"n&an l"&('a *a#ah l%)h )ana& *a#!a*a !%n()a$an $"nal ma'n ?

ma'n/ )a& !a*a *('' ma&'mal &%*"ana ma"!"n !a*a *('' #%n*ah. K(m)na'

*%nan *('' ma&'mal *a!a$ m%n"#"n&an l"&('a *a#ah an l%)h )ana&.

T%#a* n$%#a&' 'n%#' an$a#a ()a$ *a)%$%' (#al a$" l)l%&lam* *an

m%$+(#mn.

B6 Saran

1. P%n*%#$a '%lal" #"$n "n$"& &(n$#(l "la *a#ah.

2. P%n*%#$a m%n&(n'"m' ()a$ an$ *a)%$& (#al '%'"a an"#an *(&$%#

'%hna *a!a$ $%#a* n$%#a&' an 'n%#' an$a# ()a$ an$ *a)%$& (#al

'%hna $*a& $%#a* h!(l&%ma.

3. P%n*%#$a m%naa !(la ma&an '%hna **a!a$&an %+%& n$%#a&' ()a$

*an ma&anan an 'aln 'n%#' '%hna $*a& $%#a* $%#a*

h!(l&%ma.

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DA4TAR PUSTAKA

Da#m(n(.1==1.S%# K"lah %n*(n(l(-m%$a)(l&.FK UNDIP.

Ha#$a$/S#.2002.M%na!a *a)%$%' )ana& m%na&)a$&an &%#"'a&an (#an $")"h *an

)aamana &%a*anna.S%ma#an7Bala P%n%#)$ FK UNDIP.

Sla.1==5.Pa$(+'(l( K(n'%! Kln' P#('%' ? P#('%' P%na&$.Ja&a#$a7E.

FK UI.200>.Fa#ma&(l( Dan T%#a!.Ja&a#$a7FKUI.

2=


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