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Rahmatini Bagian Farmakologi & Terapi Fakultas Kedokteran Universitas Andalas

FARMAKOLOGI KLINIK. Rahmatini Bagian Farmakologi & Terapi Fakultas Kedokteran Universitas Andalas. DEFINISI. WHO ( 1988) Disiplin dalam bidang kedokteran berdasarkan prinsip ilmiah, menyatukan keahlian farmakologi & keahlian klinik dengan tujuan meningkatkan manfaat & keamanan obat.

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Rahmatini Bagian Farmakologi & Terapi Fakultas Kedokteran Universitas Andalas

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  1. FARMAKOLOGI KLINIK Rahmatini Bagian Farmakologi & Terapi Fakultas Kedokteran Universitas Andalas

  2. DEFINISI WHO ( 1988) Disiplin dalam bidang kedokteran berdasarkan prinsip ilmiah, menyatukan keahlian farmakologi & keahlian klinik dengan tujuan meningkatkan manfaat & keamanan obat

  3. TUJUAN FARMAKOLOGI KLINIK Terapi Efektif, Aman , Rasional

  4. RATIONAL DRUG USE Ratio Benefit – Risk - Cost F.Kinetika F Dinamika F Ekonomi

  5. PHARMACOLOGICAL ASPECTS IN CLINICAL PRACTICE Pharmacokinetic Pharmacodynamic How drugs act The dynamics of drug conc. in the body * Absorption / bioavailability * Distribution * Biotransformation * Excretion

  6. THERAPEUTIC DRUG MONITORING (TDM)

  7. Measuring the plasma drug conc. Provide useful information about the adequacy of the dosage regimen or the likehood toxicity

  8. Therapeutic Drug Monitoring (TDM) Ph dynamic Ph kinetic Drug-interaction • Measuring/ interpreting plasma drug conc. • Therapeutic • response • Side effects • Toxic effects

  9. Time-drug conc. relationship 40 30 Drug toxicity 20 Drug conc. (mg/l) Therapeutic level 10 m.e.c Low therapy 2 1 3 4 Time (hour)

  10. Therapeutic Drug Monitoring (TDM) 1. Narrow margin of safety drugs 2. Drugs for prevention/ therapy of life threatening diseases or life saving drugs 3. Difficulty in ditinguishing between the effects of a disease and the toxic effects of a drug 4. Potent drugs  drug amount is very small 5. Drugs that show variability of drug conc. in plasma

  11. Factors that modify drug plasma concentration for a given dose • Drug formulation • Drug interaction • Environmental factors • Genetic variation • Renal and hepatic function

  12. Reasons for monitoring drug treatment • To see whether there is • therapeutic response 2. To assess drug toxicity 3. To assess compliance

  13. Examples of difficulty in ditinguishing between the effects of a disease and the toxic effects of a drug Digoxin toxicity Congest.Heart Failure 1. Nausea / anorexia / arrythmias 2. Gentamycin toxicity Gram (–) septicaemia Renal damage

  14. Pharmacokinetic parameters Cmax (peak) Drugs- plasma conc. Half life AUC24 Cmin (trough) Time

  15. Visualisation of half-life First order elimination of a drug (t ½ : 2 hours) The plasma conc. falls by half each half-life 20 Drug conc. (mg/l) t ½ 10 t ½ 5 t ½ 2.5 2 4 6 Hours

  16. Clinical application of half life (t½) * Designing drug dosage regimen * Determining time to reach steady state drug level which show clinical effect * Determining time to reach the drug level which have no clinical effect anymore

  17. CONSIDERATION Ph’dynamic Ph’economic Ph’kinetic RATIONAL & GOOD CLINICAL THERAPY

  18. SESUNGGUHNYA BAGIMU, ADA MALAIKAT- MALAIKAT YANG SELALU MENGAWASI PEKERJAANMU QS 82 :10

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