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

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Presentasi berjudul: "Rahmatini Bagian Farmakologi & Terapi Fakultas Kedokteran Universitas Andalas FARMAKOLOGI KLINIK."— Transcript presentasi:

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2 Rahmatini Bagian Farmakologi & Terapi Fakultas Kedokteran Universitas Andalas FARMAKOLOGI KLINIK

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

4 FARMAKOLOGI KLINIK Terapi Efektif, Aman, Rasional TUJUAN

5 RATIONAL DRUG USE Benefit – Risk - Cost F.KinetikaF DinamikaF Ekonomi Ratio

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

7 THERAPEUTIC DRUG MONITORING (TDM)

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

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

10 Drug conc. (mg/l) Time (hour) Therapeutic level Low therapy Drug toxicity Time-drug conc. relationship m.e.c

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

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

13 Reasons for monitoring drug treatment 1.To see whether there is therapeutic response 2. To assess drug toxicity 3. To assess compliance

14 DRUGTHERAPEUTIC TOXIC DIGOXIN0,0010-0,0022 µg/ml > 0,0025 DIPHENYLHI DANTOIN > 25 LIDOCAIN 1,5-5 > 9 PHENOBARBITA L > 40 THEOPHYLINE > 20

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

16 Pharmacokinetic parameters C max (peak) Half life Time C min (trough) Drugs- plasma conc. AUC 24

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

18 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

19 CONSIDERATION Ph’kinetic Ph’dynamicPh’economic RATIONAL & GOOD CLINICAL THERAPY

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


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