Bagian Farmakologi & Terapi Fakultas Kedokteran Universitas Andalas

Presentasi berjudul: "Bagian Farmakologi & Terapi Fakultas Kedokteran Universitas Andalas"— Transcript presentasi:

1 Bagian Farmakologi & Terapi Fakultas Kedokteran Universitas Andalas
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 Terapi Efektif, Aman , Rasional
TUJUAN FARMAKOLOGI KLINIK Terapi Efektif, Aman , Rasional

4 RATIONAL DRUG USE Benefit – Risk - Cost Ratio 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 Measuring/ interpreting plasma drug conc.
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 1 2 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 2. To assess drug toxicity
drug treatment To see whether there is therapeutic response 2. To assess drug toxicity 3. To assess compliance

13 DRUG THERAPEUTIC TOXIC DIGOXIN 0,0010-0,0022 µg/ml > 0,0025 DIPHENYLHI DANTOIN 10- 20 > 25 LIDOCAIN 1,5-5 > 9 PHENOBARBITAL 15-30 > 40 THEOPHYLINE 10-20 > 20

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

15 Pharmacokinetic parameters
Cmax (peak) Drugs- plasma conc. Half life AUC 24 Cmin (trough) Time

16 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

17 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

18 RATIONAL & GOOD CLINICAL THERAPY
CONSIDERATION Ph’kinetic Ph’dynamic Ph’economic RATIONAL & GOOD CLINICAL THERAPY

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