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Perhitungan Dosis Untuk Anak (contoh 2)

Contoh soal sediaan Serbuk : R/ Atropin sulfat 0,5 mg (DM sekali: 1 mg, DM sehari 3 mg) Sacchar.lact. qs m.f.pulv. d.t.d. no.X. S. t.d.d. Pulv. I Pro: Rifki

(12th)

Analisa resep : dari resep diketahui untuk membuat 10 bungkus serbuk sediaan, mengandung 0,5 mg atropin sulfat setiap bungkus, aturan pakai 3 kali sehari satu bungkus. Jawab :

a. DM sekali pakai untuk anak 12 tahun DM sekali pakai = (12/20) x 1 mg = 0,6 mg DM atropin sulfat sekali pakai sedangkan untuk Persentase DM sekali :

= (0,5/0,6 mg) x 100% = 83,3% (boleh diracik dan diserahkan karna tidak lebih dari 100%)
b. DM untuk sehari untuk anak 12 tahun DM sehari = (12/20) x 3 mg = 1,8 mg DM dosis atropin untuk sehari .

Sedangkan untuk Persentase DM searah sehari :

= (3x0,5)/1,8 x 100% = 83,3 % (boleh diracik dan diserahkan karna tidak lebih dari 100%)

Untuk Lebih lengkap maka saya tambahkan rumus dibawah ini : Rumus menghitung dosis untuk anak-anak : 1. Berdasarkan umur a. Rumus young (untuk anak <8 tahun)

n : umur dalam tahun

b. Rumus

dilling (untuk

anak

lebih Besar

atau

sama

dengan

tahun)

umur

dalam

tahun

c. Rumus

Fried (untuk

bayi)

umur

dalam

bulan

Disadur dari : farmasi UNISB


Dosis adalah takaran obat yang diberikan kepada pasien yang dapat memberikan efek farmakologis (khasiat) yang diinginkan. dosis dibagi menjadi 2: dosis lazim dan dosis maksimum/maksimal. Dosis lazim adalah dosis yang digunakan sebagai pedoman umum pengobatan, sifatnya tidak mengikat (biasanya diantara dosis mimimum efek dan dosis maksimum), sedangkan dosis maksimum adalah dosis yang terbesar yang masih boleh diberikan kepada pasienbaik untuk pemakaian sekali maupun sehari tanpa membahayakan. Takaran dosis yang ada dalam farmakope umumnya untuk dosis orang dewasa, sedangkan untuk anakanak memerlukan rumus perhitungan tertentu. Cara menghitung dosis untuk anak-anak : 1. Berdasarkan umur a. Rumus young (untuk anak <8 tahun)

umur

dalam

tahun

b. Rumus

dilling (untuk

anak Besar-sama

dengan

tahun)

n c. Rumus Fried (untuk n

umur

dalam

tahun bayi)

umur

dalam

bulan

2. Berdasarkan berat badan Perhitungan dosis berdasarkan berat badan sebenarnya lebih tepat karna sesuai dengan kondisi pasien ketimbang umur yang terkadang tidak sesuai dengan berat badan, bila memungkinkan hitung dosis melalui berat badan d. Rumus Thermich n : berat badan dalam kilogram

3. Rumus untuk menentukan persentase DM obat Persentase DM sekali :

Persentase

DM

sehari

Category Archives: Obat yang aman untuk ibu Hamil & Menyusui
Drugsafety Antikonvulsan, Obat Tidur, Sedatif, dan Migren
DEC 30 Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI
Antikonvulsan, Obat Tidur, Sedatif, dan Migren
Nama Obat

R.Hamil

R.Menyusui

Sumatriptan

C Chloral hydrate Methyprylon Bromide Secobarbital Zolpidem Bishydroxycoumarin Warfarin Carbamazepine Ethosuximide Magnesium sulfate C D D B D C C B

L3 L3 NR L5 L3 L3 NR L2 L2 L4 L1
L2

Phenytoin

Valproic acid

L2

Lactation Risk Categories


L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

Pregnancy Risk Categories A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk) X (contraindicated in pregnancy) NR: Not Reviewed. This drug has not yet been reviewed by Hale.

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Drugsafety Obat TBC dan Malaria


DEC 30 Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI
Obat TBC dan Malaria
Nama Obat Obat TB Cycloserine Ethambutol Isoniazid
C B C L3 L2 L3 Risiko Kehamilan Risiko Menyusui

Rifampin Obat malaria Chloroquine Hydroxychloroquine Pyrimethamine Quinine

L2

C C C D

L3 L2 L4 L2

** Per Medications and Mothers Milk by Thomas Hale, PhD (2004 edition).

Lactation Risk Categories


Pregnancy Risk Categories


L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk) X (contraindicated in pregnancy)

NR: Not Reviewed. This drug has not yet been reviewed by Hale.
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Drugsafety Anti Hipertensi, Anti Aritmia, dan Diuretik


DEC 30 Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI
Anti Hipertensi, Anti Aritmia, dan Diuretik
Kategori Risiko Kehamilan** C

Nama Generik

RisikoMenyusui** L2

Acetazolamide

Bendroflumethiazide Chlorothiazide Chlorthalidone Hydrochlorothiazide (HCT) Spironolactone Disopyramide Flecainide Mexiletine Procainamide Quinidine Captopril Diltiazem/Diltiazem HCL

D D D D D C C B C C D C C (1st trim.) D (2nd, 3rd trim.) C C C B

L4 (may inhibit lactation) L3 L3 L2 L2 L2 L3 L2 L3 L2 L3 (if used after 30 days) L3

Enalapril/Enalapril Maleate Hydralazine Labetalol Methyldopa Metoprolol

L2 L2 L2 L2 L3 L2(topically) L3 (orally) L4 L2

Minoxidil Nadolol Nifedipine

C C C

NR

Oxprenolol Propranolol Sotalol


C B L2 L3

Timolol Verapamil Digoxin

C C C

L2 L2 L2

Approved: (Table 6) Maternal Medication Usually Compatible With Breastfeeding* Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001.
Concern: (Table 4) Drugs for Which the Effect on Nursing Infants Is Unknown but May Be of Concern Caution: (Table 5) Drugs That Have Been Associated With Significant Effects on Some Nursing Infants and Should Be Given to Nursing Mothers With Caution NR: Not Reviewed. This drug has not yet been reviewed by the AAP.

** Per Medications and Mothers Milk by Thomas Hale, PhD (2004 edition).

Lactation Risk Categories


Pregnancy Risk Categories


L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk) X (contraindicated in pregnancy)

NR: Not Reviewed. This drug has not yet been reviewed by Hale.
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Drugsafety Anti Jamur dan Anti Virus


DEC 30 Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI
Anti Jamur dan Anti Virus
Nama Generik Risiko Kehamilan RisikoMenyusui

Antijamur Fluconazole Ketoconazole Antivirus Acyclovir Interferon-alpha


C C L2 L2 C C L2 L2

* Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001.
Approved: (Table 6) Maternal Medication Usually Compatible With Breastfeeding Concern: (Table 4) Drugs for Which the Effect on Nursing Infants Is Unknown but May Be of Concern Caution: (Table 5) Drugs That Have Been Associated With Significant Effects on Some Nursing Infants and Should Be Given to Nursing Mothers With Caution NR: Not Reviewed. This drug has not yet been reviewed by the AAP.

** Per Medications and Mothers Milk by Thomas Hale, PhD (2004 edition).

Lactation Risk Categories


Pregnancy Risk Categories


L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk) X (contraindicated in pregnancy)

NR: Not Reviewed. This drug has not yet been reviewed by Hale.
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Drugsafety Antibiotik
DEC 27 Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI
Antibiotik
Kategori Risiko Kehamilan B B B B B B C B B C B

Nama Generik

Risiko Menyusui L1 L2 L1 L1 L2 L1 L1 L1 L2 L3 L3 L1 L3 early postnatal

Amoxicillin Aztreonam Cefadroxil Cefazolin Cefotaxime Cefoxitin Cefprozil Ceftazidime Ceftriaxone Ciprofloxacin Clindamycin

Erythromycin

NR

Fleroxacin Gentamicin Kanamycin


C D L2 L2

NR

Moxalactam Nitrofurantoin Ofloxacin


B C L2 L2

Penicillin Streptomycin

B D

L1 L3

NR

Sulbactam Sulfisoxazole Tetracycline Ticarcillin Trimethoprim/sulfamethoxazole


C D B C L2 L2 L1 L3

* Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001.
Approved: (Table 6) Maternal Medication Usually Compatible With Breastfeeding Concern: (Table 4) Drugs for Which the Effect on Nursing Infants Is Unknown but May Be of Concern Caution: (Table 5) Drugs That Have Been Associated With Significant Effects on Some Nursing Infants and Should Be Given to Nursing Mothers With Caution NR: Not Reviewed. This drug has not yet been reviewed by the AAP.

** Per Medications and Mothers Milk by Thomas Hale, PhD (2004 edition).

Lactation Risk Categories


Pregnancy Risk Categories


L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk) X (contraindicated in pregnancy)

NR: Not Reviewed. This drug has not yet been reviewed by Hale.
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Drugsafety Antasida, Laksan (Pelancar BAB) dan Obat Diare


DEC 27 Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI
Antasida, Laksan (Pelancar BAB) dan Obat Diare
Nama Generik Cimetidine (Antacid) Cisapride (GI tract stimulant) Domperidone (used for nausea & vomiting, stimulates lactation) Cascara/Cascara Sagrada Danthron Magnesium sulfate Senna Loperamide B C C B B
Risiko Kehamilan Risiko Menyusui

L2 L2 L1 L3 NR L1 L3 L2

* Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001.
Approved: (Table 6) Maternal Medication Usually Compatible With Breastfeeding Concern: (Table 4) Drugs for Which the Effect on Nursing Infants Is Unknown but May Be of Concern Caution: (Table 5) Drugs That Have Been Associated With Significant Effects on Some Nursing Infants and Should Be Given to Nursing Mothers With Caution NR: Not Reviewed. This drug has not yet been reviewed by the AAP.

** Per Medications and Mothers Milk by Thomas Hale, PhD (2004 edition).

Lactation Risk Categories


Pregnancy Risk Categories


L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous)

A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk)

L5 (contraindicated)

X (contraindicated in pregnancy)

NR: Not Reviewed. This drug has not yet been reviewed by Hale.
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Drugsafety Antihistamin
DEC 27 Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI
Antihistamin
AAP approved?*

Nama Obat

Risiko Menyusui**

not reviewed

L3 (moderately safe)

Brompheniramine Chlorpheniramine (Chlor-Trimeton) CTM


not reviewed

L3 (moderately safe)

not reviewed

L2 (safer)

Cetirizine (Zyrtec) Dexbrompheniramine maleate with d-isoephedrine Diphenhydramine (Benadryl)


yes not reviewed

L2 (safer) not

reviewed

not reviewed L4 (possibly hazardous)

Doxylamine Fexofenadine (Allegra)


yes L3 (moderately safe)

yes

L2 (safer)

Loratadine (Claritin) Terfenadine (Seldane) Triprolidine (Actidil, Actifed)


yes not reviewed

yes

L1 (safest)

* Per the AAP Policy Statement The Transfer of Drugs and Other Chemicals Into Human Milk, revised September 2001.
Approved: (Table 6) Maternal Medication Usually Compatible With Breastfeeding Concern: (Table 4) Drugs for Which the Effect on Nursing Infants Is Unknown but May Be of Concern Caution: (Table 5) Drugs That Have Been Associated With Significant Effects on Some Nursing Infants and Should Be Given to Nursing Mothers With Caution NR: Not Reviewed. This drug has not yet been reviewed by the AAP.

** Per Medications and Mothers Milk by Thomas Hale, PhD (2004 edition).

Lactation Risk Categories


Pregnancy Risk Categories


L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk) X (contraindicated in pregnancy)

NR: Not Reviewed. This drug has not yet been reviewed by Hale.
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Drugsafety Obat Asma, Obat Batuk, dan Spray Hidung


DEC 27 Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI
Obat Asma, Obat Batuk, dan Spray Hidung
Nama Generik Dyphylline Terbutaline Theophylline Nama Obat Codeine Dextromethorphan Guaifenesin Phenylephrine Pseudoephedrine (Sudafed, Actifed) Beclomethasone (Vanceril, Beclovent, Beconase, Vancenase) Cromlyn sodium (Nasalcrom) Fluticasone (Flonase) Mometasone (Nasonex) Phenylephrine (in some forms Kategori Risiko Kehamilan** C B C RisikoMenyusui** L3 L2 L3
Risiko Menyusui**

L3 (moderately safe) L1 (safest) L2 (safer) L3 (moderately safe) L3 (moderately safe) for acute use L4 (possibly hazardous) for chronic use due to potential for decreasing milk supply

L2 (safer) L1 (safest) L3 (moderately safe) L3 (moderately safe) L3 (moderately safe)

of Sinex and Neo-Synephrine) Triamcinolone Acetonide (Nasacort) L3 (moderately safe)

** Per Medications and Mothers Milk by Thomas Hale, PhD (2004 edition).

Lactation Risk Categories


Pregnancy Risk Categories


L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk) X (contraindicated in pregnancy)

NR: Not Reviewed. This drug has not yet been reviewed by Hale.
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Drugsafety NSAIDs dan Steroid


DEC 27 Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI
NSAIDs dan Steroid
Nama Generik Azapropazone (apazone) Dipyrone Flufenamic acid Ibuprofen Kategori Risiko Kehamilan** B (1st, 2nd trim.) D (3rd trim.) RisikoMenyusui** L2 NR NR L1

Indomethacin Ketorolac Mefenamic acid Naproxen Phenylbutazone Piroxicam Suprofen Tolmetin Methylprednisolone Prednisolone Prednisone
Lactation Risk Categories
L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated)

B (1st, 2nd trim.) D (3rd trim.) B (1st, 2nd trim.) D (3rd trim.) B B C C C C

L3 L2 NR L3 L4 NR L2 NR L3 L2 L2 L2

Pregnancy Risk Categories


A (controlled studies show no risk ) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk) X (contraindicated in pregnancy) NR: Not Reviewed. This drug has not yet been reviewed by Hale.

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Drugsafety ANALGETIK

DEC 26 Posted by dr.Rozi Abdullah

DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI ANALGETIK

Nama Obat Acetaminophen (Tylenol)

Risiko Kehamilan B C (1st, 2nd trim.) D (3rd trim.)

Risiko Menyusui L1

Aspirin

L3

Azapropazone (Rheumox) Butalbital (Fioricet, Fiorinal, Bancap, Two-dyne)


D B (1st, 2nd trim.) D (3rd trim.) C C D B B B (1st, 2nd trim.) C (3rd trim.) B C B (1st, 2nd trim.) D (3rd trim.) B (1st, 2nd trim.) D (3rd trim.) B (1st, 2nd trim.)

L2

L3

Butorphanol (Stadol) Celecoxib (Celebrex)) Codeine (in Tylenol #3, #4) Colchicine Diclofenac (Cataflam, Voltaren) Fentanyl (Sublimaze) Flurbiprofen (Ansaid, Froben, Ocufen) Hydrocodone (Lortab, Vicodin) Hydromorphone(Dilaudid) Ibuprofen (Advil, Nuprin, Motrin, Pediaprofen)

L3 L2 L3 L4 L2 L2

L2 L3 L3

L1

Indomethacin (Indocin) Ketorolac (Toradol, Acular)

L3 L2

D (3rd trim.) L2;

Meperidine (Demerol) Methadone (Dolophine) Morphine (Duramorph, Infumorph, Epimorph, MS Contin) Nalbuphine (Nubain) Naproxen (Anaprox, Naprosyn, Naproxen, Aleve)

B B

L3 early postpartum L3

B B

L3 L2 L3; L4 for chronic use

NR

Nefopam (Acupan) Oxycodone (Tylox, Percodan,Oxycontin, Roxicet, Endocet, Roxiprin, Percocet) Pentosan polysulfate(Elmiron) Piroxicam (Feldene) Propoxyphene(Darvocet N, Propacet, Darvon) Secobarbital (Seconal) Tolmetin (Tolectin) Tramadol HCL(Ultram, Ultracet)

B B B

L3 L2 L2

C D C C B (1st, 2nd trim.) D (3rd trim.) C B

L2 L3 L3 L3

Butorphanol Codeine Fentanyl

L3 L3 L2 L2 L3 (if used early postpartum) L3

Meperidine Methadone

B B

Morphine Propoxyphene

B C

L3 L2

** Per Medications and Mothers Milk by Thomas Hale, PhD (2004 edition).

Lactation Risk Categories


Pregnancy Risk Categories

L1 (safest) L2 (safer) L3 (moderately safe) L4 (possibly hazardous) L5 (contraindicated) A (controlled studies show no risk) B (no evidence of risk in humans) C (risk cannot be ruled out) D (positive evidence of risk) X (contraindicated in pregnancy)

NR: Not Reviewed. This drug has not yet been reviewed by Hale.
1. Aspirin use is discouraged in children and nursing mothers due to the risk o 2. f Reyes syndrome and internal bleeding. 3. Fioricet (Fiorinal, Bancap, Two-dyne) contains acetaminaphen or asprin, caffeine, and butalbital. Per Hale, baby should be observed for sedation. 4. Hale suggests weakened or premature infants be observed for sedation and apnea. 5. Hale suggests newborns be observed for sedation, apnea, constipation. 6. Per Hale, use of frequent, higher dose may result in infant sedation. 7. Per Hale, Meperidine use during labor or early postpartum has been associated with sedation, poor sucking reflex, and neurobehavioral delay in infants. 8. Per Hale, observe infant for sedation, respiratory depression, addiction, withdrawal syndrome. 9. Per Hale, higher doses may result in infant sedation. 10. Per Hale, should be used with caution due to its long half-life and its effect on babys cardiovascular system, kidneys and GI tract; short-term, infrequent or occasional use is not necessarily incompatible with breastfeeding. 11. Roxicet, Endocet, Roxiprin, Percocet also contain acetaminophen. Per Hale, observe infant for sedation. 12. Per Hale, observe infant for sedation. 13. Per Hale, observe infant for GI cramping, distress, diarrhea. 14. Per Hale, observe infant for sedation. 15. Per Hale, observe infant for sedation.

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