Oleh INDAH FITRI DAMAYANTI, S.SI, APT Bagian Farmakologi Fakultas Kedokteran UNIZAR
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organ
pada tingkat
organisme
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AKSI OBAT
1. Pada tingkat molekular
a. Molekul obat
b. Molekul sasaran aksi obat (molekul makro) - reseptor, - enzim, - sistem transport
* molekul carrier * ion channels
AKSI OBAT
2. Pada tingkat struktural subselular
a. Membran sel
- reseptor - carrier molecule - ion channels
b. Organela
- mitochondria,
- lysosomes,
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Ion channels
molecule carrier
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Seluler aksi potensial pada motor end plate Jaringan / organ : tonus otot rangka organisme : tidak lesu,
,
seluler
menghambat sintesis RNA (Mycobacterium tbc) sintesis protein intraseluler myc. tbc terhambat kematian mycobacterium tbc
jaringan / organ : mencegah kerusakan paru organisme : sistem respirasi tidak terganggu 23/01/2007 interaksi antar organisme : pergaulan > baik Ngatidjan, FARMAKODIN
AKSI OBAT
1. Melalui aksi (cara kerja) nonspecific
- Antasida [ Al(OH)3 + Mg(OH)2]
- Mercurochrom, jodium tinctur - Adsorben : kaolin, activated charcoal cholestyramine (pengikat asam empedu) - Diuretika osmotik : manitol
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AKSI OBAT
2. Melalui cara (kerja) khas (specific)
* Memacu / menghambat enzim
- menghambat dopa decarboxylase (methyldopa)
AKSI OBAT
Beraksi pada protein sasaran :
- enzim,
- reseptor
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AKSI OBAT
dapat beraksi secara selektif :
- enzim spesifik,
- reseptor spesifik
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arachidonic acid
Cyclooxygenase
lipooxygenase
PGH2
isomerase Prostacycline synthetase Tx-synthetase
PGE2
- PG2a
PGI2
- PGI2 - PGF1a
TxA2
- TxA2
- TxB2
Aggregasi thrombocytes blood clotting
- PGD2
- PGF2a - HHT
LTC4
LTB4
LTD4
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15 pseudoallergy (bronchoconstriction)
inflammatory stimuli
(heat, mechanical, chemical)
COX2
inducible amount markedly in response to inflammatory mediators
TX-A2
(platelet functions)
prostacyclin
- gastroprotective
- antithrombotic properties
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of vascular endothelium
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Reseptor
* Unsur penerima stimulus (sensing elements)
dalam sistem komunikasi antar sel
Reseptor
Pre (pra) sinaptik
- r-2, r-2, r-M1
SELECTIVE b-BLOCKERS
memblok r-b1 secara selektif
- menghambat denyut jantung, - tidak berpengaruh pada r-b2,
NON-SELECTIVE b-BLOCKERS
memblok r-b secara tidak selektif
- menghambat denyut jantung,
- dan berpengaruh pada r-b2 di lain organ,
SELECTIVE M1-BLOCKERS
blokade r-M1 secara selektif
- menghambat pelepasan histamin dari sel ECL, menghambat sekresi HCl lambung,
terhambat dsb.)
NON-SELECTIVE M-BLOCKERS
memblok r-M secara tidak selektif
- menghambat sekresi asam lambung (melalui
blokade r-M1,
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r-BDZ
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r-nikotinik 26
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r-nikotinik 27
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CALCIUM ANTAGONISTS
blokade calcium channels
- varapamil, galopamil, ketopamil heart
- diltiazem
- nifedipine, nimodipin vascular affinity - others : flunarizine, cinarizine, oxatomide etc.
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r-N
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r-nikotinik
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r-BDZ
- intercorrelate with r-GABA - 2 type : r-BDZ1 and BDZ2 - located at subunit-g r-GABA frequency of ion channel opening - endazepin (bezodiazepin like substance)
r-GABA
- r-GABAA and r-GABAB - r-GABAA consists of subunit-a (6), -b (4) and -g (3) - GABA interact Dwith 4 Ngatidjan, FARMAKODIN subunit-a and b 33
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AKSI OBAT
pada Carrier Molecules
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active transport
0
drug ekstraselular
carrier molecule
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intraselular 36
AKSI OBAT
dan Farmakokinetika Obat
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Pharmacokinetic Process
Pharmacodynamic Process
Therapeutical Process
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(site of action)
efek obat
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50
100
12,5
25
peroral
intravena
0
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10
12
14
waktu (jam)
40
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Interaksi FARMAKODINAMIK
Potensiasi
sulfametoxazol - trimetoprim
Sinergistik aditif
b-blockers - diuretika
Antagonistik
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asam dihidrofolat
DHFR
asam tetrahidrofolat
T purin / pirimidin DNA
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INTERAKSI FARMAKODINAMIK
Terapi keracunan sianida
Na-nitrit Hb++ nitrite metHb+++ + CNCyano metHb Na-thiosulfat rhodanase
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Cyano cytochrome
Cytochrome oxydase
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Thiocyanat
metHb+++
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Adverse drug reactions and DRUG INTERACTION IN THE METABOLISM PHASE elicit the effect reabsorption
free estrogen and progesteron (active) liver metabolism (first pass metabolism)
deconjugasi by intestinal bacteria systemic blood circulation liver metabolism 23/01/2007 (conjugation) excretion (from liver to intestine
48
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liver metabolism (first pass metabolism) systemic blood circulation liver metabolism (conjugation)
broad spectrum AB
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