Makalah DDS Nasal Pulmonary PDF Office2000

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{\phpg\posx2268\pvpg\posy2277\absw3273\absh1355 \b \f20 \fs21 \cf0 \b \f20 \fs21
\cf0 TUGAS KELOMPOK
\par}{\phpg\posx2268\pvpg\posy2277\absw3273\absh1355 \sl-412 \b \f20 \fs21 \cf0
{\i "}{\i Sistem}{\i Penghantaran}{\i Obat}{\i " }
{\b0 Pengampu: }
Anita Sukmawati, Ph.D., Apt. \par
}
\cf0 M A K A L A H \par
}
{\phpg\posx3406\pvpg\posy5177\absw6205\absh571 \b\i \f20 \fs25 \cf0 \b\i \f20 \f
s25 \cf0 "Biofarmasetika Sediaan yang diberikan melalui
\par}{\phpg\posx3406\pvpg\posy5177\absw6205\absh571 \sl-324 \b\i \f20 \fs25 \cf0
\fi1551 Nasal dan Paru-Paru" \par
}
\cf0 Disusun Oleh:
\par}{\phpg\posx5506\pvpg\posy9459\absw1574\absh610 \sl-412 \b \f20 \fs21 \cf0 \
fi74 Kelompok II \par
}
{\phpg\posx4033\pvpg\posy10700\absw4678\absh984 \b \f20 \fs21 \cf0 \fi1166 \b \f
20 \fs21 \cf0 Anggota Kelompok:
\fi1240 Mustakim Masnur
Kathleen Apriana Kristiningrum Jahamou \par
}
{\phpg\posx3725\pvpg\posy12769\absw5186\absh1584 \b \f20 \fs25 \cf0 \fi1087 \b \
f20 \fs25 \cf0 Magister Farmasi Sains
Fakultas Farmasi Program Pasca Sarjana
\fi154 Universitas Muhammadiyah Surakarta
\fi2232 2015 \par
}
\sect\sectd\pard\plain
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}}\par}{\phpg\posx5302\pvpg\posy2277\absw1920\absh610 \b \f20 \fs21 \cf0 \fi609
\b \f20 \fs21 \cf0 BAB I
\par}{\phpg\posx5302\pvpg\posy2277\absw1920\absh610 \sl-412 \b \f20 \fs21 \cf0 P
ENDAHULUAN \par
}
1 \cf0 A.
Latar Belakang
\fi900 {\b0 Dewasa}{\b0
ini,}{\b0
berbagai}{\b0
macam}{\b0
turu
nan}{\b0
obat}{\b0
telah}{\b0
dibuat}{\b0
untuk }
\fi360 {\b0 meningkatkan}{\b0 efektifitas}{\b0 obat.}{\b0 Selain}{\b0 memod
ifiksi}{\b0 senyawa}{\b0 obat,}{\b0 upaya}{\b0 yang }
\fi360 {\b0 banyak}{\b0
dilakukan}{\b0
adalah}{\b0
memodifikasi}{\b
0
bentuk}{\b0
sediaan}{\b0
dan}{\b0
sistem }
\fi360 {\b0 penghantaran}{\b0
obat.}{\b0
Upaya}{\b0
ini}{\b0
tidak}
{\b0
terlepas}{\b0
dari}{\b0
peran}{\b0
farmasi}{\b0
yang }
\fi360 {\b0 memanfaatkan}{\b0 ilmu}{\b0 sains}{\b0 dan}{\b0 tehnologi}{\b0
untuk}{\b0 mengatasi}{\b0 ragam}{\b0 penyakit}{\b0 yang }
\fi360 {\b0 muncul. }
\par}{\phpg\posx2268\pvpg\posy3518\absw8296\absh10114 \sl-307 \par\b \f20 \fs21
\cf0 \fi900 {\b0 Bermacam}{\b0 sistem}{\b0 mucosal}{\b0 dalam}{\b0 tubuh}{\b
0 manusia}{\b0 (nasal,}{\b0 pulmonal,}{\b0 rectal }
\fi360 {\b0 dan}{\b0 vaginal)}{\b0 dapat}{\b0 dimanfaatkan}{\b0 untuk}{\b0
titik}{\b0 masuk}{\b0 sistem}{\b0 penghantaran}{\b0 obat. }
\fi360 {\b0 Dengan}{\b0
sendirinya}{\b0
pada}{\b0 sistem}{\b0
mucosa
l}{\b0
tersebut}{\b0
terdapat}{\b0
perbedaan}{\b0
dan }
\fi360 {\b0 persamaan}{\b0 dalam}{\b0 hal}{\b0 penghantaran}{\b0 obat. }
\cf0 \fi900 {\b0 Pengobtan}{\b0 Ayurvedi}{\b0 di}{\b0 India}{\b0 dan}{\b0
oleh}{\b0 orang}{\b0 Indian}{\b0 di}{\b0 AmerikaSelatan, }
\fi360 {\b0 melalui}{\b0 cara}{\b0 penghisapan}{\b0 (snuff)}{\b0 obat}{
\b0 untuk}{\b0 meningkatkan}{\b0 daya}{\b0 tahan}{\b0 tubuh }
\fi360 {\b0 merupakan}{\b0
salah}{\b0 satu}{\b0
bukti}{\b0
bahwa}{\b
0 sistem}{\b0
penghantaran}{\b0
obat}{\b0
nasal}{\b0
telah }
\fi360 {\b0 berlangsung}{\b0 sejak}{\b0 lama. }
\cf0 \fi900 {\b0 Kemampuan}{\b0
untuk}{\b0
mencegah}{\b0
eliminasi}{\b0
lintas}{\b0
pertama}{\b0
hepatic}{\b0
dan }

\fi360 {\b0 kenyamanan}{\b0
dalam}{\b0
penggunaan}{\b0
pada}{\b0
pa
sien}{\b0
merupakan}{\b0
keunggulan}{\b0
dari }
\fi360 {\b0 tehnik}{\b0
pemberian}{\b0
obat}{\b0
secara}{\b0
intran
asal}{\b0
yang}{\b0
dapat}{\b0
digunakan}{\b0
sebagai }
\fi360 {\b0 alternatif}{\b0
ideal}{\b0
untuk}{\b0
menggantikan}{\b0
sistem}{\b0
penghantaran}{\b0
obat}{\b0
sistematik }
\fi360 {\b0 parenteral. }
\cf0 \fi900 {\b0 Berdasarkan}{\b0 atas}{\b0 latar}{\b0 belakang}{\b0 di}
{\b0 atas,}{\b0 maka}{\b0 disusunlah}{\b0 makalah}{\b0 ini }
\fi360 {\b0 untuk}{\b0 mengetahui}{\b0 tentang}{\b0 biofarmasetika}{\b0 sis
tem}{\b0 penghantaran}{\b0 obat}{\b0 intranasal }
\fi360 {\b0 dan}{\b0
hal-hal}{\b0
yang}{\b0
berkaitan}{\b0
dengan}{
\b0
penghantaran}{\b0
sediaan}{\b0
tersebut}{\b0
serta }
\fi360 {\b0 berbagai}{\b0 faktor}{\b0 yang}{\b0 mempengaruhi}{\b0 proses}{\
b0 farmakokinetik}{\b0 dan}{\b0 biofarmasetik }
\fi360 {\b0 mulai}{\b0 dari}{\b0 penetrasi}{\b0 hingga}{\b0 menghasilkan}{\
b0 efek}{\b0 pada}{\b0 tubuh. }\par
}
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0 \fs22 \cf0 B.
Rumusan Masalah
\fi993 {\b0 Berdasarkan}{\b0 latar}{\b0 belakang}{\b0 diatas,}{\b0 terdapat}
{\b0 beberapa}{\b0 hal}{\b0 yang}{\b0 menjadi }
\fi427 {\b0 rumusan}{\b0 masalah}{\b0 dalam}{\b0 makalah}{\b0 ini,}{\b0 yai
tu}{\b0 sebagai}{\b0 berikut: }
\fi427 {\b0 a.}{\b0
Bagaimana}{\b0 Anatomi}{\b0 dan}{\b0 fisiologi}{\b0
nasal}{\b0 dan}{\b0 paru-paru? }
\fi427 {\b0 b.}{\b0
Bagaimana}{\b0 Proses}{\b0 absorpsi}{\b0 obat}{\b0 da
ri}{\b0 nasal}{\b0 dan}{\b0 paru-paru? }
\fi427 {\b0 c.}{\b0
Apa}{\b0 saja}{\b0 yang}{\b0 menjadi}{\b0 faktor
}{\b0 fisiologi,}{\b0 faktor}{\b0 fisikokimia,}{\b0 dan}{\b0 faktor }
\fi787 {\b0 formulasi}{\b0 yang}{\b0 mempengaruhi}{\b0 absorpsi}{\b0 obat}{\
b0 dari}{\b0 nasal}{\b0 dan}{\b0 paru-paru? }
\par}{\phpg\posx2268\pvpg\posy2277\absw8288\absh5331 \sl-349 \par\b \f20 \fs22 \
cf0 C.
Tujuan Penulisan Makalah
\fi1147 {\b0 Adapun}{\b0 yang}{\b0 menjadi}{\b0 tujuan}{\b0 penulisan}{\b0
makalah}{\b0 ini}{\b0 adalah: }
\fi427 {\b0 a.}{\b0 Untuk}{\b0 mengetahui}{\b0 anatomi}{\b0 dan}{\b0 fisio
logi}{\b0 nasal}{\b0 dan}{\b0 paru-paru }
\fi427 {\b0 b.}{\b0 Untuk}{\b0 mengetahui}{\b0 proses}{\b0 absorpsi}{\b0 o
bat}{\b0 dari}{\b0 nasal}{\b0 dan}{\b0 paru-paru }
\fi427 {\b0 c.}{\b0 Untuk}{\b0 mengetahui}{\b0 faktor-faktor}{\b0 yang}{
\b0 mempengaruhi}{\b0 absorpsi}{\b0 obat}{\b0 dari }
\fi787 {\b0 nasal}{\b0 dan}{\b0 paru-paru }
\fi427 {\b0 d.}{\b0 Untuk}{\b0 mengetahui}{\b0 keuntungan}{\b0 dan}{\b0 ke
rugian}{\b0 pemberian}{\b0 obat}{\b0 intranasal. }\par
}
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}}\par}{\phpg\posx2335\pvpg\posy2277\absw8284\absh11544 \b \f20 \fs21 \cf0 \fi35
30 \b \f20 \fs21 \cf0 BAB II
\fi2676 TINJAUAN PUSTAKA
\cf0 A. Anatomi dan Fisiologi Hidung
\fi360 1. Anatomi Hidung
\fi986 {\b0 Saluran}{\b0 penghantar}{\b0 udara}{\b0 hingga}{\b0 mencapa
i}{\b0 paru-paru}{\b0 adalah}{\b0 hidung, }
\fi215 {\b0 farinx,}{\b0 larinx,}{\b0 trachea,}{\b0 bronkus,}{\b0 dan}{\b0
bronkiolus. }
\cf0 \fi292 {\b0 a.}{\b0
Hidung }
\fi1209 {\b0 Nares}{\b0
anterior}{\b0
adalah}{\b0
saluran-saluran}{\b0
di}{\b0
dalam}{\b0
rongga}{\b0
hidung. }
\fi640 {\b0 Saluran-saluran}{\b0
itu}{\b0
bermuara}{\b0
ke}{\b0
dal
am}{\b0
bagian}{\b0
yang}{\b0
dikenal}{\b0
sebagai }
\fi640 {\b0 vestibulum.}{\b0 Rongga}{\b0 hidung}{\b0 dilapisi}{\b0 seba
gai}{\b0 selaput}{\b0 lendir}{\b0 yang}{\b0 sangat }

\fi640 {\b0 kaya}{\b0 akan}{\b0 pembuluh}{\b0 darah,}{\b0 dan}{\b0 be
rsambung}{\b0 dengan}{\b0 lapisan}{\b0 farinx}{\b0 dan }
\fi640 {\b0 dengan}{\b0 selaput}{\b0 lendir}{\b0 sinus}{\b0 yang}{\b0
mempunyai}{\b0 lubang}{\b0 masuk}{\b0 ke}{\b0 dalam }
\fi640 {\b0 rongga}{\b0 hidung.}{\b0 Septum}{\b0 nasi}{\b0 memisahkan}{
\b0 kedua}{\b0 cavum}{\b0 nasi.}{\b0 Struktur}{\b0 ini }
\fi640 {\b0 tipis}{\b0 terdiri}{\b0 dari}{\b0 tulang}{\b0 dan}{\b0 tul
ang}{\b0 rawan,}{\b0 sering}{\b0 membengkok}{\b0 kesatu}{\b0 sisi }
\fi640 {\b0 atau}{\b0 sisi}{\b0 yang}{\b0 lain,}{\b0 dan}{\b0 dilapis
i}{\b0 oleh}{\b0 kedua}{\b0 sisinya}{\b0 dengan}{\b0 membran }
\fi640 {\b0 mukosa.}{\b0
Dinding}{\b0
lateral}{\b0
cavum}{\b0
nasi}
{\b0
dibentuk}{\b0
oleh}{\b0
sebagian}{\b0
maxilla, }
\fi640 {\b0 palatinus,}{\b0 dan}{\b0 os.}{\b0 Sphenoidale.}{\b0 Tulang}
{\b0 lengkung}{\b0 yang}{\b0 halus}{\b0 dan}{\b0 melekat }
\fi640 {\b0 pada}{\b0 dinding}{\b0 lateral}{\b0 dan}{\b0 menonjol}{\b0 ke}
{\b0 cavum}{\b0 nasi}{\b0 adalah:}{\b0 conchae}{\b0 superior, }
\fi640 {\b0 media,}{\b0 dan}{\b0 inferior.}{\b0 Tulang-tulang}{\b0 ini}{\b0
dilapisi}{\b0 oleh}{\b0 membrane}{\b0 mukosa. }
\fi1209 {\b0 Dasar}{\b0
cavum}{\b0
nasi}{\b0
dibentuk}{\b0
oleh}{\b
0
os}{\b0
frontale}{\b0
dan}{\b0
os}{\b0
palatinus }
\fi640 {\b0 sedangkan}{\b0 atap}{\b0 cavum}{\b0 nasi}{\b0 adalah}{\b0
celah}{\b0 sempit}{\b0 yang}{\b0 dibentuk}{\b0 oleh}{\b0 os }
\fi640 {\b0 frontale}{\b0 dan}{\b0 os}{\b0 sphenoidale.}{\b0 Membrana}{
\b0 mukosa}{\b0 olfaktorius,}{\b0 pada}{\b0 bagian }
\fi640 {\b0 atap}{\b0
dan}{\b0
bagian}{\b0
cavum}{\b0
nasi}{\b0
yang}{\b0
berdekatan,}{\b0
mengandung}{\b0
sel}{\b0
saraf }
\fi640 {\b0 khusus}{\b0 yang}{\b0 mendeteksi}{\b0 bau.}{\b0 Dari}{\b0
sel-sel}{\b0 ini}{\b0 serat}{\b0 saraf}{\b0 melewati}{\b0 lamina }
\fi640 {\b0 cribriformis}{\b0 os}{\b0 frontale}{\b0 dan}{\b0 kedalam}{\
b0 bulbus}{\b0 olfaktorius}{\b0 nervus}{\b0 cranialis}{\b0 I }
\fi640 {\b0 olfaktorius. }
\fi1209 {\b0 Sinus}{\b0 paranasalis}{\b0 adalah}{\b0 ruang}{\b0 dalam}{
\b0 tengkorak}{\b0 yang}{\b0 berhubungan }
\fi640 {\b0 melalui}{\b0 lubang}{\b0 kedalam}{\b0 cavum}{\b0 nasi,}{\b0
sinus}{\b0 ini}{\b0 dilapisi}{\b0 oleh}{\b0 membrana }
\fi640 {\b0 mukosa}{\b0
yang}{\b0
bersambungan}{\b0
dengan}{\b0
cav
um}{\b0
nasi}{\b0
(Paulsen,}{\b0
Waschke. }
\fi640 {\b0 2012). }\par
}
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}}\par}{\phpg\posx5269\pvpg\posy2272\absw2728\absh239 \f20 \fs21 \cf0 \f20 \fs21
\cf0 Gambar 1: Anatomi hidung \par
}
{\phpg\posx2753\pvpg\posy6214\absw7969\absh612 \f20 \fs21 \cf0 \f20 \fs21 \cf0 S
umber: Paulsen, Waschke. 2012.{\i Sobotta}{\i Atlas}{\i Anatomi}{\i Manusia.
} Edisi-23.
\par}{\phpg\posx2753\pvpg\posy6214\absw7969\absh612 \sl-415 \f20 \fs21 \cf0 \fi2
143 Jakarta: Buku Kedokteran EGC. \par
}
{\phpg\posx2628\pvpg\posy7457\absw7848\absh2475 \f20 \fs21 \cf0 \f20 \fs21 \cf0
b. Faring
\par}{\phpg\posx2628\pvpg\posy7457\absw7848\absh2475 \sl-413 \f20 \fs21 \cf0 \fi
916 Faring adalah pipa berotot yang berjalan dari dasar tengkorak sampai
348 persambungannya dengan oesopagus dan larynx. Faring dibagi menjadi 3
348 bagian yaitu nasofarinx (faring yang mengarah ke cavum nasal
is),
348 orofarinx (faring yang mengarah ke cavum oralis) dan laryngo
farinx
348 (faring yang mengarah larynx)
2686 Gambar 2: Anatomi faring \par
}
Sumber: Paulsen, Waschke. 2012.{\i Sobotta}{\i Atlas}{\i Anatomi}{\i Manusia
.} Edisi-23.
}
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1 \cf0 c.
Laring
916 Terletak pada garis tengah bagian depan leher, sebelah dalam kulit,
348 glandula tyroidea, dan beberapa otot kecil, dan di depan laringofaring dan
348 bagian atas esopagus. Laring merupakan struktur yang lengkap terdiri atas
348 cartilago yaitu cartilago thyroidea, epiglottis, cartilago crico
idea, dan
348 arytenoidea. Terdapat juga membarana yaitu menghubungkan cartilago
348 satu sama lain dan dengan os. Hyoideum,
membrana mukosa, plika
348 vokalis, dan otot yang bekerja pada plica vokalis. \par
}
{\phpg\posx5321\pvpg\posy5998\absw2638\absh239 \f20 \fs21 \cf0 \f20 \fs21 \cf0 G
ambar 3: Anatomi laring \par
}
Sumber: Paulsen, Waschke. 2012.{\i Sobotta}{\i Atlas}{\i Anatomi}{\i Manusia
.} Edisi-23.
}
d. Trachea
\par}{\phpg\posx2628\pvpg\posy11303\absw7976\absh2848 \sl-415 \f20 \fs21 \cf0 \f
i916 Adalah tabung fleksibel dengan panjang kira-kira 10 cm dengan
i348 lebar 2,5 cm. trachea berjalan dari cartilago cricoidea kebawah
pada
i348 bagian depan leher dan dibelakang manubrium sterni, berakhir seting
gi
i348 angulus sternalis (taut manubrium dengan corpus sterni) atau sampai kira\par}{\phpg\posx2628\pvpg\posy11303\absw7976\absh2848 \sl-415 \f20 \fs21 \cf0 \f
i348 kira ketinggian vertebrata torakalis kelima dan di tempat ini berc
abang
i348 mcnjadi dua bronckus (bronchi). Trachea tersusun atas 16 - 20 lingkaran
i348 tak- lengkap yang berupa cincin tulang rawan yang diikat bersama
oleh \par
}
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}}\par}{\phpg\posx2628\pvpg\posy2272\absw7935\absh9807 \f20 \fs22 \cf0 \fi348 \f
20 \fs22 \cf0 jaringan fibrosa dan yang melengkapi lingkaran disebel
ah belakang
348 trachea, selain itu juga membuat beberapa jaringan otot.
\par}{\phpg\posx2628\pvpg\posy2272\absw7935\absh9807 \sl-347 \par\f20 \fs22 \cf0
e.
Bronchus
916 Bronchus yang terbentuk dari belahan dua trachea pada ketinggian
348 kira-kira vertebrata torakalis kelima, mempunyai struktur serupa deng
an
348 trachea dan dilapisi oleh.jenis sel yang sama. Bronkus-bronkus itu berjalan
348 ke bawah dan ke samping ke arah tampuk paru. Bronckus kanan lebih

348 pendek dan lebih lebar, dan lebih vertikal daripada yang kiri, sedikit lebih
348 tinggi dari arteri pulmonalis dan mengeluarkan sebuah cabang utama lewat
348 di bawah arteri, disebut bronckus lobus bawah. Bronkus kiri lebih panjang
348 dan lebih langsing dari yang kanan, dan berjalan di bawah
arteri
348 pulmonalis sebelurn di belah menjadi beberapa cabang yang berjalan
ke
348 lobus atas dan bawah.
916 Cabang utama bronchus kanan dan kiri bercabang lagi menjadi
348 bronchus lobaris dan kernudian menjadi lobus segmentalis. Percabangan
348 ini berjalan terus menjadi bronchus yang ukurannya semakin kecil, sampai
348 akhirnya menjadi bronkhiolus terminalis, yaitu saluran udara terkecil yang
348 tidak
mengandung
alveoli
(kantong
udara).
Bronkhiolus
term
inalis
348 memiliki garis tengah kurang lebih I mm. Bronkhiolus tidak diperkuat oleh
348 cincin tulang rawan. Tetapi dikelilingi oleh otot polos sehingga ukurannya
348 dapat berubah. Seluruh saluran udara ke bawah sampai tingkat bronkbiolus
348 terminalis disebut saluran penghantar udara karena fungsi utamanya adalah
348 sebagai penghantar udara ke tempat pertukaran gas paru-paru. Alveolu
s
348 yaitu
tempat
pertukaran
gas
assinus
terdiri
dari
bronkh
iolus
dan
348 respiratorius yang terkadang memiliki kantong udara kecil atau alveo
li
348 pada dindingnya. \par
}
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\cf0 Gambar 4: Anatomi trakea dan bronkus \par
}
{\phpg\posx2753\pvpg\posy5434\absw7969\absh612 \f20 \fs21 \cf0 \f20 \fs21 \cf0 S
umber: Paulsen, Waschke. 2012.{\i Sobotta}{\i Atlas}{\i Anatomi}{\i Manusia.
} Edisi-23.
\par}{\phpg\posx2753\pvpg\posy5434\absw7969\absh612 \sl-415 \f20 \fs21 \cf0 \fi2
}
\cf0 2. Fisiologi Hidung
\fi753 {\b0 Berdasarkan}{\b0 teori}{\b0 struktural,}{\b0 teori}{\b0 revo
lusioner}{\b0 dan}{\b0 teori}{\b0 fungsional, }
\fi43 {\b0 maka}{\b0 fungsi}{\b0 fisiologis}{\b0 hidung}{\b0 dan}{\b0
sinus}{\b0 paranasal}{\b0 adalah}{\b0 :}{\b0 1)}{\b0 fungsi}{\b0 res
pirasi }
\fi43 {\b0 untuk}{\b0
mengatur}{\b0
kondisi}{\b0
udara}{\b0
(ai
r}{\b0
conditioning),}{\b0
penyaring}{\b0
udara, }
\fi43 {\b0 humidifikasi,}{\b0
penyeimbang}{\b0
dalam}{\b0
pertukaran
}{\b0
tekanan}{\b0
dan}{\b0
mekanisme }
\fi43 {\b0 imunologik}{\b0 lokal}{\b0 ;}{\b0 2)}{\b0 fungsi}{\b0 penghidu,}
{\b0 karena}{\b0 terdapatnya}{\b0 mukosa}{\b0 olfaktorius }
\fi43 {\b0 (penciuman)}{\b0 dan}{\b0 reservoir}{\b0 udara}{\b0 untuk}{\b
0 menampung}{\b0 stimulus}{\b0 penghidu}{\b0 ;}{\b0 3) }
\fi43 {\b0 fungsi}{\b0 fonetik}{\b0 yang}{\b0 berguna}{\b0 untuk}{\b0 reson
ansi}{\b0 suara,}{\b0 membantu}{\b0 proses}{\b0 berbicara }
\fi43 {\b0 dan}{\b0 mencegah}{\b0 hantaran}{\b0 suara}{\b0 sendiri}{\b0
melalui}{\b0 konduksi}{\b0 tulang}{\b0 ;}{\b0 4)}{\b0 fungsi }
\fi43 {\b0 statistik}{\b0 dan}{\b0 mekanik}{\b0 untuk}{\b0 meringankan}{
\b0 beban}{\b0 kepala,}{\b0 proteksi}{\b0 terhadap }
\fi43 {\b0 trauma}{\b0
dan}{\b0
pelindung}{\b0
panas;}{\b0
5)}{\b0
refleks}{\b0
nasal.}{\b0
(Soetjipto}{\b0
D}{\b0
&}{\b0
Wardani
}
\fi43 {\b0 RS,2007). }\par
}
1 \cf0 B.
Konsep Dasar Penghantaran Obat
\fi360 {\b0 Ketika}{\b0 obat}{\b0 digunakan}{\b0 oleh}{\b0 pasien}{\b0

akan}{\b0 menghasilkan}{\b0 efek}{\b0 tertentu}{\b0 yang }
{\b0 disebut}{\b0 efek}{\b0 biologis.}{\b0 Efek}{\b0 biologis}{\b0 ini
}{\b0 merupakan}{\b0 hasil}{\b0 interaksi}{\b0 obat}{\b0 dengan }
{\b0 reseptor}{\b0 tertentu}{\b0 dari}{\b0 obat.}{\b0 Meskipun}{\b0 d
emikian}{\b0 obat}{\b0 yang}{\b0 dihantarkan}{\b0 ke}{\b0 tempat }
{\b0 kerja}{\b0
diatas}{\b0
pada}{\b0
kecepatan}{\b0
dan}{\b0
ko
nsentrasi}{\b0
tertentu}{\b0
dimana}{\b0
efek}{\b0
samping }
{\b0 minimal}{\b0
dan}{\b0
efek}{\b0
terapeutik}{\b0
maksimal.}{\b0
Faktor-faktor}{\b0
yang}{\b0
mempengaruhi }
{\b0 absorbsi}{\b0 obat: }\par
}
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108034a025303012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
00ffd9
}}\par}{\phpg\posx2268\pvpg\posy2272\absw8357\absh9733 \f20 \fs21 \cf0 \fi360 \f
20 \fs21 \cf0 1. Kelarutan Obat
720 Agar dapat diabsorpsi obat harus dalam bentuk larutan. Obat
yang
720 diberikan dalam bentuk larutan akan mudah diabsorpsi dibandingkan obat
720 yang harus larut dahulu dalam cairanbadan sebelum diabsorpsi.
360 2. Kemampuan Obat
720 Difusi melintasi membrane selobat yang berdifusi melintasi por
i-pori
720 membrane lipid kebanyakan obat diabsorpsidengan pasif.
360 3.
Kadar Obat
720 Semakin tinggi kadar obat dalam larutan semakin cepat obat diabsorpsi..
360 4. Sirkulasi Darah
720 Pada tempat absorpsisemakin cepat sirkulasi darah maka obat
yang
720 diabsorpsi akan semakin besar.
360 5. Luas Permukaan Kontak Obat
720 Untuk mempercepat absorpsi dapat dilakukan dengan memperkecil ukuran
720 partikel obat.
360 6. Bentuk Sediaan Obat
720 Untuk memperlambat absorpsi obat dapat dilakukan dengan penggunaan
720 obat bentuk kerja panjang.
360 7. Rute Penggunaan Obat
720 Rute pemakaian obat dapat mempengaruhi kecepatan absorpsi obat.
Perkembangan obat akhir-akhir ini diarahkan pada bentuk sediaan obat alter
natif
\par}{\phpg\posx2268\pvpg\posy2272\absw8357\absh9733 \sl-415 \f20 \fs21 \cf0 dar
i parenteral dimana obat masuk ke dalam sirkulasi sistemik melalui rute bukal,
\par}{\phpg\posx2268\pvpg\posy2272\absw8357\absh9733 \sl-412 \f20 \fs21 \cf0 sub
lingual, nasal, pulmunory dan vaginal. Rute ini juga digunakan
untuk
\par}{\phpg\posx2268\pvpg\posy2272\absw8357\absh9733 \sl-412 \f20 \fs21 \cf0 pen
gobatan lokal dimana dosis obat dapat dikurangi dan juga mengurangi ef
ek
\par}{\phpg\posx2268\pvpg\posy2272\absw8357\absh9733 \sl-415 \f20 \fs21 \cf0 sam
ping sistemik. Untuk memahami teknologi penghantar obat terdapat beberapa
\par}{\phpg\posx2268\pvpg\posy2272\absw8357\absh9733 \sl-412 \f20 \fs21 \cf0 hal
yang harus dimengerti, antara lain : \par
}

\par}{\phpg\posx2628\pvpg\posy13436\absw110\absh1358 \sl-415 \f20 \fs21 \cf0 \par}{\phpg\posx2628\pvpg\posy13436\absw110\absh1358 \sl-412 \f20 \fs21 \cf0 \par}{\phpg\posx2628\pvpg\posy13436\absw110\absh1358 \sl-415 \f20 \fs21 \cf0 - \
par
}
Konsep Bioavaibilitas
\par}{\phpg\posx2988\pvpg\posy13436\absw3287\absh1358 \sl-415 \f20 \fs21 \cf0 Pr
oses Absorpsi obat
\par}{\phpg\posx2988\pvpg\posy13436\absw3287\absh1358 \sl-412 \f20 \fs21 \cf0 Pr
oses Farmakokinetik
\par}{\phpg\posx2988\pvpg\posy13436\absw3287\absh1358 \sl-415 \f20 \fs21 \cf0 Wa
ktu untuk terapi yang optimal \par
}
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108034a025303012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
00ffd9

\cf0 \par}{\phpg\posx2628\pvpg\posy2272\absw110\absh610 \sl-412 \f20 \fs21 \cf0 - \pa
r
}
{\phpg\posx2988\pvpg\posy2272\absw6277\absh610 \f20 \fs21 \cf0 \f20 \fs21 \cf0 P
enghantaran obat yang cocok untuk " New Biotherapeutis "
\par}{\phpg\posx2988\pvpg\posy2272\absw6277\absh610 \sl-412 \f20 \fs21 \cf0 Kete
rbatasan dari terapi konvensional \par
}
\cf0 C.
Mekanisme Absorpsi Obat Nasal
\fi900 {\b0 Beberapa}{\b0
mekanisme}{\b0
telah}{\b0
diusulkan}{\b0
tetapi}{\b0
ada}{\b0
2}{\b0
mekanisme }
\fi360 {\b0 penyerapan}{\b0 obat}{\b0 yang}{\b0 digunakan: }
\fi360 {\b0 1)}{\b0
Mekanisme}{\b0 pertama }
\fi720 {\b0 Melibatkan}{\b0
rute}{\b0
berair}{\b0
transportasi,}{\b0
yang}{\b0
juga}{\b0
dikenal}{\b0
sebagai}{\b0
rute }
\fi720 {\b0 paracellular.}{\b0 Rute}{\b0 ini}{\b0 lambat}{\b0 dan}{\b0 pasi
f.}{\b0 Ada}{\b0 korelasi}{\b0 log-log}{\b0 terbalik}{\b0 antara }
\fi720 {\b0 intranasal}{\b0 penyerapan}{\b0 dan}{\b0 berat}{\b0 molekul}{\b0
senyawa}{\b0 larut}{\b0 dalam}{\b0 air.}{\b0 Kurang }
\fi720 {\b0 bioavailabilitas}{\b0 diamati}{\b0 untuk}{\b0 obat}{\b0 deng
an}{\b0 berat}{\b0 molekul}{\b0 lebih}{\b0 besar}{\b0 dari }
\fi720 {\b0 1000}{\b0 Dalton. }
\fi360 {\b0 2)}{\b0
Mekanisme}{\b0 kedua }
\fi720 {\b0 Melibatkan}{\b0 transportasi}{\b0 melalui}{\b0 rute}{\b0 lip
oidal}{\b0 juga}{\b0 dikenal}{\b0 sebagai}{\b0 proses }
\fi720 {\b0 transelular}{\b0 dan}{\b0 bertanggung}{\b0 jawab}{\b0 untuk}{\b0
pengangkutan}{\b0 lipofilik}{\b0 obat}{\b0 yang }
\fi720 {\b0 menunjukkan}{\b0 tingkat}{\b0 ketergantungan}{\b0 pada}{\b0
lipofilisitas}{\b0 mereka.}{\b0 Obat}{\b0 juga }
\fi720 {\b0 lintas}{\b0 membran}{\b0 sel}{\b0 dengan}{\b0 rute}{\b0 tr
anspor}{\b0 aktif}{\b0 melalui}{\b0 carrier-dimediasi }
\fi720 {\b0 berarti}{\b0 atau}{\b0 transportasi}{\b0 melalui}{\b0 pembuk
aan}{\b0 persimpangan}{\b0 ketat.}{\b0 Sebagai }
\fi720 {\b0 contoh,}{\b0 kitosan,}{\b0 suatu}{\b0 biopolimer}{\b0 alami}{\b0
dari}{\b0 kerang,}{\b0 membuka}{\b0 sambungan }
\fi720 {\b0 yang}{\b0 erat}{\b0 antara}{\b0 epitel}{\b0 sel}{\b0 untuk}{\b0
memfasilitasi}{\b0 transportasi}{\b0 obat. }
\fi720 {\b0 Adapun}{\b0 perjalanan}{\b0 sistem}{\b0 penghantaran}{\b0 obat}{
\b0 (}{\b0 DDS}{\b0 )}{\b0 intranasal}{\b0 dalam}{\b0 tubuh,}{\b0 adalah
}

\fi720 {\b0 sebagai}{\b0 berikut}{\b0 : }
\fi1080 {\b0 a)}{\b0
Bentuk}{\b0 sediaan}{\b0 obat}{\b0 nasal}{\b0 dengan
}{\b0 zat}{\b0 aktif }
\fi1440 {\b0 Sediaan}{\b0 nasal}{\b0 diformulasikan}{\b0 atau}{\b0 dirancang
}{\b0 dengan}{\b0 sedemikian}{\b0 rupa}{\b0 untuk }
\fi1440 {\b0 penggunaan}{\b0 efek}{\b0 lokal. }
\fi1080 {\b0 b)}{\b0
Fase}{\b0 biofarmasetik }
\fi1440 {\b0 Obat}{\b0 dihisap}{\b0 melalui}{\b0 rongga}{\b0 hidung}{\b0 ma
suk}{\b0 ke}{\b0 dalam}{\b0 sirkulasi}{\b0 sistemik.}{\b0 Fase }
\fi1440 {\b0 ini}{\b0 meliputi}{\b0 waktu}{\b0 mulai}{\b0 penggunaan}{\b
0 sediaan}{\b0 obat}{\b0 melalui}{\b0 hidung}{\b0 hingga }
\fi1440 {\b0 pelepasan}{\b0 zat}{\b0 aktifnya}{\b0 ke}{\b0 dalam}{\b0 caira
n}{\b0 tubuh. }\par
}
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108034a025303012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
00ffd9
1 \cf0 c) Ketersediaan farmasi
360 Obat siap untuk diabsorbi obat dalam bentuk zat aktif terlarut sia
p untuk
360 diabsorpsi yang selanjutnya zat aktif akan di distribusikan keseluruh tub
uh
360 (sistemik).
\par}{\phpg\posx3348\pvpg\posy2272\absw8203\absh6201 \sl-415 \f20 \fs21 \cf0 d)
Fase farmakokinetik
360 Tidak terjadi ADME fase ini meliputi waktu selama obat diangkut ke organ
360 yang ditentukan setelah obat dilepas dari bentuk sediaan.
\par}{\phpg\posx3348\pvpg\posy2272\absw8203\absh6201 \sl-412 \f20 \fs21 \cf0 e)
Ketersediaan hayati
360 Obat untuk memberi efek pada tahap ini obat mulai memberikan efek pada
360 pasien dengan cara berikatan dengan reseptor-reseptor yang ada pada tubuh.
\par}{\phpg\posx3348\pvpg\posy2272\absw8203\absh6201 \sl-415 \f20 \fs21 \cf0 f)
Fase farmakodimanik
360 Interaksi dengan reseptor ditempat kerjabila obat telah berinteraksi dengan
sisi
360 reseptor biasanya protein membrane akan menimbulkan respon biologik.
360 Tujuan utama pada fase ini adalah optimisasi dari efek biologik.
\par}{\phpg\posx3348\pvpg\posy2272\absw8203\absh6201 \sl-415 \f20 \fs21 \cf0 g)
Efek terapi
360 Obat pada akhirnya memberikan efek terapi atau pengobatan pa
da
360 pasien.Yang diharapkan dapat memberikan kesembuhan pada pasien. \par
}
{\phpg\posx2268\pvpg\posy9929\absw281\absh239 \b \f20 \fs21 \cf0 \b \f20 \fs21 \
cf0 D. \par
}
\cf0 Pelepasan dan Perjalanan Obat Intranasal \par
}
\cf0 1. \par
}
\cf0 Bentuk Sediaan Obat Dan Pembawa
\fi26 {\b0 Bentuk}{\b0 sediaan}{\b0 obat}{\b0 yang}{\b0 ideal}{\b0 dia
ntaranya}{\b0 harus}{\b0 meliputi}{\b0 hal-hal }\par
}

berikut ini: kenyamanan pasien, reproducibility, mudah di absorps
i,
\par}{\phpg\posx2834\pvpg\posy11368\absw7692\absh2474 \sl-412 \f20 \fs21 \cf0 bi
okompabilitas dan tidak ada reaksi tambahan, luas efektif area kontak, dan
\par}{\phpg\posx2834\pvpg\posy11368\absw7692\absh2474 \sl-415 \f20 \fs21 \cf0 wa
ktu kontak yang di perpanjang.
i540 Klasifikasi rute sistem penghantaran obat diantaranya: system saluran
\par}{\phpg\posx2834\pvpg\posy11368\absw7692\absh2474 \sl-415 \f20 \fs21 \cf0 ce
rna, parenteral, transmukosa, transnasal, pelepasan obat lewat paru-paru,
\par}{\phpg\posx2834\pvpg\posy11368\absw7692\absh2474 \sl-412 \f20 \fs21 \cf0 pe
lepasan obat melalui kulit, dan pelepasan obat transvagina. Hal-hal yang
\par}{\phpg\posx2834\pvpg\posy11368\absw7692\absh2474 \sl-415 \f20 \fs21 \cf0 me
mpengaruhi masuknya obat kedalam sirkulasi sistemik : \par
}
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108034a025303012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
00ffd9
}}\par}{\phpg\posx2628\pvpg\posy2272\absw8723\absh11213 \f20 \fs21 \cf0 \fi720 \
f20 \fs21 \cf0 a) Besarnya luas permukaan; contoh villi dan microcilli
pada usus
i1080 kecil memperluas permukaan sehingga memudahkan absorpsi obat.
i720 b) Aktivitas metabolik yang rendah, enzim dapat mendealtifas obat
i1080 yang akan diabsorpsi, bioavaibilitas rendah dapat disebabkan oleh
i1080 aktivitas enzim yang tinggi.
i720 c) Waktu kontak; waktu kontak dengan jaringan pengabsorpsi akan
i1080 mempengaruhi jumlah obat yang melalui mukosa.
i720 d) Suplai darah, darah yang cukup akan memindahkan obat d
ari
i1080 tempat kerja ke tempat absorpsinya.
i720 e) Aksebilitas, variasi rute penghantaran obat menunjukan berbagai
i1080 daerah tertentu yang membutuhkan bahan tambahan atau kondisi
i1080 tertentu untuk membantu obat mencapai tempat kerja.
i720 f)
Variabilitas yang rendah.
i720 g) Permeabilitas,
semakin
permiabel
suatu
epitel
maka
d
aya
i1080 absorpsinyapun semakin tinggi.
\par}{\phpg\posx2628\pvpg\posy2272\absw8723\absh11213 \sl-307 \par\f20 \fs21 \cf
0 \fi720 Sistem penghantaran obat dan penargetan obat yang ideal, diantaranya
i720 :
0 \fi720 a) Obat mempunyai target yang spesifik
i720 b) Menjaga obat pada jaringan yang bukan target
i720 c) Meminimalisasi pengurangan kadar obat ketika mencapai target
i720 d) Melindungi obat dari metabolisme
i720 e) Melindungi obat dari klirens dini
i720 f)
Menahan obat pada tempat kerja selama waktu yang dikehendaki
i720 g) Memfasilitasi transport obat kedalam sel
i720 h) Menghantarkan obat ke target intraseluler
i720 i)
Harus biokompatibel, biodegradable dan non antigenic
0 {\b 2.}{\b
Proses}{\b Penggunaan}{\b Intranasal }
i540 Proses penggunaan DDS Intranasal dapat melalui penghantaran dua arah dengan
laju
\par}{\phpg\posx2628\pvpg\posy2272\absw8723\absh11213 \sl-415 \f20 \fs21 \cf0 na
fas, sebagai berikut : \par
}
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108034a025303012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
00ffd9
1 \cf0 {\f63 \u61692\'3f}{\f20
Ketika}{\f20 nafas}{\f20 dikeluarkan}{\f20
ke}{\f20 dalam}{\f20 alat,}{\f20 langit-langit}{\f20 lunak}{\f20 secara}{\f
20 otomatis}{\f20 menutup }
360 {\f20 rapat}{\f20 rongga}{\f20 hidung. }
\par}{\phpg\posx2628\pvpg\posy2271\absw8810\absh4338 \sl-415 \f10 \fs21 \cf0 {\f
63 \u61692\'3f}{\f20
Nafas}{\f20 memasuki}{\f20 satu}{\f20 lubang}{\f20 h
idung}{\f20 lewat}{\f20 mulut}{\f20 pipa}{\f20 yang}{\f20 menyegel. }
63 \u61692\'3f}{\f20
Dan}{\f20 memicu}{\f20 pengeluaran}{\f20 partikel}{\f
20 ke}{\f20 dalam}{\f20 aliran,}{\f20 memajukan}{\f20 partikel}{\f20 melew
ati}{\f20 klep }
360 {\f20 hidung}{\f20 untuk}{\f20 menuju}{\f20 tempat}{\f20 sasaran. }
63 \u61692\'3f}{\f20
Aliran}{\f20 udara}{\f20 melewati}{\f20 communication
}{\f20 posterior}{\f20 ke}{\f20 sekat}{\f20 hidung}{\f20 dan}{\f20 keluar}
{\f20 melalui }
360 {\f20 bagian}{\f20 hidung}{\f20 yang}{\f20 lain}{\f20 di}{\f20 jurusan}
{\f20 berlawanan. }
360 {\f20 Sehingga}{\f20 proses}{\f20 tersebut}{\f20 akan}{\f20 menghasilkan
}{\f20 : }
63 \u61558\'3f}{\f20
90}{\f20 %}{\f20 dosis}{\f20 obat}{\f20 didepositkan
}{\f20 melalui}{\f20 katup}{\f20 nasal. }
{\f20 >}{\f20 70}{\f20 %}{\f20 dosis}{\f20 didepositkan}{\f20 di}{\f20 ba
wah}{\f20 posterior}{\f20 2/3}{\f20 rongga}{\f20 nasal..{\f63 \u32768\'3f} }
63 \u61558\'3f}{\f20
Reproducibility}{\f20 tinggi}{\f20 dari}{\f20 pendepos
itan}{\f20 melalui}{\f20 katup}{\f20 nasal. }
63 \u61558\'3f}{\f20
Tidak}{\f20 ada}{\f20 endapan}{\f20 pada}{\f20 paru}
{\f20 -}{\f20 paru. }\par
}
\cf0 E. Kelebihan dan Kekurangan DDS Intranasal
cf0 \fi900 {\b0 Seperti}{\b0 halnya}{\b0 obat}{\b0 yang}{\b0 diberikan}{
\b0 secara}{\b0 intranasal}{\b0 adalah}{\b0 untuk}{\b0 efek }
\fi360 {\b0 lokal}{\b0 seperti}{\b0 obat}{\b0 tetes}{\b0 hidung}{\b0 atau}{
\b0 dalam}{\b0 bentuk}{\b0 spray}{\b0 yang}{\b0 biasa}{\b0 digunakan }
\fi360 {\b0 penderita}{\b0
untuk}{\b0 menghentikan}{\b0 serangan}{\b0 seba
gai}{\b0 tindakan}{\b0 pencegahan}{\b0 dengan }
\fi360 {\b0 cara}{\b0
pemberian}{\b0
obat}{\b0
secara}{\b0
langs
ung}{\b0
kedalam}{\b0
saluran}{\b0
nafas}{\b0
melalui }
\fi360 {\b0 penghisapan}{\b0 yang}{\b0 memungkinkan}{\b0 obat}{\b0 langsun
g}{\b0 mencapai}{\b0 sistemik}{\b0 sehingga }
\fi360 {\b0 memberikan}{\b0 efek}{\b0 lebih}{\b0 cepat}{\b0 untuk}{\b0 meng
atasi}{\b0 serangan.}{\b0 Selain}{\b0 itu}{\b0 dosis}{\b0 yang }
\fi360 {\b0 diperlukan}{\b0 lebih}{\b0 rendah}{\b0 untuk}{\b0 mendapatka
n}{\b0 efek}{\b0 yang}{\b0 sama}{\b0 efek}{\b0 samping }
\fi360 {\b0 obat}{\b0 minimal}{\b0 karena}{\b0 konsentrasi}{\b0 obat}{\b
0 di}{\b0 dalam}{\b0 rendah.}{\b0 Lain}{\b0 halnya}{\b0 jika }
\fi360 {\b0 pemberian}{\b0 obat}{\b0 secara}{\b0 parenteral}{\b0 atau}{\b0
oral}{\b0 sering}{\b0 menimbulkan}{\b0 efek}{\b0 samping }
\fi360 {\b0 seperti}{\b0 gangguan}{\b0 gastrointestinal}{\b0 atau}{\b0 efek}
{\b0 samping}{\b0 lainnya. }
cf0 \fi900 {\b0 Melihat}{\b0
mekanisme}{\b0
kerja}{\b0
obat}{\b0
sep
erti}{\b0
uraian}{\b0
diatas}{\b0
tersebut,}{\b0
maka }
\fi360 {\b0 kelebihan}{\b0 dan}{\b0 kekurangan}{\b0 penghantaran}{\b0 un
tuk}{\b0 lokal}{\b0 pada}{\b0 pemberian}{\b0 obat }
\fi360 {\b0 intranasal,}{\b0 adalah}{\b0 sebagai}{\b0 berikut: }
cf0 \fi360 {\b0\i Kelebihan: }
cf0 \fi360 {\b0 \f40 {\f63 \u61623\'3f}}{\b0
Dosis}{\b0 yang}{\b0 diperlu
kan}{\b0 untuk}{\b0 efek}{\b0 farmakologinya}{\b0 dapat}{\b0 dikurangi }\pa
r
}
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108034a025303012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
00ffd9
}}\par}{\phpg\posx2268\pvpg\posy2262\absw9153\absh11396 \f40 \fs21 \cf0 \fi360 \
f40 \fs21 \cf0 {\f63 \u61623\'3f}{\f20
Konsentrasi}{\f20
rendah}{\f20
dalam}{\f20
sirkulasi}{\f20
sistemik}{\f20
dapat}{\f20
mengurangi}{
\f20
efek }
i720 {\f20 samping}{\f20 sistemik }
0 \fi5139 {\f20 \fs14 3 }
i360 {\f63 \u61623\'3f}{\f20
Area}{\f20 permukaan}{\f20 untuk}{\f20 abso
rpsi}{\f20 luas}{\f20 (}{\f20 160}{\f20 cm}{\f20
) }
0 \fi360 {\f63 \u61623\'3f}{\f20
Onset}{\f20 of}{\f20 action}{\f20 yang}
{\f20 cepat }
i360 {\f63 \u61623\'3f}{\f20
Aktivitas}{\f20 metabolisme}{\f20 yang}{\f
20 rendah}{\f20 dibandingkan}{\f20 peroral,}{\f20 menghindari }
i720 {\f20 reaksi}{\f20 saluran}{\f20 cerna}{\f20 metabolisme}{\f20 hati }
0 \fi360 {\f63 \u61623\'3f}{\f20
Bentuk}{\f20 sediaan}{\f20 alternative,}
{\f20 jika}{\f20 tidak}{\f20 dapat}{\f20 digunakan}{\f20 obat}{\f20 salura
n}{\f20 cerna }
i360 {\f63 \u61623\'3f}{\f20
Mudah}{\f20 diakses}{\f20 untuk}{\f20 pengh
antaran}{\f20 obat }
0 \fi360 {\i \f20 Kekurangan}{\i \f20 : }
0 \fi360 {\f63 \u61623\'3f}{\f20
Difusi}{\f20 obat}{\f20 terhalang}{\f20
oleh}{\f20 mucus}{\f20 dan}{\f20 ikatan}{\f20 mucus }
0 \fi360 {\f63 \u61623\'3f}{\f20
Mukosa}{\f20 nasal}{\f20 dan}{\f20 sekr
esinya}{\f20 dapat}{\f20 mendegradasi}{\f20 obat }
i360 {\f63 \u61623\'3f}{\f20
Iritasi}{\f20 lokal}{\f20 dan}{\f20 sensiti
visasi}{\f20 obat}{\f20 harus}{\f20 diperhatikan }
0 \fi360 {\f63 \u61623\'3f}{\f20
Mucociliary}{\f20
clearance}{\f20
me
ngurangi}{\f20
waktu}{\f20
retensi}{\f20
obat}{\f20
dalam}{\f20
r
ongga }
i720 {\f20 hidung }
i360 {\f63 \u61623\'3f}{\f20
Kurang}{\f20 reproduksibilitas}{\f20 pada}{\
f20 penyakit}{\f20 yang}{\f20 berhubungan}{\f20 dengan}{\f20 rongga }
i720 {\f20 hidung }
i360 {\f63 \u61623\'3f}{\f20
Hanya}{\f20 untuk}{\f20 obat}{\f20 yang}{\
f20 poten}{\f20 (dosis}{\f20 kecil)}{\f20 dengan}{\f20 ukuran}{\f20 partik
el}{\f20 5}{\f20 -}{\f20 10 }
i720 {\f20 m }
0 \fi900 {\f20 Biasanya}{\f20 penbawa}{\f20 obat}{\f20 intranasal}{\f20 beru
pa}{\f20 spray}{\f20 dengan}{\f20 menggunakan}{\f20 motered}{\f20 dosis }
i360 {\f20 spraymisalnya}{\f20 berupa}{\f20 aerosol}{\f20 yaitu}{\f20 sy
stem}{\f20 koloid}{\f20 bahan}{\f20 padat}{\f20 atau}{\f20 cair}{\f20
dalam}{\f20 gas, }
i360 {\f20 sedangkan}{\f20 drop}{\f20 menggunakan}{\f20 penetes. }

0 {\b \f20 F.}{\b \f20 Faktor}{\b \f20 yang}{\b \f20 Mempengaruhi}{\b \f20
DDS}{\b \f20 Intranasal }
0 \fi427 {\f20 Ada}{\f20 berbagai}{\f20 faktor}{\f20 yang}{\f20 mempenga
ruhi}{\f20 bioavailabilitas}{\f20 sistemik}{\f20 dari}{\f20 obat }
\par}{\phpg\posx2268\pvpg\posy2262\absw9153\absh11396 \sl-415 \f40 \fs21 \cf0 {\
f20 yang}{\f20
diberikan}{\f20
melalui}{\f20
rute}{\f20
hidung.}{\f2
0
Faktor-faktor}{\f20
ini}{\f20
dapat}{\f20
mempengaruhi }
f20 terhadap}{\f20 sifat}{\f20 physiochemical}{\f20 dari}{\f20 obat,}{\f
20 sifat}{\f20 anatomi}{\f20 dan}{\f20 fisiologis}{\f20 dari}{\f20 r
ongga }
f20 hidung}{\f20 dan}{\f20 jenis}{\f20 dan}{\f20
karakteristik}{\f20
dari}{\f20 sistem}{\f20 pengiriman}{\f20 obat}{\f20
yang}{\f20 dipili
h }
f20 hidung.}{\f20 Faktor-faktor}{\f20 ini}{\f20 memainkan}{\f20 peran}{\f20
kunci}{\f20 untuk}{\f20 sebagian}{\f20 besar}{\f20 obat}{\f20 untuk }
f20 mencapai}{\f20 tingkat}{\f20 darah}{\f20 terapi}{\f20 efektif}{\f20
setelah}{\f20 pemberian}{\f20 hidung.}{\f20 Faktor}{\f20 yang }\par
}
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108034a025303012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
00ffd9
\cf0 mempengaruhi \par
}
{\phpg\posx4029\pvpg\posy2272\absw1140\absh239 \f20 \fs21 \cf0 \f20 \fs21 \cf0 p
enyerapan \par
}
{\phpg\posx5459\pvpg\posy2272\absw487\absh239 \f20 \fs21 \cf0 \f20 \fs21 \cf0 ob
at \par
}
{\phpg\posx6195\pvpg\posy2272\absw737\absh239 \f20 \fs21 \cf0 \f20 \fs21 \cf0 hi
dung \par
}
{\phpg\posx7186\pvpg\posy2272\absw1020\absh239 \f20 \fs21 \cf0 \f20 \fs21 \cf0 d
ijelaskan \par
}
{\phpg\posx8482\pvpg\posy2272\absw812\absh239 \f20 \fs21 \cf0 \f20 \fs21 \cf0 se
bagai \par
}
{\phpg\posx9528\pvpg\posy2272\absw779\absh239 \f20 \fs21 \cf0 \f20 \fs21 \cf0 be
rikut \par
}
(Krishnamoorthy R et al, 1998;.. Kisan R et al, 2007).
0 \fi67 1. Sifat fisiko kimia obat
i360 a.
Keseimbangan Lipofilik-hidrofilik
0 Sifat HLB dari obat mempengaruhi proses penyerapan. Dengan meningkatka
n
\par}{\phpg\posx2268\pvpg\posy2685\absw8390\absh10262 \sl-413 \f20 \fs21 \cf0 li
pofilisitas, permeasi senyawa biasanya meningkat melalui mukosa hi
dung.
\par}{\phpg\posx2268\pvpg\posy2685\absw8390\absh10262 \sl-415 \f20 \fs21 \cf0 Me
skipun mukosa hidung ditemukan memiliki beberapa karakter hidrofil
ik,
\par}{\phpg\posx2268\pvpg\posy2685\absw8390\absh10262 \sl-412 \f20 \fs21 \cf0 ta
mpak bahwa mukosa ini terutama lipofilik di alam dan domain lipid memainkan
ran penting dalam fungsi penghalang membran ini. Obat lipofilik
seperti
\par}{\phpg\posx2268\pvpg\posy2685\absw8390\absh10262 \sl-412 \f20 \fs21 \cf0 na
lokson, buprenorfin, testosteron dan etinilestradiol hampir sepenuhnya di
serap
\par}{\phpg\posx2268\pvpg\posy2685\absw8390\absh10262 \sl-415 \f20 \fs21 \cf0 bi
la diberikan rute intranasal.
0 \fi360 b. Degradasi enzimatik dalam rongga hidung
0 Obat seperti peptida dan protein memilikibioavailabilitas yang rendah
di rongga
\par}{\phpg\posx2268\pvpg\posy2685\absw8390\absh10262 \sl-415 \f20 \fs21 \cf0 hi
dung, sehingga obat ini mungkin memiliki kemungkinan untuk mengalami

\par}{\phpg\posx2268\pvpg\posy2685\absw8390\absh10262 \sl-412 \f20 \fs21 \cf0 de
gradasi enzimatik dari molekul obat dalam lumen rongga hidung atau sewaktu
lewati penghalang epitel.Pada ke dua bagian initerjadi exo-peptidases da
n
\par}{\phpg\posx2268\pvpg\posy2685\absw8390\absh10262 \sl-412 \f20 \fs21 \cf0 en
do-peptidases,
exo-peptidases
adalah
mono-aminopeptidases
dan
di\par}{\phpg\posx2268\pvpg\posy2685\absw8390\absh10262 \sl-415 \f20 \fs21 \cf0 am
inopeptidases. Ini memiliki kemampuan untuk membelah peptida pada mereka
\par}{\phpg\posx2268\pvpg\posy2685\absw8390\absh10262 \sl-412 \f20 \fs21 \cf0 N
dan C termini dan endo-peptidases seperti serin dan sistein,
yang dapat
nyerang ikatan peptida internal.
0 \fi360 c.
Ukuran molekul
0 Penyerapan obat melalui rute hidung dipengaruhi oleh ukuran molekul.
Obat
\par}{\phpg\posx2268\pvpg\posy2685\absw8390\absh10262 \sl-415 \f20 \fs21 \cf0 li
pofilik memiliki hubungan langsung antara MW dan permeasi obat sedangka
n
\par}{\phpg\posx2268\pvpg\posy2685\absw8390\absh10262 \sl-412 \f20 \fs21 \cf0 se
nyawa yang larut dalam air menggambarkan hubungan terbalik. Ting
kat
rmeasi sangat sensitif terhadap ukuran molekul untuk senyawa dengan MW
{\field{\*\fldinst SYMBOL 179 \\f Symbol }}
\par}{\phpg\posx2268\pvpg\posy2685\absw8390\absh10262 \sl-412 \f20 \fs21 \cf0 30
0 Dalton. \par
}
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108034a025303012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
00ffd9
1 \cf0 2. Karakteristik sediaan Obat Intranasal
292 a.
Formulasi (Osmolaritas, pH, Konsentrasi)
292 {\f10 {\f63 \u61656\'3f}} Osmolaritas bentuk sediaan mempengaruhi peny
erapan obatdi hidung.
652 Sebagai contoh ialahnatrium klorida yang mempengaruhi penyerapan
652 hidung. Penyerapan maksimum dicapai dengan konsentrasi natrium
652 klorida 0.462 M, konsentrasi yang lebih tinggi tidak hanya menyebabkan
652 bioavailabilitas meningkat tetapi juga mengarah pada toksisitas pada epitel
652 hidung.
292 {\f10 {\f63 \u61656\'3f}} pH sediaan obat dan permukaan hidung dapat
mempengaruhi permeasi
652 obat ini. Untuk menghindari iritasi hidung, pH sediaan obat
harus
652 disesuaikan dengan pH 4,5 - 6,5 karena lisozim ditemukan di sekret
652 hidung, yang bertanggung jawab untuk menghancurkan bakteri tertentu
652 pada pH asam. Dalam kondisi basa, lisozim tidak aktif dan jaringan yang
652 rentan
terhadap
infeksi
mikroba.
Selain
menghindari
iritas
i,
itu
652 menghasilkan
memperoleh
permeasi
obat
efisien
dan
mencegah
\par}{\phpg\posx2335\pvpg\posy2272\absw8203\absh8063
652 pertumbuhan bakteri.
292 {\f10 {\f63 \u61656\'3f}} Gradien konsentrasi
ngat penting dalam proses
\sl-412 \f20 \fs21 \cf0 \fi

\sl-415 \f20 \fs21 \cf0 \fi
memainkan peran yang sa
\sl-412 \f20 \fs21 \cf0 \fi
652 penyerapan/permeasi
obat
melalui
membran
hidung
karena
kerusakan

652 mukosa hidung. Contoh untuk ini adalah penyerapan L-Tirosin, dimana
652 konsentrasi obat dalam percobaan perfusi hidung. Sedangkanpada absorpsi
652 asam salisilat konsentrasi obatnyamenurun. Penurunan ini kemungkinan
652 karena kerusakan mukosa hidung yang permanen. \par
}
b. Distribusi Obat dan deposisi
i360 Distribusi obat dalam rongga hidung merupakan salah satu faktor penting
i360 yang mempengaruhi efisiensi penyerapan hidung. Modus pemberian obat
i360 dapat mempengaruhi
distribusi obat di rongga hidung
yang
pada
i360 gilirannya akan menentukan efisiensi penyerapan obat. Penyerapan dan
i360 bioavailabilitas bentuk sediaan hidung terutama tergantung pada loka
si
i360 disposisi.
Bagian
anterior
hidung
menyediakan
waktu
perum
ahan
i360 berkepanjangan
hidung
untuk
disposisi
dari
formulasi,
hal
ini \par
}
ffd8ffe000104a46494600010100000100010000ffdb004300010101010101010101010101010101
01010101010101010101010101010101010101010101010101010101010101010101010101010101
010101010101010101ffdb0043010101010101010101010101010101010101010101010101010101
0101010101010101010101010101010101010101010101010101010101010101010101010101ffc0
001108034a025303012200021101031101ffc4001f00000105010101010101000000000000000001
02030405060708090a0bffc400b5100002010303020403050504040000017d010203000411051221
31410613516107227114328191a1082342b1c11552d1f02433627282090a161718191a2526272829
2a3435363738393a434445464748494a535455565758595a636465666768696a737475767778797a
0101010101010101010000000000000102030405060708090a0bffc400b511000201020404030407
05040400010277000102031104052131061241510761711322328108144291a1b1c109233352f015
6272d10a162434e125f11718191a262728292a35363738393a434445464748494a53545556575859
5a636465666768696a737475767778797a82838485868788898a92939495969798999aa2a3a4a5a6
00ffd9
2 \cf0 akanmeningkatkan penyerapan obat. Dan ruang posterior dari
rongga
\par}{\phpg\posx2988\pvpg\posy2272\absw7525\absh2101 \sl-412 \f20 \fs22 \cf0 hid
ung akan digunakan untuk pengendapan bentuk sediaan, melainkan
\par}{\phpg\posx2988\pvpg\posy2272\absw7525\absh2101 \sl-415 \f20 \fs22 \cf0 dih
ilangkan
oleh
proses
pembersihan
mukosiliar
dan
karenanya
\par}{\phpg\posx2988\pvpg\posy2272\absw7525\absh2101 \sl-412 \f20 \fs22 \cf0 men
unjukkan bioavailabilitas rendah. Situs disposisi dan distribusi bentuk
\par}{\phpg\posx2988\pvpg\posy2272\absw7525\absh2101 \sl-415 \f20 \fs22 \cf0 sed
iaan terutama tergantung pada pengiriman perangkat, cara pemberian,
\par}{\phpg\posx2988\pvpg\posy2272\absw7525\absh2101 \sl-412 \f20 \fs22 \cf0 sif
at fisikokimia molekul obat. \par
}
c.
Viskositas
360 Viskositas yang lebih tinggi dari formulasi meningkatkan waktu konta
k
360 antara obat dan mukosa hidung sehingga meningkatkan waktu un
tuk
360 permeasi. namun, formulasi sangat kental akan mengganggu fungsi normal
360 seperti pergerakan silia atau clearance mukosiliar dan dengan demiki
an
360 mengubah permeabilitas obat. \par
}
3. Sifat anatomi dan fisiologis dari rongga hidung
292 a.
Izin mukosiliar
652 Partikel terperangkap dalam lapisan lendir yang yang akan terbersihk
an
652 dari rongga hidung. Aksi gabungan lapisan lendir dan silia disebut kliren
652 mukosiliar.Ini adalahmekanisme pertahanan fisiologis saluran pernapasan

652 untuk
melindungi
tubuh
terhadap
bahan
berbahaya
yang
telah
652 dihirup.Waktu transit yang normal mukosiliar pada manusia tela
h
652 dilaporkan 12 sampai 15 menit. Faktor-faktor yang mempengaruhi izin
652 mucocilliary meliputi faktor fisiologis (umur, jenis kelamin, postur, tidur,
652 olahraga, polusi lingkungan umum (sulfur dioksida dan asam s
ulfat,
652 nitrogen dioksida, ozon, hairspray, dan asap tembakau, penyakit (sil
ia
652 sindrom immotile, primary ciliary dyskinesia-Kartagener.s syndrome
,
652 asma, bronkiektasis, bronkitis kronis, cystic fibrosis, infeksi
saluran
652 pernapasan akut dan obat-obatan. \par
}
}

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dung, sehingga obat ini mungkin memiliki kemungkinan untuk mengalami

\sl-412 \f20 \fs21 \cf0 \fi

\par}{\phpg\posx2335\pvpg\posy2272\absw8203\absh8063 \sl-415 \f20 \fs21 \cf0 \fi

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