BEBERAPA
SEDIAAN INJEKSI
Mahasiswa Program Spesialis Farmasi
Rumah Sakit
Universitas Airlangga Fakultas Farmasi
Surabaya
2008
Fosfomycin
Pemberian : im dan infusi iv setelah
dilarutkan dengan larutan yang
sesuai dg volume larutan 250 ml
Kurang larut dalam air, sedangkan bentuk garamnya yaitu phenitoin sodium
sangat larut
Mengandung :
corrin nucleus
atom of cobalt in center
attached are one of following
CN = cyanocobalamin
OH=hydroxocobalamin
H2O=Aquocobalamin
NO2= Nitrocobalamin
5-adenosyl=adenosylcobalamin*
-CH3=methylcobalamin*
Vitamin B-12
Structure
cobalamine
methyl
cobalamine
transport and
coenzyme form
adenosyl
cobalamine
storage and
coenzyme form
Methylcobalamin
Hcy metabolism + Methionine and THF regeneration
THF methionine
SAM
DNA
Methylcobalamin*
Methionine Synthase
DNA-CH3
SAH
5-methyl-THF homocysteine
vitamin adenosine
B-6
cystathionine
*Methyl group transferred from 5-methyl-THF
vitamin
to cobalmin and finally to Hcy B-6
cysteine
Functions of B12
Homocysteine to Methionine
methionine synthetase
requires 5-methyl THF
deficiency of B12 results in methyl-
trap of folate
results in megaloblastic anemia
synergistic effect of B12 and folate
Functions of B12
Mutases
methyl malonyl CoA mutase
proprionyl-CoA ->->succinyl-CoA
accumulation of methyl-malonate
may inhibit AcetylCoA
carboxylase
B-12 Deficiency
Pernicious anemia
megaloblastic anemia
Methyl-folate trap
Delayed or failure of normal cell division
due to impaired DNA synthesis
neuropathy
defective myelination
progressive peripheral weakening
unresponsive to folate
upper limit to folate
supplementation/enrichment
Rute
Cyanocobalamin diberikan scr IM, SC yg dlm.
Rute IV tidak direkomendasikan (dieksresi lbh
cpt drpd IM)
Dosis
Recommended Dietary Allowance (RDA)
DWS: PO 2 mcg/hari. Anak2 : PO 0.3 to 2
mcg/hari.
Upaya inkompatibilitas :
Interactions
Chloramphenicol: me efek hematologi
vitamin B12 pd px dgn pernicious anemia.
Colchicine, excessive alcohol intake,
neomycin, time-released potassium,
para-aminosalicylic acid: me absorbsi
GI dari oral vitamin B12