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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 8 tahun)

n : umur dalam tahun

c. Rumus Fried (untuk bayi)

n : 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 anak-
anak memerlukan rumus perhitungan tertentu.

Cara menghitung dosis untuk anak-anak :


1. Berdasarkan umur
a. Rumus young (untuk anak <8 tahun)

n : umur dalam tahun

b. Rumus dilling (untuk anak Besar-sama dengan 8 tahun)


n : umur dalam tahun

c. Rumus Fried (untuk bayi)

n : 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 L3
Chloral hydrate C L3
Methyprylon - NR
Bromide D L5
Secobarbital D L3
Zolpidem B L3
Bishydroxycoumarin - NR
Warfarin D L2
Carbamazepine C L2
Ethosuximide C L4
Magnesium sulfate B L1

L2
Phenytoin D
Valproic acid L2
D

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 Risiko Kehamilan Risiko Menyusui

Obat TB

Cycloserine C L3

Ethambutol B L2

Isoniazid C L3
Rifampin C L2

Obat malaria

Chloroquine C L3

Hydroxychloroquine C L2

Pyrimethamine C L4

Quinine D L2
** Per Medications’ and Mothers’ Milk by Thomas Hale, PhD (2004 edition).

Lactation Risk Categories Pregnancy Risk Categories

 L1 (safest)  A (controlled studies show no risk)


 L2 (safer)  B (no evidence of risk in humans)
 L3 (moderately safe)  C (risk cannot be ruled out)
 L4 (possibly hazardous)  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 – 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
Nama Generik Kehamilan** RisikoMenyusui**

Acetazolamide C L2
Bendroflumethiazide D L4 (may inhibit lactation)

Chlorothiazide D L3

Chlorthalidone D L3

Hydrochlorothiazide (HCT) D L2

Spironolactone D L2

Disopyramide C L2

Flecainide C L3

Mexiletine B L2

Procainamide C L3

Quinidine C L2

Captopril D L3 (if used after 30 days)

Diltiazem/Diltiazem HCL C L3

C (1st trim.)
Enalapril/Enalapril Maleate D (2nd, 3rd trim.) L2

Hydralazine C L2

Labetalol C L2

Methyldopa C L2

Metoprolol B L3

L2(topically)
Minoxidil C L3 (orally)

Nadolol C L4

Nifedipine C L2

- NR
Oxprenolol

Propranolol C L2

Sotalol B L3
Timolol C L2

Verapamil C L2

Digoxin C 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)  A (controlled studies show no risk)


 L2 (safer)  B (no evidence of risk in humans)
 L3 (moderately safe)  C (risk cannot be ruled out)
 L4 (possibly hazardous)  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 – 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 C L2

Ketoconazole C L2

Antivirus

Acyclovir C L2

Interferon-alpha C 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)  A (controlled studies show no risk)


 L2 (safer)  B (no evidence of risk in humans)
 L3 (moderately safe)  C (risk cannot be ruled out)
 L4 (possibly hazardous)  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 – Antibiotik
DEC 27

Posted by dr.Rozi Abdullah


DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL
DAN MENYUSUI
Antibiotik

Kategori Risiko
Nama Generik Kehamilan Risiko Menyusui

Amoxicillin B L1

Aztreonam B L2

Cefadroxil B L1

Cefazolin B L1

Cefotaxime B L2

Cefoxitin B L1

Cefprozil C L1

Ceftazidime B L1

Ceftriaxone B L2

Ciprofloxacin C L3

Clindamycin B L3

L1
Erythromycin B L3 early postnatal

- NR
Fleroxacin

Gentamicin C L2

Kanamycin D L2

- NR
Moxalactam

Nitrofurantoin B L2

Ofloxacin C L2
Penicillin B L1

Streptomycin D L3

- NR
Sulbactam

Sulfisoxazole C L2

Tetracycline D L2

Ticarcillin B L1

Trimethoprim/sulfamethoxazole C 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)  A (controlled studies show no risk)


 L2 (safer)  B (no evidence of risk in humans)
 L3 (moderately safe)  C (risk cannot be ruled out)
 L4 (possibly hazardous)  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 – 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 Risiko Kehamilan Risiko Menyusui

Cimetidine (Antacid) B L2
Cisapride (GI tract stimulant) C L2
Domperidone (used for nausea &
vomiting, stimulates lactation) - L1
Cascara/Cascara Sagrada C L3
Danthron - NR
Magnesium sulfate B L1
Senna - L3
Loperamide B 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)  A (controlled studies show no risk)


 L2 (safer)  B (no evidence of risk in humans)
 L3 (moderately safe)  C (risk cannot be ruled out)
 L4 (possibly hazardous)  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
Nama Obat approved?* Risiko Menyusui**

not
reviewed L3 (moderately safe)
Brompheniramine

Chlorpheniramine not
(Chlor-Trimeton) reviewed L3 (moderately safe)
CTM

not
reviewed L2 (safer)
Cetirizine (Zyrtec)
Dexbrompheniramine
maleate yes not reviewed
with d-isoephedrine

Diphenhydramine L2 (safer)
(Benadryl) not
reviewed

not
reviewed L4 (possibly hazardous)
Doxylamine

Fexofenadine yes L3 (moderately safe)


(Allegra)

yes L2 (safer)
Loratadine (Claritin)

Terfenadine yes not reviewed


(Seldane)

Triprolidine (Actidil, yes L1 (safest)


Actifed)

* 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)  A (controlled studies show no risk)


 L2 (safer)  B (no evidence of risk in humans)
 L3 (moderately safe)  C (risk cannot be ruled out)
 L4 (possibly hazardous)  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 – 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

Kategori Risiko
Nama Generik Kehamilan** RisikoMenyusui**
Dyphylline C L3
Terbutaline B L2
Theophylline C L3

Nama Obat Risiko Menyusui**

Codeine L3 (moderately safe)


Dextromethorphan L1 (safest)
Guaifenesin L2 (safer)
Phenylephrine L3 (moderately safe)
L3 (moderately safe) for acute use
Pseudoephedrine (Sudafed, L4 (possibly hazardous) for chronic use due to potential
Actifed) for decreasing milk supply
Beclomethasone (Vanceril,
Beclovent, Beconase,
Vancenase) L2 (safer)
Cromlyn sodium (Nasalcrom) L1 (safest)
Fluticasone (Flonase) L3 (moderately safe)
Mometasone (Nasonex) L3 (moderately safe)
Phenylephrine (in some forms 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)  A (controlled studies show no risk)


 L2 (safer)  B (no evidence of risk in humans)
 L3 (moderately safe)  C (risk cannot be ruled out)
 L4 (possibly hazardous)  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 – NSAIDs dan Steroid


DEC 27

Posted by dr.Rozi Abdullah


DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL
DAN MENYUSUI
NSAIDs dan Steroid

Kategori Risiko
Nama Generik Kehamilan** RisikoMenyusui**
Azapropazone (apazone) - L2
Dipyrone - NR

Flufenamic acid - NR
B (1st, 2nd trim.)
Ibuprofen D (3rd trim.) L1
B (1st, 2nd trim.)
Indomethacin D (3rd trim.) L3
B (1st, 2nd trim.)
Ketorolac D (3rd trim.) L2
Mefenamic acid - NR
L3
Naproxen B L4
Phenylbutazone - NR
Piroxicam B L2
Suprofen - NR
Tolmetin C L3
Methylprednisolone C L2
Prednisolone C L2
Prednisone C 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 – ANALGETIK
DEC 26

Posted by dr.Rozi Abdullah


DAFTAR OBAT AMAN DAN BERBAHAYA UNTUK IBU HAMIL DAN MENYUSUI
ANALGETIK

Nama Obat Risiko Kehamilan Risiko Menyusui

Acetaminophen (Tylenol) B L1

C (1st, 2nd trim.)


Aspirin D (3rd trim.) L3

-
Azapropazone (Rheumox) L2

Butalbital (Fioricet, Fiorinal,


Bancap, Two-dyne) D L3

B (1st, 2nd trim.)


Butorphanol (Stadol) D (3rd trim.) L3

Celecoxib (Celebrex)) C L2

Codeine (in Tylenol #3, #4) C L3

Colchicine D L4

Diclofenac (Cataflam, Voltaren) B L2

Fentanyl (Sublimaze) B L2

Flurbiprofen (Ansaid, Froben, B (1st, 2nd trim.)


Ocufen) C (3rd trim.) L2

Hydrocodone (Lortab, Vicodin) B L3

Hydromorphone(Dilaudid) C L3

Ibuprofen (Advil, Nuprin, Motrin, B (1st, 2nd trim.)


Pediaprofen) D (3rd trim.) L1

B (1st, 2nd trim.)


Indomethacin (Indocin) D (3rd trim.) L3

Ketorolac (Toradol, Acular) B (1st, 2nd trim.) L2


D (3rd trim.)

L2;
Meperidine (Demerol) B L3 early postpartum

Methadone (Dolophine) B L3

Morphine (Duramorph, Infumorph,


Epimorph, MS Contin) B L3

Nalbuphine (Nubain) B L2

Naproxen (Anaprox, Naprosyn, L3;


Naproxen, Aleve) B L4 for chronic use

- NR
Nefopam (Acupan)
Oxycodone (Tylox,
Percodan,Oxycontin, Roxicet,
Endocet, Roxiprin, Percocet) B L3

Pentosan polysulfate(Elmiron) B L2

Piroxicam (Feldene) B L2

Propoxyphene(Darvocet N,
Propacet, Darvon) C L2

Secobarbital (Seconal) D L3

Tolmetin (Tolectin) C L3

Tramadol HCL(Ultram, Ultracet) C L3

B (1st, 2nd trim.)


Butorphanol D (3rd trim.) L3

Codeine C L3

Fentanyl B L2

L2
Meperidine B L3 (if used early postpartum)

Methadone B L3
Morphine B L3

Propoxyphene C 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 Reye’s 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 baby’s
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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