10. Journal
ex : NEJM (The New England Journal of Medicine), JAMA, Cochrane,
Pubmed/NCBI, Medline, ELSEVIER
SISTEM PENILAIAN
Keaktifan 10%
Tugas 20%
UTS 30%
UAS 40%
PENDAHULUAN
Farmakoterapi
• Pharmacon = obat
• Therapeia = upaya penanggulangan
penyakit
• Therapeutics: cabang farmakoterapi yg
mempelajari cara-cara pengobatan
FARMAKOTERAPI adalah ilmu yang
mempelajari tentang penanganan
penyakit melalui penggunaan obat-
obatan.
TERAPI OBAT
(Farmakoterapi)
TANPA OBAT
GABUNGAN
(Non farmakoterapi)
-Radioterapi
-Hidroterapi
-fisioterapi
-Operasi
-Diet
PROSES FARMAKOTERAPI
KELUHAN TIDAK
SEMBUH SEMBUH
DIAGNOSIS EFEK
CARA PENYEMBUHAN
PENGGUNAAN OBAT
DRUG THERAPY
PENYERAHAN OBAT
PEMILIHAN OBAT
APOTEKER
INFORMATION 250,000
EXPLOSION 100,000
10,000
23
Evidence Based Medicine
http://accesspharmacy.mhmedical.com/content.aspx?bookid=68
9§ionid=48811429
Evidence Based Medicine (EBM)
• “Menggunakan segala pertimbangan bukti ilmiah
(evidence) yang sahih yang diketahui hingga kini
untuk menentukan pengobatan pada penderita
yang sedang kita hadapi”.
• Merupakan penjabaran bukti ilmiah lebih lanjut
setelah obat dipasarkan dan seiring dengan
pengobatan rasional.
Three (Es)- EBM Components
Sumber Bukti
• Pubmed & http://www.scirus.com/
• Cochrane Library
• Centre for Evidence based medicine
• Clinical Evidence
• Trip database
• Best Evidence
• Bandolier
• Therapeutic Initiative
• Google
Level of Evidence (Oxford
CEBM)
1a = Systematic reviews (with homogeneity) of
randomized controlled trials (RCT)
1b = Individual RCT (with narrow confidence
interval)
1c = All or none. Met when all patients died before
the Rx became available, but some now survive
on it; or when some patients died before the Rx
became available, but none now die on it.
Level of Evidence (Oxford
CEBM)
2a = SR (with homogeneity) of cohort
studies
2b = Individual cohort study (including low
quality RCT; e.g., <80% follow-up
2c = "Outcomes" research; Ecological
studies
3a = SR (with homogeneity) of case-control
studies
3b = Individual case-control study
Level of Evidence (Oxford
CEBM)
4 = Case-series (and poor quality cohort
and case-control studies)
5 = Expert opinion without explicit critical
appraisal, or based on physiology, bench
research or "first principles"
Grade of Recommendation
(Oxford CEBM)
A = Consistent level 1 studies
B = Consistent level 2 or 3 studies or
extrapolations from level 1 studies
C = Level 4 studies or extrapolations from
level 2 or 3 studies
D = Level 5 evidence or troubling
inconsistent or inconclusive studies at any
level