FARMAKOTERAPI

TIM DOSEN FARMAKOTERAPI

 Materi Perkuliahan
• Secara keseluruhan mata kuliah farmakoterapi
membahas tentang proses pemilihan obat dan
terapi rasional pada penyakit-penyakit atau
kelainan tertentu dalam tubuh termasuk
penggunaan antimikroba.
• Penyakit atau kelainan tertentu yang dibahas
umumnya yang prevalensi kejadiannya di
Indonesia cukup tinggi.
 Materi Perkuliahan
UTS UAS
1. Pendahuluan 1. Hipertensi
2. Diare 2. Hiperlipidemia
3. Ulkus 3. BPH
4. HIV/AIDS 4. Epilepsi dan Depresi
5. Malaria 5. Parkinson dan
6. Pneumonia Schizophrenia
7. kasus 6. Nyeri dan Migrain
7. kasus
 MATERI TUGAS (Dibagi 15 KLP)
Masing-masing kelompok membahas tentang:
1. Definisi penyakit
2. Etiologi dan Faktor risiko
3. Manifestasi klinis (gejala)
4. Patofisiologi
5. Algoritma terapi/tata laksana pengobatan (SERTAKAN
PEMBAHASAN obat-obat pilihan utk tatalaksana)
6. Kasus (langsung diberikan saat kelas berlangsung)

LITERATUR UTAMA : Farmakoterapi Dipiro dan jurnal

terkait
Point 1,2,3,4: maksimal 4 slide
 MATERI TUGAS
KULIT
1. Dermatologic drug reaction and self-
treatable skin disorder (dermatitis,
Cutaneous derug reaction,
hyperpigmentation)
2. Acne vulgaris
3. Psoriasis
4. Sun care
5. Hair treatmen
6. Insect bites
 MATERI TUGAS
MATA DAN THT
7. Glaucoma
8. Alllergi rhinitis
9. Conjungtivitis
10. Tinnitus, otitis media
11. Pharingitis
12. Dry eyes
13. Motion sickness
 MATERI TUGAS
GINJAL
14. Acute renal failure
15. Chronic renal failure
 REFERENSI

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

PENETAPAN REGIMEN PERESEPAN

DOSIS
PASIEN DOKTER

APOTEKER
 INFORMATION 250,000

EXPLOSION 100,000

10,000

MEDICAL JOURNALS 1900 1990 2000

When confronted with a clinical question,
whom do you usually you consult?
• Colleagues- experts ?
• Textbooks ?
• Others ?
 Colleagues- experts

• A great source of information.

• Quick, affordable and accessible.
– But potentially very biased
• Variability
• Not updated
 Textbooks
• Rapidly out-of-date (2-4y).
• They are a good source of background
information- pathophysiology
• BUT a poor source of information for most
foreground questions (clinical)
Burn your traditional
textbooks

23
 Evidence Based Medicine

http://accesspharmacy.mhmedical.com/content.aspx?bookid=68
9&sectionid=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