Faktor-Faktor yang Mempengaruhi

Motilitas Gastrointestinal
Mira Dewi Prawira

Pembimbing : dr. Made Agus Dwiantara Sueta, Sp.B-KBD

Program Pendidikan Dokter Spesialis – I

Program Studi Ilmu Bedah
Fakultas Kedokteran - Universitas Udayana
Denpasar 2019
Pendahuluan

Anatomi Sistem
Pencernaan

Fisiologi Saluran
Pencernaan

Mekanisme Sistem
Pencernaan
Pendahuluan

Pengaturan Fungsi Motilitas :

1. Fungsi otonom otot polos
2. Pleksus saraf intrinsik
3. Saraf ektrinsik
4. Hormon saluran pencernaan
Lapisan dinding usus halus
 Basic
Electrical
Rhythm
 Tipe
Motilitas
Gastro-
intestinal
Plexus Saraf
Intrinsik
dan
Ekstrinsik
 Neural dan
Hormonal pada
Motilitas
Gastro-
intestinal
Pengaruh Aksis
Hipotalamus Pituitari
 Gangguan Motilitas Usus

Obstruksi
Ileus paralitik
mekanik
(adinamik)
(dinamik)
Etiopatogenesis Obstruksi Mekanik
Patofisiologi
Obstruksi
Mekanik
 Trauma abdomen

Post operasi laparotomy

Etio-
patogenesis
Serum elektrolit abnormal
Ileus
Paralitik • Hipokalemia
• Hiponatremia
• Hipomagnesemia
• Hipermagnesemia
Medikamentosa Mempengaruhi
Motilitas Intestinal
Nama Obat Cara Kerja Efek
Acarbose Hormon ↓Motilitas usus
Ace- Inhibitor Aktivitas kolinergik ↑Motilitas usus
Angiotensin -2 Aktivitas kolinergik ↑Motilitas usus
antagonist
Antibiotik-Macrolid Lokal ↑Motilitas usus
Antibiotik- Hormon ↑Motilitas usus
Amoxicilin
Clavulanat
Antikolinergik Aktivitas kolinergik ↓Motilitas usus
Anti psikotik- Aktivitas kolinergik ↓Motilitas usus
Clozapine
 Nama Obat Cara Kerja Efek
Proton pump Lokal ↑Motilitas usus
inhibitors
Opiat Aktivitas kolinergik ↓Motilitas usus
SSRI - setraline Aktivitas kolinergik ↓Motilitas usus
Ticlopidine Hormon ↑Motilitas usus
Levothyroxine Hormon ↑Motilitas usus
Verapamil Aktivitas kolinergik ↑Motilitas usus
β-blockers Otonom ↑Motilitas usus
Metoclopramide Parasimpatik sentral ↑Motilitas usus
dan perifer
 Kesimpulan

1. Pengaturan fungsi motilitas dipengaruhi oleh fungsi otonom otot

polos, saraf intrinsik, saraf ekstrinsik dan hormon saluran
pencernaan
2. Terdapat 3 tipe motilitas yaitu mixing, propulsion dan separation.
3. Secara umum obstruksi intestinal dibagi menjadi 2 tipe, antara
lain; obstruksi mekanik (dinamik) dan ileus paralitik (adinamik).
4. Gangguan motilitas usus bisa mengakibatkan hipoperistaltik
dan hiperperistaltik.

5. Obat golongan opioid, antikolinergik, antidepresan trisiklik,

anti neoplasma hipomotilitas.

6. obat golongan ace-inhibitors, angiotensin-2-antagonists,

antibiotika golongan makrolid, antibiotika amoxicillin-
clavulanate, proton pump inhibitors, ticlopidine,
levothyroxime, verapamil, β-blockers dan golongan prokinetik
(metoklorpamid) hipermotilitas usus.
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Daftar •
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Pustala •
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Matur Suksma