PTO DAN MESO

Rida Syarifah
Amaliatul Khusna (4305020033)
PTO (PEMANTAUAN
TERAPI OBAT)
Menurut PERMENKES RI No. 73 Th. 2016 PTO
(Pemantauan Terapi Obat) merupakan proses yang
memastikan bahwa seorang pasien mendapatkan terapi
Obat yang efektif dan terjangkau dengan
memaksimalkan efikasi dan meminimalkan efek
samping
 KRITERIA PASIEN

01 Anak-anak dan
lanjut usia, ibu hamil
02 Menerima Obat lebih 03 Adanya
dari 5 (lima) jenis multidiagnosis
dan menyusui.

04 Pasien dengan 05 Menerima Obat 06 Menerima Obat yang

gangguan fungsi dengan indeks terapi sering diketahui
ginjal atau hati sempit. menyebabkan reaksi
Obat yang
merugikan
 KEGIATAN PTO :
1. Memilih pasien yang memenuhi kriteria.
2. Mengambil data yang dibutuhkan yaitu riwayat pengobatan pasien yang terdiri dari riwayat penyakit, riwayat
penggunaan Obat dan riwayat alergi; melalui wawancara dengan pasien atau keluarga pasien atau tenaga kesehatan lain
3. Melakukan identifikasi masalah terkait Obat. Masalah terkait Obat antara lain adalah adanya indikasi tetapi tidak
diterapi, pemberian Obat tanpa indikasi, pemilihan Obat yang tidak tepat, dosis terlalu tinggi, dosis terlalu rendah,
terjadinya reaksi Obat yang tidak diinginkan atau terjadinya interaksi Obat
4. Apoteker menentukan prioritas masalah sesuai kondisi pasien dan menentukan apakah masalah tersebut sudah atau
berpotensi akan terjadi
5. Memberikan rekomendasi atau rencana tindak lanjut yang berisi rencana pemantauan dengan tujuan memastikan
pencapaian efek terapi dan meminimalkan efek yang tidak dikehendaki
6. Hasil identifikasi masalah terkait Obat dan rekomendasi yang telah dibuat oleh Apoteker harus dikomunikasikan
dengan tenaga kesehatan terkait untuk mengoptimalkan tujuan terapi.
7. Melakukan dokumentasi pelaksanaan pemantauan terapi Obat dengan menggunakan Formulir 9 sebagaimana terlampir.
TATALAKSANA PTO
1. Seleksi Pasien
2. Pengumpulan Data Pasien
3. Identifikasi Masalah Terkait
Obat
4. Rekomendasi Terapi
5. Rencana Pemantauan
6. Tindak Lanjut
 TATALAKSANA PTO
1. SELEKSI PASIEN :
Seleksi dapat dilakukan berdasarkan:
a. Kondisi Pasien :
• Pasien yang masuk rumah sakit dengan multi penyakit sehingga menerima
polifarmasi.
• Pasien kanker yang menerima terapi sitostatika.
• Pasien dengan gangguan fungsi organ terutama hati dan ginjal.
• Pasien geriatri dan pediatri.
• Pasien hamil dan menyusui.
• Pasien dengan perawatan intensif.
 TATALAKSANA PTO
1. SELEKSI PASIEN :
Seleksi dapat dilakukan berdasarkan:
b. Obat :
a. Jenis Obat Pasien yang menerima obat dengan risiko tinggi seperti :
i. obat dengan indeks terapi sempit (contoh: digoksin,fenitoin),
ii. obat yang bersifat nefrotoksik (contoh: gentamisin) dan hepatotoksik
(contoh: OAT),
iii. sitostatika (contoh: metotreksat),
iv. antikoagulan (contoh: warfarin, heparin),
v. obat yang sering menimbulkan ROTD (contoh: metoklopramid, AINS),
vi. obat kardiovaskular (contoh: nitrogliserin).
 TATALAKSANA PTO
2. PENGUMPULAN DATA PASIEN :
Data dasar pasien merupakan komponen penting dalam proses PTO. Data tersebut dapat

diperoleh dari:
• rekam medik,
• profil pengobatan pasien/pencatatan penggunaan obat,
• wawancara dengan pasien, anggota keluarga, dan tenaga kesehatan lain.

3. IDENTIFIKASI MASALAH TERKAIT OBAT:

1. Ada indikasi tetapi tidak di terapi
2. Pemberian obat tanpa indikasi
3. Pemilihan obat yang tidak tepat
4. Dosis terlalu tinggi
5. Dosis terlalu rendah
6. Reaksi Obat yang Tidak Dikehendaki (ROTD)
7. Interaksi obat
8. Pasien tidak menggunakan obat karena suatu sebab
 TATALAKSANA PTO
4. REKOMENDASI TERAPI:
Tujuan utama pemberian terapi obat adalah peningkatan kualitas hidup pasien, yang
dapat dijabarkan sebagai berikut :
• Menyembuhkan penyakit (contoh: infeksi)
• Menghilangkan atau mengurangi gejala klinis pasien (contoh: nyeri)
• Menghambat progresivitas penyakit (contoh: gangguan fungsi ginjal)
• Mencegah kondisi yang tidak diinginkan (contoh: stroke).

5. RENCANA PEMANTAUAN :
Setelah ditetapkan pilihan terapi maka selanjutnya perlu dilakukan perencanaan
pemantauan, dengan tujuan memastikan pencapaian efek terapi dan meminimalkan efek
yang tidak dikehendaki.
 TATALAKSANA PTO
6. TINDAK LANJUT :
Hasil identifikasi masalah terkait obat dan rekomendasi yang telah dibuat oleh apoteker
harus dikomunikasikan kepada tenaga kesehatan terkait. Kerjasama dengan tenaga
kesehatan lain diperlukan untuk mengoptimalkan pencapaian tujuan terapi. Informasi
dari dokter tentang kondisi pasien yang menyeluruh diperlukan untuk menetapkan
target terapi yang optimal. Komunikasi yang efektif dengan tenaga kesehatan lain harus

selalu dilakukan untuk mencegah kemungkinan timbulnya masalah baru.

 CONTOH KASUS PTO
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MESO (Monitoring Efek
Samping Obat)
Menurut PERMENKES RI No. 73 Th. 2016 MESO
(Monitoring Efek Samping Obat) merupakan kegiatan
pemantauan setiap respon terhadap Obat yang
merugikan atau tidak diharapkan yang terjadi pada
dosis normal yang digunakan pada manusia untuk
tujuan profilaksis, diagnosis dan terapi atau
memodifikasi fungsi fisiologis.
 KEGIATAN MESO :
1. Mengidentifikasi Obat dan pasien yang mempunyai resiko tinggi mengalami
efek samping Obat.
2. Mengisi formulir Monitoring Efek Samping Obat (MESO)
3. Melaporkan ke Pusat Monitoring Efek Samping Obat Nasional dengan
menggunakan Formulir 10 sebagaimana terlampir. Faktor yang perlu
diperhatikan:
a. Kerjasama dengan tim kesehatan lain.
b. Ketersediaan formulir Monitoring Efek Samping Obat
Yang Melaporkan Meso :

● dokter,
● dokter spesialis,
● dokter gigi,
● apoteker,
● bidan,
● perawat, dan
● tenaga kesehatan lain
 Yang Perlu Dilaporkan :
Setiap kejadian yang dicurigai sebagai efek samping obat perlu dilaporkan, baik efek
samping yang belum diketahui hubungan kausalnya (KTD/AE) maupun yang sudah pasti
merupakan suatu ESO (ADR).

Cara Pelaporan :
Informasi KTD atau ESO yang hendak dilaporkan diisikan ke dalam formulir pelaporan
ESO/ formulir kuning yang tersedia. Dalam penyiapan pelaporan KTD atau ESO, sejawat
tenaga kesehatan dapat menggali informasi dari pasien atau keluarga pasien. Untuk
melengkapi informasi lain yang dibutuhkan dalam pelaporan dapat diperoleh dari catatan
medis pasien
FORMULIR KUNING
MESSO
Menu

01
Backgrounds
For teachers For students
Menu

02
Avatars
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Previous Avatar Customize it Next Avatar
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Previous Avatar Customize it 03. Reminder
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Menu

03
Reminder
 Important for the next class

Subject
Science Read today’s lesson Do exercises 1 and 2

Music Bring instrument Practice song

Language Read book Do grammar exercises

Maths Do calculation Learn lesson

 Do not forget

Tasks Subjects
● Translate text ● English
● Paint mural ● Art
● Do spelling homework ● Language
● Do exercises 4 and 5 ● Maths
What materials must I bring to class?

Notes

Eraser
Rounded scissors
Pencils
Stapler
Calculator
Markers
Student Attending M T W T F
Student 1

Student 2

Student 3

Student 4

Student 5
 Ask homework to:

● Student 1
● Student 2
● Student 3
● Student 4
● Student 5
 Today’s Tasks

● Do science exercises
● Paint mural
● Do spelling homework
 Materials

Pencils
Paintings
Books
Folder
Menu

04
Planning
 Weekly planning
Monday Tuesday Wednesday
08:00 | Go to class 17:00 | Study for Friday 10:30 | Relax time

16:30 | Do homework 18:00 | Maths class 19:00 | Piano Lesson

Thursday Friday Saturday

08:00 | Breakfast 07:30 | Review for exam 11:00 | Do homework

09:30 | Music class 11:30 | Science test

Sunday
13:30 | Lunch with mum 17:30 | Go to Sarah’s 10:00 | Plan next week
 Monthly planner

April

Mo Tu We Th Fr Sa Su

    1 2 3 4

5 6 7 8 9 10 11

12 13 14 15 16 17 18

19 20 21 22 23 24 25

26 27 28 29 30     
 First semester 2021

January February March

Mo Tu We Th Fr Sa Su Mo Tu We Th Fr Sa Su Mo Tu We Th Fr Sa Su
    1 2 3  1  2  3 4  5  6 2  1  2 3  4   5 6  7
4 5 6 7 8 9 10 7 8 9 10 11 12 9 8 9 10 11 12 13 14
11 12 13 14 15 16 17 13 14 15 16 17 18 16 15 16 17 18 19 20 21
18 19 20 21 22 23 24 19 20 21 22 23 24 23 22 23 24 25 26 27 28
25 26 27 28 29  30  31 25 26 27 28   29 30 31
                                     

April May June

Mo Tu We Th Fr Sa Su Mo Tu We Th Fr Sa Su Mo Tu We Th Fr Sa Su
    1 2 3 4         1 2 1 2 3 4 5 6
5 6 7 8 9 10 11 3 4 5 6 7 8 9 7 8 9 10 11 12 13
12 13 14 15 16 17 18 10 11 12 13 14 15 16 14 15 16 17 18 19 20
19 20 21 22 23 24 25 17 18 19 20 21 22 23 21 22 23 24 25 26 27
26 27 28 29 30      24 25 26 27 28 29 30 28 29 30         
               31                          
 Second Semester 2021

July August September

Mo Tu We Th Fr Sa Su Mo Tu We Th Fr Sa Su Mo Tu We Th Fr Sa Su
    1 2 3 4           1   1 2 3 4 5
5 6 7 8 9 10 11 2 3 4 5 6 7 8 6 7 8 9 10 11 12
12 13 14 15 16 17 18 9 10 11 12 13 14 15 13 14 15 16 17 19 19
19 20 21 22 23 24 25 16 17 18 19 20 21 22 20 21 22 23 24 25 26
26 27 28 29 30 31    23 24 25 26 27 28 29 27 28 29 30       
              30 31                         

October November December

Mo Tu We Th Fr Sa Su Mo Tu We Th Fr Sa Su Mo Tu We Th Fr Sa Su
      1 2 3  1 2   3 4  5  6  7   1 2 3 4 5
4 5 6 7 8 9 10 8 9 10 11 12 13 14 6 7 8 9 10 11 12
11 12 13 14 15 16 17 15 16 17 18 19 20 21 13 14 15 16 17 18 19
18 19 20 21 22 23 24 22 23 24 25 26 27 28 20 21 22 23 24 25 26
25 26 27 28 29 30 31  29 30 27 28 29 30 31     
                                       
Menu

05
Homework
 Write your homework
Monday - 5th april, 2021

Science Do science homework

Maths

Music

Art Draw a mural

 Write your homework

Mon Tue Wed Thu Fri

Read to book Do Science Draw Translate text Play piano

Study Maths Study Music Exercise 1

Do grammar
 Timetable
Mon Tue Wed Thu Fri
8:00 - 8:30 Music Science Language English Science

8:30 - 9:00 Art English Maths Music Art

9:00 - 10:00 Language Maths Science Art Language

10:00 - 10:45 Lunch

11:30 - 12:30 Maths Art Music Language Music

12:30 - 13:30 Science Music Art Maths Maths

 Test
Part 1
1. Link it:
a. Is a gas giant and the biggest planet Venus
b. Has a beautiful name, but it’s hot Mars
c. Despite being red, is a cold place Jupiter

2. Write the missing data:

Mass Diameter Gravity

100 355 ?
 Test
Part 1I
3. Describe Venus: It’s the second planet in the Solar System and It
has a beautiful name

4. Make a list of synonyms of the given word:

Planet ? ? ?

? ? ? ?
Menu

06
Others
 Infographic

Mars Jupiter Saturn Neptune

Despite being Jupiter is a gas giant It’s composed Neptune is the
red, Mars is a and the biggest of hydrogen farthest planet from
cold place planet and helium the Sun
 Infographic

Saturn Mercury
Saturn is composed of Mercury is the closest
hydrogen and helium planet to the Sun

Neptune Mars
Neptune is the farthest Despite being red, Mars
from the Sun is a cold place
 Infographic

Mars Saturn Jupiter

Despite being It’s composed Jupiter is a gas giant
red, Mars is a of hydrogen and the biggest
cold place and helium planet
 The slide title goes here!

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 3,450
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 Notes

Mercury Venus Mars

Mercury is the closest Venus is the second Despite being red, Mars
to the Sun planet from the Sun is a cold place

Saturn Neptune Jupiter

It’s composed of Neptune is the farthest It’s a gas giant and the
hydrogen and helium from the Sun biggest planet
 Percentages

32% 60% 88%

Mercury Neptune Saturn

Mercury is the closest Neptune is the farthest Saturn is a gas giant and
to the Sun from the Sun has several rings
This is a map

Venus
It has a nice name, but It’s
terribly hot
 333,00000
Earths is the Sun’s mass

24h 37m 23s

is Jupiter’s rotation period

386,000km
is a very long distance
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 This is a graph

Mars 40%
Despite being red, Mars
is a cold place Neptune 35%
Neptune is the farthest
Saturn 25% from the Sun

It’s composed of
hydrogen and helium

To modify this graph, click on it, follow the link,

change the data and paste the resulting graph here,
replacing this one
 Conclusions

Mercury Venus Mars

Mercury is the closest Venus is the second Despite being red, Mars
to the Sun planet from the Sun is a cold place
Need more columns of text?

Mercury Mars
Mercury is the closest Despite being red, Mars
to the Sun is a cold place

Venus Jupiter
Venus is the second It’s a gas giant and the
planet from the Sun biggest planet
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