2014 petunjuk prakt blok 22 tadulako
TRANSCRIPT
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GUIDE OF PRACTICAL WORK
PHARMACOLOGY AND THERAPY DEPARTMENT
BLOCK 22
MODUL NAME
1. Nosocomial Infection
2. Tropical Medicine
3. TB Control ro!ram
". #$%stances A%$se
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PHARMACOLOGY AND THERAPY DEPARTMENT
FACULTY OF MEDICINE
UNIVERSITAS GADJAH MADA
RULES AND REGULATIONS GOVERNING LABORATORY WORK
IN THE DEPARTMENT OF PHARMACOLOGY AND THERAPY, FACULTY OF
MEDICINE, UNIVERSITAS GADJAH MADA
1. In t&e la%orator' of &armacolo!' dnd T&erap' Department( t&e st$dents &a)e to
*ear la%orator' coats and s&oes( and are not allo*ed to *ear sandals.
2. It is imperati)e t&at st$dents %e in t&e la%orator' in time. T&ose *&o arri)e 1+
min$tes after t&e d$e time are denied permission into t&e la%orator'
3. Before a session( t&e st$dents *ill recei)e assi!nments to %e prepared for t&e
follo*in! session.
". After ta,in! part in t&e t&ree sessions( t&e st$dents *ill &a)e to sit for an e-am( t&e
time for *&ic& *ill %e anno$nced later.
+. T&e total !rade a st$dent *ill !et comprises +/ for t&e e-am and +/ for
la%orator' report.
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WRITING PRESCRIPTION
AimsT&e aims of t&is session are st$dent *ill %e a%le to0
Calc$late dr$! dose
Determine t&e proper medication dosa!e re!imen( incl$din! dose( ro$te of
administration( fre$enc' of administration( time of administration( and d$ration of
t&erap'
rite a prescription
BACKGROUND
One of t&e processes in an inte!rated patient mana!ement is prescri%in!. After t&e
doctors e-amine t&e patient( ma,e a dia!nosis( and determine t&e treatment plan( t&e ne-t
step often done %' a p&'sician is *ritin! a prescription. rescri%in! process is as important
as t&e pre)io$s processes. T&ro$!& t&is prescription s&eet( doctors *ill indirectl'
comm$nicate *it& patients t&ro$!& a p&armacist.
To *rite a !ood and ri!&t prescription( st$dents need to $nderstand &o* to calc$late
dr$! dosa!es( ro$tes of administration( fre$enc' of administration( time of administration(
and d$ration of t&erap'. In addition( t&ere are ot&er t&in!s t&at need to %e o%ser)ed *&en
prescri%in!( *&ic& is dr$! dosa!e form a)aila%le in t&e mar,et.
TOOLS AND MATERIALS
#cenarios
rescription paper
" paper
PROCEDURES
Ten cases of scenario %elo* s&o$ld %e done %' eac& st$dent. Eac& case t&en *ill %e
disc$ssed and presented to t&e ot&er st$dents. T&e follo*in! s&o$ld %e considered in t&e
disc$ssion of eac& case
1. Determine t&e proper medication dosa!e re!imen incl$de0 dose( ro$te of
administration( fre$enc' of administration( time of administration( and
d$ration of t&erap'
2. rite a prescription medicine
T&e follo*in! are t&e case0
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1. A &'sician *ants to prescri%e paracetamol ta%lets for Aldi( a 12 'ear4old %o'( "
,!( s$fferin! from common cold.
Genei! n"me D#$ D%s"$e Genei! &%m
aracetamol 141+ m!5,!5dose( e)er' "46 &o$rs Ta%let + m!#'r$p 76 ml8 12
m!5+ml
9a* material
2. A &'sician *ants to prescri%e antacid c&e*a%le ta%let to Mrs. Dede( a 3 'ear4old
*oman( + ,!( s$fferin! from ac$te !astritis.
Genei! n"me D#$ D%s"$e Genei! &%m
Mi-t$re ofAl7O:83and
M!7O:83
Al7O:83 can %e !i)en $p to 1!ram55administration
M!7O:83 can %e !i)en $p to
1 !ram55administration
Antasida DOEN c&e*a%leta%let contains Al7O:832
m! and M!7O:83 2 m!
Antasida DOEN s$spension
76ml8( eac& + ml contains0
Al7O:832 m! and
M!7O:83 2 m!
3. &'sicians *ant to prescri%e Cotrimo-a;ol s'r$p for Clara( 3 'ears 1+ ,!( s$fferin!
from d'senter' %asiler.
Genei! n"me D#$ D%s"$e Genei! &%m
Cotrimo-a;ol "
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6. A &'sician *ants to prescri%e Anti&emorroid DOEN s$ppositor' to Mr. Dian( +"
'ears old @ ,! s$fferin! from internal &emorr&oids.
Genei! n"me D#$ D%s"$e Genei! &%m
Anti&emorroidDOEN
Once a da'( 1 s$ppositor'%efore sleep
Eac& 1 rectal s$ppositor' ofAnti&emoroid DOEN
contains0
Bism$t& s$%!alat 1+ m!
:e-ac&lorofen 2.+ m!
Lido,ain 1 m!
#en! o,sida 12 m!
#$pp ad 2 !
@. Mrs #$san 36 'ears old came to t&e doctor *it& complaints of itc&in! after $sin! acertain %rand of talc$m po*der. &'sical e-amination fo$nd er't&ematosa
pap$lo)esic$la in t&e armpit( c&est and el%o*s. Doctor dia!nosed t&at s&e &as
aller!ic contact dermatitis. T&e doctor t&en prescri%ed &'drocortisone cream.
Genei! n"me D#$ D%s"$e Genei! &%m
:'drocortisone Dosa!e .+41/.
Topicall' $sed e)er' 6412 &o$rs
:'drocortison cream 1/ or
2.+/ in t$%e + !
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1. Dino( 1+ 'ears old( came to a doctor a%o$t &is %lood' diarr&ea and &ad defecated
t&ree times a da' for t*o da's. &'sical e-amination indicated t&at t&ere *ere no
si!ns of de&'dration. T&e faeces e-amination infested *it& trop&o;oit of
Entamoeba hystolitica. T&e dia!nose *as Amoe%iasis *it&o$t de&'dration and t&e
doctor prescri%ed metronida;ol and oral re&'dration li$id.
Genei! n"me D#$ D%s"$e Genei! &%m
Metronida;ole Ad$lt0 +4@+ m!5dose( e)er'
< &o$rs
Ta%let 2+ m! and + m!
Oralit Ad$lts0 2 to " mL for e)er'
diarr&eaOralit 2 ml5sac&et
L%!"'i%n 0 &armacolo!' and T&erap' Department( ac$lt' of Medicine( Uni)ersitas
?ad>a& Mada
D#"'i%n0 1 - 12 min$tes
EALUATION
Assi!nment d$rin! la%orator' practice.
9EE9ENCE#
9oac&( #. 2".Introductory Clinical Pharmacology. @t&ed.I#I( 2@. ISO Indonesia7Informasi #pesialite O%at Indonesia8(
#ri #$&armi( 22(Resep Dokter dan Proses Preskripsi yang Benar dan Rasional( Ba!ian
armasi =edo,teran a,$ltas =edo,teran U?M( o!'a,arta
#'arif( 9.A( M$rini( T.( dan a&'$nin!si&( M.#.:. 212. Pedoman Dasar Penulisan
Resep Dokter untuk Pasien nak. Ba!ian arma,olo!i dan Terapi a,$ltas =edo,teran
U?M.
Faman4Goenoes( N. 21. rs Prescribendi Resep !ang Rasional. Edisi 1. Airlan!!a
Uni)ersit' ress.
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9E#C9ITION ANAL#I#
AIM0
After doin! t&e acti)it' it is e-pected t&at st$dentHs ,no*led!e a%o$t prescription
*ritin! increases and st$dent are a%le to t&in, criticall' to an' prescription *&ic& t&e' read
and anal';e.
9E#UME O T:EO9
Until no* it is still fo$nd t&at a prescription is ille!i%le and not *ritten completel'.
:ealt& Ministerial 9e!$lation No 2651
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9OCEDU9E
Me'(%)
#t$dents are di)ided into some !ro$ps 734" persons5!ro$p8. One *ee, %efore t&is
session( eac& !ro$p *ill recei)e assi!nments to %e prepared for t&is session. T&e
assi!nment is a doctorHs prescription to %e anal';ed %' $sin! t&e follo*in! criteria %elo*.
T&e st$dents &a)e to ma,e a repot of t&e assi!nment and s$%mit it one da' %efore t&e
practical *or,. On D4da' t&e st$dent present t&e s&ort report *ritten on transparent plastic
and disc$ss it *it& ot&er !ro$ps.
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O9M O 9E#C9ITION ANAL#I#
A. Completeness of a prescription
Complete
7'es5no8
9i!&t5le!i%le
7'es5no8
E-planation
DoctorHs Identit'
Superscription 915.
925.
935.
etc.
Inscription 915.
925.
935.
etc.
Subscription 915.925.
935.
etc.
Signa "Signatura# 915.
925.
935.
etc.
DoctorHs si!nat$re 915.
925.
935.etc.
atientHs Identit'
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B. rescription form
1. T'pe of prescriptions
915.
925.
935. etc.
2. Ma!istral form 7present5none8
If t&ere is ma!istral form( e-plain $sin! t&e criteria0
In!redients T&e name of acti)e
medicinal a!ent
Effects5$nctions
Remedium Cardinale7principal dr$!s8
Remedium d$u%ant
7ad>$)ant8
Corrigens
Constituents&%ehicle
3. Official form 7present5none8
If t&ere is official form( e-plain composition and effects of t&e medicine
". #pecial form 7present5none8
If t&ere is special form( e-plain t&e content and effect of t&e medicine
+. Narcotic dr$!s 7present5none8
Name 0
rite t&e dr$! in a prescription.
B. 1 Dosa!e re!imen 7dosa!e( ro$te of administration( fre$enc'( time of
administration( and d$ration of treatment8
2. Dr$! Interaction 7present5none8
C. &armace$tical dosa!e form selected %' t&e doctor
7E-plain specification of a)aila%le dosa!e form( ad)anta!es and disad)anta!es of
t&e p&armace$tical dosa!e form8
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D. Dia!nose
Base on t&e medicines *ritten in t&e prescription( *&at is5are t&e possi%ilit' of
patientHs dia!nose
E. 1. Concl$sion and ad)ice 7ad)ices *&ic& &a)e to %e !i)en to t&e patient relatin! to
t&e disease8
2. rite t&e ri!&t and rational prescri%in! in a prescription form.
After t&e st$dents anal';e and ma,e a report a%o$t t&e prescriptions( on D4Da' t&e'
present and disc$ss t&em *it& ot&er !ro$ps.
Eac& !ro$p presents0
1. Ori!inal doctorHs prescription
2. T&e calc$lation of dr$! doses for t&is patient
3. T&e ri!&t and rational prescri%in! accordin! to st$dentsHs opinion
E-ample0
1. Loo, at t&e ori!inal doctorHs prescription %elo*
dr. Mric&i Mar'
#ip 0 @52
:ome0 ratice site 0
Gl.An!sa 2 Gl.An!!re, @
o!'a,arta o!'a,arta
o!'a,arta( 1 G$ni 2@
95. Er't&rom'cin m! 2 #acc&.lactis .s.
m.f.l.a.p$l).d.t.d.No II
#.3.d.d.p$l).
ro 0 Nila
A!e 0 1 'ear old
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2. In t&at prescription( *e do not find %od' *ei!&t of t&e patient( so *e loo, for it
from *ei!&t for a!e ta%le. rom it( *e o%tain t&at t&e %od' *ei!&t of a4'ear4old
c&ild is < ,ilo!rams. 9eferences s&o* t&at er't&rom'cin dosa!e is 34+ m!5,!
%od' *ei!&t5da' in fo$r4di)ided dose. #o(
Doses of er't&rom'cin for Nila is < - 73 +8 m!5da'
or 2"4" m!5da'
or 6 1 m!5dose
In prescription a%o)e *e also find t&at 'signa(is not complete. T&e doctor didnHt
*rite &o* man' pac,a!e or medicine and *&en t&e medicine m$st %e ta,en %' t&e patient.
#o( 'o$ &a)e to complete t&esignaas prescription %elo*.
3. T&e ri!&t and rational prescri%in! for Nila is 0
dr. Mric&i Mar'
#I 0 @52
:ome0 ractice site 0
Gl.An!sa 2 Gl.An!!re, @o!'a,arta o!'a,arta
o!'a,arta( 1 G$ni 2@
95. Er't&rom'cin m! 1
#acc&.lactis .s.
m.f.l.a.p$l).d.t.d.No II
#.3.d.d.p$l).I p.c.
ro 0 Nila
A!e 0 1 'ear old 71 ,!8
L%!"'i%n 0 &armacolo!' and T&erap' Department( ac$lt' of Medicine( Uni)ersitas
?ad>a& Mada
D#"'i%n0 1 - 12 min$tes
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9EO9T
T&e st$dents &a)e to s$%mit t&e report to la%orator' of Medical &armac' one da' %efore
t&e practical *or,.
EALUATION
resentation and report
9EE9ENCE#
?oodman and ?ilman( 21( )he Pharmaceutical Basis of )herapeutics( Ed.
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CA#E 9E#ENTATION0
#TE# O 9E#C9ITION 9ITIN?
AIM 0
To pro)ide a st$d'in! e-perience for t&e st$dents a%o$t &o* to appl' t&e steps of
prescription *ritin! to reali;e a rational prescription *ritin!
9E#UME O T:EO9
A st$d' o%tained t&at t&e fres&4!rad$ated4doctor prescri%ed *ron! dr$! or %enefit
of dr$! *as &esitated on a &alf of cases a t&ird prescri%in! *as *ron! and t*o t&irds
prescri%er did not !i)e important dr$! information to patient 7:O( 1"8.
rescri%in! is p&armacot&erap' creation t&at it &as to %e ri!&t and rational. To
create rational p&armacot&erap' in prescription *ritin! it is necessar' to $nderstand steps
of prescription *ritin! t&at &a)e %een p$%lis&ed %' :O. T&e steps are to c&oose t&e
p&armace$tical dosa!e form s$ita%le to patient condition( determine dosa!e re!imen
7doses( ro$te of administration( fre$enc'( time of administration( and d$ration of
treatment8( *rite prescription( and !i)e important information a%o$t dosa!e re!imen(
ad)erse effect t&at s&o$ld %e ,no*n %' patient.
TOOL AND MATE9IAL
4 T&e ficti)e cases
4 LCD pro>ector
4 Note%oo,5comp$ter
9OCEDU9EMe'(%)
Eac& !ro$p of st$dents are di)ided into some s$%!ro$ps 734" persons5s$%!ro$p8.
One *ee, %efore t&is session( eac& s$%!ro$p *ill recei)e an assi!nment to %e prepared for
t&is session. T&e assi!nment contains a ficti)e case and steps of prescription *ritin!. Eac&
s$%!ro$p of st$dents &as to ma,e a report of t&e assi!nment and s$%mit it one da' %efore
practical *or,. On D4da' t&e st$dents present t&e s&ort report *ritten on po*er point and
disc$ss it *it& ot&er !ro$ps.
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E-ample of case to %e presented0
Mrs. oni( a t&irt' fi)e4'ear4old *oman( comes a doctor in primar' &ealt& care %eca$se of
co$!& and %reat&lessness. #&e co$!&s fre$entl' t&ro$!&o$t t&e da' and *ill &a)e
s'mptoms 2 or 3 ni!&ts a mont& as *ell. It seems to %e *orse in cold *eat&er. :er
e-amination is normal e-cept for &er l$n!s( *&ic& re)eal e-pirator' *ⅇin!. T&e doctor
dia!nose &er *it& ac$te ast&ma and considered to !i)e P24adrenoceptor a!onist
7sal%$tamol or salmeterol8. T&e doctor t&in,s a%o$t *&ic& dr$! of t&ose s$ita%le to t&e
patient. :e remem%ers t&at $sin! steps of prescription *ritin!( t&e appropriate dr$! can %e
determined.
T&e steps of prescription *ritin! 0
1. &ic& of t&e t*o are 'o$ !oin! to c&oose for t&e patient E-plain 'o$r ans*er
7!i)e reasons8
2. Descri%e t&e )ario$s ,ind of p&armace$tical dosa!e form and t&e stren!t& of t&ose
dr$!s 7%ot& !eneric and %rand8( t&en determine one s$ita%le to patient condition
3. Esta%lis& t&e proper dosa!e re!imen 7dosa!e( fre$enc' of administration( ro$te of
administration( time of administration( and d$ration of t&e treatment8 of t&ose dr$!s
". rite all of t&e possi%le prescription forms 7ma!istral( official( and special8 t&en
select *&ic& is t&e most s$ita%le for t&e patientQ
+. ?i)e information a%o$t t&e medicines to t&e patient 7effects( side effects(
instr$ctions( *arnin!s8
Ans*er0
1. S"*+#'"m%* 7INN8 or "*+#'e%* 7U#AN8 is one of s&ort4actin! P24adrenoceptor
a!onists $sed for pre)ention and treatment of %ronc&oconstriction. T&e a!ents
%inds specificall' to t&e P24adrener!ic receptor and a)oid t&e cardio)asc$lar effects
of P14acti)ation. Acti)ation of P24receptors ca$ses %ronc&odilation. Onset of action
occ$rs in min$tes and lasts for "6 &o$rs. It is t&e treatment of first c&oice to
relie)e ac$te ast&ma. T&e preparation a)aila%le in oral( in&aler( and sol$tion *it& a
ne%$li;er. It &as a fe* side effects. E-cessi)e $se or t&e oral preparations ma'
res$lt in cardio)asc$lar effects s$c& as tac&'cardia.
1+
http://en.wikipedia.org/wiki/International_Nonproprietary_Namehttp://en.wikipedia.org/wiki/United_States_Adopted_Namehttp://en.wikipedia.org/wiki/International_Nonproprietary_Namehttp://en.wikipedia.org/wiki/United_States_Adopted_Name -
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S"*me'e%* is one of lon!4actin! P24adrenoceptor a!onists $sed onl' for
prophyla+is of ac$te %ronc&oconstriction. T&e' are not effecti)e in ac$te attac,s
%eca$se t&e' &a)e a slo*er onset of action t&an t&e s&ortactin! dr$!s 7$p to 2
min$tes for salmeterol8. It &as a m$c& lon!er &alf4life 7$p to 12 &o$rs8. T&e a!ents
are a)aila%le in metered4dose in&alers t&at prod$ce fe*er side effects t&an s'stemic
administration. Use of lon!4actin! a!ents prod$ces t&e same rela-ation in air*a'
smoot& m$scles and also appears to decrease t&e release of mediators from mast
cells and l'mp&oc'tes. T&e lon!4actin! a!ents s&o$ld not %e $sed to re)erse an
ac$te attac,.
#o( dr$! c&oosed is sal%$tamol %eca$se it can pre)ent %ronc&oconstriction and
s$ita%le for relie)e ac$te ast&ma.
2. &armace$tical dosa!e form a)aila%le in mar,et0
#al%$tamol0
?eneric 0 ta%let 2 m! and " m!.
Brand name 0
entolin ta%let 0 sal%$tamol 2 m!(
entolin s'r$p 0 sal%$tamol 2 m!5+ ml 71 ml5%ottle8entolin ne%$les 0 2(+ m! sal%$tamol 52(+ ml NaCL( $sed *it& ne%$li;er
entolin dis,&aler 0 2 R!5in&alation and " R!5in&alation
Lasal in>ection 0 (+ m!5ml of sal%$tamol 72 ml5amp$le8
?lisend in&alation aerosol0 1 R! 5spra' sal%$tamol 71@ !5can8
or Mrs. oni( ta%let is prescri%ed on t&e ass$mption t&at s&e a%le to s*allo*
ta%let( t&e dosa!e form is eas' to carr' e)er'*&ere and a)aila%le in primar' &ealt&
care( and t&e price is lo*er t&an ot&er forms 7ne%$les and dis,&aler8.
T&e components of a sal%$tamol in&aler #al%$tamol s$lfate 2 m! #al%$tamol 2 m!5+ ml
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3. Dosa!e of sal%$tamol for ad$lt0 orall' 24" m!( dosa!e c&oosed is " m!
re$enc' of administration0 orall' e)er' 6 &o$rs
9o$te of administration0 orall'
Time of administration0 e)er' 6 &o$rs 7mornin!( noon( e)enin!( at %edtime8(
D$ration of t&e treatment0 @ da's
". rescription
T&e possi%ilit' of prescription forms *&ic& ma' %e *ritten0
A. Official prescription
dr. B$diman#I 0 @52
:ome0 ractice site 0
Gl.An!sa 2 Gl.An!!re, @
o!'a,arta o!'a,arta
o!'a,arta( 1 No)em%er 21
95. Ta%.#al%$tamol m! " No III
#.p.r.n.o.6.&.Ta%.I.p.c.
ro 0 N'. oni
A!e 0 3+ '.o.
1@
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B. #pecial prescription
dr. B$diman
#I 0 @52
:ome0 ractice site 0
Gl.An!sa 2 Gl.An!!re, @
o!'a,arta o!'a,arta
o!'a,arta( 1 No)em%er 21
95. Ta%.entolin m! 2 No LI
#.p.r.n.o.6.&.Ta%.II.p.c.
ro 0 N'. oni
A!e 0 3+ '.o.
Ma!istral prescription isnHt *ritten for t&e case %eca$se dose of sal%$tamol for N'.
oni is a)aila%le in !eneric and %rand dosa!e form.
T'pe of prescription c&oosed0 official prescription %eca$se t&e price of !eneric is
lo*er t&an %rand dr$!.
+. rite effects( side effects( instr$ctions( *arnin!s *&ic& *ill %e informed and
s&o$ld %e o%e'ed %' patient
L%!"'i%n &armacolo!' and T&erap' Department( 2ndfloor of 9adiopoetro B$ildin!(
ac$lt' of Medicine( Uni)ersitas ?ad>a& Mada
D#"'i%n0 1 - 12 min$tes
Re-%'
T&e st$dents &a)e to s$%mit t&e report to la%orator' of &armacolo!' and T&erap' one da'
%efore t&e practical *or,.
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E."*#"'i%n
resentation and report
Re&een!es
?oodman and ?ilman( 21( )he Pharmaceutical basis of )herapeutics( Ed.
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CODE0 A1
BLOC= 22
:A9MACOLO? AND T:E9A DEA9T.
ACULT O MEDICINE U?M
Case resentation0
#teps of rescription ritin!
I%$ a,$ni( " ta&$n( "< ,!( per!i ,e do,ter den!an ,el$&an %at$, %erda&a,( tida, ada
nafs$ ma,an dan pen$r$nan %erat %adan. #e>a, 2 &ari 'an! lal$ %at$, disertai dara&.
emeri,saan sp$t$m0 BTA positif. oto 9on!ent t&ora- men$n>$,,an =oc& $lmon$m
a,tif. Do,ter mendia!nose se%a!ai t$%erc$losis par$ dan merencana,an pem%erian o%atantit$%erc$losis 7OAT8 ,ate!ori I fase intensif. Do,ter merencana,an pem%erian OAT
selama 2 min!!$ pertama $nt$, memonitor toleransi pasien ter&adap o%at. O%at
antit$%erc$losis 'an! a,an diresep,an melip$ti 2:9FE S7isonia;id( et&am%$tol(
rifampicine dan p'ra;inamide8 ata$ OAT =DT fase intensif de*asa 79imstar DC8 serta
)itamin 7m$lti)itamin( )it C ata$ )it B6 8.
ertan'aan 0
1. Bila anda se%a!ai do,ter( o%at mana 'an! anda pili&5resep,an dari o%at4o%at dalam
,las terapi it$ Gelas,an >a*a%an anda 7farma,o,ineti, dan farma,odinami, sem$a
o%at terse%$t8Q
2. #e%$t,an macam %ent$, sediaan o%at terse%$t 'an! ada di pasaran 7!eneri, danmere, da!an!8 dan tent$,an %ent$, sediaan o%at 7B#O8 'an! coco,5tepat %a!i
pasien terse%$tQ
3. Tent$,an >ad*al dosis $nt$, o%at 'an! anda pili& 7dosis( fre,$ensi( cara
pem%erian( *a,t$ pem%erian( dan lama pen!o%atan8Q
". T$lis sem$a >enis pres,ripsi 'an! mem$n!,in,an $nt$, pasien terse%$t
7ma!istralis( offisinalis( spesialitis8 dan tent$,an >enis mana 'an! palin! tepat %a!i
pasien it$Q
+. Beri,an informasi %er,aitan den!an o%at 'an! anda %eri,an 7efe,( efe, sampin!(
instr$,si( perin!atan8Q
2
-
8/12/2019 2014 Petunjuk Prakt Blok 22 Tadulako
21/29
CODE0 B1
BLOC= 22
:A9MACOLO? AND T:E9A DEA9T.
ACULT O MEDICINE U?M
Case resentation0
#teps of rescription ritin!
Bapa, Andi( 63 ta&$n( peri,sa ,e do,ter ,arena demam( %at$,( pile,( n'eri ten!!oro,an(
dan Jpe!al4pe!alK di sel$r$& t$%$&. #etela& dila,$,an pemeri,saan do,ter mendia!nose
common cold dan meresep,an antip'retic 7acetaminop&en ata$ i%$prop&en8( e-pectorant
7!$ap&enesine ata$ %rom&e-in8( decon!estant 7pse$doep&edrine ata$p&en'lpropanolamine8 padan'a.
ertan'aan 0
1. Bila anda se%a!ai do,ter( o%at mana 'an! anda pili&5resep,an dari o%at4o%at dalam
,las terapi it$ Gelas,an >a*a%an anda 7farma,o,ineti, dan farma,odinami, sem$a
o%at terse%$t8Q
2. #e%$t,an macam %ent$, sediaan o%at terse%$t 'an! ada di pasaran 7!eneri, dan
mere, da!an!8 dan tent$,an %ent$, sediaan o%at 'an! coco,5tepat %a!i pasien
terse%$tQ
3. Tent$,an >ad*al dosis $nt$, o%at 'an! anda pili& 7dosis( fre,$ensi( carapem%erian( *a,t$ pem%erian( dan lama pen!o%atan8Q
". T$lis sem$a >enis pres,ripsi 'an! mem$n!,in,an $nt$, pasien terse%$t
7ma!istralis( offisinalis( spesialitis8 dan tent$,an >enis mana 'an! palin! tepat %a!i
pasien it$Q
+. Beri,an informasi %er,aitan den!an o%at 'an! anda %eri,an 7efe,( efe, sampin! (
instr$,si( perin!atan8Q
21
-
8/12/2019 2014 Petunjuk Prakt Blok 22 Tadulako
22/29
CODE0 D2
BLOC= 22
:A9MACOLO? AND T:E9A DEA9T.
ACULT O MEDICINE U?M
Case resentation0
#teps of rescription ritin!
Bimo( + ta&$n( 2 ,!( di%a*a i%$n'a ,e do,ter ,arena sesa, nafas. #esa, nafas ,adan!
m$nc$l setela& %ermain. Bimo men!alami asma 142 ,ali dalam semin!!$. emeri,saan
fisi, didapat,an e,spirasi diperpan>an! dan *ⅇin!. Do,ter mendia!nose ast&ma mild
persistent dan meresep,an %ronc&odilator 7-ant&ine ata$ #ABA ata$ LABA8 dan steroid.#&ort actin! P2 a!onist 7#ABA80
#al%$tamol( ter%$taline( metaproterenol
ant&ine
Aminop&'lline( teop&'lline
Lon! actin! P2 a!onist 7LABA80
salmeterol( formoterol
#teroid
De-amet&asone( metil prednisolone( prednisone( %eclomet&asone( &'drocortisone(
fl$ticasone( %$desonide
ertan'aan 0
1. Bila anda se%a!ai do,ter( o%at mana 'an! anda pili&5resep,an dari o%at4o%at dalam
,las terapi it$ Gelas,an >a*a%an anda 7farma,o,ineti, dan farma,odinami, sem$a
o%at terse%$t8Q
2. #e%$t,an macam %ent$, sediaan o%at terse%$t 'an! ada di pasaran 7!eneri, dan
mere, da!an!8 dan tent$,an %ent$, sediaan o%at 'an! coco,5tepat %a!i pasien
terse%$tQ
3. Tent$,an >ad*al dosis $nt$, o%at 'an! anda pili& 7dosis( fre,$ensi( cara
pem%erian( *a,t$ pem%erian( dan lama pen!o%atan8Q
". T$lis sem$a >enis pres,ripsi 'an! mem$n!,in,an $nt$, pasien terse%$t
7ma!istralis( offisinalis( spesialitis8 dan tent$,an >enis mana 'an! palin! tepat %a!i
pasien it$Q
+. Beri,an informasi %er,aitan den!an o%at 'an! anda %eri,an 7efe,( efe, sampin!(
instr$,si( perin!atan8Q
22
-
8/12/2019 2014 Petunjuk Prakt Blok 22 Tadulako
23/29
CODE0 E2
BLOC= 22
:A9MACOLO? AND T:E9A DEA9T.
ACULT O MEDICINE U?M
Case resentation0
#teps of rescription ritin!
I%$ G$mira&( 6 ta&$n den!an n'eri dada 'an! men>alar ,e len!an ,irin'a selama 1
menit mendatan!i U?D r$ma& sa,it. Dia men!ata,an %a&*a dia tela& men!alami !e>ala
ini selama 3 ta&$n dan ,adan!4,adan! min$m ta%let s$%lin!$al nitro!liserin mili,
s$amin'a $nt$, men!atasin'a. N'eri serin! tim%$l mes,ip$n a,ti)itas minimal. Daripemeri,saan E=? tida, ditem$,an adan'a ,enai,an se!men #T . Dia >$!a menderita
%acterial con>$ncti)itis. Do,ter U?D mendia!onosis $nsta%le an!ina dan meresep,an
antian!ina 7Nitrat0 Isosor%id dinitrat( isosor%id mononitrat( nitro!l'cerin ATAU
Trom%o-ane In&i%itor0 aspirin8 dan anti%acteri 7c&loramp&enicol ata$ o-'tetrac'cline ata$
c'proflo-acine8.
ertan'aan0
1. Bila anda se%a!ai do,ter( o%at mana 'an! anda pili&5resep,an dari o%at4o%at dalam
,las terapi it$ Gelas,an >a*a%an andaQ
2. #e%$t,an macam %ent$, sediaan o%at terse%$t 'an! ada di pasaran 7!eneri, dan
mere, da!an!8 dan tent$,an %ent$, sediaan o%at 'an! coco,5tepat %a!i pasien
terse%$tQ
3. Tent$,an >ad*al dosis $nt$, o%at 'an! anda pili& 7dosis( fre,$ensi( cara
pem%erian( *a,t$ pem%erian( dan lama pen!o%atan8Q
". T$lis sem$a >enis pres,ripsi 'an! mem$n!,in,an $nt$, pasien terse%$t
7ma!istralis( offisinalis( spesialitis8 dan tent$,an >enis mana 'an! palin! tepat %a!i
pasien it$Q
+. Beri,an informasi %er,aitan den!an o%at 'an! anda %eri,an 7efe,( efe, sampin! (
instr$,si( perin!atan8Q
23
-
8/12/2019 2014 Petunjuk Prakt Blok 22 Tadulako
24/29
CODE0 1
BLOC= 22
:A9MACOLO? AND T:E9A DEA9T.
ACULT O MEDICINE U?M
Case resentation0
#teps of rescription ritin!
Bp. Ba>$ri( +" datan! ,e ,lini, anda ,arena &ipertensi dan !atal4!atal di p$n!!$n!n'a.
Dia >$!a mendertia dia%etes melit$s. Te,anan dara&n'a 1651 mm:!. ada p$n!!$n!
tampa, pla, t$n!!al %erdiameter " cm den!an s,$ama( er't&ema di pin!!irn'a dan %a!ian
ten!a& men'em%$&. Anda se%a!ai do,tern'a mendia!nosis &ipertensi den!an Tineacorporis dan meresep,an anti&ipertensi 7Di$reti, T&ia;id0 &'droc&lorotia;id(
%endrofl$a;id( ,lortalidon( indapamid( metola;on( -ipamid ATAU di$retic &emat ,ali$m0
spironolactone( amilorid4:Cl ATAU di$reti, ,$at0 f$rosemid( %$metanid( torasemid8 dan
antif$n!i 7*it&field ointment( ATAU imida;ol0 ,etocona;ole( ATAU Tria;ol0 itra,ona;ol(
fl$,ona;ol( ATAU olien0 amp&otericine B( nistatin ATAU !olon!an lain0 !riseo)$l)in8
$nt$,n'a.
ertan'aan0
1. Bila anda se%a!ai do,ter( o%at mana 'an! anda pili&5resep,an dari o%at4o%at dalam
,las terapi it$ Gelas,an >a*a%an anda 7farma,o,ineti,( farma,odinami,8Q
2. #e%$t,an macam %ent$, sediaan o%at terse%$t 'an! ada di pasaran 7!eneri, dan
mere, da!an!8 dan tent$,an %ent$, sediaan o%at 'an! coco,5tepat %a!i pasien
terse%$tQ
3. Tent$,an >ad*al dosis $nt$, o%at 'an! anda pili& 7dosis( fre,$ensi( cara
pem%erian( *a,t$ pem%erian( dan lama pen!o%atan8Q
". T$lis sem$a >enis pres,ripsi 'an! mem$n!,in,an $nt$, pasien terse%$t
7ma!istralis( offisinalis( spesialitis8 dan tent$,an >enis mana 'an! palin! tepat %a!i
pasien it$Q
+. Beri,an informasi %er,aitan den!an o%at 'an! anda %eri,an 7efe,( efe, sampin! (instr$,si( perin!atan8Q
2"
-
8/12/2019 2014 Petunjuk Prakt Blok 22 Tadulako
25/29
CODE0 3
BLOC= 22
:A9MACOLO? AND T:E9A DEA9T.
ACULT O MEDICINE U?M
Case resentation0
#teps of rescription ritin!
Bp. #$!ito( +3 ta&$n( seoran! ,ar'a*an s*asta men!el$& sa,it ,epala di %a!ian %ela,an!(
ten!,$, dan s$lit tid$r se>a, se%$lan 'an! lal$. =el$&an dirasa,an ter$tama %ila sedan!
t$!as di ,antor. Te,anan dara& 1+51+ mm:! sama den!an te,anan dara& semin!!$ 'an!
lal$. 9i*a'at &ipertensi se%el$mn'a disan!,al. 9i*a'at :ipertensi dalam ,el$ar!a0 positif.#elain it$ dia men!el$& mata mera& dan %erair. Do,ter mendia!nosis &ipertensi dan
%a,terial con>$n!ti)itis dan meresep,an anti&ipertensi 7Di$reti, T&ia;id0
&'droc&lorotia;id( ,lortalidon( indapamid( metola;on ATAU Di$reti, ,$at0 f$rosemid(
%$metanid( torasemid ATAU %eta %lo,er0 propanolol ATAU anta!onis ,alsi$m0 nifedipin(
amlodipin8 dan anti%a,teri 7c&loramp&enicol ata$ o-'tetrac'cline ata$ c'proflo-acine8.
ertan'aan0
1. Bila anda se%a!ai do,ter( o%at mana 'an! anda pili&5resep,an dari o%at4o%at dalam
,las terapi it$ Gelas,an >a*a%an anda 7farma,o,ineti, dan farma,odinami, sem$a
o%at terse%$t8Q
2. #e%$t,an macam %ent$, sediaan o%at terse%$t 'an! ada di pasaran 7!eneri, danmere, da!an!8 dan tent$,an %ent$, sediaan o%at 'an! coco,5tepat %a!i pasien
terse%$tQ
3. Tent$,an >ad*al dosis $nt$, o%at 'an! anda pili& 7dosis( fre,$ensi( cara
pem%erian( *a,t$ pem%erian( dan lama pen!o%atan8Q
". T$lis sem$a >enis pres,ripsi 'an! mem$n!,in,an $nt$, pasien terse%$t
7ma!istralis( offisinalis( spesialitis8 dan tent$,an >enis mana 'an! palin! tepat %a!i
pasien it$Q
+. Beri,an informasi %er,aitan den!an o%at 'an! anda %eri,an 7efe,( efe, sampin! (
instr$,si( perin!atan8Q
2+
-
8/12/2019 2014 Petunjuk Prakt Blok 22 Tadulako
26/29
CODE0 ?"
BLOC= 22
:A9MACOLO? AND T:E9A DEA9T.
ACULT O MEDICINE U?M
Case resentation0
#teps of rescription ritin!
Bp.O!a& + ta&$n peri,sa ,e do,ter ,arena >ari4>ari ,a,i dan l$t$t ,a,$ dan n'eri se>a, +
&ari 'an! lal$. Dia s$da& min$m parasetamol tetapi n'eri tida, %er,$ran!. emeri,saan
fisi, tida, ditem$,an ,elainan. Do,ter mendia!nose s$spe, osteoart&ritis dan meresep,an
N#AID oral 7indometasin ata$ melo-icam ata$ i%$profen ata$ asetosal ata$ ,etoprofenata$ fenil%$tasone8 dan N#AID topical 7napro-en ata$ di,lofena,8
ertan'aan 0
1. Bila anda se%a!ai do,ter( o%at mana 'an! anda pili&5resep,an dari o%at4o%at dalam
,las terapi it$ Gelas,an >a*a%an anda 7farma,o,ineti, dan farma,odinami, sem$a
o%at terse%$t8Q
2. #e%$t,an macam %ent$, sediaan o%at terse%$t 'an! ada di pasaran 7!eneri, dan
mere, da!an!8 dan tent$,an %ent$, sediaan o%at 'an! coco,5tepat %a!i pasien
terse%$tQ
3. Tent$,an >ad*al dosis $nt$, o%at 'an! anda pili& 7dosis( fre,$ensi( carapem%erian( *a,t$ pem%erian( dan lama pen!o%atan8Q
". T$lis sem$a >enis pres,ripsi 'an! mem$n!,in,an $nt$, pasien terse%$t
7ma!istralis( offisinalis( spesialitis8 dan tent$,an >enis mana 'an! palin! tepat %a!i
pasien it$Q
+. Beri,an informasi %er,aitan den!an o%at 'an! anda %eri,an 7efe,( efe, sampin! (
instr$,si( perin!atan8Q
26
-
8/12/2019 2014 Petunjuk Prakt Blok 22 Tadulako
27/29
-
8/12/2019 2014 Petunjuk Prakt Blok 22 Tadulako
28/29
CODE0 G1
BLOC= 22
:A9MACOLO? AND T:E9A DEA9T.
ACULT O MEDICINE U?M
Case resentation0
#teps of rescription ritin!
Bapa, Dan$ ++ ta&$n datan! ,e $s,esmas ,arena sesa, nafas sampai mem%an!$n,an
tid$r malamn'a. Dia memp$n'ai ri*a'at &ipertensi nam$n tida, r$tin min$m o%at.
emeri,saan fisi, didapat,an m$rm$r sistoli, di ape- cordis dan edema di ,ed$a t$n!,ai.
#am%il men'aran,an pemeri,saan E=? dan 9ont!en( do,ter mendia!nose &eart fail$resta!e C dan meresep,an di$reti, dan o%at anti &ipertensi 7An!iotensin II 9eseptor Bloc,er
7A9B8 ata$ Beta Bloc,er ata$ ACE in&i%itor ata$ ,om%inasi8
Di$reti,
:'droc&lorot&ia;ide( f$rosemide( spironolactone( amiloride
An!iotensin II 9eseptor Bloc,er
Losartan( )alsartan( ir%esartan( candesartan
Beta %loc,er
La%etolol( ( car)edilol( %eta-olol( %isoprolol( metoprolol s$ccinate( ace%$tolol(
propanolol
ACE In&i%itor
captopril(%ena;epril(delapril( enalapril( fosinopril( lisinopril(perindopril( $inapril(
ramipril( cila;april
ertan'aan 0
1. Bila anda se%a!ai do,ter( o%at mana 'an! anda pili&5resep,an dari o%at4o%at dalam
,las terapi it$ Gelas,an >a*a%an anda 7farma,o,ineti, dan farma,odinami, sem$a
o%at terse%$t8Q
2. #e%$t,an macam %ent$, sediaan o%at terse%$t 'an! ada di pasaran 7!eneri, danmere, da!an!8 dan tent$,an %ent$, sediaan o%at 'an! coco,5tepat %a!i pasien
terse%$tQ
3. Tent$,an >ad*al dosis $nt$, o%at 'an! anda pili& 7dosis( fre,$ensi( cara
pem%erian( *a,t$ pem%erian( dan lama pen!o%atan8Q
". T$lis sem$a >enis pres,ripsi 'an! mem$n!,in,an $nt$, pasien terse%$t
7ma!istralis( offisinalis( spesialitis8 dan tent$,an >enis mana 'an! palin! tepat %a!i
pasien it$Q
+. Beri,an informasi %er,aitan den!an o%at 'an! anda %eri,an 7efe,( efe, sampin! (
instr$,si( perin!atan8Q
2
-
8/12/2019 2014 Petunjuk Prakt Blok 22 Tadulako
29/29
Unt$, 6 ,elompo, 'an! ter%a!i dalam 3 sesi 2 ,elompo,=arena tiap !r$p mendapat 3 soal dan ada 3 sesi ma,a ada soal 'an! di%eri,an( Masin!4
masin! soal di print 2 ,ali.
%eri,$t pem%a!ian ,ode soal
#esi 10 D2( B1( 3
sesi 20 A1( E2( 1
#esi 30 G1( I1( ?"