Lect 1-Compounding and Dispensing

 

COMPOUNDING AND DISPENSING PROGRAM STUDI PROFESI APOTEKER PROGRAM FAKULTAS FARMASI DAN SAINS UNIVERSITAS MUHAMMADIYAH PROF. DR. HAMKA  JAKARTA  JAKART 2015

OLEH : ANI PAHRIYANI, M.SC., APT

 

STANDAR PELAYANAN KEFARMASIAN DI APOTEK  Pere!"e# Pere!" e# RI N$. %5 &'()! 201* •

S&'!+'r e-''!'! "e/'r'#'! + '$&e" e-)& : '. e!e-$-''! Se+''! F'r'#, A-'& Ke#e('&'!, +'! '('! Me+# H'3# P'"' 3. e-''!'! /'r'# "-!".

Pe-''!'! F'r'# F'r'# K-!" e-)& 4. e!"''! Re#e6 +. +#e!#!6 e. PePe-''!'! ''!'! I!/$r I!/$r'# '# O3'& 7PIO8 7PIO866 /. "$! $!# #ee-! !6 6 . PePe-''!'! ''!'! Ke/'r Ke/'r'#'! '#'! + r)'( 7($e ('r'4 ('r'4 4're86 4're86 (. Pe Pe'!&')' '!&')'! ! Ter' Ter' O3'& O3'& 7PTO86 7PTO86 +'! . M$! M$!&$ &$r! r! E/e E/e" " S' S'! ! O3'& O3'& 7ME 7MESO8 SO866

 

KOMPONE OMPONEN N PR PRAK AKTIKUM TIKUM COMPOUND COMPOUNDING ING AND DISPENSING 7RESEP KERING8 Re#e ('r)# +!-' 3er+'#'r"'! "e&e!&)'!9"e&e!&)'! +'-' : A. Skrini Skrining ng Resep .

Skrining Administratif  Skrining Farmasetis Skrining Farmakologi

. .

  . . .

Pe!''! Obat Pe!''!  Obat Peracikan Etiket

.

Pengemasan.

C. Pen Penyer yerahan ahan Obat D. Monito Monitoring ring Penggnaan Penggnaan Obat  Obat  E.

!ain"lain . Cara membat salinan resep .

Pengisian PMR.

 

SKRINING FARMAKOLOGI 1. A-er;ESO '! )&'';ADR &er"'& $3'& 2. I!&er'"# 7$3'&9$3'&,/'r'"$"!e&";/'r'"$+!'"e!&/, #&$'&".

 

ALERGI ; ESO ; ADR 

 A-er : US NLM : A! '--er # ' re'4&$! 3 $)r )!e ##&e &$ #$e&(! &('& +$e# !$& 3$&(er $#& $&(er e$-e. Pe$-e ?($ ('>e '--ere# $/&e! 're #e!#&>e &$ $re &('! $!e &(!. A--ere# 4'! 4')#e ' >'re& $/ #&$# #&$ # #)4( '# ' r)!! r) !! !$#e, #!ee@!, &4(!, r'#(e#, #?e--!, $r '#&('. A--ere# A--e re# 4'! r'!e /r$ !$r &$ #e>ere. A!'(-'# #  # ' #e>ere re'4&$! &('& 4'! 3e -/e9 &(re'&e!!



ESO 7E/e" S'! O3'&8 A #+e eBe4& # )#)'-- re'r+e+ '# '! )!+e#r'3-e #e4$!+'r eBe4& ?(4( $44)r# ! '++&$! &$ &(e +e#re+ &(er'e)&4 eBe4&#&'&e, $/ ' 'e, +r) ?e(&, $r e+4'&$!. eBe4&# >'r (e'-&(. /$r e'4( !+>+)'+ee!+! $! &(e er#$!# +#e'#e e!+er, S+e e&(!4& '!+' e!er'(e! #+e eBe4&# $/ ' +r) $r e+4'&$! 're #e>ere, &(e +$#'e ' 3e '+)#&e+ $r ' #e4$!+ e+4'&$! ' 3e re#4r3e+ 7???.+r)#.4$8



ADR 7A+>er#e Dr) Re'4&$!#8 A+>er#e +r) re'4&$! '# '! 're4'3- ('r/)- $r )!-e'#'!& re'4&$!, re#)-&! /r$ '! !&er>e!&$! re-'&e+ &$ &(e )#e $/ ' e+4!'- r$+)4&. A+>er#e +r) re'4&$!# 're 4-'##=e+ !&$ # &e# 7?&( !e$!4#8: +$#e9re-'&e+ 7A)e!&e+8, !$!9+$#e9re-'&e+ 7@'rre8, +$#e9re-'&e+ '!+ &e9re-'&e+ 7C(r$!48, &e9re-'&e+ 7De-'e+8, ?&(+r'?'- 7E!+ $/ )#e8, '!+ /'-)re $/ &(er' 7F'-)re8. 7L'!4e&, 20008

 

INTERAKSI OAT



I!&er'"# $3'& '+'-'( er#&?' +'!' '"# #)'&) $3'& + )3'( '&') +e!'r)( $-e( $3'& -'! '! + 3er"'! 3er#'''!.

e!&)"93e!&)" !&er'"# 3er+'#'r"' 3er+'#'r"'! ! e"'!#e "er'!' '. I!&er'"# /'r'#e&" 3. I!&er'"# /'r'"$"!e&" 4. I!&er'"# /'r'"$+!'"

er+'#'r"'! @'& '! 3er!&er'"#, +3e+'"'! e!'+ +. I!&er'"# $3'&9 $3'& e. I!&er'"# $3'&  '"'!'! /.

I!&er'"# $3'& 9 e!'"&

 

INTERAKSI FARMAKOKINETIK  

I!&er'"# /'r'"$"!e&" &er'+ 3-' #'-'( #'&) $3'& ee!'r)( '3#$r#, +#&r3)#, e&'3$-#e '&') e"#"re# $3'& "e+)' #e(!' "'+'r -'#' $3'& "e+)' e!!"'& '&') e!)r)!.

'. I!&er'"# r$#e# '3#$r# I!&er'"# ! +''& &er'+ '"3'& er)3'('! ('r' PH $3'&

er&''. Pe!'r)( '3#$r# #)'&) $3'& )!"! &er'+ '"3'& e!)r'!'! ?'"&) ()! +'-' #'-)r'! 4er!' '&') '"3'& e3e!&)"'! "$-e"#. "$-e"#. 3. I!&er'"# r$#e# +#&r3)# J"' +'-' +'r'( '+'+'-' #''& '! #''&er'+ &er+''& &e'& '!&'r' "'&'! '+' r$&e! -'#'. K$e&# )!&)" "'&'! 'r!'! #'-!'

+$! +'! ")!+! +e!'! '"3'& e!!"'&'! "'+'r -'#' +$!. 4. I!&er'"# '+' r$#e# e&'3$-#e I!&er'"# +'-' e&'3$-#e +''& &er'+ +e!'! +)'

"e)!"!'!, '"! e'4) e!@ '&') e!('3'& e!@. S)'&) $3'& re#&'! +''& e'4) e&'3$-#e $3'& -'! 7$3'& $3e"8 #e(!' eer4e'& e-!'#!' +. I!&er'"# '+' r$#e# e-!'# I!&er'"# '+' r$#e# e-!'# e-') !'- +''& &e'+

'"3'& er)3'('3 PH +'-' )r! '&') "'re!' er#'!'! &e'& "'&'! '+' ##&e

&r'! &r '!/$ /$r r'# '# '! 3e 3er/ r/)! )! # )! )!&) &)" " e" e"#" #"re re# #

 

INTERAKSI FARMAKODINAMIK  

I!&er'"# /'r'"$+!'" '+'-'( !&er'"# '!&'r' $3'&9$3'& '! e)!' "('#'& '&') e/e" #'! '! 3er-'?'!'!. I!&er'"# ! +#e3'3"'! $-e( "$e&# '+' re#e&$r '! #'', '&') &er'+'!&'r' $3'&9$3'& '! 3e"er' '+' ##&e =#$-$" '! #''



E/e" '! &er'+ '+' !&er'"# /'r'"$+!'", +'!&'r'!':

'. S!er#e I!&er'"# /'r'"$+!'" '! '-! )) &er'+ '+'-'( #!er#e '!&'r'

+)' $3'& '! 3e"er' '+' ##&e, $r'!, #e- '&') e!@ '! #'' +e!'! e/e" /'r'"$-$ '! #'' /'r'"$-$ 3. A!&'$!#e I!&er'"# &er'+ 3-' $3'& '! 3er!&er'"# e-" e/e" /'r'"$-$ '! 3er-'?'!'! #e(!' e!'"3'&"'! e!)r'!'! ('#- '! +!!"'! +'r #'&) '&') -e3( $3'&. 4. E/e" re#e&$r &+'" -'!#)! K$3!'# ! +''& 3e"er' e-'-) e"'!#e #'-!

ee!'r)( e/e" re#e&$r '! e-)& #r")-'# "e!+'- "e!+'- =#$-$ '&') 3$"' 3$" '

 

CONTOH INTERAKSI OAT 9 OAT

Cipro#oksasin $s %alsim "'-#) e!)r)!"'! '3# 4r$ Pe!'&'#'!: Cr$ Cr$ +!) +)-) 2 ' #e3e-) K'-#)

Aspirin $s cipro A#r! e!)r)!"'! e/e" 4r$

Cipro $s amiodarone K$3!'# "e+)'!' "e+)'!' eer3)r)" "e'+''! 'r&' 7e!!"'&'! !&er>'- T8

Amiodarone $s sim$astatin K$3!'# "e+)'!' e!!"'&"'! "e'+'! $'&(

 

CONTOH INTERAKSI OAT 9 PENYAKIT



A#r! '+'  &)"'" -'3)!  (!+'r C'-#) &+'" +re"$e!+'#"'! '+' e!+er&' ''- !'$+er'&e  Cr$ e!!+)"# &er'+!' re!'- 're!&  e!)r'!'! 

+$## '+ 250 , 2 #e('r

 

I NTERAKSI OAT CONTOH INTERAKSI OAT 9 MAKANAN

&etracyclines 'arfarin

and $itamin %"containing foods

(rapefrit Co*ea

and milk prodcts

)ice

+ith anti"hypertension drgs

 

LITERATUR 1.

2.

K$+'9K3-e MA  Y$)! LY 718 H'!#&e! '!+ H$r!# M'!'! C-!4'-- I$r&'!& Dr) I!&er'4&$!#, A-e+ T(er'e)&4#, I!4, V'!4$)>er K$+'9K3-e e& '- 72008 H'!+3$$" $/ A-e+ T(er'e)&4#, &( e+, L!4$&& --'#  -"!#, P(-'+e-('

M$@''! A  R'$! LP 7200*8 H'!+3$$" $/ Dr) I!&er'4&$!#9 A C-!4'- '!+ F$re!#4 G)+e, H)'!' Pre##, Ne? Jer#e *. R$+r)e# AD 720028 Dr)9Dr) I!&er'4&$!#, I! &er'4&$!#, T'-$r T'-$r  Fr'!4#, Ne?  Y$r"  Y $r" %.

5.

S&$4"-e IH 71*8 Dr) I!&er'4&$!#, % r+ e+, -'4"?e-- S4e!4e, L$!+$!

 

ESITE TOOLS  ???.'r@$!'4er&.$r

7+r) !&er'4&$!#8



???.+r)9!&er'4&$!#.4$ 7P*509e+'&e+ +r) !&er'4&$!#8  ???.&$r#'+e#.$r 7+r)9!+)4e+ 'rr(&('8  ???.e!!4er&.$r ???.e!!4er&.$r  7'!&3$&4#8  ???.+4r.+)"e.e+);re#e'r4(;=e-+#;4er&#.(&-

74'r+$>'#4)-'r

&(er'e)&4#8  ???.#(.)!4.e+);(e'-&($)&4$e#;4er&#;!+e.(& 7&(er'e)&4# ! e+'&r4#8  ???.)'3.e+)

7&(er'e)&4# $/ )#4)-$#"e-e&'- +#$r+er#8

 

Kesesuaian obat a. la lam ma terapi b. dosis (dosi (dosiss lazim, lazim, dosis dosis minimal, minimal, dosis dosis maksim maksimal, al, dosis dosis pemeliharaan, loading dose, dosis profilaksis) c. jumlah obat (Re (Resep sep terseb tersebut ut merupaka merupakan n regimen regimen terapi terapi atau atau bagian regimen terapi d. Ke Kegunaa gunaan n obat obat ( kuratif kuratif,, preventi preventif, f, simpto simptomatik matik )

 

DO! •

Dosis Sub terapi 

•



Kesalahan penetapan dosis Frekuensi pemakaian yang tidak tepat



Lama pemakaian yang tidak tepat



Penyimpanan tidak benar



Cara/rute penggunaan yang tidak benar

Dosis terlalu besar  

Kesalahan penetapan dosis



Frekuensi pemakaian tidak tepat



Lama pemakaian tidak tepat

 

"djusment dose "djusment dose # a. He Hepa pati ticc dis disffun unct ctio ion n Liver dysfunction may not only reduce the blood/plasma clearance of drugs eliminated by hepatic metabolism or biliary excretion, it can also affect plasma protein binding, which in turn could influence the  processes of distribution and elimination (er (erbeec!, beec!, "##$%.  b. &idney disease. 'hronic !idney disease affects renal drug elimination and other pharmaco!inetic processes involved in drug disposition (e.g., absorption, drug distribution, nonrenal clearance metabolism)% (&/D*+% (&/D*+% c. *bese patients 'lassical pharmaco!inetic parameters such as volume of distribution ( V d%, d%, clearance ('l% and protein  binding can change for some drugs in morbidly obese patients. Highly lipophilic substances such as

 barbiturates and ben-odia-epines show significant increases in

V d

for obese individuals (#xford ournal%

 

$%R&!'*" DO! a. +e +erd rdas asark arkan an +er +erat at +a +ada dan n lark-s rule Dosis "nak "nak +erat +adan (lb) 0 Dosis De1asa   234 berat badan bukan dalam kg, tapi lb dimana 2kg5,5lb

 

b. +erdasarkan mur 6oung-s rule (anak 7 8 th) Dosis "nak mur (tahun) 0 Dosis De1asa   mur925 anak : ;  8 th Dosis "nak (mur )0 Dosis De1asa   54 uas $ermukaan 'ubuh (+od= urface "rea) Rumus menghitung +" ?osteller +"  akar kuadrat dari tinggi badan (cm) 0 berat badan (kg)   @A44 Dosis "nak "nak ?osteller +" 0 Dosis De1asa   2,B@

 

?odifikasi skala Denekamp

 

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