You are on page 1of 21

FARMAKOLOGI

KLINIK

Rahmatini
Bagian Farmakologi &
Terapi Fakultas Kedokteran
Universitas Andalas

DEFINISI
WHO ( 1988)

Disiplin dalam bidang


kedokteran berdasarkan
prinsip ilmiah, menyatukan
keahlian farmakologi &
keahlian klinik dengan tujuan
meningkatkan manfaat &
keamanan obat

KONSEP

RESEPTOR

OBAT

EFEK
OBAT

KOMPLEK
O+R

KADAR OBAT
DALAM
PLASMA/SERUM

TUJUAN
FARMAKOLOGI KLINIK

Terapi Efektif, Aman , Rasional

RATIONAL DRUG USE


Ratio

Benefit Risk - Cost

F.Kinetika

F Dinamika

F Ekonomi

PHARMACOLOGICAL ASPECTS
IN CLINICAL PRACTICE
Pharmacokinetic

Pharmacodynamic

How drugs act


The dynamics of drug conc. in
the body

* Absorption / bioavailability
* Distribution
* Biotransformation
* Excretion

THERAPEUTIC DRUG
MONITORING (TDM)

Measuring the plasma drug conc.

Provide useful information about


the adequacy of the dosage
regimen or the likehood toxicity

Therapeutic Drug Monitoring (TDM)

Ph dynamic

Ph kinetic
Druginteraction
Measuring/
interpreting
plasma drug conc.

Therapeutic
response
Side effects
Toxic effects

Time-drug conc. relationship

Drug conc. (mg/l)

40

30

Drug toxicity

20

Therapeutic level
10

m.e.c

Low therapy
1

Time (hour)

Therapeutic Drug Monitoring (TDM)

1. Narrow margin of safety drugs


2. Drugs for prevention/ therapy of life threatening
diseases or life saving drugs
3. Difficulty in ditinguishing between the effects
of a disease and the toxic effects of a drug
4. Potent drugs drug amount is very small
5. Drugs that show variability of drug conc.
in plasma

Factors that modify drug plasma


concentration for a given dose

Drug formulation
Drug interaction
Environmental factors
Genetic variation
Renal and hepatic function

Reasons for monitoring


drug treatment

1. To see whether there is


therapeutic response
2. To assess drug toxicity
3. To assess compliance

Examples of difficulty in ditinguishing between


the effects of a disease and
the toxic effects of a drug
1.

Digoxin toxicity

Congest.Heart Failure

Nausea / anorexia / arrythmias


2.

Gentamycin toxicity

Gram () septicaemia

Renal damage

Drugs- plasma conc.

Pharmacokinetic parameters
Cmax (peak)

Half life
AUC 24
Time

Cmin
(trough)

Visualisation of half-life
Drug conc. (mg/l)

First order elimination of a drug (t : 2 hours)


20

10

The plasma conc. falls by half each half-life

5
2.5
2

Hours

Clinical application of half life (t)

* Designing drug dosage regimen


* Determining time to reach steady state
drug level which show clinical effect
* Determining time to reach the drug level
which have no clinical effect anymore

OBAT INDEK TERAPI LEBAR


BATAS DOSIS TERAPI DAN
DOSIS TOKSIK CUKUP LEBAR
RELATIF LEBIH AMAN
CONTOH:
PARASETAMOL
AMOKSISILIN
ASETOSAL dll

CONSIDERATION

Phkinetic

Phdynamic

Pheconomic

RATIONAL & GOOD CLINICAL THERAPY

TUGAS

CONTOH OBAT INDEK TERAPI LEBAR &


SEMPIT
FAKTOR FAKTOR YANG
MEMPENGARUHI RESPON PENDERITA
TERHADAP OBAT

Alhamdulillah

You might also like