1.

Sebelum makan (lansoprazol)

Obat lambung dikonsumsi sebelum makan
“Then therapy with omeprazole or lansoprazole is indicated, medication should be taken before a
meal for optimal control of daytime gastric acidity.”
Sumber: https://www.ncbi.nlm.nih.gov/pubmed/11012470

2. dosis furosemid untuk jantung coroner

Furosemide memang digunakan untuk Hipertensi dengan komorbid Jantung Koroner
we concluded that the optimal dose (20 mg/day furosemide)  tapi ini kombinasi spironolakton
Sumber:

a. https://www.ecrjournal.com/articles/diuretic-therapy-hf
b. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4774326/pdf/etm-11-03-0890.pdf
3. masa kerja insulin regular
Insulin Rapid
 onset aksi = 5-15 menit
 peak = 1- 2 jam
 durasi = 4 – 6 jam

Insulin Regular

 onset = ½ - 1 jam
 peak = 2 – 4 jam
 durasi = 6 – 8 jam
Sumber: https://dtc.ucsf.edu/types-of-diabetes/type2/treatment-of-type-2-diabetes/medications-and-
therapies/type-2-insulin-rx/types-of-insulin/

4. obat HT yg menyebabkan gonekomastia (spirono, thiazid, amlo, metoprolol)

Reserpine, methyldopa, and spironolactone are older drugs associated with gynecomastia;
however, calcium antagonists (more commonly), angiotensin-converting enzyme inhibitors, and
alpha1 blockers may also be associated with this finding.
Sumber: https://www.ncbi.nlm.nih.gov/pubmed/15860966

5. obat HT yg menyebabkan penurunan gula (glukokorticoid, acein, diuretik)

Indeed, ACE-I and ARBs have the most favorable effect on insulin resistance and the
development of T2DM. Moreover, CCBs have an overall neutral metabolic effect
Sumber: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110601/

6. masih bisa memproduksi insulinv, OHO nya apa?

7. Pt inr (warfarin)

The goal of warfarin therapy is to decrease the clotting tendency of blood, not to prevent clotting
completely. Therefore, the effect of warfarin must be monitored carefully with blood testing. On
the basis of the results of the blood test, your daily dose of warfarin will be adjusted to keep your
clotting time within a target range. The blood test used to measure the time it takes for blood to
clot is referred to as a prothrombin time test, or protime (PT). The PT is reported as the
International Normalized Ratio (INR).Sumber: https://www.heart.org/en/health-
topics/arrhythmia/prevention--treatment-of-arrhythmia/a-patients-guide-to-taking-warfarin

8. Es digoksin (bradikardi)

Thirty-six patients were noted to develop cardiac arrhythmias which were attributed to digoxin.
Bradycardia (ventricular rate < 55/min) was observed in 26 individuals (16 cases of slow atrial fibrillation
and 10 cases of sinus bradycardia). Frequent ventricular ectopic beats occurred in 4 cases, atrial
tachycardia in 4 cases, nodal rhythm in one case and complete atrio-ventricular dissociation in one case.

Sumber: https://pmj.bmj.com/content/57/668/358.short

9. indeks terapi sempit (digoksin)

Pasien yang menerima obat dengan risiko tinggi seperti :

i. obat dengan indeks terapi sempit (contoh: digoksin,fenitoin)
Sumber:

Panduan PTO Dirjen Farmasi Kemenkes RI

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&cad=rja&uact=8&ved=2ahUK
Ewioh6qGnr7kAhXBOo8KHbTrAJ8QFjACegQIAxAC&url=http%3A%2F%2Ffarmalkes.kemkes.go.id%2F%3F
wpdmact%3Dprocess%26did%3DMTg1LmhvdGxpbms%3D&usg=AOvVaw3fbAtjud4N3GXZ8qai4cez
10. selektif beta 1 beta 2 (propanolol)

Sumber:
https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=18&ved=2ahUKEwiJgvb_n77kAh
WFbX0KHfpDCJEQFjARegQIBhAC&url=http%3A%2F%2Fwww.jocpr.com%2Farticles%2Fblockers-a-
systematic-review.pdf&usg=AOvVaw3tHrIJGNIgEH9EWHu2WC3O

https://pdfs.semanticscholar.org/2e02/d6b1d2d48a48088519121a3ace84d5cd3ed6.pdf

11. penyebab hipertiroid primer kecuali? (iodine defisiensi, latrogenis Hypotiroid, hashimoto, pituitary)

Hipertiroid:

Primer:

 Thyroid nodules
 Thyroid adenoma
 Graves’ disease
 Thyroiditis

Sekunder :

 Carcinoma
 TSH-secreting tumors
 TRH-secreting tumors

Sumber: https://www.labce.com/spg864464_hyperthyroidism_primary_versus_secondary.aspx

12.Vasodilator (propanolol, reserpine, diuretik)

Alpha-antagonists, colloquially known as alpha blockers, work in the peripheral vasculature and inhibit
the uptake of catecholamines in smooth muscles cells resulting in vasodilation and blood pressure
lowering. Alpha-antagonists including doxazosin prazosin, and phentolamine - are primarily used in the
treatment of hypertension and urinary retention

Vasodilator = α1-adrenergik blocker contoh Alfuzosin, Tamsulosin, Doxazosin, Terazosin, Silodosin,

Prazosin, Doxazosin, Terazosin

Sumber: https://www.ncbi.nlm.nih.gov/books/NBK539830/

13. yg paling aman buat hamil? (metildopa)

Rekomendasi WHO: hydralazine, calcium channel blockers (nifedipine, nimodipine, nicardipine and
isradopine), labetalol, methyldopa, diazoxide, prostacyclin, ketanserin, urapidil, magnesium sulfate,
prazosin and isosorbide

Sumber: https://extranet.who.int/rhl/topics/preconception-pregnancy-childbirth-and-postpartum-
care/antenatal-care/who-recommendation-antihypertensive-drugs-women-severe-hypertension-
during-pregnancy

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4558097/pdf/nihms716228.pdf

14.yang gaboleh buat ibu hamil? (ramipril, nifedipin)

ACE inhibitors, angiotensin II receptor blocker, spironolakton, renin-inhibitors
Sumber: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4558097/

15.uji klinis efektivitas dan efek samping (uji klinis fase 1,2,3)

Fase 1: orang sehat untuk mengetahun rentang dosis

Fase 2: pada pasien untuk mengetahui efikasi dan efek samping

Fase 3: pada pasien untuk mengetahui efikasi, efektivitas dan keamanan

Fase 4: postmarket, pasien untuk mengetahui efikasi dan keamanan

Sumber: https://www.fda.gov/patients/drug-development-process/step-3-clinical-research

16. warfarin minumnya kapan? (pagi, siang, malam, pagi dan sore)

Warfarin diberikan pagi dan malam

“Given that vitamin K interferes with the effectiveness of warfarin, it is conceivable that matching the
time of greatest warfarin activity to the period of most consistent vitamin K availability (i.e., taking
warfarin at breakfast) might lead to greater stability in warfarin's anticoagulant effect.:

Jadi paling disarankan pagi

Sumber: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4973068/

https://clinicaltrials.gov/ct2/show/NCT02376803

17.gol statin yang bisa sambil makan? (ator, rosu, fluvas,)

Rosuvastatin (Crestor): Crestor comes in tablet form. The manufacturers advise taking it once a day by
mouth, with or without food.

18. metformin (saat makan)

Saat makan, tetapi optimal 5 menit sebelum makan sebagai estimasi produksi glukosa hepatic dan
insulin sebelum makan

“ 5 minute intervals for estima- tion of hepatic glucose production (HGP) “

Sumber: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1445-5994.1991.tb01375.x

19.sakit kepala, gastritis (PCT)

PCT (Acetaminophen)

Switching from aspirin or NSAIDs to another pain reliever may help as well. Acetaminophen (Tylenol,
Panadol) is not known to cause gastritis.

Sumber: https://www.emedicinehealth.com/gastritis/article_em.htm
20. bisa nurunin HBA1C 2% (insulin+alfa glukoksidase, metformin+sulfonil)

The 2 available TZDs, pioglitazone and rosiglitazone, are approved for use in combination with MET,
SFUs, glinides, and insulin. These drugs have been shown to produce similar reductions in HbA1c of
approximately -1.6%, with reductions ranging from -1.2% to -2.3% over 3-12 months of therapy
[20,21,38-41]Sumber: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2940872/

21. meningkatkan sensitivitas insulin (glitazon, glinid, akarbose)

Biguanid: (metformin) Biguanides are old agents that work by reducing hepatic glucose output and, to a
lesser extent, enhancing insulin sensitivity in hepatic and peripheral tissues

Sulfonilurea: In contrast, the secondgeneration sulfonylureas (glipizide, gliclazide, glibenclamide, called

also glyburide) and glimepiride are widely employed worldwide. They work by stimulating insulin release
from the insulin secreting ßcells located in the pancreas

Meglitinid dan Turunan Fenilalanin: Mekanisme Kerja adalah meningkatkan sintesis dan sekresi insulin
oleh kelenjar pankreas (biasanya dikombinasikan dengan antidiabetik lain).

Contoh obat: Repaglinid, Nateglinid

Sumber:

22.yang mempengaruhi efek dan toksisitas obat (waktu paruh, ikatan protein, waktu oengosongan
lambung, klirens)

23. waktu paruh? (absorbsi, eliminasi, eksresi)

The elimination half-life of a drug is a pharmacokinetic parameter that is defined as the time it
takes for the concentration of the drug in the plasma or the total amount in the body to be
reduced by 50%. In other words, after one half-life, the concentration of the drug in the body
will be half of the starting dose.

24. fraksi terabsorbsi 1 artinya apa? (terabsorpsi sempurna, 1%, tidak terabsorpsi)

Obat terabsorpsi sempurna

Sumber: https://pdfs.semanticscholar.org/8fd3/31d3171d65105d038032e8144789f71401cd.pdf

25. Komplikasi mikrovaskukar DM (retinopathy)

Diabetes is a group of chronic diseases characterized by hyperglycemia. ... Generally, the injurious
effects of hyperglycemia are separated into macrovascular complications (coronary artery disease,
peripheral arterial disease, and stroke) and microvascular complications (diabetic nephropathy,
neuropathy, and retinopathy).

Sumber: https://clinical.diabetesjournals.org/content/26/2/77

26. Amlodipin pagi, simvastatin malam

Amlodipin pagi: Morning administered amlodipine had a better effect on the circadian BP compared with
evening administrated amlodipine in mild-to-moderate essential hypertension

Sumber: https://www.ncbi.nlm.nih.gov/pubmed/14618095

27. Sublingual (ISDN)

28. Efek batuk kaptopril (meningkatkan bradikinin)

the production of which may be stimulated by bradykinin

Sumber:

https://www.ncbi.nlm.nih.gov/pubmed/16428706

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340691/

29.

30.