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LABORATORIUM ILMU FARMASI

FAKULTAS KEDOKTERAN UNIVERSITAS


ISLAM MALANG
2014
Tugas Farmasi
04 April 2014
Pembimbing:
Yudi Purnomo, S.Si, Apt,
M.Kes
1.Gastro-Intestinal System
1.1 Dyspepsia and gastro-
oesophageal reflux disease
1.1.1 Antacids and simeticone
Magnesium trisilicate
Mixture
SF
(Contains about 6mmol of sodium in 10ml,
laxative)
Co-magaldrox
Suspension
SF
195/220 (low sodium, bowel neutral)

1.1.2 Compound alginates and proprietary
indigestion preparation
Gaviscon Advance
Liquid (Contains 4.6 mmol of sodium in 10ml, plus 2
mmol of potassium)
Tablets (Contains 2.25 mmol of sodium per tablet,
plus 1 mmol of potassium)
Gaviscon Infant
Oral powder
SF
(Contains 0.92 mmol of sodium per
dose)

1.2 Antispasmodics and other drugs
altering gut motility
Antimuscarinics
Dicycloverine Hydrochloride
Syrup 10mg/5ml
Hyoscine butylbromide
Injection 20mg in 1ml
Tablets 10mg
Antispasmodics
Mebeverine
Tablets 135mg

Drugs altering gut motility
Metoclopramide
Tablets 10mg
Syrup 5mg/5ml
Injection 10mg/2ml
Domperidone
Tablets 10mg
Suspension 5mg/5ml
Suppository 30mg

1.3 Antisecretory drugs and mucosal
protectants
1.3.1 H2receptor antagonists
Ranitidine
Tablets 150mg, 300mg
Effervescent tablets 150mg, 300mg
Syrup 75mg/5ml
Injection 50mg in 2ml

1.3.3 Chelates and complexes
Sucralfate
Tablets 1g
Oral Suspension 1g in 5ml
1.3.4 Prostaglandin analogues
Misoprostol
Tablets 200 micrograms

1.3.5 Proton Pump Inhibitors (PPIs)
Omeprazole
Capsules 10mg, 20mg, 40mg
Dispersible tablets 10mg, 20mg, 40mg
Lansoprazole
Capsules 15mg, 30mg
Dispersible tablets 15mg, 30mg
Pantoprazole
Tablets 20mg, 40mg
Injection 40mg
Esomeprazole
Tablets 20mg, 40mg

1.4 Acute diarrhoea
1.4.2 Antimotility drugs
Loperamide
Capsules 2mg
Oral Syrup
SF
1mg/5ml
Orodispersible Tablets 2mg (For reducing stoma
output in ileostomy patients with high stoma output
of greater than 2L over 24 hours only. Hospital
prescribing and supply)
Codeine phosphate
Tablets 15mg, 30mg
Syrup 25mg/5ml

1.5 Chronic bowel disorders
1.5.1 Aminosalicylates
Mesalazine
Asacol

MR tablets 400mg, 800mg


Mezavant

XL tablets 1.2g
Pentasa

tablets 500mg
Foam enema 1g
Suppositories 500mg, 1g
Sulfasalazine
Tablets e/c 500mg

1.5.2 Corticosteroids
Budesonide
Capsules - Enteric coated granules 3mg
Capsules - Modified release 3mg
Hydrocortisone
Foam enema 10%
Prednisolone
Tablets (non-enteric coated) 1mg, 5mg, 25mg
Retention enema 20mg
Rectal foam 20mg
Suppositories 5mg

1.5.3 Drugs affecting the immune
response
Azathioprine U
Tablets 25mg, 50mg
Neoral

(ciclosporin) U
Capsules 10mg, 25mg, 50mg, 100mg
Oral solution 100mg/ml
Mercaptopurine U
Tablets 50mg
Methotrexate U
Tablets 2.5mg

1.6 Laxatives
1.6.1 Bulkforming laxatives
Ispaghula husk N
Sachets 3.5g

1.6.2 Stimulant laxatives
Bisacodyl N
Tablets 5mg
Suppositories 5mg (paed),
10mg
Senna N
Tablets 7.5mg sennosides
Syrup 7.5mg sennosides in
5ml
Docusate sodium N
Capsules 100mg
Paediatric oral solution
12.5mg/5ml,
Adult oral solution
50mg/5ml
Glycerol N
Suppositories 1g, 2g, 4g
Co-danthramer N
Capsules 25/200
Suspension 25/200 in 5ml

1.6.3 Faecal softeners
Arachis oil enema N
Enema 130ml
1.6.4 Osmotic laxatives
Lactulose N
Solution
Liquid Paraffin & Magnesium Hydroxide
Oral emulsion
Macrogol oral powder, compound

N
Sachets
e.g. Laxido, Movicol
Movicol

Paediatric Plain
Sachets
Phosphate N
Enema 128ml
Sodium citrate N
Micro-enema 450mg

1.6.5 Bowel cleansing solutions

Picolax


Oral powder
Klean-Prep


Oral powder

1.6.6 Peripheral opioidreceptor
antagonists

Methylnaltrexone bromide
NICE TA277: Methylnaltrexone for treating opioid-
induced bowel dysfunction in people with advanced
illness receiving palliative care (terminated
appraisal)March 2013
NICE is unable to recommend the use in the NHS of
methylnaltrexone for treating opioid-induced bowel
dysfunction in people with advanced illness receiving
palliative care because no evidence submission was
received from the manufacturer of the technology.

1.6.7 5HT4 Receptor Agonists

Prucalopride
Tablets 1mg, 2mg

1.7 Local preparations for anal and
rectal disorders
1.7.1 Soothing haemorrhoidal preparations
Anusol


Cream, 23g
Suppositories


1.7.2 Compound haemorrhoidal
preparations with corticosteroids

Scheriproct


Suppositories
Ointment

1.7.3 Rectal sclerosants

Phenol, oily
Injection 5% in 5ml

1.7.4 Management of anal fissures

Glyceryl Trinitrate
Rectogesic

Ointment 0.4% (Maximum duration of
use - 8 weeks)

Diltiazem Ointment U
Only when treatment with GTN ointment has failed

Botulinum Toxin A U
Injection 100units / vial (Xeomin)

1.9 Drugs affecting intestinal
secretions
1.9.1 Drugs affecting biliary composition and
flow
Ursodeoxycholic acid
Capsules 250mg
Suspension 250mg/5mL

1.9.2 Bile acid sequestrants

Colestyramine
Powder 4g sachet

1.9.4 Pancreatin

Creon


Capsules 10,000
Capsules 25,000 (High strength)
Capsules 40,000 (High strength)
Creon

Micro
20G Granule pack

Thank You
2.CARDIOVASCULAR SYSTEM
2.1 POSITIVE INOTROPIC DRUG
2.1 Positive Inotropic Drug (Bipiridin)
2.1.1 Cardiac Glycosides (digoxin)
2.1.2 phospodiesterase inhibitor (exoximone,
milrinore)

2.2 Diuretics
2.2.1 Thiazides and releted diuretic
(Hidroklorotiazid)
2.2.2 loop diuretics (Furosemid, bumetanide)
2.2.3 potassium sparring diuretics (Amilorid )
2.2.4 potassium sparring diuretics with other
diuretic (amiloride, triamteren)



2.3. ANTI ARRHYTHMIC DRUG
2.3.1 Drugs for arrhytmia (qinidin sulphate)
2.4 Beta-adrenoceptor blocking drugs
(propanolol, atenolol)

2.5 Drug Effecting the renin-angiotensin system
and some other antihypertensive drug
2.5.1 Vasodilator anti hypertensive drug (Hidralazin, minoxidil
)
2.5.2 centrally acting anti hypertensive drug (klonidin,
metildopa)
2.5.3 adrenergic neurone bloking group (reserpin, guanetidin)
2.5.4 Alpha adrenoceptor blocking drugs (prazosin, doxazosin)
2.5.5 drugs affecting the renin angiotensin system
2.5.5.1 angiotensin converting enzyme inhibitor(captopril,
lisinopril, ramipril)
2.5.5.2 angiotensin II receptor antagonist (valsartan)
Cont
2.5.6 Ganglion blocking drugs (trimetafan)
2.5.7 Tyrosine hydroxylase inhibitor (trimetaphan)

2.6 Nitrate, Ca Channal Blocker and Potassium activator
2.6.1 Nitrate(ISDN)
2.6.2 Ca Channel blocker (amlodipin, nifedipin)
2.6.3 potassium channel blocker (amiodaron, dofetilide)
2.6.4 peripheral and cerebral vasodilator
2.6.4.1 peripheral vasodilator and related drugs
(Minoxidil)
2.6.4.2 cerebral vasodilation (nitrixe oxide)
2.7 SYMPATHOMIMETIC
2.7.1 Inotropic Sympathomimetic (dopamin,
dobutamin, isoprenasin)
2.7.2 vasoconstriction Sympathomimetic
(noradrenalin, norepinephrine)
2.7.3 cardiopulmonary recucitation (adrenalin,
amiodaron, atropin)


2.8 anticoagulant and protamine
2.8.1 Parenteral anticoagulants (heparin)
2.8.2 oral anticoagulants (aspirin, sulfinpirazon,
dipiridamol)
2.8.3 Protamin sulphate (u/ menetralkan
antikoagulan heparin, ex: Protamin sulphate )

2.9 antiplatelet drug (Aspirin, clopidogrel)

2.10 Myocardial Infarction and
fibrinolisis
2.10.1 Fibronolytic drugs (streptokinase,
urokinase)
2.11 antifibrinolytic drug and hemostatics (asam
traneksamat)
2.12 Lipid regulation drugs (simvastatin)
2.13 local sclerosants (sodium tetradecyl
sulphate )
TERIMAKASIH

3. Respiratory system
1. Bronkodilator
1.1 Adenoreseptor agonis (Bronkodilatasi)
ex : Noradrenaline, phenylephrine, xylometazoline. (Alfa 1
agonist)
1.2 Selective beta blocker
ex : Salbutamol, Folmeterol, terbutaline
1.3 Other adenoreseptor agonist
ex : Alfa 2 agonist (Agmatine, clonidine, xylazine
dexmedetomidine.
1.4 antimuscarinic bronkodilator (menghambat asetilkolin)
ex : Atropin, lipratopium bromide
1.5 Theophyline (golongan metilxantin, menghambat enzim
fosfodiesterase)
Other preparations
Aminophylline injection
Caffeine citrate oral solution
Caffeine citrate intravenous injection
1.6 Coumpound broncodilator preparations
ex : salbutamol
1.7 Peak flow meter, inhaler devices and nebuliser.
ex : Nebuchamber
,
Volumatic
,
AeroChamber Plus
,
Pari
Vortex






2. Cortocisteroid (relaksasi otot polos jalan nafas)
ex : Methylprednisolone, prednison
3. Cromoglicate, related therapy and leukotriens
reseptor antagonist
3.1 Cromoglicate, related therapy
ex : Cromolyn Dan Nedocromil
3.2 leukotriens reseptor antagonist (menurunkan
reaktivitas bronkus, edema, hipersekresi)
ex : Zafirlukost, montelukost, zileuton

4. Antihistamin, hiposensitisation, and allergic emergency
4.1 Antihistamine
Non-sedating antihistamines should be offered first line
to all patients, especially children and adolescents.
(Cetirizine, Fexofenadine, loratadine)
Sedating antihistamin
(Chlorphenamine (chlorpheniramine), Alimemazine (trim
eprazine), Hydroxyzine
4.2 Allergic immunotherapy (ex : Omalizumab)
4.3 Allergic emergency
ex : Adrenaline injection
5. Respiratory stimulant and pulmonary surfactant
5.1 Respiratory stimulant (ex : doxapram)
5.2 Pulmonary surfactant (ex : poractant)
6. Oxygen
7. Mucolytics
ex: Bromhexine, N-acetylcystein, Ambroxol
8. Aromatic inhalation
ex : Aromatic ammonia
9. Cough preparations
9.1 Cough suppresant
ex : Codein, DMP
9.2 Expectorant and demulcent preparation
ex : Doveri, glyceril guaiacolate, potio nigra conta
tussim
10. Systemic nasal decongestant
ex : Pseudoefedrin, efedrin

4.CENTRAL NERVOUS SYSTEM
1. Hipnotik & Anxiolitik
Hipnotik Golongan obat yang dapat menyebabkan
kantuk dan memudahkan seseorang tertidur. Ex:
Valium/Diazepam, Lorazepam, Midazolam, Alprazolam
Anxiolitik: Benzodiazepin, non-Benzodiazepin (Buspiron)
Barbiturat: Dietilbarbiturat, Fenobarbital, Tiopental,
Pentobarbital

2. Psikosis
Antipsikotik: Chlorpromazine, Halloperidol, Risperidon
Antimanik: Litium Carbonat, Karbamazepin

3. Antidepresan
Trisiklik: Amitriptilin, Imipramin
Monoamine-Oxidase Inhibitor (MAOI): Moclobemide
Selective Serotonin Reuptake Inhibition (SSRI): Sentralin,
Fluvoxamin, Fluoxetin, Paroxetin
Antidepresan lain: Trazodon, Mianserin, Maprolitin
4. Central Nervous System Stimulants
Amfetamin
Dekstroamfetamin
Metamfetamin
MDMA (ecstasy)
Metilfenidat
Pemolin

5. Drugs used in the tratment of obesity
5HT (5 hidroksi triptofan)
reuptake norepinephrine inhibitor (sibutramine)
Stimulan (methylphenidate)
lipase inhibitor (orlistat)
agonist serotonin (phentermine)
6. Drugs used in nausea and vertigo
Betahistin Dihidroklorida
Meklizin
Dimenhidrinat
Perfenazin
Skopolamin (emplastrum)

7. Analgesik
Non-opioid: Parasetamol, Asetosal
Opioid: Morfin, Heroin, Kodein, Petidin, Metadon
Neuropatic pain: Natrium Diklofenak, Meloxicam
Antimigrain: Ergotamin, Caffein, Flunarizine, Cinnarizine
8. Antiepileptik
Control of epilepsy: Fenitoin, Fenobarbital, Karbamazepin,
Diazepam, Klorazepam, Klobazam, Asam Valproat
Status epileptikus: Diazepam, Fenitoin, Fenobarbital
Febril Konvulsi: Diazepam, Fenobarbital

9. Drugs used in Parkinsonism
Dopaminergik sentral: Levodopa, Bromokriptin, Carbidopa
Antimuskarinik: oxybutynin klorida, tolterodine, trospium
klorida, darifenacin, fesoterodine fumarat
Mengurangi gejalan Parkinson: Pramipexole (untuk
mengurangi gejala dari Parkinson seperti tremor, kekakuan
dan gerak yang lambat)

10. Drugs used for Dementia
Galatamin
Rivastigmin
Donepezil
Pentoxifilin
Piracetam
Ginkogiloba

5.ANTIBIOTIK
ANTIBACTERIAL DRUGS
Penicillins
Benzypenicillin and phenoxymethyplenicillin
Benzylpenicillin, Phenoxymethylpenicillin (Penicillin
V), Benzathine benzylpenicillin, Procaine
benzylpenicillin
Penicillinase-resistant penicillins Flucloxacillin
Broad-spectrum penicillins Amoxicillin, Co-
amoxiclav
Antipseudomonal penicillins Piperacillin with
Tazobactam
Mecillinams Pivmecillinam
Cephalosporins Cefalexin, Cefotaxime,
Cefixime, Ceftazidime, Ceftriaxone,
Cefuroxime
Tetracyclines Oxytetracycline, Doxycycline
Aminoglycosides Gentamicin, Tobramycin,
Neomycin sulphate
Macrolides Clarithromycin, Erythromycin,
Azithromycin
Clindamycin Clindamycin
Some other antibacterials Vancomycin,
Sodium fusidate, Chloramphenicol
Sulphonamides and trimethoprim
Trimethoprim, Co-trimoxazole, Sulfadiazine

Antituberculous drugs Rifampicin,
Isoniazid, Ethambutol, Pyrazinamide,
Streptomycin
Antileprotic drugs Dapsone
Metronidazole Metronidazole
Quinolones Ciprofloxacin
Urinary-tract infections Nitrofurantoin,
Fosfomycin
ANTIFUNGAL DRUGS
Triazole antifungals Fluconazole,
Itraconazole, Voriconazole
Imidazole antifungals Ketoconazole
Polyene antifungals Amphotericin
Echinocandin antifungals Caspofungin
ANTIVIRAL DRUGS
HIV infection Stribild
Herpes virus infections
Herpes simplex and varicella-zoster infection
Aciclovir, Valaciclovir
Cytomegalovirus (CMV) infection Valganciclovir
Viral hepatitis Adefovir dipivoxil, Entecavir,
Tenofovir disoproxil, Boceprevir, Telaprevir
Influenza Oseltamivir, Zanamivir
Respiratory syncytial virus (RSV) Palivizumab

ANTIPROTOZOAL DRUGS
Antimalarials Doxcycycline, Quinine
sulphate, Quinine dihydrochloride,
Artesunate, Clindamycin, Pyrimethamine/
Sulfadoxine, Artemether with lumefantrine,
Chloroquine sulphate, Primaquine
Amoebicides Metronidazole
Trichomonacides Metronidazole
Antigiardial drugs Metronidazole
Leishmaniacides Sodium stibogluconate
Trypanocides
Drugs for toxoplasmosis Pyrimethamine,
Sulfadiazine
Drugs for pneumocystis pneumonia Co-
trimoxazole, Pentamidine isetionate

ANTIHELMINTICS DRUGS
Drugs for treadworms Mebendazole, Piperazine
Ascaricides Mebendazole, Levamisole
Drugs for tapeworm infections Niclosamide,
Praziquantel
Drugs for hookworms Mebendazole
Schistosomicides Praziquantel
Filaricides Diethylcarbamazine, Ivermectin
Drugs for cutaneous larva migrans Tiabendazole,
Albendazole
Drugs for strongyloidiasis Albendazole, Ivermectin
6. Endocrine system Drugs
Drugs used in diabetes
Insulin
Type of Insulin &
Brand Names
Onset Peak Duration
Role in Blood
Sugar
Management
Rapid-Acting
Humalog or lispro 15-30 min. 30-90 min 3-5 hours
Rapid-acting insulin
covers insulin
needs for meals
eaten at the same
time as the
injection. This type
of insulin is often
used with longer-
acting insulin.
Novolog or aspart 10-20 min. 40-50 min. 3-5 hours
Apidra or glulisine 20-30 min. 30-90 min. 1-2 hours
Short-Acting
Regular (R)
humulin or novolin
30 min. -1 hour 2-5 hours 5-8 hours
Short-acting insulin
covers insulin
needs for meals
eaten within 30-60
minutes
Velosulin (for use in
the insulin pump)
30 min.-1 hour 2-3 hours 2-3 hours
Intermediate-Acting
NPH (N) 1-2 hours 4-12 hours 18-24 hours
Intermediate-acting
insulin covers
insulin needs for
about half the day
or overnight. This
type of insulin is
often combined
with rapid- or short-
acting insulin.
Long-Acting
Long-acting insulin
covers insulin
needs for about
one full day. This
type of insulin is
often combined,
when needed, with
rapid- or short-
acting insulin.
Lantus (insulin
glargine)
1-1 hour
No peak time;
insulin is delivered
at a steady level
20-24 hours
Levemir (insulin
detemir)
1-2 hours 6-8 hours Up to 24 hours
Pre-Mixed*
Humulin 70/30 30 min. 2-4 hours 14-24 hours
These products are
generally taken two
or three times a day
before mealtime.
Novolin 70/30 30 min. 2-12 hours Up to 24 hours
Novolog 70/30 10-20 min. 1-4 hours Up to 24 hours
Humulin 50/50 30 min. 2-5 hours 18-24 hours
Humalog mix 75/25 15 min. 30 min.-2 hours 16-20 hours
*Premixed insulins are a combination of specific proportions of intermediate-acting and short-acting
insulin in one bottle or insulin pen (the numbers following the brand name indicate the percentage of
each type of insulin).
Oral Antidiabetics drugs
Golongan Senyawa Mekanisme Kerja
Sulfonilurea Gliburida/Glibenkla
mida
Glipizida
Glikazida
Glimepirida
Glikuidon
Merangsang sekresi insulin di
kelenjar pankreas, sehingga hanya
efektif pada penderita diabetes yang
sel-sel pankreasnya masih
berfungsi dengan baik
Meglitinida Repaglinide Merangsang sekresi insulin di
kelenjar pankreas
Turunan
fenilalanin
Nateglinide Meningkatkan kecepatan sintesis
insulin oleh pankreas
Biguanida Metformin Bekerja langsung pada hati (hepar),
menurunkan produksi glukosa hati.
Tidak merangsang sekresi insulin
oleh kelenjar pankreas
Tiazolidindion Rosiglitazone
Troglitazone
Pioglitazone
Meningkatkan kepekaan tubuh
terhadap insulin. Berikatan dengan
PPAR (peroxisome proliferator
activated receptor-gamma) di otot,
jaringan lemak, dan hati untuk
menurunkan resistensi insulin
Inhibitor -
glukosidase
Acarbose
Miglitol
Menghambat kerja enzim-enzim
pencenaan yang mencerna
karbohidrat, sehingga
memperlambat absorpsi glukosa ke
dalam darah
Terapi hipoglikemia

1. Segera mengkonsumsi pisang atau roti atau karbohidrat kompleks
lainnya
2. Bisa juga menggunakan teh gula, air gula kental atau madu yang
dimasukkan di bawah lidah.
3. Jika penderita tidak sadar, injeksi glukosa 40% Intra vena 25 ml
(encerkan 2x dengan aqua injeksi) juga infus glukosa 10% atau
Dekstrose 10%. Bila belum sadar dapat diulang 25 cc glukosa 40%
setiap 30 menit. Dapat diulang sampai 6x sampai penderita sadar. 1
flakon D40% 24 meq dapat menaikkan kadar gula darah 25-50
mg/dl. Periksa Gula Darah Sewaktu 30 menit setelah Intra vena
terakhir.
4. injeksi efedrin 25-50 mg (bila tdk ada kontra indikasi jantung pada
jantung) atau glukagon 1 mg Intra muskuler.
5. Sementara obat anti diabetes dihentikan dulu.

Treatment of hypoglicemic
Nephropathy
1. Istirahat
2. Diet
Diet disesuaikan dengan kebutuhan penderita, 35
Kcal/kgBB/hari
Protein dibatasi 0,8 g/kgBB/hari bila ada albuminur
ACEI/ACEI+antagonis kalsium bila ada hipertensi
3.Medikamentosa
Obat pertama :
Insulun, bila gula darah tidak terkontrol dengan diet
4.Hemodialis
5.Transplantasi ginjal

Treatment of diabetic nephropathy and
neuropathy
Diagnostic and monitoring agents
Laboratory Tests in the Diagnosis and Management of Hyperglycemic
Emergencies
Plasma glucose Sodium
SUN Potassium
Creatinine Bicarbonate
Ketone bodies Chloride
Osmolality Blood pH
Criteria for the Diagnosis of Diabetes
Symptoms of diabetes and a casual plasma glucose > 200 mg/dl. Casual is defined as any
time of day without regard to time since last meal. The classic symptoms of diabetes
include polyuria, polydipsia, and unexplained weight loss
OR
FPG 126 mg/dl. Fasting is defined as no caloric intake for at least 8 h. Should be
repeated on a separate occasion.
OR
2-h plasma glucose 200 mg/dl during an OGTT. The test should be performed as
described by the World Health Organization, using a glucose load containing the equivalent
of 75 g anhydrous glucose dissolved in water.
OR
A1C 6.5%. The test should be performed in a laboratory using a method that is NGSP
certified and standardized tot he DCCT assay.
Thyroid and Antithyroid Drugs
Thyroid hormones
Antithyroid drugs

ANTITIROID



Proses dihambat Contoh
Transport I- Perchlorat, fluoborat, SCN
Iodinasi tiroglobulin Thionamid, PTU, Mtimazol
Reaksi Coupling Thionamid, Sulfonamid
Pelepasan Hormon Garam Li, Iodida
Deiodinasi iodotirosin Nitrotirosin
Deiodinasi periver Der. TU, Amiodaron
Corticosteroid
corticoteroids Compared
Type Drug Equivalent
Doses
Relative
Glucocorticoid
Potency
Relative
Mineralocorticoi
d Potency
Short-acting.
Biological half
life*:
8-12 hours
Cortisol
Hydrocortisone
20 mg
25 mg
1
0.8
2
2
Intermediate-
acting.
Biological half
life:
18-36 hours
Prednisolone
Triamcinolone
Methylprednisolo
ne
5 mg
4 mg
4 mg
4
5
5
1
0
0
Long-acting.
Biological half
life:
36-54 hours
Dexamethasone
Betamethasone
0.75 mg
0.75 mg
25-50
25-50
0
0
Mineralocorticoi
ds
Aldosterone
Fludrocortisone
0.3 mg
2 mg
0
15
300
150
*Duration of adrenocorticotrophic hormone (ACTH) suppression after a single dose of the drug.
Sex Hormones
Hormone Function
Progesterone Prepares uterus to receive conceptus
Maintains uterus during pregnancy
Stimulates growth of mammary glands
Regulates secretion of LH and FSH

Androgens Required for spermatogenesis
Induce and maintain secondary sex characteristics of males
Regulate secretion of LH and FSH
Promote increase in muscle mass and tone

Estrogens Necessary for oogenesis
Stimulates growth and activity of mammary glands
Stimulate growth of uterus
Induce and maintain femal body shape and fat distribution
Regulate secretion of LH and FSH
Required for skeletal maturation and bone mineralization in
male and females
Reproductive hormones
Hormone Primary Source
Steroid Hormones
Progestins Ovary, Placenta
Androgens Testis
Estrogens Ovary, Placenta
Protein Hormones
FSH Anterior Pituitary
LH Anterior Pituitary
Prolactin Anterior Pituitary
hCG Placenta
Peptide Hormones
GnRH Hypothalamus, Placenta
Oxytocin Posterior Pituitary
Natural
Hormone
Agonist Antagonist Use
Progesterone Levonorgestrel Contraceptive
RU-486 Abortifacient
Estrogen Mestranol Contraceptive
Raloxifene Breast Cancer
-endorphin Naloxone
Male erectile
dysfunction
Examples of Reproductive Hormone Agonists and Antagonists
Hormone replacement therapy (HRT) replaces two female
hormones that a womans body is no longer producing due
to menopause. These hormones are:
oestrogen: the oestrogen used in HRT is taken from plants or from
the urine of pregnant horses
progesterone: HRT uses a synthetic version of progesterone
called progestogen because it is easier for the body to absorb
While there are more than 60 different preparations of HRT, the three
main types are discussed below.
Oestrogen-only HRT
Oestrogen-only HRT is usually recommended for women who have
had their womb and ovaries removed during a hysterectomy. There
is no need to take progestogen because there is no risk
ofendometrial cancer (cancer of the lining of the womb).

Oestrogen and HRT
Jenis Kontinyu Dosis
Estrogen konjugasi Oral 0.3-0.4 mg
17 estradiol
Oral 1-2 mg
Transdermal 50-100 mg
Subkutan 25 mg
Estradiol valerate Oral 1-2 mg
Estradiol Oral 0,625-1,25
Dosis Anjuran Sulih Estrogen
Dosis Anjuran Sulih Progesteron
Jenis Sekuensial Kontinyu
Progesteron 300 mg 100 mg
Medroksiprogesteron asetat (MPA) 10 mg 2,5-5 mg
Siproteon asetat 1 mg 1 mg
Didrogesteron 10-20 mg 10 mg
Normogestrol asetat 5-10 mg 2,5-5 mg
Hypothalamic and anterior pituitary
hormones and anti-oestrogens

Anterior pituitary hormones
Tetracosactide
Synacthen

Injection 250 micrograms in 1ml (30 minute diagnostic test)


Synacthen Depot

Injection 1mg in 1ml (5 hour diagnostic test)



Gonadotrophins
Chorionic Gonadotrophin (HCG)
Pregnyl

Injection with solvent 1500 units, 5000 units


Human Menopausal Gonadotrophins
Fostimon

Injection powder for reconstitution 75 units follicle-stimulating hormone



Growth hormone
Somatropin
Genotropin

Injection & Prefilled pens 5.3mg (16 units), 12mg (36 units)

Hypothalamic hormones
Gonadorelin
Injection 100 microgram vial with diluent
Protirelin
Injection 100 microgram/ml

Posterior pituitary hormones and
antagonists

Posterior pituitary hormones
Desmopressin
Desmomelt

Sublingual tablets 120 micrograms, 240 micrograms


DDAVP

tablets 100 micrograms


Tablets 200 micrograms
Nasal spray 10 micrograms per metered spray, 150
micrograms per metered spray
Injection 4 micrograms in 1ml, 15 micrograms in 1ml
Terlipressin
Injection 1mg in 5ml

Vasopressin
Injection 20 units/ml


Antidiuretic hormone antagonists
Demeclocycline
Capsules 150mg. Note: Demeclocycline may be
used in the treatment of hyponatraemia resulting
from inappropriate secretion of antidiuretic
hormone.
Tolvaptan
Tablets 15mg. Note: Tolvaptan is only for use in
patients with small cell lung cancer who have
failed or not tolerated demeclocycline.

Drugs affecting bone metabolism
Calcitonin (salmon) injection
Teriparatide injection - specialist use ony - 1st
line treatment of osteoporotic vertebral crush
fracture
Bisphosphonates
Alendronic acid tablets (once weekly tablets) -
preferred oral bisphosphonates in
osteoporosis

Other endocrine drugs
Bromocriptine and other dopaminergic drugs
Recommended:
Cabergoline (TLS Amber)
Alternative:
Bromocriptine (TLS Amber 1 month)
Specific Indication:
Quinagolide (TLS Red)
the treatment of hyperprolactinaemia & prolactinomas
where other treatments have failed, are contraindicated or
the patient has had adverse effects.
Quinagolide offers a non-ergot derived treatment option.

Drugs affecting gonadotrophins
Danazol (TLS Amber 1 month)
Gonadorenlin analogues
Buserelin nasal spray
TLS Red for uterine fibroid reduction & fertility
treatments and TLS Amber for endometriosis
Goserelin 3.6mg implant
TLS Red for uterine fibroid reduction & fertility
treatments and TLS Amber for endometriosis
Triptorelin (Decapeptyl

SR) 3mg injection



Metyrapone and trilostane
Specific indication: (TLS Blue)
Metyrapone - management of Cushing's
syndrome.

7. OBSTETRICS, GYNAECOLOGY
AND URINART-TRACT DISORDER
7.1 Drug in obstetrics
7.1.1 prostaglandin dan oxytocin
Yaitu obat yang berfungsi untuk menginduksi
aborsi ( kelahiran), dan berfungsi sebagai
pemacu kontraksi uterus juga dapat sebagai
obat meminimalisir pengeluaran darah dari
lepasnya plasenta.
Ex: misoprostol, oxytocin, dinoprostone.
7.2 treatment of vaginal and vulval
conditions
7.2.1 preparation for vagina atrophy
Atrophy vagina biasanya terjadi pada wanita-
waninta yang kekurangan hormon esterogen
biasanya pada wanita-wanita yang sudah
menopouse.
Ex: extradiol, estriol
7.2.2 anti infective drugs
Infeksi pada vagina:
Contoh:
Candidiasis : cotrimoksazole
Gonnorrhea: ampicilin
Trikomonas: metronodazole
7.3 kontrasepsi
7.3.1 combine hormone kontrasepsi
Biasa yang dipakai kombinasi esterogen dan
progesteron
Ex:Ethinylesstradiol dengan norethisterone :
loestrin
Ethinylestradiol dengan desogestrel: mercilon



Perentral progesteron kontrasepsi:
Depo- profera (medroxyprogesterone acetat
150 mg/ml)
Noristerat (norethisterone anantate 200
mg/ml)
Implant:
Implanon (containing etanogestrel 68 mg)
Intra uterine device (IUD)
Levonogestrel (progestin)
MIRENA (Progestogen)
Spermicidal kontrasepsi
Spermididal (delfen)
Spermicid
Kontrasepsi lain:
Kondom, condom vagina.

7.4 drugs for genito-urinary disorder
7.4.1 drugs for urinary retention
Alpha blocker: doxazosin, indoramin ,terazosin
7.4.2 drugs for urinary frequency,enuresis
and incontinence
Ex: flavoxate hydrochloride, propineprine
hydrochloride, trospium chlorida
7.4.3 drugs used in urological pain
(Alkalisasi dan keasaaman urin, Cystitis,
gangguan ginjal)
Ex: potasium citrate ,sodium bicarbonate
(penetral asam pada pasien asidosis tubulus
renalis),sodium citrate

Bladder instillations and urological n surgery
(blood clots, bladder cancer, interstitial cistitis)
Ex: sodium sitrate, mytomycin,dimethyl
sulfoxide
Catheter patency solution
-chlorhexidine 0,02%
- Mandelice acid 1%
- Sodium cloride 0,9%
7.4.5 Drugs for erectile dysfuntion
Ex: alprostadil (prostaglandin E1) pemberian
secara iv
Apomorphine: pemberian tablet sublingual/
inj subkutan
8. MALIGNANT DISEASE AND
IMMUNOSUPRESSION
Cytotoxic drugs
Alkylating drugs
1. Bendamustine
2. Busulfan
3. Carmustine
4. Chlorambucil
5. Cyclophosphamide
6. Ifosfamide
7. Lomustine
8. Melphalan
9. Thiotepa
10. Treosulfan
Anthracyclines and other cytotoxic
antibiotics
1. Bleomycin
2. Dacintomycin
3. Daunorubicin
4. Doxorubicin
5. Pegylated Doxorubicin
6. Epirubicin
7. Idarubicin
8. Mytomycin
Alkylating drugs
Chlormethine hydrochloride
Mustargen
Chlorethamine hydrochloride
Cyclophosphamide
Cytoxan
Cyclomet
Cycloxan
Estramustine Phosphate
Emcyt
Estracyt
Ifosfamide
Endoxan
Cytoxan
Melphalan
Alkeran
Thiotepa
Thioplex
Thiotepa
Treosulfan
Treosufan
Dihydroxybusulfan
Ovastat

Cytotoxic Antibiotics
Daunorubicin
Cerubidin
Doxorubicin Hydrochloride
Epirubicin Hydrochloride
Idarubicin hydrochloride
Mitomycin

Sex hormones and hormone antagonist
in malignant disease
Estrogens
Diethylstilbestrol
Progesterons
Medroxyprogesteron acetate
MegestrolNorethisterone
Hormone antagonist
Breast cancer :- Anastrazole
-Exemestane
-Letrozole
- Tamoxifen


Gonadorelin analogues and gonadotrophin-
releasing hormone antagonist
Gonadorelin Analogues
Buserelin
Triptorelin
Anti androgens
Bicalutamide
Cyproterone
Abiraterone
Gonadotrophin- releasing hormone antagonist
Degarelix
Somastostatin analogues
Octreotid
Lanreotide
Other antineoplastic drugs
1. Amsacrine
2. BevacizumabBexarotene
3. Bortezomib
4. Cetuximab
5. Crisantaspase
6. DacarbazineHydroxycarbamide
7. Tretinoin
8. Carboplatin
9. Nutrition and blood
Iron deficiency anaemias
Oral iron
1. Ferrous fumarate
Tablets 210mg (equivalent to 68mg ferrous
iron per tablet)
Syrup 140mg/5mL (equivalent to 45mg
ferrous iron per 5mL)
2. Ferrous sulphate
Tablets 200mg (equivalent to 65mg ferrous
iron per tablet)

3. Sodium feredetate (Sytron )
Elixir SF 190mg in 5ml (equivalent to 27.5mg
of ferrous iron
4. Polysaccharide- iron complex (Niferex)
Elixir (equivalent to approximately 500
micrograms of ferrous iron per drop) - 30ml
dropper bottle only.
Parenteral iron
1. Iron dextran (CosmoferInjection 50mg/ mL)
2. Iron sucrose (Venofer ) Injection 20mg/ mL
Drugs used in megaloblastic
anaemias
1. Folic acid
Tablets 5mg
Tablets 400 microgram N
Syrup SF 2.5mg in 5ml
Syrup SF 400 microgram in 5ml N
Folic Acid injection 15mg/ ml U
2. Hydroxocobalamin
Injection 1mg/ mL
3. Cyanocobalamin SLS
Tablets 50 micrograms
Drugs used in hypoplastic,
haemolytic and renal anaemias
1. Aranesp (Darbepoetin alfa)
Prefilled syringes 10, 15, 20, 30, 40, 50, 60, 80,
100, 150, 130, 300, 500 micrograms
SureClick 20, 40, 60, 80, 100, 150, 300, 500
micrograms
2. Eprex (Epoetin alfa)
Prefilled syringes 1000, 2000, 3000, 4000,
10,000, 40,000 units
3. NeoRecormon(Epoetin beta)
Prefilled syringes 500, 2000, 3000, 4000 units
4. Iron overload
Desferrioxamine Injection 500mg
Drugs used in platelet disorders
Idiopathic thrombocytopenic purpura
1. Eltrombopag
Tablets 25mg, 50mg
2. Romiplostim
Injection, powder for reconstitution 250
microgram vial
Essential thrombocythaemia
1. Anagrelide
Capsules 500 micrograms
Drugs used in neutropenia
1. Filgrastim (Neupogen)
Injection 30 million units (300 micrograms) in
1ml vial or pre- filled syringe
Injection 48 million units (480 micrograms) in
1.6ml vial or pre- filled syringe
2. Filgrastim (Zarzio)
Injection 30 million units (300 micrograms) in
0.5ml pre- filled syringe
Injection 48 million units (480 micrograms) in
0.5ml pre- filled syringe
3.Lenograstim (Granocyte)
Pre- filled syringe 13.4 million units (105
micrograms)
Pre- filled syringe 33.6 million units (263
micrograms)
Oral preparations for fluid and
electrolyte imbalance
1. Oral potassium
Potassium Chloride
Sando- K
Effervescent tablets each containing 12mmol
potassium
Kay- Cee- L
Syrup SF containing 1mmol potassium per ml
Slow- K
Modified release tablets each containing 8mmol
potassium
Management of hyperkalaemia (Potassium Removal)
Polystyrene sulphonate resins
1. Calcium Resonium
Powder calcium polystyrene sulphonate.
Enema 30g in 100mL U
2. Resonium A
Powder sodium polystyrene sulphonate.
2. Oral sodium and water
Sodium chloride
Slow Sodium
Modified release tablets containing 600mg
sodium chloride (equivalent to 10mmol
Sodium)
Oral solution 30% U
3. Oral bicarbonate
Sodium bicarbonate
Capsules, sodium bicarbonate 500mg (approx.
6mmol each of sodium and bicarbonate)
Parenteral preparations for fluid
and electrolyte imbalance
Products routinely used in Primary Care
1. Sodium chloride 0.9%
for injection: 5ml, 10ml, 20ml ampoules 50ml vials
2. Water for injection N
5ml, 10ml, 20ml ampoules
3. Glucose 50%
50ml Min- I- jet,50ml vial U
3. Oral Glucose
Glucose 30%
10ml oral solution U
Additional products for infusion are available
for use in secondary care, please contact
pharmacy
1. Sodium bicarbonate
Intravenous Infusion 1.26%, 2.74%,
4.2%, 8.4%
Intravenous Injection 8.4%
Min- I- jet 4.2%, 8.4%
Plasma and plasma substitutes
Gelatin
Gelaspan 4 % Intravenous infusion,
succinylated gelatin 40g (4%) 500ml
Intravenous nutrition
Proprietary infusion fluids for parenteral
feeding
1. Intralipid10%
500mL
2. Intralipid20%
500mL
3. Triomel N4-700E
Contains 4g Nitrogen/ litre; 1500mL bag
4.TriomelN7-1140E
Contains 7g Nitrogen/ litre; 2000mL bag
5. Triomel N9-1070E
Contains 9g Nitrogen/ litre; 2000mL bag
6. Plasma- Lyte 148 (water)
Solution for Infusion, pH 7.4, 1000mL
7. Vamin14
1000mL
Supplementary preparations

Addiphossolution
20mL vial
Calcium and magnesium

Calcium supplements
1. Adcal
Chewable tablets containing 600mg calcium (15mmol)
2. Sandocal-400
Effervescent tablets containing 400mg calcium
(10mmol)
3. Sandocal-1000
Effervescent tablets containing 1000mg
calcium (25mmol)
4. Calcium Sandoz
Syrup containing 108.3mg calcium (2.7mmol) in 5ml
Calcium Gluconate 10%
10ml ampoule
Calcium chloride 10%
Min- I- jet 10ml
Hypercalcaemia
1 . Cinacalcet
Tablets 30mg, 60mg, 90mg
Magnesium
1. Magnesium glycerophosphate U
Capsules containing 4mmol magnesium per capsule
Liquid containing 10mmol in 10mL
2. Magnesium sulphate
Injection 50% (approximately 2 mmol magnesium per
ml) 10ml amps.
Phosphorus
Phosphate supplements
1. Phosphate- Sandoz
Effervescent tablets containing the
equivalent of 16.1mmol phosphate
2. Phosphate mixture U
Mixture 100mL, containing the equivalent of
527mmol phosphate/ L
Phosphate- binding agents
1. Alu- Cap
Capsules aluminium hydroxide 475mg
Zinc
Zinc
1. Zinc sulphate U
Capsule 220mg
Vitamin A
Vitamin A
1. Vitamin A and D
Capsules vitamin A 4000 iu and vitamin D 400
iu
2. Vitamin A
Injection 100,000 iu in 2ml
Healthy Start Childrens Vitamin Drops
Oral drops vitamin A 5000 units, vitamin D 2000 units,
ascorbic acid 150mg/ ml
Healthy Start Women's vitamin tablets
Tablets vitamin C 70mg, vitamin D3 10 micrograms,
folic acid 400 micrograms
Vitamin tablets (with calcium and iodine) for nursing
mothers
Tablets vitamin A 8mg, ascorbic acid 60mg,
ergocalciferol 400 units, calcium hydrogen phosphate
190mg, potassium iodide 130 micrograms, ascorbic acid
60mg
Vitamin B
1. Vitamin B Compound
Tablets containing nicotinamide 15mg,
riboflavin 1mg, thiamine 1mg
2. Vitamin B Compound Strong
Tablets containing nicotinamide 20mg,
pyridoxine 2mg, riboflavin 2mg, thiamine
5mg
3. Thiamine
Tablets 50mg, 100mg
Injection 250mg in 5ml U
4. Pyridoxine
Tablets 10mg, 20mg, 50mg
Injection 50mg/2ml U
5. Pabrinex
Injection I/ M High potency
Injection I/ V High potency
Vitamin C
1. Ascorbic Acid
Tablets 50mg,100mg, 500mg
Effervescent 1g (Not NHS)
Vitamin D
1. Alfacalcidol
Capsules 250 nanograms, 500 nanograms, 1 microgram
Oral drops 2 microgram in 1ml
Injection 2 micrograms 1ml (1ml ampoules)
2. Calcitriol
Capsules 250 nanograms, 500 nanograms
Injection 1 microgram in 1ml, 2 micrograms in 1ml
3. Colecalciferol (vitamin D3)
Liquid 3,000 units in 1mL U
Capsules 50,000 units U
4. Ergocalciferol (vitamin D2)
Injection 300,000 units in 1ml
With calcium
1. Adcal D3
Chewable tablets containing 600mg calcium and 400 units of vitamin D
(as vitamin D3)
Caplets containing 300mg Calcium and 200units of vitamin D (as vitamin
D3)
Dissolve, effervescent tablets containing 600mg calcium and 400 units of
vitamin D (as vitamin D3)
2. Calceos
Chewable tablets containing 500mg calcium and 400 units of vitamin D
(as vitamin D3)
3. Calcichew D3 Forte
Chewable tablets containing 500mg calcium and 400 units of vitamin D
(as vitamin D3)
4.Calcichew D3 500mg/400iu Caplets
Tablets containing 500mg calcium and 400 units of vitamin D (as vitamin
D3)
Vitamin E
1.Alpha tocopheryl acetate
Suspension 500mg in 5ml
Vita- E capsules 50mg (75iu), 268mg (400iu)
Vitamin K
1. Phytomenadione
Injection 10mg in 1ml (Konakion
MM) [Not for intramuscular injection]
Injection (KonakionMM Paediatric) 2mg in
0.2ml [May be administered by mouth,
intramuscular injection or intravenous injection].
2. Menadiol sodium phosphate
Tablets 10mg
Multivitamin preparations
1. Vitamins
Capsules BPC
2. Sanatogen A- Z Complete
Tablets
3. Abidec
(Vitamin A 1333iu, ergocalciferol 400iu, thiamine 0.4mg, riboflavin 0.8mg, pyridoxine 0.8mg,
nicotinamide 8mg, ascorbic acid 40mg per 0.6ml)
Drops 25ml, 50ml
4. Dalivit
Vitamin Drops 25ml, 50ml
5. Ketovite
( Vitamin A 2500iu, ergocalciferol 400iu, choline chloride 150mg, cyancobalamine 12.5
microgram/5ml)
Tablets
Liquid
Drugs used in metabolic disorders
Wilson's disease
Penicillamine
o Tablet 125mg
Carnitine deficiency
Carnitine
o Oral liquid, 10%
o Oral liquid, Paediatric solution, 30%
o Injection 1g in 5ml
Acute porphyrias
Acute porphyrias Haem arginate
Normosang
o Concentrate for IV infusion 25mg/ ml
10.MUSKULOSKELETAL &
JOINTDISEASE
10.1.1 Non steroidal anti inflammatory
drugs
Ibuprofen
Tablets 200mg, 400mg, 600mg
SuspensionSF 100mg in 5ml
Notes:
Ibuprofen remains the
first line NSAID. If a patient
says that they have tried
ibuprofen check that they have
taken an anti- inflammatory
dose, at least 400mg
Naproxen
Tablets 250mg, 500mg
Notes:
Patients at high risk from
developing gastrointestinal
adverse effects should be
prescribed omeprazole 20mg.
Indometacin
Capsules 25mg, 50mg
Suppository 100mg
Notes:
Indometacin is the first- line
NSAID in the management of
gout (see section 10.1.4).Its use
is limited by high incidence of
side effects such as headache
and dizziness
Mefenamic acid
Capsule 250mg
Tablet 500mg
Flurbiprofen
Tablet 50mg

Diclofenac
Tablets e/ c 25mg, 50mg
Dispersible tablets 50mg
Suppositories 12.5mg, 25mg,
50mg, 100mg
Injection 75mg in 3ml
Notes:
Diclofenac suppositories may be
preferred to diclofenac injection (which may be
painful when given IM) for
the acute relief of pain eg.
biliary colic.
Voltarol Dispersible tablets
are more suitable for short-
term use in acute conditions
for which treatment is required for
no more than 3 months

Celecoxib
Tablets 100mg, 200mg
Tablets 100mg, 200mg
Hyaluronic acid
Consultant Rheumatologist use only
Hyaluronic acid 20mg in 1ml prefilled
syringe

10.1.2 Corticosteroids
Dexamethasone
Injection 8mg in 2ml
Hydrocortisone acetate
Injection 25mg in 1ml
Methylprednisolone
acetate (Depo- MedroneR)
Injection 40mg in 1ml
Injection plus lidocaine
40mg +10mg in 1ml

Triamcinolone acetonide
Injection 50mg in 5ml
vial
Injection 40mg in 1ml
Triamcinolone
hexacetonide U
Injection 20mg in 1ml
10.1.3 Drugs which suppress the
rheumatic disease process
Sodium aurothiomalate
Injection 10mg in 0.5ml,
50mg in 0.5ml
Penicillamine
Tablets 125mg, 250mg
Chloroquine
Tablets 250mg
Syrup 68mg in 5ml
Drugs affecting the immune response
Leflunomide
Tablets 10mg & 20mg
Methotrexate
Tablets 2.5mg, 10mg
Notes:
if aspirin or other NSAIDs are
given concurrently the dose of
methotrexate should be carefully
monitored. Patients should be
advised to avoid self- medication
with over- thecounter aspirin or
ibuprofen.
MetojectR Injection prefilled
syringe 10mg, 15mg, 20mg,
25mg
Cytokine modulators
Abatacept
OrenciaR Intravenous infusion
250mg
Adalimumab
HumiraR Injection 40mg
Certolizumab Pegol
CimziaR Pre- filled syringe 200mg
Etanercept
EnbrelR Injection 25mg & 50mg
Golimumab
SimponiR Injection 50mg
Infliximab
RemicadeR Intravenous infusion
100mg
Tocilizumab
RoActemraR Intravenous infusion
20mg in 1ml
10.1.4 Gout and cytotoxic induced
hyperuricaemia
Acute attacks of Gout
Indometacin
Capsules 25mg, 50mg
Suppositories 100mg
Naproxen
Tablets 250mg, 500mg
Colchicine
Tablets 500 micrograms

Long- term control of Gout
Allopurinol
Tablets 100mg, 300mg
Notes:
The dose of allopurinol and
colchicine should be reduced in
patients with renal failure.
Febuxostat
Tablets 80mg, 120mg

Hyperuricaemia associated with
cytotoxic drugs
Rasburicase
IV infusion 1.5mg, 7.5mg vial
10.1.5 Other drugs for rheumatic
diseases
Osteoarthritis does not recommend the use of chondroitin
or glucosamine preparations. Therefore they are not
included in the formulary.
10.2.1 Drugs which enhance
neuromuscular transmission
Pyridostigmine
Tablets 60mg
Edrophonium chloride
Injection 10mg in 1ml
Notes:
Edrophonium is used as a diagnostic agent
for myasthenia gravis.

10.2.2 Skeletal muscle relaxants
Baclofen
Tablets 10mg
LiquidSF 5mg in 5ml
Dantrolene sodium
Capsules 25mg, 100mg
Notes:
Diazepam (section 4.1.2) may also be
used. Sedation and, occasionally,
extensor hypotonus are disadvantages

Nocturnal leg cramps
Quinine sulphate
Tablets 200mg, 300mg
Notes:
Before use of quinine for nocturnal
leg cramps, the risks should be
carefully considered relative to the
potential benefitsPatients should be
monitored closely during the early
stages for adverse effects as well as
for benefit.
Treatment should be interrupted at
intervals of approximately 3 months to
assess the need for further quinine treatment.
Patients should be warned not to
exceed the recommended dose.
Serious side effects including
irreversible blindness and death may
occur with overdose

10.3.1 Enzymes
Hyaluronidase
Powder for reconstitution 1500 unit amp
10.3.2 Rubefacients, topical NSAIDS,
capsaicin and poultices
Topical NSAIDs and counter-
irritants
AlgesalR
Cream containing
diethylamine salicylate
10%
TransvasinR
Cream
Ibuprofen
Gel containing 5%
Notes:
NICE clinical guideline 59
Osteoarthritis: Paracetamol and/
or
topical NSAIDs should be offered to
patients with knee or hand
osteoarthritis before considering
oral NSAIDs, COX-2 inhibitors or
opioids.
Treatment should be reviewed
after two weeks and stopped if not
effective
11. EYE
PEMBERIAN OBAT PADA MATA
Pada dasarnya termasuk dalam 4 kelompok utama
mengendalikan gangguan mata:
1. Obat pelumas dan sediaan air mata buatan
2. Obat antinflamasi (mengurangi pembengkakan
dan mata memerah)
3. Obat antiinfeksi ( membunuh dan
mengendalikan bakteri dan virus)
4. Obat glaukoma
Cara pemberian obat untuk penyakit
mata

Lokal
Tetes mata
Salep mata
Sistemik:
Per oral
Suntikan
CONTROL OF MICROBIAL
CONTAMINATION
Sediaan untuk mata harus steril saat diberikan. Untuk
menghindari kontaminasi, pipet atau tabung tidak
boleh menyentuh mata ( atau apa pun ) .

Tetes mata yang digunakan di rumah tidak boleh
digunakan 4 minggu setelah pembukaan pertama
( kecuali beberapa produk yang dapat bertahan sampai
6 bulan ) .

Tetes mata untuk digunakan dalam bangsal rumah sakit
biasanya dibuang 2 minggu setelah pembukaan
pertama .
SEDIAAN OBAT-OBAT ANTIINFEKSI
PADA MATA
b. Antifungal
Econazole
Eye drops 1%
c. Antivirus
Acyclovir
Eye ointment 3%
Ganciclovir
Ophthalmic gel 0.15%



a. Antibacterials
Chloramphenicol (Chlomycetin)
Chlortetracycline (Aureomycin)
Ciprofloxacin (Ciloxan)
Framycetin sulphate
(Soframycin)
Fusidic acid (Fucithalmic)
Gentamicin (Garamycin)
Lomefloxacin (Okacyn - Black
triangle)
Neomycin sulphate (Neosporin)
Ofloxacin (Exocin)
Polymyxin B sulphate (Polyfax,
Polytrim)
Propamidine isetionate (Brolene )

Sediaan kortikosteroid dan anti
inflamasi lainnya
a. Kortikosteroid
Betamethasone sodium phosphate 0.1% (eye drops, eye ointment)
Betamethasone sodium phosphate 0.1% with neomycin sulphate 0.5%
(eye drops, proprietary name Betnesol-N)
Prednisolone acetate 1% (eye drops, proprietary name Pred-Forte)
Prednisolone sodium phosphate 0.03% (eye drops)
Fluorometholone 0.1%, polyvinyl alcohol 1.4% (eye drops, proprietary
name FML)
b. Other anti-inflammatory preparations
Sodium cromoglicate 2% eye drops has a prophylactic action, and is used
to treat allergic conjunctivitis
Olopatadine 1mg/1mL (eye drops, Opatanol) is an antihistamine which
is an alternative treatment for adults and children with ocular signs and
symptoms of seasonal allergic conjunctivitis
Mydriatics and cycloplegics

1. Tropicamide 0.5% and 1% (eye drops) is an antimuscarinic
drug.
2. Cyclopentolate 0.5% and 1% (eye drops) is an
antimuscarinic drug which is used as a mydriatic and
cycloplegic both before and after ophthalmic procedures.
3. Atropine 1% (eye drops) is the most potent antimuscarinic
mydriatic and cycloplegic, producing complete cycloplegia
which lasts for seven days or more
4. Phenylephrine 2.5% and 10% (eye drops) is a mydriatic
which is used prior to ophthalmic procedures.

Pengobatan Glaukoma
Ada dua mekanisme untuk menurunkan
tekanan intraokuler:
1. mengurangi produksi cairan mata
2. memperbanyak pengaliran keluar cairan
mata
CHOLINERGIC AGONISTS
Pilocarpine
Carbachol
ALPHA AGONISTS
Brimonidine
Iopidine
CARBONIC ANHYDRASE
INHIBITORS
Dorzolamide
ADENERGIC AGONISTS
Epinephrine
Dipivefrin
BETABLOCKERS
Timolol
Metipranolol
Carteolol
Betaxolol
Levobunolol

PROSTAGLANDIN ANALOGUES
Latanoprost

Local Anasthetics
1. Anastesi Topical
Proparacaine hydrochloride (ophtaine, dll )
Tetracaine hydrochloride ( pontocaine)
Benoxinate hydrochlodirde
2. Anastesi Lokal Untuk Suntikan
Lidocain hydrochloride (xylocaine)
Procaine hydrochloride (novacaine)
Bupivacaine hydrochloride (marcaine, sensorcaine)
Etiocaine hydrochloride (duranest)

Miscellaneous Ophthalmic
Preparations
a. Tear deficiency, ocular lubricants and astringents
Acetylcysteine (Ilube)
Carbomers (Viscotears) 0.2% (eye drops, single dose units)
Hydroxyethylcellulose (Minims Artificial Tears)
Hypromellose 0,3 % (Isopto)
Liquid paraffin (Lacri-Lube)
Yellow soft paraffin (Simple Eye Ointment)
Polyvinyl Alcohol (eye drops proprietary name Liquifilm Tears)
Povidine (Oculotect)
Sodium chloride 0.9% drops
Ocular Diagnostic and Perioperative Preparations
and Photodynamic Treatment

Ocular diagnostic preparations
Fluorescein 1%, 2% (single use eye drops) is recommended as a stain for diagnosis of corneal
abrasions and herpes keratitis. It is also used in tonometry.
Fluorescein 10% or 20% (injection) is used for assessment of retinal vascularisation, detection of
retinal ischemia, chronic macular oedema and other retinal pathology.
Indocyanine Green (injection) is used for assessment of choroidal circulation and subretinal
neovascular membranes [unlicensed preparation].
Ocular peri-operative drugs
Acetylcholine chloride 1% plus mannitol 3% (Miochol-E) (solution for intra-ocular irrigation)
Balanced salt solution (eye irrigation)
Balanced salt solution plus (intra-ocular irrigation)
Botulinum Toxin Type A 100 or 500 units (Botox or Dysport) (injection)
Diclofenac sodium 0.1% (eye drops)
Dimethylsilicone oil 1000cS (injection)
Potassium ascorbate 10% (eye drops)
Sodium chloride 5% (eye drops, eye ointment)
Minims sodium chloride 0.9% (eye drops)
Sodium hyaluronate 10mg/mL (Microvisc) (injection)
Photodynamic Treatment
Metode ini menggunakan laser non-termal bersamaan dengan obat intravena untuk menghentikan
atau memperlambat progresi kondisi degenerasi makular


Lensa Kontak
Lensa kontak adalah lensa korektif, kosmetik,
atau terapi yang biasanya ditempatkan di korenea
mata.
Lensa kontak biasanya mempunyai kegunaan
yang sama dengan kacamata konvensional tetapi
lebih ringan dan bentuknya tak nampak saat
dipakai.
Fungsi lensa kontak yaitu mengubah arah sinar
cahaya untuk memfokuskannya ke arah yang
benar pada retina.
12. Ear, Nose and Oropharynx

12. Ear, Nose and Oropharynx
by Diah Bagus Pitoyo
12.1 Drugs acting on the ear
12.1.1 Otitis externa
12.1.2 Otitis media
12.1.3 Removal of ear wax

12.2 Drugs acting on the nose
12.2.1 Drugs used in nasal allergy
12.2.2 Topical nasal decongestants
12.2.3 Nasal preparations for infection
12.3 Drugs acting on the oropharynx
12.3.1 Drugs for oral ulceration and
inflammation
12.3.2 Oropharyngeal anti- infective
drugs
12.3.3 Lozenges and sprays
12.3.4 Mouth washes, gargles, and
dentifrices
12.3.5 Treatment of dry mouth
12.1 Drug acting on the ear
12.1.1 Otitis externa
Anti- inflammatory preparations
Betamethasone Ear drops: Betamethasone sodium phosphate 0.1%
Prednisolone Ear drops: Prednisolone Sodium phosphate 0.5%
Prolonged use of topical corticosteroids should be avoided.

Anti-infective preparations
Clotrimazole Solution 1%
Gentamicin Ear drop 0.3%

Anti- infective plus anti-inflammatory combination preparations
Betnesol- N Ear drops: Betamethasone sodium phosphate 0.1%, neomycin sulphate 0.5%
Locorten- Vioform Ear drops: flumetasone pivalate 0.02%, clioquinol 1%
Predsol-N Ear drops: prednisolone sodium phosphate 0.5%, neomycin sulphate 0.5%
Gentisone HC Ear drops: hydrocortisone acetate 1%, gentamicin 0.3%
Otomize Ear Spray: dexamethasone 0.1%, neomycin sulphate 3250 units/ ml, glacial acetic acid 2%
Otosporin Ear drops: hydrocortisone 1%, neomycin sulphate 3400units, polymixin B sulphate 10,000 units / ml
Sofradex Ear drops: Dexamethasone 0.05%, framycetin sulphate 0.5%, gramicidin 0.005%

Other preparations
Acetic acid Ear spray 2%
Aluminium acetate Ear drops 8%
12.1.2 Otitis media
For prescribing information refer to Antimicrobial Guidelines for
Primary Care (Chapter 5).
12.1.3 Removal of ear wax
Olive Oil-N Ear drops
Sodium bicarbonate Ear drops 5%
Note:
Olive oil eardrops are considered as the standard first line
product for the removal of earwax. It is extremely cheap and
skin reactions to it are almost unheard of.
Sodium bicarbonate occasionally causes irritation.
Some proprietary preparations contain organic solvents which
may cause irritation e.g. Cerumol, and are not recommended.
(See BNF)
All preparations for removal of earwax listed in the BNF are
available over the counter at a cost less than the current
prescription charge.
12.2 Drug acting on the nose
12.2.1 Drugs used in nasal allergy
Beclometasone
Beconase Aqueous nasal spray, 50 micrograms
per spray

Fluticasone propionate
Flixonase Nasal spray, 50 micrograms per spray
Notes: Flixonase to be used for perennial rhinitis.

Fluticasone furoate
Avamys Nasal spray, 27.5 micrograms per spray
Notes: Avamys to be used for allergic rhinitis.

Triamcinolone
Nasacort Nasal spray, 55 micrograms per spray


Betamethasone sodium phosphate
Drops 0.1%
Notes:
Drops 0.1%There are no published studies
showing that any one nasal steroid is more
effective than any other. Aqueous sprays tend
to causeless irritation.
GPs should prescribe Beconase as the first- line
choice therapy for allergic rhinitis and ensure
the patient knows how to use their nasal spray
effectively.
Beclomethasone nasal spray is consider ed as
first line therapy. It is relatively cheap, effective
and well tolerated, requiring twice daily
administration.
Systemic absorption may follow on from any
nasal steroid particularly if the doses are high
and prolonged.
CSM recommends that when children are
receiving prolonged treatment with nasal
corticosteroids the height of the child should
be monitored. If growth is slowed then
paediatric referral should be considered.
12.2.2 Topical nasal decongestants
Xylometazoline hydrochloride
Nasal drops 0.1%
Paediatric nasal drops 0.05%

Ephedrine hydrochloride
Nasal drops 0.5%, 1%
Notes:
Topical nasal decongestants containing sympathomimetics, ephedrine and xyometazoline, can cause rebound
congestion following prolonged use (more than 7 days) and are therefore of limited value.
Ephedrine nasal drops should be used with caution in infants under 3 months of age. There is no good evidence
of value if irritation occurs it might narrow the nasal passage.

Sodium chloride
Nasal drops 0.9%
Note: Sodium Chloride 0.9 % given as nasal drops may help relieve nasal congestion by helping to liquefy mucous
secretions.

Antimuscarinic
Ipratropium bromide
Rinatec nasal spray 0.03%
Notes: Ipratropium may be useful to treat non- allergic watery rhinorrhoea. It does not act directly to reduce blood
flow to the nose but reduces watery secretions.
12.2.3 Nasal preparations for infection and
epistaxis
For treatment of acute sinusitis refer to Antimicrobial Guidelines for Primary Care
(Chapter 5).

Betnesol- N Drops: Betamethasone sodium phosphate 0.1%, neomycin sulphate 0.5%

Nasal staphylococci
NaseptinNasal cream: chlorhexidine hydrochloride 0.1%, neomycin sulphate 0.5%
Mupirocin Bactroban Nasal ointment 2%
Note: Mupirocin (Bactroban) should be kept in reserve to avoid resistance
developing. It is particularly useful in a hospital setting to treat MRSA. To avoid
the development of resistance, the treatment course should not exceed 7 days
and the course not repeated on more than one occasion. Please seek advice
from Infection Control or Microbiology.

Epistaxis
Bismuth and iodoform Paste Impregnated gauze
12.3 Drug acting on the oropharynx
12.3.1 Drugs for oral ulceration and
inflammation
Benzydamine
Difflam oral rinse 0.15%
Difflam spray 0.15%

Hydrocortisone
Buccal tablets 2.5mg

Carmellose sodium
Orabase protective paste
Orahesivepowder
Choline salicylate-N
Dental gel 8.7%
For use in adults and children over 16 years only
Notes:
Benzydamine is useful to treat discomfort in a
variety of ulcerative conditions. It may cause
stinging, often reduced by dilution with an equal
volume of water.
Orabase is cheap and effective in providing
mechanical protection of oral and perioral lesions.
Corticosteroids are useful for some forms of mouth
ulcers.
Hydrocortisone pellets may be fairly easily placed
near or on the ulcer site.
All preparations for oral ulceration and
inflammation are available over the counter.
12.3.2 Oropharyngeal antiinfective drugs
Nystatin N
Oral suspension 100,000 units/ ml
Notes:
Due to the high sucrose content of nystatin suspension,
500mg/1ml, ensure that diabetic patients are aware of this.
Nystatin is the first line choice, however miconazole may be
considered due to the differing formulations.

Miconazole N
Oral gel SF 20mg/g
12.3.3 Lozenges and sprays
Merocets
Lozenge: Cetylpyridinium chloride 1.4mg

Merocaine
Lozenge: Benzocaine10mg, cetylpyridinium 1.4mg
Note: For symptomatic relief in hospital only. Not to be prescribed
on FP10.
12.3.4 Mouthwashes, gargles, and dentifrices
Chlorhexidine gluconate
Mouthwash 0.2%

Hexetidine
Mouthwash 0.1%
Notes:
Sodium chloride mouthwash may be used to relieve pain from
traumatic ulceration.
A simple sodium chloride mouthwash may be made by adding one to
two teaspoonfuls of salt to a pint of freshly boiled and cooled water.
Chlorhexidine may be used as an antiseptic to prevent secondary
infection in mouth ulcers or following oral surgery.
It can also prevent the formation of plaque.All above products are
available over the counter.
12.3.5 Treatment of dry mouth
Glandosane
Aerosol spray

Pilocarpine
Tablets 5mg

Notes:
When treating dry mouth it may be worthwhile to first consider non-
pharmaceutical measures e.g. sugar free boiled sweets, pineapple
chunks, ice cubes or frozen tonic water.
Glandosane should be prescribed within ACBS guidelines to treat
dry mouth as a result of receiving, or having undergone,
radiotherapy, chemotherapy or sicca syndrome.
Pilocarpine tablets are indicated for the treatment of xerostomia
following irradiation for head and neck cancer.
13. SKIN
13.1 Management of Skin
Conditions
13.1.1 Vehicles creams, gels, lotions,
oinments, pastes
13.1.2 Suitable quantities for prescribing
13.1.3 Excipients and sensitisation
13.1 Emollient and Barrier
preparations
13.2.1 Emollients
Non proprietary emollient
preparationsAqueous cream,
emulsifying ointment, hydrous
ointment, parafin white and yellow
soft
Proprietary emollient
preparationscetraben emollient
cream, decubal cream, dermamist,dll
13.2.2 Emollients bath additives
13.2.3 Barrier preparations
13.1 Emollient and Barrier
preparations
13.2.2 Emollients bath additives
Alpha keri bath, aveeno, dermalo,
emollient medicinal bath oil
13.2.3 Barrier preparations
Non proprietary barrier
preparations zinc cream, zinc
ointment, zinc castor oil ointment
Proprietary barrier preparations
drapolene cream, medicaid,
sudocream, vasogen.
13.3 Topical Local Anaesthetics
and Anti Pruritus
Anti PruritusCalamine, doxepin
hydrochloride
Topical Local
AnaestheticsPrilocain, lidocain
Topical antihistamines
tripelennamine HCL, doxepin HCL,
dexpanthenol
13.4 Topical Corticosteroids
Hydrocortisone
Hydrocortisone butyrate
Aclometasone dipropionate
Beclometasone dipropionate
Betamethasone esters
Clobetasol propionate

13.4 Topical Corticosteroids
Clobetasone butyrate
Desoximetasone
Diflucortolone valerate
Fludroxycortide
Fluocinolone acetonide
Fluocinonide
Fluocortolone
Fluticasone propionate
Halcinonide
Mometasone furoate
Triamcinolone acetonide
13.5 Preparations for
eczema and psoriasis
13.5.1 Preparations for eczema
Ichthammol
13.5.2 Preparations for psoriasis
Calcipotriol, calcitriol, tacalcitol,
tazarotene, coal tar, dithranol,salicylic
acid, acitretin (oral)
13.5.3 Drug affecting the immune
response Ciclosporin, methotrexate,
pimecrolimus, tacrolimus
13.6 Acne and Rosacea
13.6.1 Topical preparation for acne
Benzoil peroxide, azelaic acid,
antibiotics, adapalene, corticosteroids,
salicylic acid
13.6.2 Oral preparation for acne Co-
cyprindiol, isotretinoin
13.7 Preparations for warts
and calluses
salicylic acid
Glutaraldehyde
Silver nitrate
Imiquimod
Podophyllum

13.8 Sunscreens and
Camouflagers
13.8.1 Sunscreen preparation Delph,
E45 sun, sunsense, tretinoin,
13.8.2 Camouflagers Covermark,
dermacolor
13.9 Shampoo and other Preparations for
Scalp conditions
Alphosyl 2 in 1
Betadine
capasal,
Nizoral
Selsun
Minoxidil
13.10 Anti infective skin
preparations
13.10.1 Antibacterial preparations
13.10.1.1 Antibacterial preparations
only use topically Neomycin
sulphate, mupirocine, polymyxins,
silver sulfadiazine
13.10.1.2 Antibacterial preparations
also use systemically Fusidic acid,
metronidazole

Cont
13.10.2 Antufungal preparations
Benzoic acid, clotrimazole, econazole
nitrate, ketoconazole, miconazole
nitrate, nystatin salicylic acid, dll
13.10.3 Antiviral preparations
Aciclovir, panciclovir, idoxuridine in
dimethyl sulfoxide
13.10.4 Parasiticidal preparations
13.10.5 preparations for minor cuts and
abrations
Cont
13.10.4 Parasiticidal preparations
Benzyl benzoate, carbaryl, malathion,
permethrine, phenothrin
13.10.5 preparations for minor cuts and
abrations Cetrimide cream,
proflavine, collodium
13.11 Skin Cleansers and
Antiseptics
13.11.1 Alcohols and saline Alcohol,
sodium chloride
13.11.2 Chlorhexidine salt
chlorhexidine (cepton skin wash,
hibisol solution)
13.11.3 Cationic surfactants and soaps
cetrimide
13.11.4 Chlorine and Iodine
chlorinated solutions (chlorasol
solution), Iodine compounds (betadine,
savlon)
13.11.5 Phenolics Hexachlorophene,
triclosan
13.11.6 Astringents, oxidisers and dyes
Hydrogen peroxide, potassium
permanganate
13.11.7 Preparation for promotion of
wound healing Growth factor
(regranex), varidase topical.
Cont
14. Immunological products and
vaccines
Active immunity
Vaksin BCG
Vaksin Polio
Vaksin DPT
Vaksin HIB (Hemofilus Influensa)
Vaksin Thypoid
Vaksin Hepatitis B
HIV
Storage and use
Aturan umum: sebagian besar
harus didinginkan pada suhu 2-8
o
C
DPT, Hib, hepatitis B, hepatitis A (tdk beku)
OPV, Yellow fever (dapat dalam kead. beku)

Anti Sera
Botulism Anti Toxin
Anti Bisa Ular
ADS (Anti Diffteri Serum)
ATS (Anti Tetanus Serum)



Immunoglobulin
Varicella zoster immunoglobulin.
Cytomegalovirus (CMV) immunoglobulin.
Imunisasi Aktif
Definisi: pemberian antigen pada inang untuk
menginduksi pembentukan antibodi dan
imunitas seluler.
Tujuan: menginduksi perlindungan terhadap
berbagai bahan infeksius

Bahan: materi yang diinaktivasi (mati) atau
bahan hidup yang dilemahkan
Lebih disukai karena:
a. kadar antibodi tinggi dipertahankan
dalam jangka lebih lama
b. frekuensi pemberian lebih jarang
c. secara beriringan membentuk imunitas
seluler


Imunisasi Pasif
Definisi: pemindahan imunitas pada inang
menggunakan produk imunologis yang sudah
terbentuk
Tujuan: memberikan perlindungan terhadap
antigen
Bahan: Imunoglobulin


Sasaran :
Individu yang tidak mampu membentuk antibodi
(agammaglobulinemia kongenital)
Pencegahan penyakit ketika waktu tidak
memungkinkan imunisasi aktif (misal: pasca
paparan)
Terapi penyakit tertentu yang secara normal
dicegah dengan imunisasi (misal: tetanus)
Terapi dalam kondisi imunisasi aktif tidak
tersedia atau tidak dapat dilaksanakan (misal:
tergigit ular)
JENIS VAKSIN
Vaksin Hidup Attenuated
bakteri atau virus hidup yang dilemahkan
dengan cara pembiakan berulang-ulang
harus dpt berkembang biak respon imun
respon imun = infeksi alamiah
bersifat labil, rusak oleh panas & cahaya
contoh: campak, mumps, rubela, polio (virus)
BCG, demam tifoid oral (bakteri)
Vaksin Inactivated
bakteri, virus/ komponennya yg dibuat tidak
aktif dgn pemanasan atau bahan kimia
tidak dapat replikasi seluruh dosis ag
tidak dapat menyebabkan penyakit
tidak dipengaruhi oleh ab yg beredar
selalu membutuhkan dosis ganda
sedikit atau tidak menimbulkan respon seluler
contoh: difteri, tetanus (toksoid)
haemophilus influenza(polisakarida)

TATA CARA PEMBERIAN IMUNISASI
Sebelum melakukan imunisasi
memberitahu risiko vaksinasi dan tdk imunisasi
persiapan bila terjadi reaksi ikutan
baca dgn teliti informasi produk
tinjau apakah ada kontraindikasi
periksa pasien dan beri antipiretik bila perlu
periksa kondisi vaksin (warna, kadaluarsa)
pemberian sesuai jadwal
berikan vaksin dengan tehnik yang benar

Setelah pemberian imunisasi
berilah petunjuk kpd pengasuh/ortu apa yg
harus dikerjakan dalam kejadian reaksi biasa
atau reaksi ikutan yang lebih berat
catat imunisasi dalam rekam medis
laporkan hasil imunisasi ke Dinkes
periksa status imunisasi keluarga yg lain

Penyimpanan Vaksin
Aturan umum: sebagian besar
harus didinginkan pada suhu 2-8
o
C
DPT, Hib, hepatitis B, hepatitis A (tdk beku)
OPV, Yellow fever (dapat dalam kead. beku)
Pengenceran
Vaksin kering yang beku harus diencerkan
Dengan pelarut khusus
Digunakan dalam periode waktu tertentu, mis
vaksin campak yg telah diencerkan cepat berubah
warna pada suhu kamar.
15. Anaesthesia Drugs

GENERAL ANAESTHESIA :

1. Intravenous anaesthetic
2. Inhalation anaesthetic
3. Sedative and analgetic peri-operative drugs
4. Anxiolytics and neuroleptics
5. Non-opioid analgesic
6. opioid analgesic
7. Muscle relaxants
8. Anticholinesterase used in anaesthesia
9. Antagonists for central and respiratory depression
10. Drugs for malignant hyperthermia

LOCAL ANAESTHESIA
ANAESTHESIA DRUGS

Intravenous
anaesthetic

Inhalation
anaesthetic
Nitrous oxide
Halothane (Fluothane)
Methoxyflurane (Penthrane)
Enflurane (Ethrane)
Isoflurane (Forane)
Desflurane (Suprane)
Sevoflurane (Ultane)
Sedative and analgetic
peri-operative drugs
propofol,
Etomidate
Ketamine
Fentanyl
Midazolam
Anxiolytics and
neuroleptics
Diazepam
Midazolam
Temazepam

DICLOFENAC
KETOROLAC
ALFENTANIL
FENTANYL
MORPHINE
PETHIDINE
Non-opioid
analgesic
Opioid analgesic
Muscle relaxants
NON-DEPOLARISING AGENTS :
ATRACURIUM
MIVACURIUM
PANCURONIUM
VECURONIUM
ROCURONIUM
DEPOLARISING AGENTS :
SUXAMETHONIUM
Anticholinesterase
used in anaesthesia
edrophonium,
neostigmine
Antagonists for central
and respiratory
depression
Drugs for malignant
hyperthermia
Doxapram, Naloxone,
Flumazenil
Dantrolene sodium

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