adalah efek yang tidak diinginkan dan muncul pada dosis terapi dan tidak selalu timbul pada setiap pasien. Efek samping perlu diketahui agar pengobatan tidak serta merta dihentikan karena ketidaknyamanan akibat efek samping. All Drugs are No Drugs are Dangerous Dangerous if used properly
Some drugs Some drugs have a
have a low low incidence of therapeutic ratio horrendous effects
Some drugs are
The most dangerous in dangerous drugs acute poisoning have the greatest but not when GOOD potential for used BAD benefit therapeutically Some adverse Some adverse effects can be effects occur predicted if you How dangerous a drug is after a delay or know the depends on the skill of the after stopping pharmacology prescriber (Type A); some are not (Type B) The Risk to Benefit Ratio
When prescribing drugs a doctor must assess
risk to benefit ratio in the individual patient by •Choosing an appropriate class of drug then an appropriate individual agent RISK BENEFIT •Is it effective ? •What are the chances of adverse effect ? •Are there features in this patient which affect choice eg other drugs, organ failure, aged •Tailoring the dose •Considering duration of treatment Setiap obat mempunyai efek samping Faktor yang berkontribusi : ◦ Umur ◦ Berat badan ◦ Jenis kelamin ◦ Kondisi kesehatan ◦ Keseriusan penyakit Pemakaian suatu obat harus dilakukan secara hati-hati pada kondisi tertentu karena dapat terjadi efek atau keadaan yang tidak diinginkan oleh pasien. Misalnya, peringatan pemakaian pada kondisi pasien gagal ginjal, hamil atau menyusui atau riwayat alergi. Selain itu, termasuk peringatan pemakaian obat secara bersamaan atau simultan dengan obat lain. Jika muncul efek samping obat yang tidak diinginkan maka : ◦ Mengganti obat baru ◦ Mengganti dosis ◦ Menghentikan penggunaan obat ◦ Cari bantuan tenaga medis yang kompeten ◦ Cari dokumen efek samping dan patient medication report Mual Muntah Fatigue(kelelahan) Pusing Mulut kering Sakit kepala Gatal, kemerahan Nyeri otot Abdominal Pain Blurred Vision Heart Palpitations Constipation Coordination Diarrhea Problems Dizziness Ringing in the Ears Headaches Skin Rashes or Hives Loss of Appetite Swelling of Hands or Memory Loss Feet Loss of Consciousness or Fainting Types of Adverse Drug Reactions (A-B-C-D-E):
Type A: Augmented pharmacologic effects - dose
dependent and predictable (e.g. hypoglycaemia with insulin, bleeding after anticoagulants, drowsiness after opioids)
They are common but often not severe, they are usually caused by too high dosage or alered pharmacokinetics (genetic factors, age, reduced renal or hepatal elimination)
Type B: Bizarre effects (or idiosyncratic) - dose
independent and unpredictable are relatively rare and may occur with very low doses (e.g. drug allergy – skin rashes – anaphylaxis) Types of Adverse Drug Reactions (A-B-C-D-E):
Type C: Chronic effects after chronic administration
(e.g. analgesic nephropathy after some analgesics or tardive dyskinesia after antipsychotics)
Type D: Delayed effects (e.g. teratogenic effects –
thalidomide , cancerogenic effects – stilbestrol during pregnancy > vaginal carcinoma in daughters 20+years later)
Type E: End-of-treatment effects (e.g. withdrawal
effects corticosteroid) Examples of adverse effects associated with specific medications