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GASTROPATI OBAT ANTI INFLAMASI
NON STEROID (OAINS/NSAID)
Saptino Miro, MDSub Bagian Gastroentero-Hepatologi
Bagian Ilmu Penyakit Dalam FK Unand
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Pemakaian OAINS (Obat Anti In!ama"i Non Steroi#)
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$omp!ika"i Ga"trointe"tina!
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Page !
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Page "
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Page #
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Page $
Faktor Perta%anan M&ko"a Lamb&n'
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Page %
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Page & 'etabolisme asam arakidonat dlm proses in(lamasi
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GASTROPATI OAINS
P+,SS I.F/0'0SI /0'BU.G 10.G DISB0BK0.
,/H P.GGU.00. ,0I.S
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Page ))
ENISENIS OAINS
Inibitor 3,4 .on Selekti(
5urunan 0sam salisilat 6 0spirin7 natrium salisilat7 kolinmagnesium7 sul(asala8in7 olsala8in
5urunan para amino(el 6 0setamino(en
0sam asetat Indol dan Inden 6 Indometasin dan sulindak
0sam asetat eteroaril 6 5olmetin7 diklo(enak7 ketorolak
0sam 0rilpropionat 6 Ibupro(en7 .aproksen7 Ketopro(en7
oksapro8in
0sam 0ntranilat 9Fenamat: 6 0sam me(enamat7 asammeklo(enamat
0sam nolat 6 ,ksikam 9Piroksikam7 'eloksikam:
0lkanon 6 .abumeton
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Page )2
ENISENIS OAINS
Inibitor 3,4-2 Selekti(
Furanon tersubsitusi diaril 6 +o(ekoksib
Pira8ol tersubsitusi diaril 6 3ele;o
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PEMILI*AN OAINS
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RISI$O $OMPLI$ASI GASTROINTESTINAL
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Page )"Patogenesis Kerusakan /ambung yang Diinduksi ,0I.S
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Patoi"io!o'i Ga"tropati OAINS
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Page )$
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Page )%
$!a"iika"i #an Etio!o'i
A!iran #ara% M&ko"a
Sekre"i M&ko"a
Sekre"i Ion Bikarbonat
Menin'katkan Perta%anan epite!
Pro"ta'!an#in
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FA$TOR RISI$O $OMPLI$ASI GASTROINTESTINALATAS A$IBAT OAINS
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Dia'no"i" Ga"tropati OAINS
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Page 2)
$e!&%an Ga"tropati OAINS
Perdarahan-Perforasi
Ulkus
Dispepsia
Tidak Bergejala
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DI0G.,S5IK
.D,SK,PI
Kongesti 'ukosa
rosi Ke;il-Ke;il
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P.050/0KS0.00.
G0S5+,P05I ,0I.S
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Men+e'a% !k&"
Lamb&n'
,0I.S 0+H2
,0I.S 0nalog Prostaglandin
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Page 2"
ANTAGONIS RESEPTOR *- (AR*-) DOSIS TINGGI
+0.I5IDI. )"* 'G=Hr
FK5IF '.I.GK05K0. pH /0'BU.G
'.U+U.K0. P+D0+0H0. /0'BU.G
F0',5IDI. !* 'g 2
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Page 2#
Pen'obatan
5eRi.aat !k&"
>Pen''&naan Obat Lain
>
eni", Lama, Do"i" OAINS
>$e!&%an Ga"trointe"tina!
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Page 2$
G,/DS5I. 92**%:P./I5I. D,UB/ B/I.D
'U/5I3.5+
U/KUS
0SPI+I.
3/3,4IB
$?
0SPI+I.
.0P+,4.
27?
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Page 2%
'IS,P+,S5,/
Prostaglandin Sintesis 0nalog
5erapi /ini pertama
(ek Samping yang @@@
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Page 2&
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Page *
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Page )
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$ESIMPLAN
,bat anti in(lamasi non steroid komplikasigastrointestinal melalui pengambatan produksi
prostaglandin
Faktor +isiko komplikasi gastrointestinal terkait,0I.S 6 usia7 kombinasi obat lain7 kombinasi oains
lain7 gangguan keseatan lain
ndoskopi merupakan standar emas diagnostik
gastropati ,0I.S
Pengambat Pompa Proton Ulkus lambung
dan komplikasi
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'anaAemen Pasien yg 'endapat aspirin