Refrat Anestesi Adrenergic

7/23/2019 Refrat Anestesi Adrenergic

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OBAT ADRENERGIK DAN ADRENERGIK

BLOCKING AGENT

Oleh :

Perseptor :

Dr.Nasman Puar Sp.An

BAGIAN ILMU ANESTESI RSUP DR M DJAMIL

A!ULTAS !EDO!TERAN UNI"ERSITAS ANDALAS

PADANG

#$%$

KATA PENGANTAR

OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



Pu&' (an s)u*ur penul's u+ap*an *eha('rat ALLA, S-T *arena

/er*at rahmat (an h'(a)ahN0A penul's (apat me)elesa'*an re1erat )an2

/er&u(ul OBAT ADRENERGI! DAN ADRENERGI! BLO3!ING AGENT.

Re1erat 'n' merupa*an salah satu pemenuhan s)arat *epan'teraan*l'n'* (' /a2'an Ilmu Pen)a*'t Dalam a*ultas !e(o*teran Un'4ers'tas

An(alas. Penul's men2u+ap*an ter'ma*as'h *epa(a (r.Nasman Puar Sp.An

sela*u (osen pem/'m/'n2 /eserta semua p'ha* )an2 telah mem/antu

pen)usunan re1erat 'n'.

A*h'r *ata penul's /erharap a2ar re1erat 'n' /'sa /erman1aat /a2'

*'ta /ersama serta (apat menam/ah 5a5asan pen2etahuan (an

pemahaman se/a2a' *l'n's' )an2 nant'n)a (apat.('apl'*as'*an untu*

penatala*sanaan pas'en (en2an le/'h /a'* (an *omprehens'1.

Pa(an2 %6 Desem/er#$%$

Penul's

# | OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



DATAR ISI

!ATA PENGANTAR 777777777777777777777777777..#

DATAR ISI 77777777777777777777777777777778

BAB I PENDA,ULUAN

%.% Latar

Bela*an2777777777777777777777777779

%.# Batasan

Masalah7777777777777777777777777..

%.8 Tu&uan

Penul'san7777777777777777777777777.

%.9 Man1aat

Penul'san777777777777777777777777...

%. Meto(e

Penul'san7777777777777777777777777

BAB II TINJAUAN PUSTA!A

#.% De;n's' O/at a(rener2'+7777777777777..<

#.# !las';*as' O/at a(rener2'*7777777777777777777

%$

#.8 arma*o('nam'* (an 1arma*o*'net'*777777777777.#%

#.9 De;n's' A(rener2'* /lo+*'n2 a2ent77777777777..

#. !las';*as' A(rener2'* /lo+*'n2 a2ent77777777777.

#.< arma*o('nam'* (an 1arma*o*'net'*77777777777..

BAB III PENUTUP

8.%

!es'mpulan777777777777777777777777777#6

8.#

Saran77777777777777777777777777777..#6

8 | OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



REERENSI7777777777777777777777777777777.#

=

BAB I

PENDAHULUAN

1.1 Latar Belakang

Gastroeso1a2us re>u? ('sease @GERD merupa*an *ela'nan saluran

+erna /a2'an atas )an2 ('se/a/*an oleh re>u*s 2astroeso1a2us patolo2'*.

re*uens'n)a +u*up t'n22' (' ne2ara ma&u (en2an ('et (an o/es'tas

se/a2a' 1a*tor )an2 mempen2aruh'. D' In(ones'a pen)a*'t 'n' ser'n2 t'(a*

ter('a2nos's oleh (o*ter /'la /elum men'm/ul*an *eluhan )an2 /erat

sepert' eso1a2't's.

Re>u*s 2astroeso1a2us a(alah per'st'5a masu*n)a 's' lam/un2 *e

(alam eso1a2us )an2 ter&a(' se+ara 'nterm'ten pa(a set'ap oran2

terutama setelah ma*an. Re>u*s )an2 ter&a(' tanpa men'm/ul*an 2e&ala

(an peru/ahan h'stolo2'* mu*osa eso1a2us ('se/ut re>u*s

2astroeso1a2us ;s'olo2'*. B'la re>u*s ter&a(' /erulan2ulan2 seh'n22a9 | OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



t'm/ul 2e&ala (an *ompl'*as' ('se/ut re>u*s 2astroeso1a2us patolo2'*.

!ea(aan patolo2's se/a2a' a*'/at re>u*s *an(un2an lam/un2 *e (alam

esopha2us (en2an /er/a2a' 2e&ala )an2 t'm/ul a*'/at *eterl'/atan

eso1a2us lar'n2 (an saluran na1as. Pen)a*'t re>u*s 2astroeso1a2usmem'l'*' /e/erapa 'st'lah )an2 mel'put' re>u*s eso1a2't's (an re>u*s

s'mtomat's. Pa(a re>u*s eso1a2't's ter&a(' peru/ahan h'stolo2'*

se(an2*an re>u*s s'mtomat's men'm/ul*an 2e&ala tanpa peru/ahan

h'stolo2'* ('n('n2 eso1a2us.

Man'1estas' *l'n's pen)a*'t re>u*s 2astroeso1a2us san2at /er4ar'as'

(an 2e&ala )an2 t'm/ul *a(an2*a(an2 su*ar ('/e(a*an (en2an *ela'nan

1un2s'onal la'n (ar' tra*tus 2astro'ntest'nal. Ge&ala re>u*s &u2a /'sa ter&a('

(' e*stra esopha2us atau /ah*an men'm/ul*an *ompl'*as' sepert' str'*tur

esopha2us Barret h'n22a a(eno*ars'noma esopha2us. Penatala*sanaan

pen)a*'t re>u*s 2astroeso1a2us ter2antun2 (ar' /erat r'n2ann)a pen)a*'t

(an ter('r' (ar' /e/erapa te*n'* mula' (ar' peru/ahan pola h'(up terap'

1arma*olo2' h'n22a terap' /e(ah (an en(os*op'. Terap' /e(ah )an2

('la*u*an &u2a t'(a* terlepas (ar' e1e* samp'n2. Se/a2a' (o*ter *eluar2a

arahan terap' GERD 'n' le/'h /an)a* (' pr'or'tas*an untu* pen+e2ahan

(an pen2en(al'an *e/'asaan )an2 /er's'*o serta terap' 1arma*olo2' )an2

tepat sasaran a2ar t'(a* ter&a(' *ompl'*as' )an2 1atal pa(a pas'en.

1.2 Batasan Masala

Re1erat C OBAT ADRENERGI! DAN ADRENERGI! BLO3!ING AGENT

'n' mem/ahas men2ena' (e;n's' !las';*as' 1arma*o*'net'*

1arma*o('nam'* (an e1e* samp'n2 (ar' o/at a(rener2'* (an anta2on's

a(rener2'+.

1.! T"#"an Pen"l$san

| OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



Re1erat 'n' ('susun (en2an tu&uan untu* le/'h memaham' men2ena'

tentan2 o/at a(rener2'* (an anta2on's a(rener2'* se*al'2us se/a2a' salah

satu pemenuhan ses' pem/ela&aran (o*ter mu(a /a2'an Ilmu anestes'

RSUP DR M DJAMIL (alam ses' u&'an a*h'r.

1.% Man&aat Pen"l$san

Re1erat 'n' ('susun (en2an harapan (apat men'n2*at*an

pemahaman men2ena' o/at a(rener2'+ (an anta2on'st a(rener2'+

seh'n22a nant'n)a (apat ('apl'*as'*an (en2an /a'* pa(a *asus ('

lapan2an sesua' *ompetens' (o*ter *eluar2a.

1.' Met()e Pen"l$san

Re1erat 'n' ('susun /er(asar*an stu(' *epusta*aan (ar' /er/a2a'

/u*u (an &urnal )an2 mem/ahas men2ena' o/at a(rener2'* (an anta2on's

a(rener2'*.

BAB II

TIN*AUAN PU+TAKA

2.1 De,n$s$ (-at a)renerg$

O/at 2olon2an ('se/ut o/at a(rener2'* *arena e1e* )an2

('t'm/ul*ann)a m'r'p peran2san2an sara1 a(rener2'+ atau m'r'p e1e*

neuro transm'tter norep'ne1r'n (an ep'ne1r'n.

!er&a o/at a(rener2'+ (apat ('*elompo**an (alam &en's:

%. Peran2san2an or2an per'1er : otot polos pem/uluh (arah *ul't (an

mu*osa*elen&er l'ur (an *er'n2at.

#. Pen2ham/atan or2an per'1er : otot polos usus/ron*uspem/uluh

(arah otot ran2*a

8. Peran2san2an &antun2 (en2an a*'/at pen'n2*atan (en)ut &antun2

(an *e*uatan *ontra*s'< | OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



9. Peran2san2an SSPm'saln)a peran2san2an pernapasanpen'n2*atan

*e5aspa(aana*t'4'tas ps'*omotorpen2uran2an na1su ma*an

. E1e* meta/ol'* m'saln)a pen'n2*atan 2l'*o2enol's's (' hat' (an

ototl'pol's's (an pen2lepasan asam lema* /e/as (ar' &ar'n2anlema*

<. E1e* en(o*r'n : mempen2aruh' se*res' 'nsul'nren'n (an hormon

h'po;s's

. E1e* pras'napt'*

#.# !las';*as' O/at a(rener2'+

Ber(asar*an +ara *er&an)a o/at a(rener2'+ ter/a2' # :

O/at a(rener2'* *er&a lan2sun2

• A2on's F

/ 0 norep'ne1r'n (an ep'ne1r'n

F *lon'('n (an met'lnorepne1r'n F

FH 1en'le1r'n (an metaram'nol

• A2on's 3

30 ep'ne1r'n (an 'soprenal'ne

sal/utamol (an ter/utal'n

H norep'ne1r'n (an (o/utam'ne

o/at )an2 sele*t'1 reseptor F

ep'ne1r'n (an norep'ne1r'n ('rusa* (alam usus (an mempun)a' (uras'

*er&a pen(e* /'la (' sunt'**an *arena a(an)a am/'lan (an meta/ol'sme.

Ep'ne1r'n men'n2*at*an te*anan (arah (en2an men'n2*at*an 1re*uens'

(an *e*uatan (en)ut &antun2. St'mulas' reseptor F pem/uluh (arah

men)e/a/*an 4aso*ontr'*s' @4'sera*ul'ttetap' st'mulas' men)e/a/*an

| OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



4aso('latas' @otot s*elet (an a*h'rn)a res'stens' per'1er total /'sa

menurun.

Norep'ne1r'n mempun)a' se('*'t e1e* atau t'(a* sama se*al' pa(a reseptor

pem/uluh (arah (an *arena 'tu 4aso*onstr'*s' )an2 ('peranta' reseptorF t'(a* (' la5an. Ter&a('n)a pen'n2*atan te*anan (arah a*'/at hal

terse/ut a*h'rn)a a*n memperlam/at &antun2/'asan)a men2atas' a*s'

st'mulas' H se+ara lan2sun2 pa(a (en)ut &antun2. Ep'ne1r'n )an2

('/er'*an melalu' sunt'*an mempun)a' *e2unaan pent'n2 pa(a s)o*

ana;la*t'*.

O/at sele*t'1 reseptor

Isoprenal'n menst'mulas' semua reseptor men'n2*at*an 1re*uens' (an

*e*uatan (en)ut &antun2 serta men)e/a/*an 4aso('latas' e1e* terse/ut

men)e/a/*an penurunan te*anan ('astol'* (an te*anan arter' rata rata

(en2an se('*'t peru/ahan pa(a te*anan s'stol'*

A2on'st a(renoreseptor a(alah o/at )an2 relat'1 sele*t'1 men)e/a/*an

/ron*o('latas' pa(a (os's )an2 men)e/a/*an e1e* m'n'mal pa(a &antun2.

A2on'st 'n' res'sten terha(ap MAO (an *emun2*'nan t'(a* ('am/'l *em/al'

*e (alam neuron. Pen22unaan utaman)a a(alah pa(a terap' asma.

O/at a(rener2'+ *er&a t'(a* lan2sun2

S'mpatom'met'* )an2 /e*er&a se+ara t'(a* lan2sun2 men)erupa' stru*tur

norep'nepr'n )an2 ('transport oleh am/'lan pertama *e (alam term'nal

sara1 ('mana s'mpatom'met'* men22eser norep'ne1r'n 4as'*ular *e

(alam s'toplasma /e/erapa norep'ne1r'n (' meta/ol'sme oleh MAO namun

s'san)a ('lepas*an oleh transport )an2 ('perantara' pem/a5a untu*

men2a*t'4as' a(renoseptor.

3ontoh o/at a(rener2'+ *er&a t'(a* lan2sun2 :

o E1e(r'n

o Amphetam'n

o !o*a'n

6 | OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



Amphetam'ne res'sten terha(ap MAO. A*s' per'1er m'saln)a

ta*'*ar(' h'pertens' (an a*s' st'mulan +entraln)a terutama ('se/a/*an

oleh pelepasan *ate*olam'n.

!o*a'n sela'n se/a2a' anestet'* lo*al merupa*an s'mpatom'met'**arena *o*a'n men2ham/at am/'lan *em/al' norep'ne1r'n oleh term'nal

sara1. !o*a'n mempun)a' e1e* st'mulan sentral )an2 *uat.

E1e(r'n sela'n men)e/a/*an pelepasan norep'ne1r'n &u2a

mempun)a' e1e* /e*er&a se+ara lan2sun2. E1e* e1e(r'n men)erupa' e1e*

ep'ne1r'n namun (uras' *er&an)a &auh le/'h pan&an2. E1e(r'n merupa*an

suatu st'mulan sentral )an2 r'n2an tetap' amphetam'ne le/'h mu(ah

masu* *e (alam ota* mempun)a' e1e* st'mulan )an2 &auh le/'h he/at

terha(ap moo( (an *es'2apan serta mempun)a' e1e* (epres' pa(a na1su

ma*an.

arma*o('nam'* (an 1arma*o*'net'*

EPINERIN

arma*o('nam'*

!ar('o4as*uler : pem/uluh (arah

Dom'nas' reseptor F pem/uluh (arah men)e/a/*an pen'n2*atan

res'stens' per'1er )an2 men2a*'/at*an pen'n2*atan te*anan (arah. Pa(a

5a*tu *a(ar ep' menurun e1e* pa(a reseptor F le/'h (ulu men2h'lan2

se(an2*an terha(ap reseptor men)e/a/*an h'potens' se*un(er pa(a

pem/er'an ep' se+ara s'stem'*. Ep' pa(a (os's )an2 t'(a* /an)a*

mempen2aruh' te*anan (arahmen'n2*at*n res'stens' pem/uluh (arah

2'n&al(anmen2uran2' al'ran (arah 2'n&al 9$K. E*sres' Na!3l

/er*uran24olume ur'n /ertam/ah/er*uran2 atau t'(a* /eru/ah.

Ep' memper*uat *ontra*s' (an memper+epat rela*sas'. Dalam

memper+epat (en))ut &antun2 (alam *'saran ;s'olo2'sep'

memperpen(e* 5a*tu s'stol'* tanpa memperpen(e* 5a*tu ('astol'*.

A*'/at n)a +urah &antun2 /ertam/ah tetap' *er&a &antun2 (an pema*a'an

o*

= | OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



2.% De,n$s$ A)renerg$k -l(k$ng agent

Pen2ham/at a(rener2'* atau a(renol't'* 'alah 2olon2an o/at )an2

men2ham/at peran2san2an a(rener2'*. Ber(asar*an tempat *er&an)a

2olon2an o/at ' n' (' /a2' atas anta2on's a(renoreseptor (an pen2ham/at

sara1 a(rener2'*.

Anta2on's a(renoreseptor atau a(renoreseptor /lo*er 'alah o/at

)an2 men(u(u*' a(renoreseptor seh'n22a men2halan2'n)a untu*

/er'ntera*s' (en2an o/at a(rener2'* (an (en2an (eme*'an men2halan2'*er&a o/at a(rener2'* pa(a sel e1e*torn)a.In' /erart' e(renoreseptor

/lo+*er men2uran2' respons sel e1e*tor a(rener2'* terha(ap

peran2san2an sara1 a(rener2'* maupun teha(ap o/at a(rener2'*

e*so2en. Untu* mas'n2 ms'n2 a(renoreseptor F atau F/lo+*er mem/lo*

han)a reseptor F (an t'(a* men(u(u*' reseptor . Se/al'*n)a anta2on's

reseptor atau /lo+*er mem/lo* han)a reseptor (an t'(a*

mempen2aruh' reseptor F.Pen2ham/at sara1 a(rener2'* 'alah o/at )an2 men2uran2' respon

sel e1e*tor terha(ap peran2san2an sara1 a(rener2'* tetap' t'(a* terha(ap

o/at a(rener2'* e*so2en. O/at 2olon2an 'n' /er*er&a pa(a u&un2 sara1

a(rener2'* men22an22u pen2elepasan (anatau pen)'mpanan

norep'ne1r'n @NE.

2.' Klas$,kas$ A)renerg$k -l(k$ng agent

Ber(asar*an tempat *er&an)a :

o Anta2on's a(renoreseptor atau a(renoreseptor /lo+*er

Anta2on's a(renoreseptor F @F Blo+*er

• F Blo+*er nonsele*t'1

• FH Blo+*er sele*t'1 %$ | OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



• F Blo+*er sele*t'1

Anta2on's a(renoreseptor @ Blo+*er

o Pen2ham/at sara1 a(rener2'+

2.4 5ar6ak()$na6$k )an &ar6ak(k$net$k

I. Anta2on's a(renoreseptor atau a(renoreseptor /lo+*er

Anta2on's a(renoreseptor F @F Blo+*er

F Blo+*er nonsele*t'1

A(a 8 *elompo* :

%. Der'4at haloal*'lam'n

Se/a2a' haloet'lam'n ters'er o/at o/at 'n' (alam suasana netral

atau /asa (alam (arah a*an *eh'lan2an 2u2us halo2en (an

mem/entu* +'n+'n et'len'mon'um )an2 rea*t'1 (an t'(a* sta/'l. !emu('an

+'n+'n et'len'mon'um 'n' pe+ah (an mem/entu* 'on *ar/on'um )an2

san2at rea*t'1 )an2 a*an /erea*s' (en2an 2u2us sul1h'(r'l am'no (an

*ar/o*s'l mem/entu* '*atan *o4alen )an2 sta/'l (en2an a(renoreseptor

F. A*'/atn)a ham/atan /ers'1at 're4ers'/le.O/at 2olon2an 'n' (' se/ut F

/lo+*er )an2 non*ompet't'1 (an *er&an)a pan&an2 (' samp'n2 *er&an)a

)an2 nonsele*t'1 pa(a reseptor FH maupun F. Se/a2a' +ontoh ('/enam'n

(an 1eno*s'/enam'n.

arma*o('nam'*. !arena s'1at ham/atan )an2 'rre4es'/le (apat

('an22ap /e*er&a (en2an +ara men2uran2' &umlah a(renoreseptor F )an2

tese('a untu* ('ran2san2. eno*s'/enam'n mem/lo* reseptor FH maupun

F pa(a otot polos artero'l (an 4ena seh'n22a men'm/ul*an 4aso('latas'

(an 4eno('latas'. A*'/atn)a te*anan (arah turun (an ter&a(' re>e*

st'mulas' &antun2. ,am/atan reseptor F (' u&un2 sara1 a(rener2'*

men'n2*at*an pelepasan NE (ar' u&un2 sara1 )an2 men'n2*at*an

%% | OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



reseptor H pa(a &antun2. ,am/atan 4aso*onstr'*s' 'n' &u2a ter&a(' pa(a

h'po4olem'a (an 4aso('latas' a*'/at anestes'a.

arma*o*'net'*. A/sorps' 1eno*s'/enam'n (ar' saluran +erna han)a #$

8$ K. -a*tu paruhn)a *uran2 (ar' #9 &am tetap' lama *er&an)a/er21antun2 &u2a pa(a laman)a s'ntes's reseptor F. D' perlu*an 5a*tu

/erhar' har' se/elum &umlah reseptor F pa(a permu*aan sel tar2et

*em/al' normal. Tetap' lama *er&an)a t'(a* terlalu pan&an2 *arena a(an)a

+a(an2an reseptor FH (' otot polos pem/uluh (arah.

E1e* samp'n2 utama a(alah h'potens' postural )an2 ('serta' (en2an

re>e* ta*'*ar('a (an ar'tm'a la'nn)a. U&' Ames meun&u*an

1eno*s'/enam'n /ers'1at muta2en'* (an pem/er'an /erulan2 pa(a

he5an +o/a men)e/a/*an sar*oma per'toneal (an tumor paru tetap'

pa(a manus'a /elum ('*etahu'.

Pen22unaan utama 1eno*s'/enam'n a(alah untu* pen2o/atan

1eo*romos'toma )a*n' tumor ana* 2'n&al )an2 melepas se/a2'an /esar

NE (an Ep' *e (alam s'r*ulas' (an men'm/ul*an h'pertens' )an2 ep'so('*

(an /erat. eno*s'/enam'n ('/er'*an pa(a pas'en )an2 t'(a* (apat

men&alan' ('operas' (an )an2 (alam pers'apan untu* (' operas'. O/at 'n'

men2en(al'*an ep'so(e h'pertens' /erat (an e1e* /uru* NE (an Ep'

la'nn)a m'saln)a /er*uran2n)a 4olume plasma (an *erusa*an m'o*ar(.

Dos's a5al %$ m2 # *al' sehar' % 8 m'n22u se/elum operas'. Dos's ('

t'n2*at*an # har' se*al' sampa' men+apa' te*anan (arah )an2 (''n2'n*an.

Dos's total sehar' /'asan)a antara 9$ %#$ m2 (' /a2' (alam # 8

pem/er'an. eno*s'/enam'n &u2a e1e*t'1 untu* pen2o/atan s'mptomat'*

h'perplas'a prostat /en'2na @ BP,. Pa(a pr'a proses menua ('serta'

(en2an /er*uran2n)a pro(u*s' testosteron. Se/a2a' *ompensas'

('/entu* le/'h /an)a en'm F re(u*tase )an2 mere(u*s' testosteron

men&a(' ('h'(rotestosteron @ D,T )an2 le/'h a*t'1. Tetap' D,T

meran2san2 pertum/uhan prosat. F /lo+*er merela*sas' otot otot ('

leher *an(un2 *em'h (an (' *elen&ar prostat )an2 *a)a (en2an reseptor

FH seh'n22a memper/a'*' al'ran ur'n (an men2uran2' 2e&ala 2e&ala )an2

%# | OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



('t'm/ul*an a*'/at o/stru*s' prostat terse/ut. Pen2o/atan 'n' t'(a* la2'

('2una*an *arena men'm/ul*an h'potens' ortostat'*.

#. Der'4at Im'(aol'nentolam'n (an tolaol'n mem'l'*' e1e* )an2 sama terha(ap s'stem

*ar('o4as*ular (en2an 1eno*s'/enam'n. O/at o/at 'n' &u2a

men2ham/at reseptor seroton'n melepas*an h'stam'n (ar' sel mast

meran2san2 reseptor mus*ar'n'* (' saluran +erna meran2san2 se*res'

asam lam/un2 sal'4a *er'n2at (an a'r mata.

E1e* samp'n2 )an2 utama a(alah h'potens'. Re>e*s st'mulas' &antun2

men)e/a/*an ta*'*ar(' )an2 he/at ar'tm'a &antun2 (an 's*em'a m'o*ar(

sampa' 'n1ar* m'o*ar(. St'mulas' *e saluran +erna men)e/a/*an n)er'

lam/un2 mual (an e*saser/as' ul*us pept'*um. entolam'n terse('a

(alam 4'al m2 untu* pem/er'an I" (an IM se(an2*an tolaol'n (alam

*a(a # m2ml untu* sunt'*an I". entolam'n ('2una*an untu* men2atas'

ep'so(e a*ut h'pertens' pa(a 1eo*romos'toma (en2an (os's m2

('/er'*an se/a2a' 'n1us )an2 lam/at men2atas' pseu(o o/stru*s' usus

pa(a 1eo*romos'toma men+a2ah ne*ros's *ul't a*'/at e*stra4asas' F

a2on's *r's's h'pertens' (an ('s1un2s' ere*s'.

8. Al*alo'( er2ot

Ialah F /lo+*er )an2 pertama (' temu*an. S'1at 1arma*olo2'sn)a

*omple*s se/a2a' a2on's atau anta2on's pars'al pa(a reseptor F

a(rener2'* reseptor (opam'ne (an reseptor seroton'n. Er2otam'ne (an

(er'4at (eh)(ro2enat tertentu mem'l'*' e1e* ant' a(renal'ne )an2 lemah

tetap' (apat memper*uat e1e* (ar' o/at pressor )an2 la'n terutama pa(a

pas'en (en2an h'pertens'. E1e* 4aso*onstr'*s'n)a a(alah a*'/at st'mulas'

F a(rener2'*

FH /lo+*er sele*t'1

Der'4at *u'naol'n

%8 | OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



Dalam *elompo* 'n' termasu* praos'n teraos'n al1ulo'n (an

tamsulo'n. Semuan)a merupa*an anta2on's *ompet't'1 pa(a reseptor FH

)an2 san2a poten (an sele*t'1.

arma*o('nam'*. E1e* )an2 utama a(alah has'l ham/atan reseptor FHpa(a otot polos arter'ol (an 4ena )an2 men'm/ul*an 4aso (an

4eno('latas' seh'n22a menurun*an res'stens' per'1er (an al'ran /al'* 4ena.

Penurunan res'stens' per'1er men)e/a/*an penurunan te*anan (arah

tetap' /'asan)a t'(a* men'm/ul*an e1e* ta*'*ar('a. ,s'l 'n' ('se/a/*an

*arena FH /lo+*er t'(a* mem/lo*reseptor F pras'naps seh'n22a t'(a*

men'n2*at*an pen2elepasan NE (ar' u&un2 sara1 penurunan al'ran /al'*

4ena men)e/a/*an /er*uran2n)a pen'n2*atan +urah &antun2(an (en)ut

&antun2 /e*er&a sentral untu* men2uran2' pen2elepasan NE (ar' u&un2

sara1 (' per'1er (an mene*an 1un2s' /aroreseptor pa(a pas'en h'pertens'.

!arena e1e* 4aso('latas'n)a ma*a al'ran (arah (' or2an or2an 4'tal

(apat ('pertahan*an (em'*'an &u2a (en2an al'ran (arah per'1er ('

e*str'm'tas. !elompo* o/at 'n'+en(erun2 mempun)a' e1e* )an2 /a'*

terha(ap l'p'( serum menurun*an *olesterol LDL (an tr'2l'ser'(a serta

men'n2*at*a/ *olesterol ,DL.

arma*o*'net'*. Semua (er'4at *u'naol'n (' a/sorps' (en2an /a'*

pa(a pem/er'an oralter'*at *uat pa(a prote'n plasma@terutama FH2l'*o

prote'nmen2alam' meta/ol'sme )an2 e*stens'1 (' hat'(an han)a se('*'t

)an2 ('e*s*res' utuh melalu' 2'n&al.

Per/e(aan utama terleta* pa(a 5a*tu paruh el'm'nas'n)a.Praos'n

mempun)a' 5a*tu paruh #8 &am seh'n22a harus ('/er'*an #8 *al'

sehar'.Teraos'n mempun)a' 5a*tu paruh %# &am seh'n22a harus

('/er'*an %# *al' sehar'.Se(an2*an (o*saos'n (en2an 5a*tu paruh #$

##&am (apat ('/er'*an se*al' sehar'.Tamsulo'n mempun)a' 5a*tu paruh

%$ &amal1ulo'n 8 &am.

Se('aan. Semua (er'4at *u'naol'n ('/er'*an per oral.Praos'n (alam

/entu* ta/let % m2 (an # m2(em'*'an &u2a teraos'n (an

(o*saos'n.Tamsulo'n *apsul $# m2se(an2*an al1uos'n ta/let ER %$

m2.




E1e* samp'n2. E1e* samp'n2 utama )an2 potens'al (apat ter&a(' pa(a

pem/er'an FH/lo*er a(alah 1enomen (os's pertama)a*n' h'potens'

postural )an2 he/at (an s'n*op )an2 ter&a(' 8$=$ men't setelah

pem/er'an (os's pertama.,al 'n' ('se/a/*an oleh penurunan te*anan(arah )an2 +epat pa(a pos's' /er('r' a*'/at mula *er&a )an2 +epat tanpa

('serta' re>e*s ta*'*ar('a se/a2a' *ompensas'/ah*an ('per*uat oleh

*er&a sentral )an2 men2uran2' a*t'4'tas s'mpat's(' samp'n2 (os's a5al

)an2 terlalu /esar.enomen 'n' &u2a ter&a(' pa(a pen'n2*atan (os's )an2

telalu +epat atau pa(a penam/ahan ant'h'pertens' *e(ua pa(a pas'en

)an2 telah men(apat FH/lo*er (os's /esar.Tolerans' terha(ap 1enomen

'n' ter&a(' (en2an +epatme*an'smen)a t'(a* ('*etahu'.R's'*o ter&a('n)a

1enomen 'n' (apat ('*uran2' (en2an mem/er' (os's a5al )an2 ren(ah @%

m2 praos'n se/elum t'(urmen'n2*at*an (os's (en2an perlahan(an

menam/ah*an ant'h'pertens' *e(ua (en2an hat'hat'.Pa(a pem/er'an FH

/lo*erte*anan (arah harus ('u*ur pa(a 5a*tu /er('r' maupun /er/ar'n2

untu* mel'hat a(an)a e1e* postural 'n'.enomen (os's pertama 'n' *e+'l

*emun2*'nan ter&a('n)a pa(a pem/er'an (o*saos'n*erena sela'n

('la*u*an t'tras' (os's )an2 hat'hat'o/at 'n' mempun)a' mula *er&a )an2

lam/at @)an2 men)erta' masa *er&an)a )an2 pan&an2 seh'n22a

penurunan te*anan (arah ter&a(' se+ara perlahan @2ra(ual.

E1e* samp'n2 )an2 pal'n2 ser'n2 /erupa pus'n2 @h'potens'

posturalsa*'t *epalan2antu*palp'tas'e(ema per'1er(an mual.

Pen22unaan Terap'

,'pertens'. Semua (er'4at *u'naol'n (''n('*as'*an untu*

h'pertens')an2 merupa*an pen22unaan utama (ar' *elompo* o/at 'n'.

Ga2al &antun2 s'stol'* @GJS. Se/a2a' 4aso('latorF/lo*er telah

('2una*an untu* pen2o/atan GJ!.F/lo*er men)e/a/*an ('latas' arter'ol

(an 4enaseh'n22a men2uran2' a1terloa( (an preloa(.A*'/atn)a+urah

&antun2 men'n2*at (an *on2est' paru /er*uran2seh'n22a *emampuan

mela*u*an a*t'4'tas ;s'* men'n2*at (an 2e&ala sesa* napas

/er*uran2.Pa(a pen22unaan &an2*a pan&an2 (en2an praos'ne1e* terap'

'n' menetap tetap' &umlah *emat'an t'(a* /er*uran2.La'n haln)a (en2an

% | OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



pen22unaan pen2ham/at A3E atau *om/'nas' h'(rala'n (en2an n'trat

)an2 (apat memperpan&an2 h'(up pas'en GJ!.FH/lo*er la'nn)a*arena

relat'1 mas'h /aru/elum ('tel't' e1e* &an2*a pan&an2n)a untu* GJ!.

Pen)a*'t 4as*uler per'1er. Praos'n (apat men2uran2' 'ns'(en4asospasme ('2'tal pa(a pas'en pen)a*'t Ra)nau(.Pem/er'an (o*saos'n

pa(a pas'en (en2an h'pertens' r'n2an sampa' se(an2 (en2an *lau('*as'o

'nterm'ten (apat memper/a'*' 2e&ala pen)a*'t terse/ut.

,'perplas'a prostat /en'2na @BP,. Pem/er'an FH/lo*er pa(a BP,

men)e/a/*an rela*sas' otototot tr'2on (an s;n2ter (' leher *an(un2

*em'h serta otot polos *elen&ar prostat )an2 mem/esarseh'n22a

memper/a'*' al'ran ur'n serta 2e&ala2e&ala la'n )an2 men)erta' o/stru*s'

prostat terse/ut.

F Blo+*er sele*t'1

Se/a2a' F sele*t'1 han)a ('*enal )oh'm/'n )an2 ('temu*an ('

(alam *ul't /atan2 pohon Pausinystalia yohimbe (an (alam a*ar

Rauwolfa. 0oh'm/'n masu* SSP (en2an mu(ah ('s'tu mem/lo* reseptor

F pas+as'naps (an men)e/a/*an pen'n2*atan a*t'4'tas neurona(rener2'* sentral seh'n22a men'n2*at*an pelepasan NE (ar' u&un2 sara1

a(rener2'* (' per'1er. A*'/atn)a ter&a(' pen'n2*atan te*anan (arah (an

(en)ut &antun2 serta a*t'4'tas motor'* (an &u2a ter&a(' tremor. 0oh'm/'n

&u2a merupa*an anta2on's seroton'n. Dulu o/at 'n' /an)a* ('pa*a' untu*

pen)a*'t ('s1un2s' ere*s' pa(a pr'a.

Anta2on's a(renoreseptor @ Blo+*er

Anta2on's a(renoreseptor )an2 se*aran2 ter(apat (' pasaran :

%. Propanolol @ ta/ %$ (an 9$ m2 %%. Atenolol @ $ (an %$$

m2

#. Na(olol @ ta/ 9$ (an 6$ m2 %#. B'soprolol @ ta/ # (an

m2

8. P'n(olol @ ta/ (an %$ m2 %8. Esmolol

%< | OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



9. T'molol @ tetes mata $# K (an $ K %9. !ar4e('lol @ ta/ <#

(an # m2

. Alprenolol %. La/etalol

<. O*sprenolol %<. !arteolol @ ta/ m2. Pen/utolol %. Beta*solol @ Tetes mata $

K

6. Sotalol @ ta/ 6$ m2 %6. Sel'prolol

=. Ase/utolol @ *ap #$$ (an ta/ 9$$ m2 %=. Ne/'4olol

%$. Metoprolol @ ta/ $ (an %$$ m2

arma*o('nam'*. Blo+*er men2ham/at se+ara *ompet't'1 e1e* o/at

a(rener2'+ /a'* NE (an Ep' en(o2en maupun o/at a(rener2'+ e*so2en

pa(a a(renoreseptor . Potens' ham/atan ('l'hat (ar' *emampuan o/at

terse/ut (alam men2ham/at ta*'*ar('a )an2 ('t'm/ul*an oleh

'soproterenolatau oleh e?er+'se. !arena ham/atan 'n' /ers'1at *ompet't'1

re4ers'/le ma*a (apat ('atas' (en2an men'n2*at*an *a(ar o/at

a(rener2'+. Ase/utolol Ne/'4olol Metoprolol Atenolol B'soprolol

Esmolol Beta*solol (an Sel'prolol mem'l'*' s'1at *ar('osele*t'1 )an2

art'n)a a1t'n'tas )an2 le/'h t'n22' terha(ap reseptor H (' /an('n2*an

reseptor .

!ar('o4as*ular. E1e* terha(ap s'stem *ar('o4as*ular merupa*an e1e*

Blo+*er )an2 terpent'n2. Blo+*er men2uran2' (en)ut &antun2 (an

*ontra*t'l'tas m'o*ar(. Pem/er'an &an2*a pen(e* men2uran2' +urah

&antun2 res'stens' per'1er men'n2*at a*'/at re>e* s'mpat's )an2

meran2san2 reseptor F pem/uluh (arah. Al'ran (arah *e semua &ar'n2an

/er*uran2. Penurunan al'ran (arah 2'n&al (an (en2an penurunan la&u

'ltras' 2lomerulus. Pa(a pem/er'an *ron'* res'stens' per'1er *em/al' *e

n'la' a5al atau menurun pa(a pas'en h'pertens'.

Te*anan (arah. Blo+*er t'(a* menurun*an te*anan (arah pa(a

pas'en normotens' tetap' menurun*an te*anan (arah pa(a pas'en

h'pertens'. Blo+*er )an2 nonsele*t'1 m'saln)a propanolol men2ham/at

% | OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



e1e* 4aso('latas' melalu' reseptor . A*/atn)a ter&a(' ham/atan e1e*

4aso(epresor 'soproterenol (an pen'n2*atan e1e* pressor ep'ne1r'n.

Saluran na1as. Bron*o('latas' a(rener2'* (' perantara' oleh

a(renoreseptor e1e* /ron*o*onstr'*s' 'n' *e+'l pa(a oran2 normal tap'/'sa mem/aha)a*an untu* pas'en asma (an PPOM. Blo+*er (apat

memper*uat /ron*ospasme oleh seroton'n (an e1e* potens'as' 'n' le/'h

*uat pa(a pas'en asma ('/an('n2 (en2an oran2 normal. Oleh *arena 'tu

Blo+*er ('*ontra 'n('*as'*an untu* pas'en asma (an PPOM.

Meta/ol'*. Propanolol men2ham/at 2l'*o2enol's's (' sel hat' (an ran2*a

seh'n22a men2uran2' e1e* h'per2l'*em'a (ar' ep'ne1r'n e*so2en maupun

ep'ne1r'n en(o2en )an2 ('lepas*an oleh a(an)a h'po2l'*em'a. A*'/atn)a

*a(ar 2ula (arah pa(a h'po2l'*em'a (' perlam/at. Sela'n 'tu st'mulas'

se*res' 'nsul'n oleh o/at a(rener2'* &u2a ('ham/at oleh propanolol.

,ormon. Blo+*er men2ham/at se*res' ren'n pa(a &u*sta2lomerulus

2'n&al oleh o/at a(rener2'* atau a*t'4'tas s'stem a(rener2'* (an se/a2'an

se*res' )an2 ('t'm/ul*an oleh ('et ren(ah 2aram.

La'n la'n. Blo+*er men2ham/at tremor )an2 ('t'm/ul*an oleh

ep'ne1r'n atau o/at a(rener2'* la'nn)a. Blo+*er men2ham/at rela*sas'

uterus )an2 ('t'm/l*an oleh *ate*olam'n tetap' t'(a* mempen2aruh'

*ontra*s'n)a oleh *ate*olam'n. Blo+*er &u2a mem/lo* ham/atan

(e2ranulas' sel mast oleh *ate*olam'n.

arma*o*'net'*. Blo+*er )an2 mu(ah larut (alam lema* )a*n'

propanolol alprenolol la/etalol *ar4e('lol o*sprenolol (an metoprolol.

Semuan)a ('a/sor/s' (en2an /a'* @ =$ K (ar' saluran +erna tetap'

/'oa4a'la/'l'tasn)a ren(ah *arena men2alam' meta/ol'sme l'ntas pertama

)an2 e*stens'1 (' hat'. El'm'nas'n)a melalu' meta/ol'sme (' hat' san2at

e*stens'1 seh'n22a o/at utuh )a2 (' e*sres'*an melau' 2'n&al san2at

se('*'t. Blo+*er )an2 mu(ah larut (alam a'r )a*n' sotalol na(olol (an

atenolol. Sotalol ('a/sor/s' (en2an /a'* (' saluran +erna (an t'(a*

men2alam' meta/ol'sme l'ntas pertama )an2 /erart' seh'n22a ('peroleh




/'oa4a'la/'l'tas )an2 t'n22'. Na(olol (an atenolol *uran2 /a'* a/sor/s'n)a

(' saluran +erna seh'n22a /'oa4a'la/'l'tasn)a ren(ah. Mempun)a' 5a*tu

paruh )an2 pan&an2 )a*n' %# &am *e+ual' atenolol han)a < &am.

Blo+*er )an2 *elarutann)a antara a'r (an lema* )a*n' t'molol /'soprolol/eta*solol ase/utolol p'n(olol (an *arteolol. O/at o/at 'n' ('a/sor/s'

(en2an /a'* (' saluran +erna. El'm'nas'n)a melalu' 2'n&al (an hat' sama

/an)a* atau hamp'r sama /an)a* *e+ual' untu* t'molol han)a %$ #$ K

melalu' 2'n&al.

D'str'/us'n)a *e (alam SSP se&a&ar (en2an *elarutann)a (alam lema*.

Oleh *arena 'tu ter(apat per/e(aan 'n('4'(ual (alam *apas'tas

meta/ol'sme hat' ma*a Blo+*er )an2 men2alam' el'm'nas' pres'stem'*

(' hat' memperl'hat*an *a(ar plasma )an2 san2at /er4ar'as' setelah

pem/er'an (os's oral )an2 sama pa(a pas'en. -a*tu paruh o/at )an2

('el'm'nas' (' 2'n&al ('perpan&an2 pa(a pas'en )an2 men2alam' 2a2al

2'n&al. Pen)a*'t hat' &u2a men2uran2' *apas'tas meta/ol'sme hat' (ar'

o/at o/at terse/utseh'n22a men'n2*at*an /'oa4a'la/'l'tasn)a pa(a

pem/er'an oral.

E1e* samp'n2. Blo+*er (apat men)e/a/*an atau men+etus*an

2a2al &antn2 pa(a pas'en (en2an 2an22uan 1un2s' m'o*ar( m'saln)a

2a2al &antun2 )an2 ter*ompensas' 'n1ar* m'o*ar( a*ut atau *ar('ome2al'.

Bra('ar'tm'a merupa*an respon )an2 normal terha(ap Blo+*er (an

o/at ('hent'*an han)a pa(a pas'en (en2an *eluhan. Tetap' Blo+*er

(apat men'm/ul*an ('sos'as' A" (an hent' &antun2 pa(a pas'en )an2

su(ah men2alam' 2an22uan *on(u*s' A". Bron*ospasme )an2 ter&a('

*arena Blo+*er men'n2*at*an res'stens' &alan na1as (an (apar

men'm/ul*an asma pa(a pas'en (en2an r'5a)at asma /ron*'t's *ron's

ataupun aler2' /erat. Blo+*er (apat men)e/a/*an e*str'm'tas ('n2'n

men+etus*an atau memper/erat 2e&ala pen)a*'t ra)nau( (an

men)e/a/*an *am/uhn)a *lau('*as'o 'nterm'ten. Pa(a /e/erapa pas'en

2an22uan 4as*ular 'n' (apat se(em'*'an he/at sampa' men'm/ul*an

s'anos's (an 2an22ren. Pen22unaan *ron'* Blo+*er men'm/ul*an

supersens't'4'tas terha(ap A2on's *arena ('per*'ra*an ter&a('

%= | OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



pen'n2*atan &umlah reseptor se/a2a' me*an'sme a(aptas'. Pa(a

pen)a*'t &antun2 *oroner 2e&ala putus Blo+*er /erupa seran2an an2'na

)an2 (apat /era*'/at 'n1ar* m'o*ar( ar'tm'a 4entr'*uler (an /ah*an

*emat'an. Blo+*er men2ham/at 2l'*o2enol's's (an a*an men'm/ul*anta*'*ar('a se/a2a' tan(a pent'n2 pa(a h'po2l'*em'a. A*'/atn)a

pem/er'an Blo+*er (apat memper/erat (an memperpan&an2 1ase

h'po2l'*em'a a*'/at 'nsul'n atau h'po2l'*em'* oralpa(a pas'en ('a/etes.

Blo+*er nonsele*t'1 (apat menurun*an *a(ar *olesterol ,DL (an

men'n2*at*an tr'2l'ser'(a (alam serum. Blo+*er &u2a (apat

men'm/ul*an rasa lelah 2an22uan t'(ur (an (epres'. Blo+*er (apat

men)e/a/*an 2an22uan saluran +erna 5alaupun &aran2 (an 2an22uan

1un2s' se*sual alopes'a m'opat' (an atropat' &u2a (apat ter&a('.

Pen22unaan *l'n'*

%. An2'na pe+tor's

#. Ar'tm'a. Blo+*er men2ham/at e1e* *ate*olam'n pa(a reseptor H

(' &antun2

8. ,'pertens'. Blo+*er a(alah o/at ant'h'pertens' )an2 e1e*t'1.

9. In1ar* m'o*ar(

. Ga2al &antun2 s'stol'*. Blo+*er pa(a 2a2al &antun2 s'stol'* a*an

men2ham/at a*t'4'tas s'mpat's seh'n22a a*an men2ham/at

pro2res' 2a2al &antun2 (an men2uran2' res'*o ter&a('n)a ar'tm'a.

<. !ar('om'opat' o/stru*t'1 h'pertro;*

. eo*romos'toma

6. T'roto*s'tos's

=. M'2ren

%$. Glau*oma. T'molol top'*al e1e*t'1 untu* pen2o/atan 2lau*oma

su(ut ter/u*a. Blo+*er men2uran2' te*anan 'ntrao*uler

mun2*'n (en2an men2uran2' pro(u*s' +a'ran /ola mata oleh /a(an

s'l'ar's.

%%. Ans'etas. Blo+*er nonsele*t'1 sama e1e*t'1n)a (en2an

/eno('aep'n untu* ans'etas (en2an 2e&ala 2e&ala somat'* )an2

&elas.

#$ | OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



%#. S'ros's (en2an 4ar'ses.

II. Pen2ham/at sara1 a(rener2'*

Pen2ham/at sara1 a(rener2'* men2ham/at a*t'4'tas sara1 a(rener2'* /er(asar*an 2an22uan s'ntes's atau pen)'mpanan (an

pen2lepasan neurotransm'ter (' u&un2 sara1 a(rener2'*. Dalam

*elompo* 'n' termasu* 2uanet'('n 2uana(rel reserp'n (an met'ros'n.

• Guanet'('n (an 2uana(rel

Guanet'('n

A(alah pen2ham/at sara1 a(rener2'*. E1e* utaman)a a(alah

pen2ham/at respon terha(ap st'mulas' sara1 a(rener2'* (an o/ara(rener2'* )an2 /e*er&a se+ara t'(a* lan2sun2. Tempat ham/atan 'n'

a(alah pras'naps. Mula mula pa(a (os's terap' a*an mensta/'l*an

mem/ran u&un2 sara1 a(rener2'* seh'n22a u&un2 sara1 'n' t'(a*

respons'1 terha(ap st'mulas' sara1 a(rener2'*. D' (alam u&un2 sara1

a(rener2'* 2uanet'('n ('transport a*t'1 *e (alam 4es'*el (an

men22eser NE *eluar (ar' 4es'*el terse/ut. Tetap' se/a2'an telah

terle/'h (ahulu (' rusa* oleh MAO 'ntraneural.

arma*o('nam'*. A*'/at ter&a('n)a pen2oson2an NE pa(a u&un2

sara1 a(rener2'* ma*a o/at 'n' men)e/a/*an ham/atan reseptor F

maupun . Re1le* *ar('o4as*ular ter2an22u seh'n22a ser'n2 ('&umpa'

h'potens' ortostat'* maupun h'potens' se5a*tu mela*u*an *e2'atan

;s'*. Guanet'('n men'n2*at*an mot'l'tas saluran +erna (an (apat

men)e/a/*an ('are )an2 +u*up /erat. ,al 'n' ('hu/un2*an (en2an

(om'nas' s'stem paras'mpat's a*'/at ham/atan s'stem s'mpat's.

arma*o*'net'*. B'oa4a'la/'l'tas oral ren(ah (an /er4ar'as' antara 8

$ K. -a*tu paruh har'. Se*'tar $ K men2alam' meta/ol'sme (an

s'san)a (' e*sres'*an utuh (alam ur'n.

E1e* samp'n2. 0an2 pal'n2 pent'n2 h'potens' ortostat'* h'potens'

(apat ('serta' 2e&ala 2e&ala 's*em'a sere/ral (an 's*em'a m'o*ar(.

Retens' a'r (an 2aram men)e/a/*an e(ema (an *e2a2alan terap' &'*a

#% | OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



t'(a* ('/er'*an /ersamaan (en2an ('uret'*. !r's's h'pertens' (apat

ter&a(' a*'/at sens't'sas' oleh 2uanet'('n terha(ap s'mpatom'met'*.

In('*as'. Satu satu n)a se/a2a' ant'h'pertens'.

Guana(relGuana(rel (an 2uanet'('n /e*er&a (en2an +ara )an2 sama.

Per/e(aan )an2 utama antara *e(uan)a a(alah s'1at

1arma*o*'net'*n)a. B'oa4a'la/'l'tas t'n22' (an 5a*tu paruh elem'nas'

han)a %$ &am.

• Resepr'n

Resepr'n men2oson2*an *ate*olam'n (an ,T (' /er/a2a' or2antermasu* me(ula a(renal (an ota*. Deples' (' me(ula a(renal le/'h

lam/at (an *uran2len2*ap (' /an('n2*an &ar'n2an la'n. Resepr'n ter'*at

(en2an *uat pa(a mem/ran 4es'*el (alam u&un2 sara1 a(ren'* per'1er

maupun sentral. I*atan 'n' men)e/a/*an ham/atan me*an'sme

transport a*t'1 NE (an am'n la'n (ar' s'toplasma *e (alam 4es'*el

a(rener2'*. ,am/atan am/'lan NE (ar' s'toplasma men)e/a/*an NE

)an2 ('am/'l *em/al' (ar' +elah s'naps terpapar pa(a (an ('rusa* oleh

MAO )an2 ter(apat pa(a s'toplasma. Dem'*'an &u2a )an2 (en2an NE

)an2 men2alam' ('1us' pas'1 *eluar (ar' 4es'*el *e s'toplasma a*an

('rusa* oleh MAO 'ntraneural.

arma*o('nam'*. 3urah &antun2 (an res'stens' /er*uran2 pa(a

terap' &an2*a pan&an2 (en2an resepr'n. Penurunan te*anan (arah

/erlan2sun2 (en2an lam/at. re*uens' &antun2 (an se*res' ren'n

/er*uran2. Ter&a(' retens' 2aram (an a'r )an2 ser'n2 men'm/ul*an

pseu(otoleran+e.

arma*o*'net'*. Resepr'n ('meta/ol'sme seluruhn)a t'(a* a(a

/entu* utuh )an2 ('se*res'*an melalu' ur'n O/at 'n' terse('a (alam

/entu*ta/let $% m2 (an $# m2.

E1e* samp'n2. Se(as' (an t'(a* mampu /er*onsentras' atau

mela*u*an tu2as )an2 *omple* a(alah 2e&ala pal'n2 er'n2 ('t'm/ul*an

oleh resepr'n. !a(an2 *a(an2 ter&a(' (epres' ps'*ot'* sampa' a*h'rn)a

## | OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT



/unuh ('r'. E1e* samp'n2 la'nn)a a(alah h'(un2 tersum/at (an

e*saser/as' ul*us pept'*um.

• Met'ros'n

Met'ros'n merupa*an pen2ham/at en'm t'ro*s'n h'(ro*s'lase )an2men2*atal's's *on4ers' t'ros'n men&a(' DOPA (an )an2 merupa*an

en'm penentu (alam /'os'ntes's NE (an Ep'. Pa(a (os's % 9 2 sehar'

o/at 'n' men2uran2' /'os'ntes' NE se/an)a* 8 6$ K pa(a pas'en

1eo*romos'toma. Met'ros'n (apat men)e/a/*an *r'stalur'a se(as'

2e&ala e*strap'ram'(al ('are ans'etas (an 2an22uan ps'*'s. !arena 'tu

(os's harus ('t'tras' untu* men(apat*an e1e* terap' )an2 opt'mal

(en2an e1e* samp'n2 )an2 m'n'mal.

DA5TAR PU+TAKA

%. ,aeusler G. Pharma+olo2) o1 Blo+*er: +lass'+al aspe+t an( re+ent

(e4elopment. J 3ar('o4as+ Pharma+ol %==$%< @ suppl :S% S=.

#. MIMS. %$8r( e(. #$$<.

8. Oates J. Ant'h)pertens'4e a2ent an( the (ru2 therap) o1

h)pertens'on. In: ,ar(man JG L'm/'r( LE Mol'no PE e('tors.

Goo(man Q G'lmans the Pharma+olo2'+al Bas's o1 Therapeut'+s. =th.

Ne5 )or* M+Gra5,'ll %==< p.=$%.

9. Op'e L, Gersh BJ. Dru2 1or the heart. < th e(.3h. %. Ph'la(elph'a:

Else4'er Saun(ers #$$. p.%8#.

. Ph)s'+'ans Des* Re1eren+e. =th e(. #$$.

<. -est1all T3 -est1all DP A(rener2'+ a2on'st an( anta2on'st. In:

Brunton LL Lao JS Par*er !L e('tors. Goo(man Q G'lmans the

Pharma+olo2'+al Bas's o1 Therapeut'+s. %%th e(. 3h %$. Ne5

0or*:M+Gra5h'll#$$<. p.#<8=.

#8 | OBAT ADRENERGIK DAN ADRENERGIK BLOCKING AGENT

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