SMW KLOMPOK

8/18/2019 SMW KLOMPOK

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INTERAKSI OBAT FARMAKODINAMIK YANG BERSIFAT ANTAGONISME

BETA BLOCKER DENGAN BETA2 AGONIS PADAPASIEN ASMA

PARTNER 1

• Vebriani Zebua (121524008)

•Delviana (121524016)

•Siti Ira!ani (121524028)

•"a#arni $ana%a& (12152402')

•ebia Sari (12152406)

•De**! +,tavia (12152401)•Sa-ri.a (12152401/)

•$ariani Daani, (121524020)

•Dara Su,a Ratel!a (12152402/)

•"u&aa. Na*ara& (1215240/8)4216 121524048 1


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Beta Blocker eta bl3,er a.ala& 3bat3bat !an

en&alani n3re-ine-&rine .ane-ine-&rine (a.renalin) .ari -eni,atanre*e-t3rre*e-t3r beta -a.a *!ara7

Diuna,an untu, -en3batananti&i-erten*i aal 9antun .an aalin9al7

e,ani*e: ebl3, a.ren3*e-t3r eta!aitu beta1 .an beta 2 .i berbaai 3ran.an 9arinan .i.ala tubu&7

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Beta2 – Agon!

eta2 a3ni* a.ala& 3bat !an .iuna,an *ebaai*tiulan -a.a a.ren3*e-t3r beta27

Diuna,an -a.a -en.erita a*a untu,erela,*a*i,an 3t3t br3n,u* *e&ina ebu,a

*aluran u.ara .an e9ala a*a .a-at .iata*i7

"e,ani*e : ena,ti,an a.ren3*e-t3r eta2-a.a *!ara *e&ina eberi,an ee,

br3n,3.ilat3r !an erela,*a*i 3t3t -3l3* *alurannaa*7

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INTERA;SI +AT ETA AN ETA2A>+NIS PADA PASIEN AS"A

+n*et : Ra-i. (.ala 24 9a)

Severit! : "3.erate(Penurunan-eruba&an *tatu*,lini* -a*ien)

D3?uentati3n : -r3bable ( Sanat*erin ta-i ti.a, terbu,ti *e?ara,lini*)

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Ee,:

etabl3,er en&ilan,an ee,

br3n,3.ilata*i a,tivat3r beta2a.ren3*e-t3r !an .iuna,an untu,-a*ien a*a7

"e,ani*e Intera,*i +bat:

ara,3.inai, anta3ni*7 etabl3?,er .a-at ere.u,*i eta2 a3ni*

(te3%lin) *e&ina enia.a,an ee,br3n,3.ilata*i a,tivat3r beta2a.ren3*e-t3r !an .iuna,an untu,-a*ien a*a7

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+bat3bateta2a3ni*

r3n,u

*

r3n,3.ilata*i

A.ren3*e-t3r eta

eta 1 eta 2

eta bl3?,ern3n *ele,ti r3n,u*

r3n,3,3n*tri,*i

"e,ani*e Intera,*i +bat eta l3?,er .enan eta2 A3ni*

ter&a.a- Pa*ien A*a4216 121524048 6


7/62

"ena9een ;lini* :

• "3nit3r -eruba&an ,lini* -a*ien

• "3nit3r ,a.ar 3bat beta2 a3ni*.ala -la*a ,eti,a 3bat betabl3?,er .iuna,an atau-un.i&enti,an

• >anti 3bat eta bl3?,er n3n *ele,tien9a.i beta bl3?,er *ele,ti7

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@urnal 3nline

@u.ul : betabl3,er* u*e in -atient* #it& ?&r3ni?3b*tru?tive -ul3nar! .i*ea*e an. ?3n?3itant?ar.i3va*?ular ?3n.iti3n*

Penaran : ;&ale. Alb3uaini "3&ae. An.r3n Albert Ala&ar an. "3&ane. Ere.

Ta&un : 200/

Stateent !an .iabil :"an! -atient* #it& =+PD &ave ?3n?3itant?3n.iti3n* 3*tl! ?3r3nar! arter! .i*ea*e (=AD) t&atreBuire t&e u*e 3 betabl3?,er* (*)7 $3#ever.e*-ite t&e ?lear evi.en?e 3 * eCe?tivene** t&erei* a eneral relu?tan?e t3 u*e t&e in -atient* #it&=+PD .ue t3 a -er?eive. ?3ntrain.i?ati3n an. ear 3

in.u?in a.ver*e rea?ti3n* an. br3n?&*-a* 74216 121524048 8

http://www.ncbi.nlm.nih.gov/pubmed/?term=Albouaini%20K%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Andron%20M%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Alahmar%20A%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Egred%20M%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Egred%20M%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Alahmar%20A%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Andron%20M%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Albouaini%20K%5Bauth%5D


9/62

Intera,*i +bat ara,3.inai, aner*iat Anta3ni*e

ararin v* Vitain ;

Di*u*un +le&

;el3-3, II

=ut Putri Ar&an.i (121524041)Pebrina $arian9a (121524044)

Sri $7 $utabarat (121524045)

=ut Alina Za&ra(12152404)

itri R3*.iana (121524048)

De*i Purnaa*ari (121524054)Aini Savitri (121524058)

$erli ul#itara (12152405')

San.r3 "7 Siani-ar (121524100)

uni,a Arian.a (1215240')

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un*i utaan!a .ala tubu& a.ala& *ebaai ,3enFie*en*ial .ari *i*te enFi !an en*inte*a a,t3r-ebe,uan .ara& !a,ni a,t3r II (-r3t3bin) VII

(-r3,3nvertin) IG (=&ri*a*t a?t3r) .an H (S7P7a?t3r)7

;&u*u* -a.a ,ea.aan .e%*ien*i Vit7 ; .enan a.an!aba&a!a -en.ara&an 9ua -a.a 3ver.3*e .enan

anti,3aulan una ela#an ee,n!a

S"at" !en#a$a %engan akt&ta!

!e'aga (encega) Ter*a%n#a(e+'ek"an %ara) ,T*a# %anRa)ar%*a- 2../0

Vitain ;

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12/62

Anti,3aulan .erivat ?3uarin !an enuba& *inte*i*a,t3r -ebe,uan .ara& II (-r3tr3bin) VII

(-r3?3nvertin) IG (,3-3nen tr3b3-la*tin -la*a).an G (a,t3r StuartPr3#er) .i &ati .enanenanu ,er9a vitain ; (Tatr32008)

ararin

untu, -r3%la,*i* .an -en3batan tr3b3*i* vena .an

-er-an9anann!a eb3li -aru -en3batan ,3-li,a*itr3b3eb3li !an ter,ait .enan %brila*i atriu .an atau -enantian ,atu- 9antun .an *ebaai taba&an

.ala -en3batan 3,lu*i ,3r3ner (Tatr3 2008)

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14/62

ararin v* Vitain ;

+NSET :Dela!e.

Severit! :"3.erate

D3,uenta*i :E*tabli*&e.

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VITA"IN ; .a-at en&abat ee,#ararin -a.a a,t3r -ebe,uan VITA"IN

;.e-en.ent (Trat3r 2008)

"e,ani*e;er9a

;er9a anti,3aulan 3ral .ilea&,an atau

terbali, !an enara& ,e ,eun,inan-ebentu,an tr3bu*7 Penurunan a*u-anVITA"IN ; .a-at enin,at,an ee,

anti,3aulan7

Ee,

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17/62

(Dru Intera?ti3n a?t* 200')

"anaeent

"en&in.ari atau einial,an,3n*u*i variabel a,anan atau

*u-leen iFi !an enan.un Vitain;7

"eantau in.e,* ,3aula*i .anenaati tan.atan.a -ebentu,an

tr3bu* atau -er.ara&an *elaa,3n*u*i variabel VITA"IN ;7D3*i* anti,3aulan 3ral un,in -erlu

.iuba&

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;n3#le.e 3 =3ua.in *e an. Vitain; Intera?ti3n in Atrial ibrillati3n Patient*

1DL

3e% M4 Mo!!

Utah StateUniversity

2..5

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Stu.i ini enun9u,,an ,urann!a -eneta&uan-a*ien enenai intera,*i =3ua.in .an vitain ;-a.a -a*ien .enan a,t3r ri*i,3 *tr3,e7 Pen.i.i,an!an ti.a, ea.ai enenai vitain ; .anintera,*in!a .enan =3ua.in .a-at en!ebab,an

-enin,atan ri*i,3 *tr3,e .an -er.ara&anintra,ranial7 Pen.i.i,an intera,*i 3bat&ara=3ua.in .a-at enurani ri*i,3 -a*ien ,eti,a.iabun,an .enan ,e-atu&an .an .a-at *e?ara

ee,ti .i,el3la elalui e.ia au.i3vi*ual7 Penelitianlebi& lan9ut .i-erlu,an untu, enu,ur -enaru&,urann!a -a*ien -eneta&uan tentan 3rbi.ita*.an 3rtalita* .an interven*i -en.i.i,an !an*e*uai

Ke!+("lan

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Intera,*i +bat ara,3.inai,!an er*iat Anta3ni*e

"et3tre,*at .an A*a 3lat

Rini Tari*a 1215240//

RiF,! a!a *ari 121524081Ri*tina &a*ibuan 121524085

"a!a *ari 121524061 Trie ;urnia al.ini 121524064

NuraFi*a& 12152406N3la A#al


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"ET+TRE;SAT

"et3tre,*at (4ain3Net&!l-ter3lutai? a?i.)*e?ara lua* .iuna,an*ebaai anta3ni* -a.a,e3tera-i ,an,er

Ee, tera-euti,n!a

be.a*ar,an .ari in&ibi*ienFi 3lat re.u,ta*e7

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"e,ani*e

"et3tre,*at bertin.a, *ebaaianta3ni* a*a 3lat !an

en&abat *inte*i* -urin .an-irii.in .enan ?ara eni,atenFi .i&i.r33latre.u,ta*e *e?ara

rever*ibel *e&ina en?ea&,3nver*i a*a 3lat en9a.i

tetra&i.r33lat7

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A*a 3lat

Asam folat merupakan suatu turunan

tetrahidrofolat, akan mengganggu efek toksik

maupun terapeutik dari metotreksat .

Asam folat penting dalam pembentukan sel-

sel baru dan pemeliharaan sel.

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"e,ani*e ;er9a

A*a3lat

A*a.i&i.r33lat

Di&i.r33latRe.u,ta*e (DR)

$4 3latDR

u Sinte*i* DNA4216 121524048 24


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Ee, ara,3l3i

A*a 3lat .a-atenurun,an ee,

tera-i .ari

et3tre,*at

Tera-i anti,an,er

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Intera,*i +bat

• +n*et

.ela!e.

•Severit!3.erate.

• D3?uentati3n

*u*-e?te.

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Purin .an -irii.in

A*a 3lat et3tre,*at

EnFi.i&!.r33latre.u?ta*e

EnFi.i&!.r33latre.u?ta*e

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"ananeent

• Pa*ien !an *e.an enuna,anet3tre,*at untu, in.i,a*i tertentu&aru* en&in.ari -ea,aian a*a

3lat !an ti.a, .ian9ur,an.an ti.a, .ia#a*i7 3latuun!a ter,an.un .ala *e.iaan

ultivitain7• ti.a, .iberi,an -a.a #a,tu !an

ber*aaan

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@urnal +nline

• 1"%"l : T)e En7#+atc 3#%rol#!! o8Met)otre9ate an% Folc Ac%

• Pengarang: =arl =7 3l.an

• Ta)"n: 1'66• State+ent: "et&3treHate (4ain3N10

et&!l-ter3!llutai? a?i.) i* #i.el! u*e.a* a 3li? a?i. anta3ni*t in t&e

?&e3t&era-! 3 ?an?er7 It* t&era-euti?a?ti3n i* ba*e. 3n in&ibiti3n 3 t&e enF!e3late re.u?ta*e7

4216 121524048 2'


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• 1"%"l : Folate !"((le+entaton an%+et)otre9ate treat+ent n r)e"+ato%art)rt!: a re&e$

• Pengarang: S7


31/62

Intera,*i 3bat ara,3.inai,

!an er*iat Anta3ni*e


32/62


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Se'aga 7at #ang +eng"rang ata" +eng)ala"

ra!a n#er tan(a +eng)langkan ke!a%aran4 O'at n %golongkan +en*a%

analgetka (er8er ,non narkotk0 analgetka narkotk K)a!at +el("t :@analget!-ant(retk- ant@na+a! ,antra%ang0

%an 'an#ak %g"nakan "nt"k +eng)langkange*ale (en#akt re+a !e(ert art)rt!r)e"+atca- artro!! %an !(on%#lo!!4

Meng)a+'at akt&ta! !klook!gena!e,CO0

↓!nte!! (ro!taglan%n %an (rek"r!ortro+'ok!an %ar a!a+ arak%onat4

NSAID %eal )en%akn#a )an#a+eng)a+'at CO @2 ,(era%angan0 %ant%ak 'ere8ek (a%a CO ; ,(erln%"ngan

+"ko!a la+'"ng04

DEINI

SI

; E

R @A

+A T

NSAIDS ,NON STEROID ANTIINFLAMATORY DRGS

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"e,ani*e ;er9a NSAID*

4216 121524048 4

INTERA;SI +AT


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INTERA;SI +AT


36/62

"e,ani*e

Ee,

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• EFEK :

• Menngkatkan e8ek 8ar+akolog %an e8ektok!k %ar LIT3IM

• MEKANISME :

• NSAID! +e+(engar") (ro%"k!(ro!taglan%n % renal !e)ngga %a(at+en"r"nkan el+na! renal %ar Lt)"+- *a% la*" ek!kre! %ar Lt)"+ %k"rangka%ar Lt)"+ %ala+ Pla!+a +enngkatTok!k

• MANA1EMEN :

• Ketka NSAID! +"la %'erkan ata" % !to(-+ontor le&el LIT3IM !eta( = – < )ar

!a+(a teta( ata" t%ak 'er"'a) %an4216 121524048 /


38/62

• T M abaran ;lini* : Tan.a O tan.a a#al : ual tre3r -u*in &au*

iritabel 3t3t ,era?unan &ebat : a*i,ula*i 3t3t ,e.utan

rii.ita* &i-erree,*ia *eranan ,e9an&i-3teri bi?ara !an ti.a, 9ela* tre3r

3btun.a*i ataHia (,e&ilanan ,e*eibanan).an ,3a


39/62

"3nit3rin ,a.ar


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@RNA< +N


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@urnal ini ela-3r,an *ebua& ,a*u* tentan -a*ien-en.erita i-3lar ACe?tive Di*3r.er !an beru*ia 58ta&un .an enalai -r3%la,*i* lit&iu !an

.i*ebab,an 3le& -eberian 3bat ber*aaan .enanNSAID* .an .iureti, t&iaFi. untu, untu, ,3n.i*i !anabn3ral7 ;a*u* ini enea*,an tentan ,ebutu&an-a*ien untu, .iberi,an ,3n*elin ber,enaan .enane9ala O e9ala ,era?unan .an a,t3r re*i,3 !an uu

*ebelu -en3batan .enan lit&iu .iberi,an7

"r*7 AD 58 ta&un eneria -en3batan untu,&i-erten*i .an &i-3tir3i. !aitu teli*artane (40.a!) lev3t&!r3Hine (50 ?.a!) 9ua .ire*e-,anlit&iu (600 .a!) .an Buetia-ine (200 &ari)*etela& ,abu& .e-re*in!a (e-i*3.e) 8 bulan !an lalu7Pa*ien ini tela& en,3n*u*i lit&iu *elaa 25 ta&untera,&ir ,arena -en!a,it ental .i*3r.ern!a .enan*eru lit&iu .i 3nit3r .enan interval !an teratur74216 121524048 41


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• Suatu ,eti,a "r*7 AD enelu&,an n!eri .i-er*en.ian .an ,e*ulitan ber9alan7


43/62

INTERA;SI +AT PADA >IN@A


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=a-t3-ril

• =a-t3-ril a.ala& 3bat anti&i-erten*i3l3nan A=E in&ibit3r

• Diuna,an untu, en3bati&i-erten*i =$ (=3ne*tive $eartailure) .an untu, en?ea& aalin9al a,ibat &i-erten*i .an .iabete*7

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"e,ani*e ,er9a

• "en&abat enFi !an enuba& AT Ien9a.i AT II va*3.ilata*i*e,re*i al.3*ter3n

• ,3n*entra*i *eru ,aliu

Ee,*a-in

• ;uran atau &ilann!a in.ra -ene?a-

neutr3-enia -r3teinuria batu, ,erin

4216 121524048 45


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Mekan!+e Ker*a

=a-t3-ril

Va*3.ilata*ienurun,an *e,re*i

al.3*ter3n

4216 121524048 46


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S-ir3n3la,t3n

• S-ir3n3la,t3n a.ala& .iureti, &eat,aliu e,er9a -a.a : re*e-t3r al.3*ter3n(ber,3-eti*i) .i *it3-la*a -a.a tubulu*.i*tal a,&ir

• In.i,a*i e.ea !an ber&ubunan.enan e,*,re*i al.3*ter3n berlebi&an&i-erten*i aal 9antun ,3ne*ti

&i-eral.3*ter3ni* -rier &i-3,aleia*ir3*i* &ati !an .ii,uti .enan e.eaatau a*ite*7

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*-ir3n3la,t3n

• E8ek !a+(ng E.ea anuan SSP *e-ertienantu, let&ari *a,it ,e-ala an3re,*iaual unta& ,ra -erut .iare -en.ara&anlabun ul*era*i a*triti* unta&

aranul3*it3*i* t3,*i*ita* &e-at3*elular-enin,atan ,3n*entra*i N7

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Mekan!+e ker*a

S-ir3n3la,t3n

Mekanisme :

Aldosteron berikatan dengan

reseptor → protein → membukacelah Na → Na+ masuk melalui

celah natrium ke dalam sel →

muatan lebih + di dalam sel → K+

keluar menuju lumen → obat

berikatan dengan reseptor →

protein tidak dihasilkan → celahNa tdk terbuka → Na tertahan di

lumen → K tetap di dalam sel

karena di lumen lebih + → Na

dkeluarkan bersama urin

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Intera,*i +bat

+NSET• Dela!e.

SEVERIT•"a93r("enan?a

9i#a,eru*a,an-eranen)

D3?uentati3n• Pr3bable

"e?&ani*• n,n3#n

1

Sini%?an?e

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52/62

Interak!

Ca(to(rl S(ronolakton

• Da-at enin,at,an ,a.ar ,aliu

.ala .ara& ( -a.a -a*ien .e&i.ra*iatau !an e-un!ai -en!a,itin9al .iabete* aal 9antun atau-a.a -a*ien u*ia lan9ut)7

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"ana9een

• Penunaan ?a-t3-ril .an *-ir3n3la,t3n -a.a -a*ien.enan anuan in9al .iabete* u*ia tua :

"+NIT+R,3n*entra*i,aliu *eru.an un*iin9al

$eat3l3i rutin .an>R (Stae 1: n3ral>R '0


54/62

7777ana9een

Re,3en.a*i .3*i* *-ir3n3la,t3n 25&ari(.3*i* laFi 2 .. 50 )

;3n*elin .iet (en9aa a*u-an a,anan!an enan.un ,aliu)

$in.ari -ea,aian Su-leen ,aliu atau.ia#a*i .enan ,etat -ela,*anaann!a aa,

*ulit .ila,u,an

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A RETROSPECTIE STDY ON T3E POTENTIAL DRG INTERACTIONBETEEN ANGIOTENSIN CONERTING ENYME IN3IBITOR ORANGIOTENSIN RESEPTOR ANTAGONIST AND OT3ER DRGS INEND@STAGE C3RONIC RENAL FAILRE PATIENTS

@RNA<

$3ne! I*,an.ar a&!u.i un $i.a!at .an S!a*u.in

(2012)

4216 121524048 55


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=a-t3-ril *-ir3n3la,t3

n

Dila,u,an&e3.iali*i*

rutin

44 -a*ien =Ren.*tae

4 3ran-a*ien

Penin,atan

*eru,aliuen?a-ai61 EB<

ter9a.i i73=a-t3-ril *-ir3n3la,t3

n

Prevalen*i'0'

N3ral55 EB<

4216 121524048 56

INTERA;SI +AT PADA >IN@A< ATA SA


57/62

INTERA;SI +AT PADA >IN@A< ATA SA


58/62

+bat !an en&abat area*i

tr3b3*it *e&ina ter&abatn!a-ebentu,an tr3bu* !an terutaa*erin .iteu,an -a.a *i*te arteri7Analeti, anti-ireti, .an antiinaa*i

!an lua* .iuna,an .an .i3l3n,an.ala 3bat beba*7

SALISILAT a*a a*etil*ali*ilat

a*et3*al a*-irin

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SODIM SITRAT

Natr"+ Strat A!a+ Strat

Anti,3aulan -eni,at i3n ,al*iu7 Dala .ara& a,an eni,at ;al*iuen9a.i ,3-le,* ,al*iu *itrat7 an!a,.iuna,an .ala .ara& untu, tran*u*i,arena ti.a, t3,*i,7 Natriu *itrat bertin.a, *ebaai al,aliFer*i*tei,7

4216 121524048 5'


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Sini%?an?e :

+n*et : Dela!e.

Severit! : in3r

D3?uentati3n : e*tabli*&e.

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Sali*ilat *3.iu*itrat

Ee, ,e.ua 3bat :

S3.iu *itrat .iberi,an-a.a *aat ,era?unan

*ali*ilat aar urine.a-at .i,eluar,an

"e,ani*e

;eti,a -$ urineenin,at e,*,re*i

*ali*ilat .i.i*tribu*i,an3le& -r3*e* -eni,at i3n

.ala ?airan tubular*e&ina ;liren* in9al

*ali*ilat enin,at*e?ara .rati* -$ .i ata* /

Ee, t3,*i, !an ter9a.i bi*aen!eran 9antun

-en.ara&an a*tr3inte*tinal*tr3,e &e3rai, tinitu* atau

,e&ilanan -en.enaran7.anaal in9al

Ee, tera-i untu,-en3batan 9antun atau*tr3,e *a,it ,e-ala atau

.ea

"anaeent "enin,at,an ee,

*ali*ilat

"eantau -enu9ian -$urine

4216 121524048 61

@urnal +nline


62/62

@urnal +nlineD"re!! ata" alkaln!a! "rn "nt"k kerac"nan

!al!lat,Brt!) +e%cal *o"rnal &ol42>< ;6 no& ;5>2 PAPER AND S3ORT

REPORT-

L F PRESCOTT- M BALALI – MOOD- 1 A 1 3 CRIT3C3LEY- A F 1O3NSTONE-

A T PRODFOOT0S"+'er : (a!en !e)at ,"!a ;?@?< ta)"n0 %engan (e+'eran a!(rn

#ang 'erle') o&er%o!! %'erkan ;@ = (era$atan ter+a!"kkea+anan %ala+ ket%aktok!kan4 ? (a!en %engan (e+'eran!al!lat kon!entra! (la!+a 2

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