Professional Documents
Culture Documents
ANTIPIRETIK)
Oleh
Wiwik Kusumawati
TUJUAN
1. Menyebutkan tentang penggolongan obat AINS
2. Menjelaskan tentang mekanisme kerja
(farmakodinamik) obat AINS (analgesik,
antipiretik, antiinflamasi)
3. Menjelaskan farmakokinetik obat AINS
(analgesik antipiretik)
4. Menjelaskan aspek EBM obat AINS (analgesik
antipiretik)
5. Menentukan penggunaan klinis obat AINS
(analgesik antipiretik)
OBAT AINS (NSAIDs)
Analgesik Antiinflamasi Nonsteroid
Nonsteroidal Anti-inflammatory
Drugs
Efek analgesik
Efek antipiretik
Efek antiinflamasi
Penggolongan
SALISILAT (aspirin, asetosal, diflunisal, dll)
PARAAMINOFENOL
(asetaminofen/parasetamol)
PIRAZOLON (dipiron/metampiron,
aminopirin, fenilbutazon, dll)
ASAM ORGANIK LAIN (ibuprofen, asam
mefenamat, indometasin, diklofenak, dll)
The evolution of NSAID
chemistry for the control of
pain
Coxib
Class
Acetic
Oxicam Acid Celecoxib
Class Class Rofecoxib
Propionic
Acid Valdecoxib
Salicylic Piroxicam Diclofenac Etoricoxib
Acid Class Etodolac
Meloxicam Parecoxib
Class Lumiracoxib
Ibuprofen
Aspirin ketoprofen
swelling hoarseness
COX-1 COX-2
PROSTAGLANDIN
COX inhibitor
The role of COX in inflammatory pain
COOH
COX-1 COX-2
Arachidonic acid
Prostaglandines Prostaglandines
PGE2, PGI2, TXA2 PGE2, PGI2, TXA2
COX-2
Non-specific COX-inhibitor specific inhibitor
Gastric Inflammation
mucosal Pain
protection Fever
TRAUMA/LUKA
FOSFOLIPID KORTIKO
STEROID
FOSFOLI ASAM
PASE ARAKIDONAT OBAT AINS
COX 1 / 2
SIKLOOK
SIGENASE PROSTAGLANDIN
1, 2, 3?
Efek antipiretik
PIROGEN
EKSOGEN
(infeksi Virus, bakteri, dll)
DEMAM
HIPO
TALAMUS
PIROGEN
ENDOGEN
PROSTA
(INTERLEUKIN-1)
GLANDIN
OBAT AINS
SALISILAT
Aspirin, Asetosal, Diflunisal, dll.
Prototipe obat AINS
Efek analgesik, antipiretik, antiinflamasi
Efek antiinflamasi, urikosurik (dosis tinggi :
2-4 gram)
Efek antiagregasi trombosit (dosis rendah)
Efek keratolitik, astringent
REYE Sindrome
SALISILAT
Absorbsi sempurna di lambung
Lama kerja 4 jam (4-6x/hari)
Ekskresi meningkat dengan alkalinisasi
urin
Iritasi saluran cerna (ulkus, perdarahan)
Pseudoalergi (Bronkokonstriksi)
SALISILAT
Results of the clinical trials consistently show that a single dose of ibuprofen is
more effective than paracetamol at reducing temperature over an 8 hour
period. The onset of effect of ibuprofen starts within 30 minutes of dosing.
Ibuprofen has been shown to be more effective than paracetamol in reducing
high fevers, particularly above 39°C (102°F).
Symptoms of Fever
Infections can disrupt the body temperature balance, and lead to temperatures
higher than 37.4°C (a fever). Fevers can lead to increased loss of fluid from
the body causing dehydration, discomfort for a child, and in a small proportion
of children, febrile convulsions.A fever over 38°C or 100°F should be treated.
The key to treating a fever is to reset the body's thermostat to bring the
temperature back down to around 37°C or 98.5°F. Giving a child plenty to
drink, to compensate for the fluid lost through sweating is important to avoid
dehydration.
IBUPROFEN
Ibuprofen and gastrointestinal bleeding
Level III.1 - Evidence obtained from well designed controlled trials without
randomization.
Level III.2 - Evidence obtained from well designed cohort or case control
analytic studies preferably from more than one centre or research group.
Level III.3 - Evidence obtained from multiple time series with or without the
intervention. Dramatic results in uncontrolled experiments.