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Obat hematologik

antikoagulan
Heparin(standard/LMWH)
Antikoagulan oral warfarin
Heparin
Mekanisme kerja: + Antitrombin III
SK / IV
Ind: peny2 thromboemboli/lab/,MI,dll
KI : peny prdarahan: HT,stroke,alergi,
operasi SSP,alkoholisme,dll
Efek lain: -penyembuhan luka
-imunitas seluler, T4, aldosteron
-lipotropik,dll

F.kinetik:
- IV/SK
- metab: hati
- waktu paruhdosis,peny hati, ginjal
- tdk melalui placenta/ASI
- ekskresi mel urin
Anticoagulan oral
Gol 4-hidroksikumarin: warfarin,
dicoumarol
Antagonis vit K
Warfarin( wkt paruh 48 jam)
Interaksi obat(meatau meefek warf)
Indikasi/KI sama heparin
Hati2 pd kehamilan hipoprotombinemi
pd neonatus

Antithrombotik
(antiplatelets)

ASPIRIN
DIPYRIDAMOLE
TICLOPIDINE
CLOPIDOGREL
THROMBOLYTIC DRUGS
STREPTOKINASE
UROKINASE
Rt-PA
HAEMOSTATICS
TRANEXAMIC ACID(as. traneksamat)
APROTININ
ETHAMSYLATE
CARBAZOCHROME capillary
SOMATOSTATIN/OCTREOTIDE
ANTI HEMOPHILIC FACTOR
DESMOPRESSIN
Asam traneksamat
Kompetitif inhibitor plasminogen aktivator
Antifibrinolitik(synthetic fibrinolytic inhibitor
Ind: prdarahan sal cerna, kemih,dll
Antidot thd streptokinase/urokinase
SP: hamil, laktasi, disfungsi hepatic/renal
Dose: 0,5-1 gr 2-3 x/hari
Interaksi: estrogen, beta-lactam Ab
Aprotinin
Suatu inhibitor enzim proteolitik(tripsin,
plasmin, dll)
Inaktivasi free plasmin
Hambat aktivitas fibrinolitik dr plasmin-
streptokinase complex
Ind: open-heart surgery(sirkulasi extra
corporal), life-threatening haemorrhage
akibat hiperplasminemia

Inj 10.000 KIU/ml 50 ml
Dosis: 50-100 ml (IV inj atau infus) max
rate 10 ml/mnt. Kalau perlu 20 ml/jam
sampai bleeding stop
Interaksi: corticosteroid, heparin, asam
amino(solution), tetrasiklin
Ethamsilate
Mencegah/terapi prdarahan kapiler
Non vasoconstrictive/non fibrinolytic
specialty
Ind: cegah prdarahan pd kasus2 bedah,
hematuria, hematemesis, melena,
epistaxis, fragilitas kapiler, dll
Dosis umum: 500mg 3x sehari
Somatostatin
Anti GH
Ind:- sekresi eksesif tumor endokrin GIT
- prdarahan akut/ hebat GIT(ulcus
peptik)
- haemorhagic gastritis prdrhan varices
esophagus
Dose: 250 mg IV(bolus) 3mg/12 jam
2-5 hari


Octreotide
somatostatin
Anti GH
Ind: - VIP-secreting tomours
- bleeding gastro-esophageal varices
Dose: - GEPE tumour: 0,05 mg SC 1-2x/hr
- Bleeding varices: 25 mcg/jam
5 hr ( continuous IV infusion)
Interaksi: ciclosporin, cimetidine
desmopressin
Synthetic vasopressin
Ind: hemophilia A, von willebrand 1
Side effect: hipertension, headache
flushing, nausea
Dose: 0,3 mcg IV------ 15 min/2-3 days