CHAPTER I

INTRODUCTION

1.1 Background Of The Study

Diarrhea is a bowel movement more than three times a day caused by

several factors. Diarrhea is defecating liquid more than three times in 24 hours
and more emphasize on the consistency of stool than on counting the frequency of
defecation. (WHO, 1999). Diarrhea is a disease with a soft or liquid bowel
movements can even be a liquid which frequency more often than usual that is
three times or more in a day. (DepKes RI, 2002). Diarrhea is a bowel movement
more than usual that is about three times a day or more in 24 hours. Diarrhea is
usually caused by a viral infection, a bacterium that causes vomiting. Besides that
diarrhea has typical symptoms of watery stool mixed with blood and mucus most
often caused by bacterial infection of dysentery.

According to the preliminary study when the writer did job training in
dr.M.Munir Abdulrachman Saleh Air Force Hospital. The writer found the patient
got diarrhea dissesae. Based on the preliminary it be solved by Loperamide. In
line with this loperamide is drug can be solve the dissease. According to
Loperamide Hydrochloride is a drug used to treat acute diarrhea. This type of
diarrhea strikes suddenly and usually stops within a few days. The disease is
generally caused by infections caused by bacteria, viruses or other germicidal
germs. This antidiarrheal medication serves to slow down the activity of the large
intestine so that food will be retained longer in the intestine. so the gut will absorb
more water and the stool will become more solid. Diarrhea due to irritable bowel
syndrome can also be treated with loperamide. For the explanation and the
preliminary study above, the writer is interested in doing a case on the analysis of
Loperamide Hydrochloride for solving diarrhea especially for patient with age 22
years old.

1
1.2 The Statement of The Problems

1. How to use Loperamide Hydrochoride to solve diarrhea?

2. What are the cause diarrhea dissease?

3. How to solve diarrhea dissease non pharmacology?

4. How to prevent diarrhea dissease?

1.3 The Objective of The Study

1. Symptomatic treatment of acute diarrhea; additional therapy for

rehydration in acute diarrhea in adults and children older than 4 years;
chronic diarrhea for adults only.
2. The basic mechanism for the occurrence of diarrhea is osmotic disorders
(foods that can not be absorbed will cause osmotic pressure in the
intestinal cavity increased so that air and electrolytes occur into the
intestinal cavity, the contents of the intestinal cavity is excessive due to
diarrhea).

1.4 The Significance of The Study

1. For the teacher

2. For the reader
3. For the student
4. For the nextwriters

1.5 Scope and Limitation

1.5.1 Scope

This analysis focuses the use of Loperamide Hydrochloride drugs to the

patient in dr.M.Munir Abdulrachman Saleh Air Force Hospital. Especially
Loperamide is a drug to treat sudden diarrhea. How it works is to slow the
movement of the intestine and make the feces become more dense. Imodium is
one of the best known brands of loperamide drugs. Loperamid is a synthetic

2
derivative of Pethidine that can inhibit bowel motility and also reduce
gastrointestinal secretion. Loperamid is believed to work by disrupting the
cholinergic and non-cholinergic mechanisms involved in peristaltic reflexes,
decreasing circular and longitudinal muscle activity in the intestinal wall.

1.5.2 Limitition

The writer limit her study only on the use of Loperamide Hydrocloride
drugs to solve the patient in 22 years old. It doesn’t include the analysis of another
drug and another disease. The authors restricted their research to the use of
Loperamide Hydrochloride drugs to treat patients aged 22 years. That does not
include analysis of other drugs and other diseases. Although loperamide is also
often combined with other drugs if the patient has other diseases outside of
diarrheal diseases.

1.6 Assumption

Loperamide can slow the activity of the intestine so that food will be
retained longer in the intestine.

1.7 Definition of Key Term

1. Diarrhea : Diarrhea is an abnormal or unusual condition of stool

expenditure. changes that occur in the form of increased volume of fluid
and frequency with or without blood mucus, such as more than three times
a day. (Hidayat, 2008)
2. Loperamide: synthetic derivative of Pethidine that can in bowel motility
and also reduce gastrointestinal secretion.
3. Bacterial Infections : Invasion and multiplication of microorganisms
(bacteria) in body tissues that produce signs and symptoms such as
immune responses. (WHO, 2014)

3
 CHAPTER II
LITERATURE REVIEW

2.1 Diarrhea

Pict .2.1
Diarrhea disease (diarrheal disease) is derived from the word diarroia
(Greek) which means to flow through (to flow through), an abnormal state of stool
expenditure is too often. This is due to changes in the transport of water and
electrolytes in the gut, especially in conditions with intrannal disturbances in
digestion, absorption, and secretion. Diarrhea is often defined as mild flab liquid
to liquid a lot ≤ 3 times per day.
According to WHO (1980) diarrhea is a watery or liquid bowel movement
more than three times a day. Acute diarrhea is diarrhea that is initially sudden and
lasts briefly, within a few hours or days.
Acute diarrhea is diarrhea lasting less than 15 days. Chronic diarrhea is
diarrhea lasting more than 15 days but not continuously and can be accompanied
by other diseases. Persistent diarrhea is a term used overseas that states that
diarrhea lasts 15-30 days and lasts continuously.

4
2.2 Etiology of Diarrhea

2.2.1 Drawing Table Etiology Diarrhea in the form of viruses, bacteria, and protozoa.
1. Infection
a) Virus
It is the most common cause of acute diarrhea in children (70 - 80%).
Rotavirus serotype 1, 2, 8, and 9: in humans. Serotypes 3 and 4 are found in
animals and humans, and serotypes 5, 6, and 7 are found only in animals. Norwalk
virus: present at all ages, generally due to borne foam or borne transmission
water, and may also occur person-to-person transmission.
b) Bacteria:
Enterotoxigenic E.coli (ETEC). It has 2 important virulence factors that
are colonization factors that cause these bacteria to attach to enterocytes in the
small intestine and enterotoxins (heat labile (HL) and heat stabile (ST) causing
fluid and electrolyte secretions that produce watery diarrhea.ETEC does not cause
brush border damage or invade the mucosa Enterophatogenic E.coli (EPEC) The
mechanism of the occurrence of diarrhea is unclear The finding of the EPEC
attachment process to the intestinal epithelium caused damage from the micro
villous membrane which would interfere with the absorbtion surface and
disaccharidase activity Shigella invaded and multiplied colonic epithelial cells,
causing death mucosal cells and the occurrence of ulcers Shigella rarely enters the
bloodstream Virulent factors include: smooth lipopolysaccharide cell-wall antigen
that has endotoxin activity and aids in cytotoxic and neurotoxic invasive and toxic
processes and may cause watery diarrhea (Zeinª, 2004). 8

5
c) Protozoa
Entamoeba histolytica prevalence. Amoebic dysentery is varied, but
spread throughout the world. Incidence increases with age, and especially in adult
males. Approximately 90% of asymptomatic infections are caused by non
pathogenic E.histolytica. Symptomatic aminoasis may be mild and persistent
diarrhea to fulminant dysentery (Zeinb 2004). Cryptosporidium. In developing
countries, cryptosporidiosis is 5 -15% of cases of diarrhea in children. Infection is
usually symptomatic in infants and asymptomatic in older children and adults.
Clinical symptoms of acute diarrhea with watery diarrhea type, mild and usually
selflimited. In patients with immune system disorders such as those with AIDS,
cryptosporidiosis is a reemerging disease with more severe diarrhea and is
resistant to some types of antibiotics (Zeinª, 2004).
2. Malabsorption of carbohydrates, fats, and proteins
3. Stale food, toxic, spicy food.
4. Psychological example of fear and anxiety (Arif et al, 2000).

2.3 Classification of Diarrhea

- Diarrhea Classification by nature:
1. Acute diarrhea
Is a diarrhea caused by a virus called Rotaviru that is characterized by a
flabby / liquid bowel movement can even be water only whose frequency is
usually (3kali or more in a day) and lasts less than 14 days. Rotavirus diarrhea is a
pathogenic bowel virus that ranks first as the cause of acute diarrhea in children.
2. Diarrhea Problematic
It is caused by viral infections, bacteria, parasites, lactose intolerance,
cow's milk protein allergy. Fecal-oral transmission, person-to-person contact or
person-to-person contact. Diarae is generally preceded by liquid diarrhea and then
on the second or third day new blood appears, with or without mucus, abdominal

6
pain followed by the emergence of hot tenesmus accompanied by loss of appetite
and body feels weak.
3. Persistent diarrhea
It is a persistent acute diarrhea, where the central point of pathogenesis of
persistent diarrhea is bowel mucosal cleft. The cause of persistent diarrhea is
similar to that of acute diarrhea.
- Classification of Diarrhea by mechanism:
1. Secretory diarrhea
Diarrhea usually occurs when there is a cedara in the intestine and fluid
and electrolyte secretion occurs into the intestinal lumen.
2. Osmotic diarrhea
Diarrhea is usually caused by a hard solute absorbed in the intestine. The
causes are lactose intolerance and asmotic laxative inflammation.

2.4 Symptoms of Diarrhea

As for the signs and symptoms caused by diarrhea:

2.4.1. Diarrhea with mild dehydration, with symptoms as follows:

1) Frequency of defecation 3 times or more in a day

2) Good general state and conscious

3) Normal eye and tears exist

4) Mouth and tongue wet

5) Do not feel thirsty and can drink

2.4.2. Diarrhea with moderate dehydration, fluid loss up to 5-10% by weight

body, with symptoms as follows:

1) Frequency of defecation more than 3 times a day and often

2) Sometimes vomiting, feels thirsty

7
3) Piss a little, less appetite

4) Decreasing activity

5) Concave eyes, mouth and tongue dry

6) Restless and sleepy

7) pulse faster than normal, crowned crown

2.4.3. Diarrhea with severe dehydration, fluid loss of more than 10% of body
weight, with symptoms:

1) Frequency of defecation constantly

2) Vomiting more often, feels very thirsty

3) No pee, no appetite

4) Very weak until unconscious

5) The eyes are very sunken, the mouth is very dry

6) Breath very quickly and deeply

7) The pulse is very fast, weak or not palpable

8) The crown is very sunken

2.5 Mode of Diarrheal Transmission

Mode of transmission of diarrhea through faecal-oral means through food

or drink contaminated with germs or direct contact of the patient's hand or
indirectly through the fly (via 5F = faeces, flies, food, fluid, finger).

- The risk factors for diarrhea are:

1. Behavioral factors

2. Environmental factors

8
- Behavioral factors include:

a. Not providing breast milk / breast milk (exclusive breastfeeding), providing

complementary feeding / MP AS too early will accelerate the baby's contact with
germs.

b. Using a bottle of milk proved to increase the risk of diarrheal diseases because
it is very difficult to clean milk bottles

c. Not apply Habits Wash hands with soap before feeding / eating, after defecation
(BAB), and after cleaning CHAPTER children

d. Unhygienic food storage.

- Environmental factors include:

a. Inadequate availability of clean water, lack of availability of Washroom Bath

(MCK)

b. Poor environment and personal hygiene

In addition to the above mentioned risk factors there are several factors of the
patient who can increase the tendency for diarrhea, among others: malnutrition /
malnutrition, especially malnourished children, immunosuppression /
immunosuppression and measles (Kemenkes RI, 2011).

2.6 Prevention of Diarrhea

Diarrheal disease can be prevented through:

1) Using clean water

Water signs:

a. Colorless

b. No smell

c. Does not taste

9
2) Cooking water until boiling before drinking to kill most germs.

3) Thoroughly dispose of baby and child stools.

Prevention of vomiting can be done by pursuing a clean and healthy environment.

1. Always wash your hands before touching the food.

2. Try also maintain the cleanliness of the cutlery.

3. Cooked water is completely boiling, clean, odorless, colorless and tasteless.

4. Close the food and drinks provided on the table.

5. Every time out go always wash hands, feet, and face.

6. Familiarize children to eat at home and not snack at random places. If you can
bring your own food when you go to school

7. Make healthy basic sanitation facilities in the neighborhood, such as clean

water and adequate latrines / toilets.

8. The latrine production should be in accordance with standard sanitary

requirements. For example, the distance between latrines (also neighboring
latrines) with wells or water sources is at least 10 meters so that water is not
contaminated. Thus, residents can use clean water for everyday purposes, for
cooking, bathing, and so forth.

2.7 Procedures

Handling fluid deficiency is the first action in dealing with diarrhea

patients. Simple things like drinking lots of water or oral rehydration solution
(ORS) like oralit should be done fast. Giving this up immediately if the symptoms
of diarrhea have started to arise and we can do it ourselves at home. A common
mistake is that new ORS administration is performed after dehydration symptoms
appear.

10
 In patients with diarrhea accompanied by vomiting, intravenous
administration of electrolyte solution is the main choice to replace body fluids, or
in other words need to diinfus. Problems can arise because there are some people
who are reluctant to care for the patient, for various reasons, ranging from cost,
kesulitam in keeping, fear of getting worse after admission, and others. This
considerable consideration causes the response time to overcome the problem of
diarrhea longer, and the more rapid the decline in the patient's condition towards
the fatal.

Diarrhea due to virus usually does not require treatment other than ORS.
If the condition is stable, then the patient can recover because the virus infection
causes diarrhea can be solved alone by the body (self-limited disease).

Diarrhea due to bacterial and parasitic infections such as Salmonella sp,

Giardia lamblia, Entamoeba coli need to get rational antibiotic therapy, meaning
that given antibiotics can eradicate germs.

Because most diarrheal causes are viruses that do not require antibiotics,
symptomatic recognition and laboratory testing should be performed to determine
the exact cause. In the case of acute and severe diarrhea, supportive treatment
takes precedence and sometimes does not require further examination if the
condition has improved.

The management that can be done is as follows:

1. Drink a lot

2. Rehydration perinfus

3. Appropriate antibiotics

Diit high protein and low residue

5. Anti-cholinergic drugs to relieve abdominal seizures

6. Tintura opium and paregorik to overcome diarrhea (or other drugs)

11
7. Transfusion in case of bleeding

8. Surgery in case of perforation

9. Observe fluid balance

10. Prevent complications.

2.8 Loperamide Drug Information

2.8.1 Loperamide drug image.

Group Antidianare

Category of prescription drugs

Benefits Overcome acute diarrhea

Consumed by Adults and children aged 12 and over

Form Tablet and capsule

12
 Loperamide hydrochloride is an active substance contained in diarrhea
medicine. Loperamid is a synthetic derivative of Pethidine that can inhibit
intestinal motility and also reduce gastrointestinal secretion.6 Loperamid is
believed to work by interfering with the cholinergic and non-cholinergic
mechanisms involved in peristaltic reflexes, decreasing circular and longitudinal
muscle activity in the intestinal wall.

a. Loperamide Work Mechanism

Loperamid is a synthetic derivative of Pethidine that can inhibit bowel

motility and also reduce gastrointestinal secretion. Loperamid is believed to work
by disrupting the cholinergic and non-cholinergic mechanisms involved in
peristaltic reflexes, decreasing circular and longitudinal muscle activity in the
intestinal wall.

b. Indication

Symptomatic treatment of acute diarrhea; additional therapy for

rehydration in acute diarrhea in adults and children older than 4 years; chronic
diarrhea for adults only.

c. Contraindications to Loperamide

Hypersensitivity to Loperamide. Abdominal pain without diarrhea. Should

not be given to the conditions under which peristaltic obstruction should be
avoided, especially in ileus or constipation conditions. Loperamide should not be
used as a primary therapy under conditions:

• Bacterial enterocolitis, which among others is caused by Salmonella, Shigella,

and Camphylobacter organisms;

• Acute dysentery;

• Acute ulcerative colitis;

13
• Pseudomembranous colitis associated with the use of broad-spectrum antibiotics.
Infants / children under 2 years old.

d. Dosage of Loperamide

Adult dose:

- Acute diarrhea: initial dose of 4 mg orally, followed by 2 mg every next diarrhea

up to 5 days; the usual dose of 6-8 mg per day, maximum 16 mg per day. If the
acute diarrhea does not heal / no improvement within 2 days, should the drug use
be stopped.

- Chronic diarrhea: initial dose of 4 mg orally, followed by 2 mg of diarrhea to

controlled diarrhea, maximum 16 mg per day. Average dose for maintenance:
dose-tattoos as per individual requirement, average dose per day 4-8 mg orally
taken as a single or divided dose, maximum 16 mg per day. If there is no
improvement within 10 days with administration of 16 mg per day, drug use is
discontinued.

Dose of children:

Acute diarrhea: 2-6 years of age (13-20 kg): 1 mg orally three times daily; age 6-8
years (20-30 kg): 2 mg orally twice daily; age 8-12 years (> 30 kg): 2 mg orally
three times daily.

Chronic diarrhea: therapeutic dose in children has not been established / not
allowed for chronic diarrhea in children4, but a dose of 0.08-0.24 mg / kg / day in
2-3 divided doses has been used.

In the UK, it is not allowed to be used in children under 4 years of age, while in
America, not allowed in children under 2 years of age.

e. Interactions With Other Drugs:

14
 Clinical data show that loperamide is a substrate of P-glycoprotein.
Administration of loperamide (16 mg single dose) together with quinidine or
ritonavir in which both are inhibitors of p-glycoprotein will increase plasma
loperamide levels by 2-3 times of pharmacokinetic interactions with p-
glycoprotein inhibitors when loperamide is administered at recommended doses
(2 mg up to a maximum dose of 16 mg per day) remains unknown. In the
administration of 16 mg single loperamide dose with 600 mg single-dose
saquinavir, then loperamide will decrease 54% saquinavir exposure, which is
clinically related with therapeutic efficacy reduction of saquinavir. The removal of
saquinavir against loperamide is clinically very small. So if loperamide is
administered together with saquinavir, the efficacy of saquinavir therapeutics
should always be monitored.

Loperamid increases the absorption of gastrointestinal Desmopressin.

Major interaction: Saquinavir (probable). Moderate interaction: Gemfibrozil
(established), Itraconazole (established).

f. Side Effects of Loperamide

- Skin disorders and subcutaneous tissue

Rash, pruritus, urticaria, angioedema, and very rare bull eruptions including
erythema multiforme, Steven-Johnson syndrome and Toxic Epidermal Necrolysis
have been reported on Imodium use.

- Abnormalities of the immune system

Very rare allergic reactions and severe cases of hypersensitivity including

anaphylactic shock and anaphylactoid reactions have been reported in the use of
Imodium.

- Gastrointestinal disorders

Dry mouth, abdominal pain, bloating or discomfort, nausea, vomiting, flatulence,

dyspepsia, constipation, paralytic ileus, megacolon, including toxic megacolon.

15
- Kidney and urinary disorders

Urinary retention

- Abnormalities of the nervous system

Drowsy, dizzy

g. Warning and Caution

Anaphylaxis, dehydration in children, lack of fluids and electrolytes.

Patients with liver disorders due to the presence of first cross-liver metabolism.
Use in children should be noted because of the large variability of response in this
age group, so it is not recommended in infants.

h. Description

Loperamide hydrochloride - powder from white to yellowish. It is soluble

in methanol, isopropyl alcohol, xloroforme, slightly soluble in water. Molecular
weight 513,51.

16
 CHAPTER III

SKRINING RECIPES

3.1 Recipe

A. SKRINING ADMINISTRATION YES NO

Name 
Age 
Kink Type 
Height / Weight 
Name Dokter 
Practice Number 
Doctor Address 
Signature Doctor 
Date Recept 
Room / Unit of Origin 

17
 B. CLINICAL SCRINING YES NO
Accuracy Indication 
Dosage 
Usage Time 
Duplication Treatment 
Drug Allergy 
Drug Interactions 
Drug Side Effects 
Contra Indications 
Effects Aditive 

3.2 Patient Assessment Results

Patients suffering from Acute Diarrhea and Bowel and Stomach Disease.

3.5 Patient Data

Name of patient: Ny.Siti Mauliyah

Age : 22 years old

Date of birth : July 31, 1995

Gender : Female

3.6 Drug Description in Prescription

a. Spuit 3cc

b. NaCl

Form of dosage : NaCL Infusion Liquid

18
 Indications : Lost isotonic plasma replacement, fluid replacement under
conditions of hypochloremic alkalosis.

KI : hipernatermia, hypokalemia.

c. D5%

Dosage form : Intravenous fluid D5%

Indication : used as a nutrient solution with calorie content about 200

calories / liter. Also used to add volume of blood
circulation in the state of dehydration and shock.

KI : Hyperlislisia, diabetes insufidus, and patients with

"Glucose galactose malabsorbtion - syndrome". Patients
anoria, intracranial or intraspinal, haemorrhage.

d. Attapulgit

Dosage form : Tablets

Weight : 600mg, 650mg

Indications : treatment of non-specific diarrhea

KI : hypersensitivity, do not give to the patient where

constipation should be avoided with intestinal obstruction.

e. Loperamide

Dosage form : Tablets and Capsules

Weight : 2mg

Indications : Symptomatic treatment of acute diarrhea; additional

therapy for rehydration in acute diarrhea in adults and
children above 4 years; chronic diarrhea for adults only.

19
 KI : Children under 12 years old, acute colitis as it can causing
a toxic megacolon, under which circumstances
constipation should be avoided, hypersensitive sufferers
against this drug.

f. Cotrimoxazole

Dosage forms : Tablets, and syrups

Weight : 120mg / tab, 480 mg / tab, 240 mg every 5ml syrup.

Indications : Urinary tract infections, GI infections, Channel infections

breath, ear canal infection, Pneumonia.

KI : Patients with impaired liver function, anemia,

hypersensitive to Cotrimoxazole.

g. Omeprazole

Dosage form : Capsules, Vials, Ampoules.

Weight : 20mg capsule, 40mg vial, 10ml solvent.

Indications : - Short-term treatment of patients with duodenal ulcers.

- Short-term treatment of gastric ulcers.

KI : Should not be used in patients who have a history

Hypersensitive to omprazole components.

20
 CHAPTER IV

PLAN OF LIVING CULTURE

4.1 Purpose of Diarrhea Therapy

The symptoms of diarrhea will generally improve within 24-72 hours.

Monitoring of frequency and volume of bowel movements. It also needs to
monitor appetite increase, body weight, serum osmolarity, serum electrolytes,
complete blood cell count, urine and environmental culture. In patients with acute
diarrhea without severe fever and severe dehydration will generally heal by itself.
Patients only need outpatient treatment with oral rehydration therapy,
symptomatic treatment and diet. While in patients with severe diarrhea, rapid
rehydration is necessary. Patients with cases of poisoning (fever, dehydration,
hematochezia, and hypotension) should be hospitalized and receive intravenous
fluids and empirical antibiotics while awaiting culture test results and sensitivity.

The goal of therapy in the treatment of diarrhea is to prevent excessive

water exposure, electrolytes and acid-base disorders, cure symptoms, address the
causes of diarrhea, and regulate secondary disorders that cause diarrhea.

4.2 Therapeutic Target

Target therapy:

• The cause of diarrhea

Diarrhea caused by infection by pathogenic bacteria, germs and viruses. As for

ragsangan caused by worm disease, certain nutritional influences, as well as nerve
influences such as shock, fear, anxiety, and so on.

• Symptoms of diarrhea

Usually diarrhea sufferers are dehydrated to mouth and dry skin, sunken eyes.
Also feel abdominal cramps, nausea and vomiting, headaches, loss of appetite,
soft and fluffy feces and usually accompanied by blood.

21
4.3 Therapy Strategy

a. Pharmacology Therapy

Pharmacological therapy is generally nonspecific diarrhea can heal by

itself, but to reduce the symptoms of diarrhea can be used several drugs, including
antimotility, antisecretori, adsorbent and other drugs such as probiotics, lactase
and zinc enzymes (Berarrdi et al., 2009; Spruill and Wade , 2008). Antimotility In
this class are opiates and their derivatives, which work by delaying intraluminal
displacement or increasing bowel capacity, prolonging contact and absorption.
Most opiates work through peripheral and central mechanisms, except loperamide
only peripherally. Loperamid inhibits the calcium-binding protein of calmodulin,
which regulates chloride expenditure. Loperamid is recommended for treating
acute and chronic diarrhea. If used properly, these drugs do not cause side effects
such as dizziness and constipation.

b. Non Pharmacological Therapy

- Multiply drinking water

- Maintain the hygiene of food and beverages consumed.

- Avoid soda and high drink glucose levels.

4.4 Compounding and Dispending

1. Receive a recipe.

2. Check and appreciate recipes.

3. Confirm the prescription price to the patient.

4. If the patient agrees, give a payment receipt.

5. Give the queue number.

6. Review the recipe and recipe entry.

22
7. Recipe Entry.

8. Take: Take 3cc Spuit as much as 3 pieces, NaCL infusion liquid as much as 3
bags, take D5% infusion fluid as much as 2, Take Attapulgite as much as 12
tablets input palstik clip and give etiquette. Take loperamide as many as 10 tablets
input plastic clip give etiquette, take cotrimoxazole 480 mg as much as 10 tablets
of plastic input clip give etiquette, take omeprazole as much as 10 tablets input
plastic clip give etiquette.

9. Give to patients and IEC

4.5 IEC

Mrs Siti Maulidiyah is the medicine, there are seven kinds of bu. This is a
syringe and fluid infusion please restored again to the doctor. And Drug
Attapulgite for diarrhea taken two tablets after CHAPTER, drug Loperamide
taken three times a day tablet after CHAPTER, cotrimoxazole medication for
antibiotik taken three times a day one tablet after meal and must run out.
Omeprazole medicine for peptic ulcer is taken one day before meals. Get well
soon.

4.6 Monitoring and Evaluation

Monitoring and evaluation needs to be done to see and improve the

success of therapy for these patients. Implementation of this activity requires the
recording of patient medical data (medication record). control of drug use of such
patients can be controlled through the medical records contained in the Hospital
dr. M. Munir, can be done through the doctor's prescription records, and can also
be done through the patient's Drug Card.

23
 CHAPTER V

CLOSING

5.1 Conclusions

Diarrhea is a bowel movement (defecation) with a liquid or half-liquid

(half solid) stool, more than 200 grams of stool water content normally or 200ml /
24h. Another definition uses the frequency criterion, ie a watery stool more than 3
times / day. Urinary discharge can be accompanied by mucus and blood.

Diarrhea is also caused by several factors: bacteria, viruses, food,

malabosrbsi carbohydrates or fats, deworming and also nerve influences such as
anxiety, fear, and so on.

Drug therapy in patients is used antidiarrheal drugs to stop stools more

than 3 times a day and also treat dehydration by giving intravenous fluids or other
electrolyte fluids.

Provision of therapy in patients named Siti Maulidiyah aged 22 years at

the Hospital dr. M. Munir Lanud Abd Saleh is correct according to the existing
literature. Already in accordance with drug therapy for diseases suffered by these
patients.

Non-pharmacological therapy also needs to be done by patients, such as

changing healthy lifestyles, regular exercise, washing hands before eating and
drinking, drinking with clean water, and also eat healthy foods that are free from
bacteria or viruses

24
5.2 Suggestions

Get used to always live healthy so that we are not exposed to diarrhea,
improve the health of both individuals and the environment, so as not to get sick.
Cook water until boiling, wash your hands before and after eating defecate (BAB)
and Urinate (BAK) in latrines (WC)..

25
 BIBLIOGRAPHY

1. Syamsul Hilal, Dasar-dasar cairan dan elektrolit, 2014, page 14

2. Dr.Elfradi, Diare, Tahun 2014, hal 10

3. Renny Yuliani Santoso, Farmakolog Info, tahun 2008

4. Umar Zein, Universitas Sumatra Utara, Diare disebabkan oleh

Bakteri, 2004, page 4

5. Lukman Zulkifli Amin, Tata Laksana Diare Akut, 2015

6. Materi Pembelajaran Persiapan pre simulasi apotek, page 3

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