Professional Documents
Culture Documents
2020
Introduction
• WSMI : classification of
medicinal products into
two classes: Prescription
The 1990’s • 2000- WHO “guidelines for
the regulatory assessment of
and non-prescription medicinal products for use in
• 1980_ medicines on self-medication
prescription to be non- • 1997-WSMI “review of • 2000-2005-The Benefits of
prescription status. Responsible Self-Medication
consumer surveys:
• 2006-2010 and the future-A
• Ibuprofen & hidrokortison “Health care, self-care and globalizing world. Prevention
self-medication of disease through self-care
• 1998, Role of pharmacist and responsible
in self-medication by self-medication
(1970-1990) WSMI
• 1999- “responsible
self-medication”. 2000-2005
– Indonesia _ 44,1% masyarakat berusaha untuk melakukan pengobatan sendiri (Laporan Kemenkes
RI, 2012)
– Hasil RISKESDAS (2013) _ sejumlah 103.860 (35,2%) rumah tangga dari 294.959 rumah tangga di
Indonesia menyimpan obat untuk swamedikasi
Sources and Factors influencing Self-medication
Medicines used are those indicated for conditions that are self-
recognisable and for some chronic or recurrent conditions (following
initial medical diagnosis)
Convenience
Incorrect self-diagnosis
Failure to seek appropriate medical advice promptly
Incorrect choice of therapy
Failure to recognize special pharmacological risks
Rare but severe adverse effects
Failure to recognize or self-diagnosis contraindications, interactions,
warnings and precautions
Failure to recognize that the same active substance is already being
taken under a different name
Failure to report current self-medication to the prescribing physician
(double medication/harmful interaction)
Failure to recognize or report adverse drug reactions
Incorrect route of administration
Inadequate or excessive dosage
Excessively prolonged use
Risk of dependence and abuse
Food and drug interaction
Prevention of Potential Risks Associated
with Self-medication
Role of pharmacist
1. As a communicator
The pharmacist should initiate dialogue with the patient to obtain a sufficiently
detailed medication history
in order to address the condition of the patient appropriately the pharmacist
must ask the patient key questions and pass on relevant information to patient
(how to take the medicines )
the pharmacist must provide objective information about medicines
2. As a quality drug supplier
The pharmacist must ensure that the products he/she purchases are from reputable
sources and of good quality
3. As a trainer and supervisor
4. As a collaborator
collaborative relationships with the other health care professionals,
national professional associations, the pharmaceutical industry,
governments (local/national), patients and general public
5. As a health promoter
the pharmacist must participate in health screening to identify health
problems and those at risk in the community, participate in health
promotion campaigns to raise awareness of health issues and disease
prevention, provide advice to individuals to help them make informed
health choices
BERTANYA KEPADA PASIEN SEBELUM PEMBERIAN OBAT :
Metode 1 : “WHAM”
A : Action taken
A : Age
E : Extra Medicines
T : Time persisting
H : History
1. Diskusi Pembuka
2. Diskusi Untuk Mengumpulkan Informasi dan
Mengidentifikasi Kebutuhan
3. Diskusi Untuk Menyusun Rencana Asuhan dan
Mengatasi Masalah
4. Diskusi Untuk Memberikan Informasi dan Edukasi
5. Diskusi Penutup
Protokol Konseling Rawat-Mandiri
(Swamedikasi)
1. Diskusi Pembuka
Identitas Pasien : memastikan bahwa pasien mengethui riwayat medis dan gejala
jika tidak maka pasien sebaiknya dihubungi.
Gambaran Pasien : umur (manula dan bayi usia 2 tahun sering menunjukkan
gejala atau reaksi obat yang berbeda), wanita usia subur (hamil atau menyusui)
Riwayat Medis : kondisi penyakit kardiovakular sering KI dengan obat dan alergi
Penggunaan Obat Lain : potensi menimbulkan IO atau gejala yang timbul
merupakan ESO
Diagnosis Sebelumnya Dan/ Atau Terapi Yang Telah Dilakukan Sebelumnya
Terhadap Gejala : membantu apoteker dalam merekomendasikan produk yang
sesuai
Evaluasi Gejala : dapat menentukan sifat gejala yang dialami pasien.
Informasi yang perlu dikumpulkan tentang gejala :
Lokasi : di bagian mana gejala terjadi!
Kualitas : Bagaimana rasanya?
Keparahan : seberapa parah?
Faktor pemodifikasi : Apa dapat memperburuk atau megurangi gejala? Apakah
gejala timbul pada waktu2 tertentu (misalnya pada saat berdiri atau setelah
makan)?
Waktu : sudah berapa lama atau seberapa sering gejala muncul?
Gejala lain yang berhubungan : Apakah ada gejala lain yang berhubungan?
Terapi sebelumnya : Apa yang telah anda lakukan selama ini untuk mengurangi
gejala tersebut? Apakah sudah pernah sebelumnya berkonsultasi dengan
dokter?
3. Diskusi Untuk Menyusun Rencana Asuhan dan
Mengatasi Masalah
Nama Obat : bahan obat yang terkandung dalam produk dan indikasi
Tujuan Pengobatan : efek yang diharapkan, ex : obat ini adalah dekongestan
untuk mengatasi hidung tersumbat
Cara Penggunaan : menginformasikan cara penggunaan dan dosis yang
disarankan
ESO : menjelaskan ESO yang mungkin muncul dan memberi saran cara
menghindari atau mengatasi
Tindakan Pencegahan : memberikan peringatan untuk mencegah penggunaan
obat2 yang berinteraksi, kehamilan/menyusui, alkohol
Batas Waktu Efek Terjadi : batas efek pengobatan, ex. Laxative, antidiare
5. Diskusi Penutup
Selma,a 19 year old female, went to a local pharmacy and asked for
betamethasone cream. It was recommended by a friend who used it for a skin
condition with great results. The pharmacist inquired why she needed the
medicine, Selma responded for acne. The pharmacist tried to explain that this
product does not help acne and suggested another product. Selma was reluctant
to accept the product the pharmacist recommended and left the pharmacy. She
returned some days later with very bad acne and asked the pharmacist for help.
She admitted that she obtained betamethasone from another pharmacy and used
the product morning and night for a few days.
Wassalam & Terimakasih