TUGAS FARMAKOLOGI 1

Clarence Theodosius Bernard Harijanto

2443019212

FAKULTAS FARMASI
UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA
2020
Pertanyaan:

1. Seorang pria berusia 75 tahun didiagnosis menderita infeksi saluran kemih

dan demam tinggi. Setelah hasil kultur urin, dokter memberikan IV
gentamisin 2 mg/kg dosis sehari, diikuti oleh 3-5 mg/kg/hari dalam dosis
terbagi. Pertimbangkan nefrotoksisitas antibiotik ini untuk pasien usia
lanjut, dan jawab pertanyaan berikut.
a. Formula apa yang harus digunakan untuk menghitung toksisitas obat?
- Formula Cockroft Gault
Ccr (female) : Ccr (male) X 0,85
( 140− Age ) X Weight
Ccr (male) :
72 X SCr
b. Selain nefrotoksisitas, sebutkan efek samping potensial lain dari obat
ini untuk pasien usia lanjut!
- Nyeri sendi, kerusakan ginjal, edema, neurotoksisitas, mati rasa,
kelelahan, ototoksik, nefrotoksik, iritasi dan toksik yang berupa
nyeri pada tempat suntikan.
2. A 29-year-old man is brought to the emergency center in a drunken
stupor. He is accompanied by his wife, who states that he hasn’t been
himself at all for the past few months. According to his wife, he was
evaluated for depression by his personal physician about 3 months ago
and started on an SSRI. He responded quite well to this therapy over the
subsequent 2 months. He started feeling so good and so energetic that he
stopped taking his medication. He found that he needed less and less
sleep, to the point where he is now only sleeping 2 to 3 hours a day. He
has been showering his wife with very expensive gifts and has hit the
maximum limit on all of their credit cards. He has been extremely romantic
and more interested in sexual relations than at any time before. He has
also started drinking heavily and has passed out drunk more than once. His
work has suffered, and his boss said that he was in danger of being fired if
things didn’t straighten out. Other than being drunk, his physical
examination and blood tests are normal. He is admitted to the psychiatric
unit with a diagnosis of bipolar disorder and started on lithium.
a. What is the mechanism of action of lithium?
- lithium bekerja melalui penghambatan dari enzim second
messenger seperti Inositol Monophosfatase (gambar bagian kanan), dengan
memodulasi Protein G (gambar bagian tengah), atau dengan penurunan signal
tranduksi kaskade, yang melibatkan penghambatan dari Glycogen Syntase Kinase 3
(GSK-3) dan protein C kinase (gambar bagian kiri). Semua aktifitas dari lithium ini
akan mempengaruhi terbentuknya proteksi pada saraf dan plastisitas jangka
panjang dari sel saraf yang mampu mengurangi toksisitas dari hiperglutamat pada
skizofrenia.
b. What are the common side effects of lithium?
- Tremor, mual, diare, Berat badan meningkat, mudah lelah,
aritmia, Pernapasan terganggu, efek dermatologis, intoksikasi, sering buang
air kecil.
c. What is the mechanism of lithium-induced polyuria?
- Mekanisme di mana lithium menyebabkan poliuria adalah
interferensi dengan tubulus pengumpul untuk menghasilkan adenosin
monofosfat siklik sebagai respons terhadap stimulasi hormon antidiuretik.
Hal ini mengakibatkan penurunan kapasitas ginjal untuk mengawetkan air
bebas, yang menyebabkan gangguan kemampuan konsentrasi dan produksi
urin yang terlalu encer.