Belajar mandiri.

1. Mahasiswa mampu memahami dan menjelaskan penggolongan OWA & Precursor

berdasarkan PERMENKES

Sumber : PP 44 tahun 2010

Untuk OWA No 1 bersumber PERMENKES thun 1190

Untuk OWA No. 2

Untuk OWA no 3 bersumber : Permenkes no 1178 tahun 1990

2. Mahasiswa mampu memberikan dan menerapkan konseling dan swamedikasi terhadap
obat pada skenario.
Konseling
Inhaler fenoterol (Sumber MIMS)

Indications Listed in Dosage.

Dosage Adult : Inhalation Asthma; COPD As soln for inhalation

releasing ipratropium 20 mcg and fenoterol 50 mcg/actuation:
Acute asthma attack: 1 puff for prompt relief, 1 further dose may
be given if there is no relief after 5 min; further doses may be
required if there is no relief after 2 admin. Intermittent and long-
term treatment: 1 puff up to 4 times/day. Max: 6 puffs/day. As
soln fo nebulisation containing ipratropium 0.5 mg and fenoterol
1.25 mg/4 mL: 4 mL (in NaCl soln) via nebuliser as soon as
asthma attack starts; a 2nd dose may be given in severe cases.
Dosage Details Inhalation/Respiratory
Asthma, Chronic obstructive pulmonary disease
Adult: Available preparations:
Ipratropium 20 mcg and fenoterol 50 mcg/actuation soln for
inhalation
Acute asthma attack: 1 puff for prompt relief. If there is no
improvement after 5 min, 1 further dose may be given; further
doses may be required if there is no relief after 2 admin.
Intermittent and long-term treatment: 1 puff up to 4 times daily.
Max: 6 puffs daily.

Ipratropium 0.5 mg and fenoterol 1.25 mg/4 mL soln for

nebulisation
4 mL (in NaCl soln) via nebuliser as soon as asthma attack starts.
A 2nd dose may be required in severe cases.
Child: As soln for inhalation: >6 yr 1 puff, up to Max 3 puffs
daily. As soln for nebulisation:  ≥12 yr Same as adult dose.
Contraindications Hypersensitivity to ipratropium or fenoterol, atropine, or its
derivatives. Hypertrophic obstructive cardiomyopathy,
tachyarrhythmia.
Special Patient w/ CV disease (e.g. recent MI, arrhythmia, HTN, heart
failure, vascular disorders), cystic fibrosis, DM, narrow-angle
Precautions glaucoma, hyperthyroidism, pheochromocytoma, prostatic
hyperplasia/bladder-neck obstruction, seizure disorder. Childn.
Pregnancy and lactation.
Adverse Drug Significant: Hypokalaemia, AF, cardiac arrhythmia, ischemic
heart disease, palpitations, QT prolongation, supraventricular
Reactions tachycardia, tachycardia.
Nervous: Headache, nervousness, tremor, weakness, dizziness.
CV: HTN, palpitation, hot flushes, hypotension.
GI: Glossitis, xerostomia, nausea, stomatitis, constipation,
diarrhoea, vomiting, throat irritation.
Resp: Cough, pharyngitis, hoarseness, throat irritation.
Genitourinary: Urinary retention.
Endocrine: Hyperglycaemia.
Musculoskeletal: Muscle cramps, myalgia.
Ophthalmologic: Visual accommodation disturbance, eye pain,
increased intraocular pressure, mydriasis, acute angle-closure
glaucoma.
Dermatologic: Diaphoresis.
Potentially Fatal: Paradoxical bronchospasm. Rarely,
anaphylaxis (e.g. urticaria, angioedema, rash, bronchospasm).
Patient Rinse mouth every after inhalation. This drug may cause
dizziness, tremor and visual disturbances, if affected, do no drive
Counselling or operate machinery. Avoid contact w/ eyes.
Monitoring Monitor spirometry [e.g. FEV (forced expiratory volume), FVC
Parameters (forced vital capacity)] and serum K level.

Overdosage Symptoms: Tachycardia, palpitation, tremor, hypotension, HTN,

angina pain, widening of the pulse pressure, arrhythmia, flushing,
dry mouth, visual disturbances. Management: Administer
sedatives or tranquilisers. For severe cases, employ intensive
therapy. β1-selective blockers may be given as specific antidote.
Drug Interactions Enhanced bronchodilatory effect w/ β-adrenergic drugs and
xanthine derivatives (e.g. theophylline). Increased risk of adverse
effects w/ MAOIs or TCAs. Increased risk of CV effects w/
halogenated hydrocarbons (e.g. halothane). Reduced
bronchodilatory effect w/ β-blockers. Increased risk of
hypokalaemia w/ xanthine derivatives, corticosteroids, diuretics.

Storage Store between 15-25°C. Protect from light and heat.

 Ranitidine (Sumber Drugs.com)

Allupurinol (Drugs.com)

3. Mahasiswa mampu menerapkan kode etik terhadap pasien dan teman sejawat lainnya
4. Mahasiswa mampu menerapkan pandangan islam tentang pil KB dan precursor

KB dalam Islam menurut Rumah Fiqih Indonesia

Pandangan Islam tentang penyalahgunaan precursor (yang menyebabkan

Kerusakan )

Kesepakatan para ulama Indonesia penggunaan narkoba bukan dalam

keadaan darurat adalah haram oleh ibnu Taimiyah rahimahullah berkata, “Narkoba

sama halnya dengan zat yang memabukkan diharamkan berdasarkan kesepakatan

para ulama. Bahkan setiap zat yang dapat menghilangkan akal, haram untuk

dikonsumsi walau tidak memabukkan” (Majmu’ Al Fatawa, 34: 204).

Dalil-dalil yang mendukung,

 “Dan menghalalkan bagi mereka segala yang baik dan mengharamkan bagi mereka segala

yang buruk” (QS. Al A’rof: 157). Setiap yang khobits terlarang dengan ayat ini. Di antara

makna khobits adalah yang memberikan efek negatif.

Dari Ummu salamah ia berkata,

“Rasulullah shallallahu ‘alaihi wa sallam melarang dari segala yang memabukkan dan
mufattir (yang membuat lemah)” (HR. Abu Daud no. 3686 dan Ahmad 6: 309. Syaikh Al
Albani mengatakan bahwa hadits ini dho’if). Jika khomr itu haram, maka demikian pula
dengan mufattir atau narkoba.
Jadi penggunaan narkoba sama halnya dengan precursor yang disalahgunakan hingga
efeknya menyerupai narkoba yakni melemahkan hingga merusak diri sendiri.

5. Mahasiswa mampu menerapkan pengolongan,pengeololaan, & penyerahan precursor

berdasarkan undang-undang
Menurut PP 44 tahun 2010.
6. Mahasiswa mampu memahami dan menjelaskan wewenang asisten tenaga kefarmasiaan
berdasarkan undang-undang

7. Mahasiswa mampu menerapkan Konseling dan swamedikasi secara islami.

Dari etika islam dalam berkomunikasi diatas yang akan dijadikan landasan dalam melakukan konseling.