RESPON OBAT :

Faktor Fisiologis
dan
Patologis
What will we learn??

1 ●
Macam bentuk sediaan dan Cara pemberian

2 ●
Proses Obat dalam tubuh

3 ●
Mekanisme Transport Obat

4 ●
Faktor Fisiologi yang mempengaruhi Respon Obat

5 ●
Faktor Patologis yang mempengaruhi Respon Obat

6 ●
Kesimpulan
Macam Bentuk Sediaan dan
Cara Pemberian
 Route Bioaviabilitas Advantages Disadvantages
IV Bolus 1. Complete (100%) systemic drug Drug is given for immediate effect. Increased chance for adverse
absorption. reaction. (Anaphylaxis)
2. Rate of bioavailability considered
instantaneous

IV infusion 1. Complete (100%) systemic drug 1. Plasma drug levels more 1. Requires skill in insertion
absorption precisely controlled. of infusion set
2. Rate of drug absorption 2. May inject large fluid volumes 2. Tissue damage at site of
controlled by infusion rate. 3. May use drugs with poor lipid injection (infiltration,
solubility and/or irritating necrosis, or sterile
drugs. abscess).

IM  Rapid from aqueous solution. 1. Easier to inject than 1. Irritating drugs may be
 Slow absorption from non intravenous injection. very painful.
aqueous (oil) solutions. 2. Larger volumes may be used 2. Different rates of
compared to subcutaneous absorption depending
solutions. on muscle group
injected and blood flow.

SC  Prompt from aqueous solution. Generally, used for insulin injection. Rate of drug absorption
 Slow absorption from repository depends on blood flow and
formulations. injection volume.
Route Bioaviability Advantages Disadvantages

SL Rapid absorption from lipid- No "first-pass" effects. Not for most drugs or drugs
soluble drugs. with high doses.

PO 1. Absorption may vary. 1. Safest and easiest route Some drugs may have erratic
2. Generally, slower absorption of drug administration. absorption, be unstable in
rate compared to IV bolus or 2. May use immediate- the gastointestinal tract, or
IM injection. release and modified- be metabolized by liver prior
release drug products. to systemic absorption.
 Route Bioavailability Advantages Disadvantages

Rectal Absorption may vary from Useful when patient cannot Absorption may be erratic.
suppository. swallow medication. Suppository may migrate to
More reliable absorption from Used for local and systemic different position.
enema (solution). effects Discomfort

Transdermal 1. Slow absorption, rate may 1. Transdermal delivery Some irritation by patch or
vary. system (patch) is easy to drug.
2. Increased absorption with use. Permeability of skin
occlusive dressing. 2. Used for lipid-soluble drugs variable with condition,
with low dose and low MW. anatomic site, age, and
gender

Inhalasi Rapid absorption May be used for local or Particle size of drug
Total dose absorbed is variable. systemic effects. determines anatomic
placement in respiratory
tract.
May stimulate cough
reflex.
Some drug may be
swallowed.
Drug Process in Body
Dose administered
Drug in tissue of
IB USI distribution
ABSORPSI DI S TR

Concentration in
systemic circulation Metabolism and/or
excretion
ELIMINASI

Concentration at
site of action

Pharmacologic
Effect
Toxicity

Clinical Response
Efficacy
Drug Process in Body
Transport Mechanism
Factors Related to Drug Response
FISIOLOGIS : UMUR
Based on International Conference on Harmonization (ICH)
1. Preterm newborn
2. Newborn (0–28 days)
3. Infant (>28 days–12 months)
4. Toddler (>12 months–23 months)
5. Preschool child (2–5 years)
6. School age child (6–11 years)
7. Adolescents (12–18 years)
8. Geriatric (Based on WHO)
Women : 45 – 55 years
Men : 55 – 75 years
 Children Not a Small Adult

• Kondisi pada neonatus

–Massa tubuh yang kecil,
–kandungan lemak tubuh rendah,
–volume air tubuh tinggi dan
–permeabilitas beberapa membran lebih besar (kulit dan sawar otak)
–konsentrasi protein plasma dan
–kapasitas pengikatan albumin yang rendah
–kemampuan metabolisme lebih rendah
• Kondisi pada Bayi dan Anak
 Keasaman lambung belum mendekati nilai-nilai orang dewasa (bayi)
 Enzim hepatik pada anak sudah mature.
 Fungsi ginjal pada usia 6-12 kematangannya blm sempurna
Kondisi pada geriatri
1. Ginjal
– Renal mass decrease with age
– Reducing the Nephron function
2. Gastrointestinal
– Secretion of HCl and pepsin, decrease
– gastric emptying, unchange
3. Liver
– Progressive reduction in liver volume and blood flow
– Structure and enzymatic function alteration
4. Body composition
– Total body water reduce
– Lean body mass reduce
– Body fat increase
FISIOLOGIS : BERAT BADAN
FISIOLOGIS : GENETIK

POLIMORFISME
variasi genetic yang muncul paling sedikit
1 % atau lebih dalam sebuah populasi.

DRUG
METABOLISME
 Sitokrom

The cytochromes P450 (CYPs)

constitute the major enzyme family capable of catalyzing the oxidative
biotransformation of most drugs and other lipophilic xenobiotics and are therefore
of particular relevance for clinical pharmacology
PATOLOGI : KEHAMILAN
PERUBAHAN FISIK DAN FARMAKOKINETIKA OBAT

Cardiovascular Respiratory Endocrine

Renal System System
System System

Hematology Gastrointestinal
System System
GFR dan Aliran darah Clearance Ginjal
ke Ginjal NAIK NAIK

Eliminasi MENINGKAT
shorter half-lives
Progresteron, Waktu Pengosongan
MENINGKAT Lambung TERHAMBAT

Mual Absorpsi Obat

dan Muntah TERHAMBAT
SUMMARY
 EFFECT / DRUG
RESPONSE ??

GIVE INDIVIDUAL
PRESCRIPTION