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IOM > TM 12. IOM pada obat anti obesitas & untuk menurunkan kadar lemak darah > Flashcards

TM 12. IOM pada obat anti obesitas & untuk menurunkan kadar lemak darah Flashcards

1
Q

Kapan boleh pake obat buat orang obes?

A

Kalo udh jalanin terapi behavior & ningkatin aktivitas fisik > 6 bulan dan gagal jg

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2
Q

Indikasi penggunaan obat obes

A

INDIKASI

  1. Bmi > 30 atau > 27 dgn komorbid (sakit sendi, dm, hipertensi, dislipidemia)
  2. Pahami bahwa obat cuma tambahan aja dari perbuahan gaya hidup n bkn yg utama
  3. Punya ekspektasi yg realistik, misal turunin 1 kg/minggu
  4. Tunjukin kesiapan u berubah
  5. Udh buktiin bahwa gk mampu nurunin bb sendiri
  6. Patuh thdp obat
  7. Gk lg makan obat lain yg kontra indikasi / ada kondisi psikis
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3
Q

Kontraindikasi penggunaan obat obes

A
  1. Hamil, menyusu
  2. Penyakit jantung yg gk stabil
  3. Hipertensi > 180/110
  4. Penyakit sistemik yg parah & gk stabil
  5. Penyakit psikis yg gk stabil / riwayat anorexia
  6. Obat lain yg gk bisa bareng : MAO inhibitor, obat migrane, adrenergic agents, arrhythmic potential
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4
Q

Contoh obat yg bekerja dgn cara reduce appetite biar mengurangi intake makanan

A
  1. Naltrexone HCL 7 bupropion
  2. Semaglutide / Liraglutide
  3. Phentermine & topiramate ER
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5
Q

Cth obat yg bekerja dgn cara menghambat absorpsi >30% lemak tiap kali makan krn hambat pancreatic lipase

A

Orlistat

dimakan 3x/hari bersama makanan

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6
Q

Manfaat dan efek samping orlistat

A

Manfaat

  1. Nurunin Hba1c
  2. Nurunin LDL, tekanan darah, dan glikemia

Efek samping
1. Diare, flatulence, bloating, abdominal pain, dispepsia

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7
Q

Contoh herbal, natrual, n food suplement u weight loss therapy

A
  1. Chromium picolinate
  2. Guarana extract (cafein)
  3. Various tea extract (cafein)
  4. Garcinia gambogja extract / asam gelugur (hydroxycitric acid)
  5. Chitosan (cationic polysacharide) -> block fat absorption
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8
Q

Secondary hyperlipidamia bisa disebabkan oleh

A
  1. Liver disease
  2. Biliary disease (yg pengaruhi saluran & kantung empedu)
  3. Obes
  4. Hipotiroid
  5. Diet, alcohol excess
  6. Renal disease (nefrotic sindrom)
  7. Drug : HIV protease inhibitor, thiazide diuretic, oral contraceptive steroid
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9
Q

Antihiperlipidemic drugs dibagi jadi 5 jenis

A
  1. HMG coa reductase inhibitor
    Cth : atorvastatin, Fluvastatin, lovastatin, pravastatin, simvastatin
  2. Fibrates
    Cth : fenofibrate, gemfibrozil, clofibrate
  3. Anion – exchange resin (bile acid sequestrants)
    Cth : colesevelam, colestipol, cholestryamine
  4. Nicotinic acid
    Cth : niacin
  5. Cholesterol absorption inhibitors
    Cth : ezetimibe
  6. Other drugs
    Cth : vit E, omega 3, orlistat
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10
Q

IOM obat HMG-CoA reduktase (lovastatin)

A
  1. Gk bisa bareng makanan berserat, terutama pektin & serat larut air -> menurunkan absorbs obat
  2. Gk bisa brg minyak gk jenuh ganda (PUFA) krn nurunin waktu paruh jadi nurunin manfaatnya jg -> disaranin malem pas gk makan
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11
Q

Mekanisme kerja obat golongan fibrat

A

Meningkatkan degradasi lipoprotein dgn cara ningkatin kerja enzim lipoprotein lipase -> nurunin TG, ningkatin clearance LDL oleh hati (ikut turun jg), ningkatin HDL

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12
Q

Efek samping obat fibrat terkait IOM

A
  1. Diare -> pengaruhi absorpsi zat gizi
  2. Batu empedu -> Ningkatin pengeluaran kolesterol dari kantung empedu
  3. Ningkatin efek antikoagulan kalo diminum brg
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13
Q

Mekanisme kerja bile acid sequestrant (pengikat)

A

Obat cholestyramine mengikat asam empedu -> membentuk kompleks yg gk larut -> dibuang lewat feses -> kadar asam empedu berkurang -> hati produksi asam empedu baru dgn ambil bahan bakunya yaitu kolesterol -> kolesterol menurun

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14
Q

Efek samping cholestyramine berkaitan dgn IOM

A
  1. Lemak kurang -> Vit adek, b12, fe, carb, ca, folacin, karoten menurun absorpsinya
  2. Gi upset : konstipasi, mual, flatulence, anorex, diare
  3. Intolerance carb -> bikin hiperglkemi
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15
Q

Mekanisme kerja niasin / asam nikotinat / B3

A
  • Hambat lipolysis di jaringan adipose -> FFA berkurang -> plasma TG berkurang
  • Nurunin sintesis tgl di hepar -> sekresi VLDL berkurang -> LDL jg berkurang
  • Hambat pengambilan lipoprotein di hepar shg ningkatin HDL??
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16
Q

Efek samping nicotinic acid terkait IOM

A
  1. Nurunin sekresi tubular asam urat -> hiperuricemia

2. Ganggu toleransi glucose -< fluktuasi glukosa darah

17
Q

Mekanisme kerja obat kolesterol absorption inhibitor

A

Kolesterol gk sampe diserap krn diikat -> lgsg dibuang di feses -> liver merasa kurang -> reseptor LDL ningkat -> LDL di darah diambil u bahan baku

mirip sama bile acid sequestrant??

18
Q

Efek samping obat exetimibe berkaitan dgn IOM

A
  • Pusing, sakit kepala
  • Diare
  • Tenggorokan sakit
  • Runny nose

IOM (6 decks)

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