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KORTIKOSTEROID

SETYO S RAHARDJOBAG. FARMAKOLOGI FK-UNS 

2007

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 ANAK GINJAL / KELENJAR ADRENAL

MEDULLA CORTEX

•  Adr!"#$! • G#%&'&'r($&'$d )

&'r($*'# +hidrokortison,• M$!r"#'&'r($&'$d )

aldosteron

• H'r'!2 &#"$! )testoteron,aldosteron, DHEA,estrogen dan

 progesteron

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KOLESTEROL

PREGNENOLON

Progesteron Prasteron / DHEA

17OH-progest. kortikosteron Testoteron +

Anrogen !ain

Estraio! +

Estrogen !ain

M("'#$* &'#*(r'# d$ "!"&-$!"# d"! *$!(*" DHEA *r(" *(r'$d #"$!

kortiso! a!osteron

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MEKANISME 1ENGATURAN SEKRESI GLUKOKORTIKOID

  Mr"!*"!

  E$!!*$" %#%3

  d$"!" 'r("# +CRF,

1#"*"! !3""("!

KORTISOLKORTEKS

 ADRENAL

 ACTH

HI1OTHALAMUSSTRES

4. #%&'!'!*$*

2. M'$#$*"*$ r'($!

5. M'$#$*"*$ #"&

6. S("$#$*"*$ #$*'*'

Adrenalin

(SSP)

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KHASIAT FISIOLOGI KORTISOL

• 1r'** ("'#$* &"r'3$dr"( r'($! d"! #"&

• 1#$3"r""! &*$"!"! #&(r'#$( d"! "$r • M!"(%r 8%!*$ *$*( &"rd$'9"*&%#r *"r"8 '('( $!"#

d"! 'r"! #"$!

• M!d%&%! siste" tangkis &"# (3d  STRESS

STRESS

FISIK

- K:#"&""!- #%&" r"(- d"3"!- &d$!$!"!- &"!"*"!

- OR

1SIKIS

- "r"3- !&#- d!d"- !:$- &($d"&%"*"!

- r$!d% d%&" d##

INFEKSI DAN;AT KIMIA- &%"!- "!*(*$- &'(r"$

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KHASIAT FARMAKOLOGI

4. EFEK GLUKOKORTIKOID

". E8& antiraang8& vasokonstriksi 

. D"<" i"#nos#presi$  d"! antia!ergi

:. 1!$!&"("! g!#koneogenesis

d. E8& kata%o!is"e  osteoporosis, atrofia '('( d"! &%#$(, r(%%3"! "!"&

(r3""( !<%3"! 'r'& #"%! *%#$(

. 1!%"3"! pe"%agian !e"ak

&moon face”, “buffalo hump” 

2. EFEK MINERALOKORTIKOID

retensi !"(r$% d"! "$r &"#$% &*&r*$!<" !"$&

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DERI=AT KORTISOL SINTETIS

T%%"! ) r&%"( 8& #%&'&'r($&'$d d"! "!($r"d"!

  !3$#"!&"! 8& $!r"#'&'r($&'$d  

A' De!takortikoia

 predniso(lo)n, budesonida, desonida d"! prednikarbat 

d"<" #%&'&'r($&'$d!<" >? #$3 &%"( d"<"

$!r"#'&'r($&'$d!<" #$3 r$!"! #"" &r"!<" 2?

(' )!#orkortikoi

betametason, deksametason, triamsinolon d##

d"<" #%&'&'r($&'$d d"! "!($r"d"!!<" 40-50 ? #$3 &%"(

d"<" $!r"#'!<" r"&($* 3$#"!

( @ !<" #$3 "!"! 8& r("3"! 5->? #$3 #""

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MASA KERJA KORTIKOSTEROID

4. KERJA SINGKAT +"*" "r%3 42 ",

2. KERJA SEDANG +"*" "r%3 42-5 ",

5. KERJA LAMA +"*" "r%3 5 ",

- K'r($*'#/3$dr'&'r($*'!

- K'r($*'!- K'r($&'*(r'!- F#%dr'&'r($*'!

- --($#rd!$*'#'!- 1rd!$*'!- 1rd!$*'#'!

- Tr$"*$!'#'!

- 1"r"("*'!- B("("*'!

- D&*"("*'!

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1ENGGUNAAN GLUKOKORTIKOID

4. TERA1I SUBSTITUSI

1"d" insufisiensi adrenal  +!<"&$( Aison,

(r"d$ &r! &&%r"!"! &'r($*'# ) r"*" #($3 &%r"! (!""

'('( #"3 *irokortison

2. TERA1I NON S1ESIFIK

rd"*"r&"! 8& "!($r"d"! "!($"#r$ d"! $%!'*%r*$8 %" r&"( d"<" !3$#"!&"! malaise, r$ r"*""!

!<""! d"! *"r +sense of wellbeing ,

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INDIKASI 

A' As"a *e%at

(' Raang #s#s ak#t

+colitis ulcerosa, pen!akit "rohn,

' Pen,akit a#to-i"#n

+rema, multiple sclerosis, #$E,scleroderma, anemia

hemolitik, p% "rohn, colitis,

D' Ses#a* transp!antasi aringan

E' Kanker. sete!a* raiasi -ra,. antie"etik#"

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1ENGGUNAAN LOKAL

a' 0ata

hidrokortison, prednisolon, deksametason, betametason,fluormetolon

ES ) &"("r"& #'%&'"

%' Te!inga&'$!"*$ d!"! "!($$'($&"

' Hi#ng +*r"< 3$d%!,

rhinitis, polip

' 0#!#t 2tra*ea!3 4 &3%*%* "*" +*r"<,

beklometason, budisonida, flutikason

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e' Reta!

suppositoria %!(%& "*$r 

hidrokortison, triamsinolon  lidokain

$' Intra-artik#!er 

"d" r"d"! *!d$ +bursitis, s!novitis,

hidrokortison, triamsinolon

g' Der"a!

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EFEK SAM1ING

• E8& *"$! &'r($*'# !""& "d" pengg#naan !a"a 

*r(" osis tinggi + >0 /3"r$,

• M$r$ d!"! sindroma "ushing 

+r(!*$ :"$r"! d$ "r$!"!2 !"$&!<" d! :"( ''!

8": &"&$ ("!!" " "("* %& !%%&"! #"& d$

"3% d"! (!&%&. K%#$( ($$* %d"3 #%&" ($%# striae)

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5 K#''& E8& S"$!

4. EFEK GLUKOKORTIKOID

a% &e'ala "ushing 

b% Atrofia d"! m!opathie steroid 

c% osteoporosisd% erintango pertumbuhan "d" "!"&-"!"&

e%  Atrofia kulit 

f% Diabetogen

g% munosupresi 

h% Antimitosis

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2. EFEK MINERALOKORTIKOID

a% Hipokalemiab% *dema d"! berat badan !$!&"(

5. EFEK-EFEK UMUMNYA

a% Efek sentral  +#$*"3 r"*" ("&%( *%&"r ($d%r dr*$

d"! *$&'*, euforia

b% Efek androgen +":! 3$r*%$($* "!. H"$d,

c% cataract, gloucoma

d% +ertambahn!a sel darah

e% +ertambahn!a nafsu makan dan ++

f% -eaksi hipersensitivitas

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KORTIKOSTEROID DERMAL

• O"( "!%r %!(%& "!%"! &%#$( d$%!"&"! #%"*

• E8& antiradang  d"! antimitosis

• U!(%& ) &* dr"($($* *'r$'*$* r%r$' "("#2

TINGKAT DAYA KERJA4. LEMAH- H$dr'&'r($*'! "*("(- M($#rd!$*'#'! "*("(

2. SEDANG

- D*'&*$("*'!- D?"("*'!- H$dr'&'r($*'! %($r"(- F#%&'r('#'! $9"#"(- F#%("*'! $9"#"(- Tr$"*$!'#'! "*('!$d"

- F#%*$!'#'! "*('!$d" d##

5. KUAT- B&#'("*'! d$r'$'!"(- B("("*'! 9"#r"(- B("("*'! d$r'$'!"(- B%d*'!$d"

- D$8#%&"r('#'! 9"#r"(- H"#'("'!- 1rd!$&""( d##

6. SANGAT KUAT- K#'("*'# r'$'!"(

- B("("*'! d$r'$

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1USTAKA

T"! H. T R"3"rd" K. 2005 A".H dan /ortikosteroid  d"#"

0bat 0bat 1enting, Ed$*$ = 1T E#? Md$" K'%($!d'J"&"r(" 3"#. 7-2.

S%3r"! S. K. 2007  Adrenokortikotropin,

 Adrenokortikosteroid, Analogsintetik danantagonisn!a dalam 2armakologi dan .erapi , Ed$*$= B"$"! F"r"&'#'$ FK-UI J"&"r(" 3"#. 6->4.

K"(%! B. G. 2002 2armakologi Dasar dan /linik Ed$*$ =III 1!r$( S"#" Md$&" J"&"r(" 3"#.>75-02.