formularium penyakit dalam

8/16/2019 formularium penyakit dalam

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615.3Indf Katalog Dalam Terbitan. Kementerian Kesehatan RIIndonesia. Kementerian Kesehatan RI. Direktorat Jenderal Bina Kefarmasian dan Alat KesehatanFormularium spesialistik ilmu penyakit dalam,-- Jakarta : Kementerian Kesehatan RI. 2012

IB! "#$-602-235-15%-21. J&d&l I. '(R)*+ARI, - DI,A,615.3Indf

FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM a

KEMENTERIAN KEE!ATAN RI

F"RM#$ARI#M %EIA$ITIK I$M# %EN&AKIT DA$AM FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAMFORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM F"RM#$ARI#M %EIA$ITIK

I$M# %EN&AKIT DA$AMTIM %EN#N F"RM#$ARI#M %EIA$ITIK I$M# %EN&AKIT DA$AM 'KEMENTERIAN KEE!ATANDra. !asirah Baha&din/ At./ ))dr. orni 'adiaDita !oianti .i/ At./ )),rie &snell4anti/ )K)/ At%ER!IM%#NAN D"KTER %EIA$I %EN&AKIT DA$AM IND"NEIADR. Dr. &lki i Amin/ D/ K-/ 'I!AI)/ '778)e9akili eminat ,RARIrof. Dr. ;ana< B. =risnohadi/ D/ K-K>/ 'I!AI)8)e9akili eminat IKKIrof. Dr. Ad&l )&thali/ D/ K-;()/ 'I!AI)

8)e9akili eminat ;=DIrof. Dr. R.;.;. !el9an/ D/ K-=I/ 'I!AI)8)e9akili eminat ,=RIDR. Dr. )ardi antoso/ D/ K-,)D/ 'I!AI)8)e9akili eminat ,RK,!IDr. !anan? &kmana/ D/ K-AI/ 'I!AI)8)e9akili eminat ,RA+)*!IDr. inoa !ain??olan/ D/ K-;8)e9akili eminat ,R!,'RIDr. R&di &tranto/ D/ K-si/ 'I!AI)8)e9akili eminat KIDr. )&h. Aandi/ D/ K-er/ )AR8)e9akili eminat ,R,)IDr. Ba?&s &t& &tra &r4ana/ D/ K-R8)e9akili eminat IRAd FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAMDr. =@ah@adi Roert =./ D/ K-,;/ 'I!AI)8)e9akili eminat ;IDr. 4afr&ddin A.R. +elos&tan/ D/ K-,;/ 'I!AI)8)e9akili eminat IDR. Dr. !afrialdi/ D/ 'K/ 'I!AI)ekretariat '(ke 'itia/ K)Dr. Irma KhrisnaanditDr. IndahDr. &nt&rDra. Ardi4ani/ At/ )iAn9ar ah4&di/ )K)./ AtRen??anis ranandari/ .'arm./ At)&l4ati )&htarKer(asama '%ER!IM%#NAN D"KTER %EIA$I %EN&AKIT DA$AM IND"NEIAden?anDIT)EN *INFAR DAN A$KEKEMENTERIAN KEE!ATAN RIFORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM iKATA AM*#TAN


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Ketua #mum %engurus *esar %erhimpunan Dokter pesialis %enyakit Dalam Indonesia+%* %A%DIAssalam&alaik&m r. .ertama-tama kami an@atkan &@i s4&k&r ke hadirat Allah = den?an teritn4a &k&'orm&lari&m esialistik Ilm& en4akit Dalam/ selesai ses&ai sasaran 9akt& 4an? telahdirenanakan. Kar4a 4an? ?emilan? ini tidak akan daat kita nikmati tana ker@asama 4an?aik antara =im en4&s&n &k& terse&t den?an Kementerian Kesehatan RI/ teatn4a Dit@enBinfar dan Alkes/ Kementerian Kesehatan RI.

B&k& ini men@adi amat entin? sekaran? ini/ karena kera?aman dan @enis oat den?an @&mlah4an? amat menin?kat sehin??a dierl&kan se&ah and&an 4an? daat dimanfaatkan aikoleh dokter ma&&n asienn4a/ sehin??a men@adi elind&n? serta et&n@&k a?i ked&a < hak.

=&@&an dari &k& ini adalah en4amaian informasi 4an? teat dan o4ektif men?enaien??&naan oat a?i asien en4akit dalam. *a4a en??&naan oat rasional 4an?dilaksanakan den?an eneraan konse oat esensial/ en??&naan oat ?enerik sertainformasi men?enai en??&naan oat rasional. eneraan konse - konse oat esensialterse&t memerlihatkan hasil ka@ian manfaat terhada risiko serta manfaat terhada ia4a4an? alin? men?&nt&n?kan mas4arakat .en?&r&s Besar erhim&nan Dokter esialis en4akit Dalam Indonesia 8B ADImen?&akan selamat atas teritn4a &k& ini/ &k& 4an? mer&akan a?ian 4an? tidakterisahkan dari edoman ela4anan )edik ADI . =erima kasih &la keada sem&a an??ota

=im en4&s&n 'orm&lari&m esialistik Ilm& en4akit Dalam 4an? telah er&saha s&n??&hs&n??&h

sehin??a &k& ini terealisasi.assalam&alaik&m r. . )akarta, Desember -/Ketua #mum %* %A%DI%eriode -0 1 -/-DR. Dr. Aru 2 udoyo, p%D, K1!"M, FINAIM, FA3%ii FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAMKATA %EN4ANTARKetua Tim %enyusun Formularium pesialistik Ilmu %enyakit DalamAssalam&alaik&m arahmat&llahi aarakat&h&@i dan 4&k&r ke hadirat Allah = karena atas erkenan!4a maka &k& 'orm&lari&mesialistik Ilm& en4akit Dalam ini daat dis&s&n dan diteritkan. Kami men?&akanterimakasih keada Kementerian Kesehatan 4an? memera4akan en4&s&nan 'orm&lari&m

esialistik Ilm& en4akit dalam keada ADI dan 12 (r?anisasi &sesialisn4a.** raktek Kedokteran =ah&n 200% asal %" men4e&tkan erl&n4a setia dokterdalam melaksanakan raktek kedokteran melak&kan kendali m&t& dan kendali ia4a. asal51 men4atakan erl&n4a memerikan ela4anan medis ses&ai den?an standar rofesi. ADIsea?ai sat& or?anisasi rofesi s&dah memiliki a&an dalam ik&t serta melaksanakan ** tserent&k: tandar kometensi/ B&k& A@ar Ilm& en4akit Dalam dan B&k& and&an ela4anan)edis 4an? selal& dierar&i ses&ai erkeman?an ilm& serta era?ai Konsens&s 4an? @adia&an setia esialisC& esialis en4akit Dalam.edoman emakaian oat di idan? en4akit Dalam den?an 12 & esialisn4a m&tlakdierl&kan karena @enis oat 4an? eredar san?at era?am. =im en4&s&n 'orm&lari&m BADI dalam men4&s&n oat 4an? akan di?&nakan men?a& keada : =atalaksana era?aien4akit 4an? ada di B&k& A@ar Ilm& en4akit Dalam / B&k& and&an ela4anan )edis en4akitDalam dan konsens&s 4an? s&dah ada ata& 4an? diado oleh erhim&nan &sesialis 4an?

tent&n4a dis&s&n erdasarkan aas e< kasi/ keamanan/ k&alitas/ ketersediaan dan har?a 4an?ekonomis. J&mlah ariasi oat dis&s&n seminimal m&n?kin ses&ai a&an diatas.Den?an men?in?at asal %" dan 51 ** raktek Kedokteran dan diterakann4a sistememia4aan I!A-DR 8Indonesia Dia?nosis Related ro&s 4ait& sistem emia4aanerdasarkan aket ela4anan kesehatan maka emilihan oat har&s dilak&kan seara ermatdan rasional.)ekanisme en4&s&nan form&lari&m meliatkan anitia inti dari 12 & esialis en4akitDalam. A?ar isa menam&n? sean4ak m&n?kin &s&lan dari ara Ahli en4akit Dalam sel&r&hIndonesia maka saat en4&s&nan/ draf @&?a dikirim ke sem&a 'ak&ltas Kedokteran 4an? ada&sat endidikan Ahli en4akit. ehin??a setia Dokter esialis ata& & esialis en4akitDalam di Indonesia merasa terliat dalam en4&s&nan form&lari&m ini dan den?an en&hkesadaran men@adikann4a a&an dalam memerikan ela4anan kesehatan 4an? rofesionaldan erm&t& tin??i.

'orm&lari&m ini dis&s&n den?an indeks ?enerik 4an? s&dah di Indonesiakan. ermenkes!o ;K.02.02C),!K,C06$C2010 men4atakan kehar&san men??&nakan oat ?enerik diFORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM iiifasilitas ela4anan kesehatan emerintah. )&dah-m&dahan erat&ran ini isa konsistenden?an men@a?a ketersediaan sem&a oat ?enerik terse&t.etia saat erkeman?an ilm& kedokteran men?alami kema@&an/ e?it& @&?a den?anm&n&ln4a era?ai oat ar& 4an? m&n?kin leih aik dalam e< kasi/ keamanan/ k&alitas/ketersediaan dan har?a 4an? ekonomis/ karena it& =im en4&s&n merenanakan &nt&kmelak&kan reisi setia 3 tah&n.assalam&alaik&m arahmat&llahi aarakat&h


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)akarta, Desember -/Ketua Tim %enyusunDR. Dr. 5ulki6 i Amin, p%D, K1%, FINAIM, F33%i FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAMFORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM DAFTAR IIKata am&tan Ket&a *m&m B ADI E.............................................EEEEEE iKata en?antar Ket&a =im en4&s&n 'orm&lari&m esialistik Ilm& en4akit Dalam .. ii

Daftar Isi ................................................EEE...................EEEEEEEEEEEE *A* I. KETENT#AN #M#M .....EEE...................................................EEEE... 1*A* II. KETENT#AN REDAKI"NA$ .......................................................EEE... #*A* III. DAFTAR "*AT F"RM#$ARI#M #*%EIA$ITIK I$M# %EN&AKITDA$AM ..................................................EEEEEEEEEEEEEEE 11I. A$ER4I dan IM#N"$"4I ..............................................EEEEEEEEE... 11a. Antialer?i dan (at *nt&k Ana< laksis ......................................................E.. 111. Desloratadin ....................................................EEEEEEEEEE.. 112. Difenhidramin ;7l .................................................EEEEEEEEE 113. 'eksofenadin ;7l ................................................................................ 12%. 'eksofenadin ;7l 60 m?/ se&doefedrin ;7l 120 m? ......................... 125. ;idroksiin Di;7l ................................................................................ 136. ;omoklorsikliin ;7l ............................................................................ 13

#. Klorfeniramin )aleat ............................................................................ 1%$. +oratadin .............................................................................................. 15". +oratadin 5 m? dan se&doefedrin &lfat 120 m? ................................ 1510. )ehidrolin !aadisilat ........................................................................ 1611. etiriin ;7l .......................................................................................... 1#. Antidot dan (at +ain *nt&k Kera&nan Kh&s&s .......................................... 1#1. Atroin ................................................................................................... 1#2. Deferasiroks .......................................................................................... 1$3. Deferiron ............................................................................................. 1"%. Deferoksamin )esilat ........................................................................... 1"5. Kalsi&m 'olinat ...................................................................................... 206. Kalsi&m l&konat .................................................................................. 20#. )esna ................................................................................................... 21

$. !alokson ;7l ........................................................................................ 21". !atri&m Bikaronat ................................................................................ 22i FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM10. !atri&m =ios&lfat ................................................................................... 2311. rotamin &lfat ................................................................................... 23. Antidot dan (at +ain *nt&k Kera&nan *m&m ........................................... 23- Karon Aktif =ie 00# ............................................................................. 23d. Antiretroiral .................................................................................................. 2%1. Aakair ................................................................................................ 2%2. Didanosin .............................................................................................. 2%3. ,a< ren ............................................................................................... 25%. +ami&din ............................................................................................. 265. +oinairCRitonair ................................................................................ 26

6. !eirain 8!> ...................................................................................... 26#. ta&din 8D%= ....................................................................................... 2$$. =enoo< r 8=D' .................................................................................... 2"". ido&dinCAidotimidin 8A= ................................................................. 2"e. Kortikosteroid dan Kortikotroin ..................................................................... 301. B&desonid ............................................................................................ 302. Deksametason .................................................................................... 313. ;idrokortison &ksinat .......................................................................... 32%. )etilrednisolon .................................................................................... 325. rednison .............................................................................................. 336. =riamsinolon .......................................................................................... 3%f. (at *nt&k )iastenia rais ......................................................................... 35- !eosti?min )etils&lfat .......................................................................... 35

?. A?en Im&nos&resan ..................................................................................... 361. Aatiorin ............................................................................................... 362. )erkato&rin ....................................................................................... 363. )etotreksat .......................................................................................... 36h. Antiasma ........................................................................................................ 361. Amino< lin ............................................................................................. 362. B&desonid ............................................................................................ 3#3. er Dosis B&desonid $0 m?/ 'ormoterol %/5 m?.er Dosis B&desonid 160 m?/ 'ormoterol %/5 m?. ............................ 3#%. Deksametason 8Am: !a 'osfat .......................................................... 3$


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FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM ii5. ,fedrin ;7l ............................................................................................ 3"6. ,inefrin ;7l .......................................................................................... 3"#. Iratroi&m Bromida .............................................................................. %0$. Klen&terol ;idroklorida ........................................................................ %1". rokaterol ;7l ........................................................................................ %110. al&tamol ............................................................................................ %211. er 2/5 ml: Iratroi&m Bromida 0/5 m?/ al&tamol &lfat 2/5 m? ....... %2

12. er Disk&s 100: almeterol Finafoat 50 m? G 'l&tikason roionat100 m?/ er Disk&s 250: almeterol Finafoat 50 m? G 'l&tikasonroionat 250 m?/ er Disk&s 500: almeterol Finafoat 50 )? G'l&tikason roionat 500 m? .............................................................. %313. =eo< lin ................................................................................................... %%1%. =er&talin &lfat .................................................................................... %515. =iotroi&m .............................................................................................. %6i. er&m dan Imm&no?lo&lin ........................................................................... %61. Imm&no?lo&lin lasma Intraena 8)an&sia 2/5 ? 85H .................. %62. Antitetan&s er&m ................................................................................. %#

@. >aksin ........................................................................................................... %#1. >aksin Difteri =etan&s ............................................................................ %#2. >ir&s ;eatitis A Inaktif .......................................................................... %$

3. Anti?en 8Rekominan ;eatitis B Den?an Kem&rnian =in??i ............. %"%. &adrialent ;&man aillomair&s =4es 86/ 11/ 16/ 1$ Reominant>aine. 1 Dosis 80.5 ml )en?and&n? kira-kira +1 rotein ;> =ie6 820 m?/ =ie 11 8%0 m?/ =ie 16 8%0 m? Dan =ie 1$ 820 m? %"5. &ri< ed lit Inatiated In &ena >ir&s ............................................... 506. >aksin )enin?itis )enin?okokkal .......................................................... 50#. olisakarida Dari 23 erotie tre. ne&monia an? Dim&rnikan ...... 51II. END"KRIN dan META*"$IK .............................................................................. 52a. Antidiaetik (ral ............................................................................................. 521. Akarose ............................................................................................... 522. lienklamid .......................................................................................... 523. likaid .................................................................................................. 53%. lik&idon ................................................................................................ 5%

5. limeirid .............................................................................................. 55iii FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM6. )etformin ;7l ....................................................................................... 56. Antidiaetik In@eksi .......................................................................................... 56- Ins&lin Asart ......................................................................................... 56. ;ormon dan (at an? )emen?ar&hi 'ertilitas .......................................... 5#- =estosteron *ndekanoat ........................................................................ 5#d. ,stro?en ......................................................................................................... 5$- ,stradiol ................................................................................................. 5$e. ;ormon =iroid dan Antitiroid ........................................................................... 5"1. +&?ol ....................................................................................................... 5"2. =iamaol ................................................................................................ 603. roiltio&rasil ......................................................................................... 61

%. !atri&m +eotiroksin .............................................................................. 61f. ;ormon +ain ................................................................................................... 62- Bromokritin )esilat .............................................................................. 62?. en&r&n Kolesterol ......................................................................................... 631. 'eno< rat ............................................................................................. 632. em< roil ........................................................................................... 6%3. raastatin !atri&m .............................................................................. 65%. imastatin ............................................................................................ 66III. 4ATR"ENTER"$"4I ........................................................................................ 6#a. Antasida/ Anti&lk&s/ )&korotektan dan Anti&sa ........................................ 6#1. Al&mini&m ;idroksida/ )a?nesi&m ;idroksida .................................... 6#2. imetikon ................................................................................................ 6#3. +ansoraol ........................................................................................... 6$

%. (meraol ............................................................................................. 6"5. Ranitidin ................................................................................................ 6"6. &kralfat ................................................................................................. #0. Antiemetik ....................................................................................................... #01. Betahistin )esilat .................................................................................. #02. Dimenhidrinat ......................................................................................... #13. Domeridon ........................................................................................... #1%. )etokloramid ;7l ................................................................................ #25. (ndansetron ........................................................................................ #3FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM i


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. Antisasmodik ............................................................................................... #3- Atroin .................................................................................................. #3d. (at *nt&k Diare ........................................................................................... #%1. (ralit ..................................................................................................... #%2. +oeramid ;7l ....................................................................................... #%e. +aksatif ....................................................................................................... #51. Bisakodil ................................................................................................ #52. +akt&losa ............................................................................................... #6

f. (at *nt&k Radan? Kronik *s&s .................................................................. #6- A?en Aminosalisilat ............................................................................. #6- &lfasalain ................................................................................... #6I7. 4ERIATRI ............................................................................................................. ##a. (at Dementia ........................................................................................ ##1. Doneeil ........................................................................................ ##2. alantamin ;Br .................................................................................... #$3. Riasti?min ............................................................................................ #$. >asodilator ..................................................................................................... #"1. 'l&nariin .............................................................................................. #"2. !aftidrof&ril (ksalat ............................................................................... $03. entoksi< lin ........................................................................................... $1%. ildena< l ................................................................................................ $1

5. itikolin ................................................................................................... $26. >ardena< l .............................................................................................. $27. 4IN)A$ dan !I%ERTENI .................................................................................... $3a. Antihiertensi olon?an A7,-Inhiitor .......................................................... $31. Imidaril ................................................................................................ $32. Katoril ................................................................................................. $%3. Ramiril .................................................................................................. $5. Anti ;iertensi olon?an en4ekat Beta ...................................................... $61. Atenolol ................................................................................................. $62. Bisorolol '&marat ............................................................................... $6 FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM3. Bisorolol ;emif&marat 2/5 m? dan ;idroklortiaid 6/25 m?Bisorolol ;emif&marat 5 m? dan ;idroklortiaid 6/25 m? ................... $#

%. Karedilol ............................................................................................... $$5. roranolol ;7l ..................................................................................... $". Anti ;iertensi olon?an Anta?onis Kalsi&m ................................................ "01. Amlodiin .............................................................................................. "02. Diltiaem ;7l ........................................................................................ "03. 'elodiin ................................................................................................ "1%. !ifediin its ........................................................................................ "25. !imodiin ............................................................................................. "3d. Anti ;iertensi olon?an Alfa Bloker ............................................................. "31. Doksaosin )esilat .............................................................................. "32. raosin ;7l .......................................................................................... "%3. =eraosin ;7l ........................................................................................ "%e. Anti ;iertensi olon?an Anta?onis An?iotensin II ....................................... "5

1. Iresartan ............................................................................................... "52. Iresartan dan ;idroklortiaid ................................................................ "63. 7andesartan .......................................................................................... "6%. +osartan ................................................................................................ "#5. =elmisartan ........................................................................................... "$6. >alsartan ................................................................................................ "$f. Anti ;iertensi olon?an +ain-+ain ............................................................... ""1. Klonidin ;idroklorida ............................................................................. ""2. )etildoa Anhidrat ................................................................................ 100?. (at an? )emen?ar&hi al&ran Kemih .................................................... 101- Alfa Bloker .......................................................................................... 1011. =ams&losin ;7l ................................................................................ 1012. Alf&osin ;7l .................................................................................. 102

- 5 Alfa Red&tase Inhiitor ..................................................................... 1021. =eraosin ;7l .................................................................................. 1022. Doksaosin )esilat ......................................................................... 1033. 'inasterid ........................................................................................ 103%. D&tasterid ........................................................................................ 10%FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM ih. Anti )&skarinik ............................................................................................... 105- =olterodin +-=ar&at ................................................................................ 105i. Di&retik ......................................................................................................... 1061. '&rosemid .............................................................................................. 106


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2. ;idroklortiaid ....................................................................................... 10#3. Klortalidon ............................................................................................. 10#%. )anitol ................................................................................................... 10$5. ironolakton ......................................................................................... 10$7I. !EMAT"$"4I1"NK"$"4I .................................................................................. 10"a. Antihormon .................................................................................................... 10"- =amoksifen ............................................................................................ 10". Im&nos&resan .............................................................................................. 110

1. Aatiorin ............................................................................................. 1102. iklosorin ............................................................................................ 111. Antineolastik ................................................................................................ 1121. +-Asara?inase ...................................................................................... 1122. 5-'l&oro&rasil ........................................................................................ 1123. Daktinomisin .......................................................................................... 113%. Dakarain ............................................................................................ 1135. Doksor&isin ;7l .................................................................................. 11%6. Dosetaksel 8Anh4dro&s ......................................................................... 115#. ,ir&isin ;7l ........................................................................................ 116$. ,toosid ................................................................................................ 11#". emsitain ;7l ...................................................................................... 11$10. oserelin Asetat .................................................................................... 11$

11. ;idroksi&rea .......................................................................................... 11"12. Ifosfamid ............................................................................................... 12013. Irinotekan ;7l =rihidrat .......................................................................... 1211%. Karolatin ........................................................................................... 12115. +e&koorin ............................................................................................ 12216. )erkato&rin ....................................................................................... 1231#. )esna ................................................................................................... 1231$. )etotreksat ............................................................................................ 12%ii FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM1". aklitaksel .............................................................................................. 12520. Rit&ksima ............................................................................................ 12621. iklofosfamid ........................................................................................ 12#22. islatin .................................................................................................. 12#

23. itarain ............................................................................................... 12$2%. =alidomid ............................................................................................... 12$25. >inlastin &lfat ..................................................................................... 12"26. >inkristin &lfat ...................................................................................... 130d. Antianemia .................................................................................................... 1311. Asam 'olat ........................................................................................... 1312. 'erro &lfat .......................................................................................... 1313. 'erro '&marat ........................................................................................ 132%. >itamin B12 ........................................................................................... 132e. (at an? )emen?ar&hi Darah ................................................................... 1321. Asetosal ................................................................................................. 1322. Diiridamol ............................................................................................. 1333. !a ;earin ............................................................................................. 13%

%. Kloido?rel ............................................................................................. 1355. tretokinase ........................................................................................ 1366. arfarin ................................................................................................. 136f. ;emostatik ..................................................................................................... 13#- >itamin K1 ............................................................................................. 13#?. ;ematooietik ............................................................................................... 13#- Rekominan ,ritrooetin )an&sia ........................................................ 13#h. 'raksi lasma *nt&k emakaian Kh&s&s ................................................... 13$1. Al&min )an&sia .................................................................................. 13$2. 'aktor >III 8Konsentrat .......................................................................... 13"i. en??anti lasma .......................................................................................... 13"1. Dekstran %0 .......................................................................................... 13"2. ;4dro4 ,th4l tarh 8;, 6H ........................................................... 1%0

7II. !E%AT"$"4I ....................................................................................................... 1%1a. Antiir&s ......................................................................................................... 1%11. Adefoir Diioksil ................................................................................ 1%1FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM iii2. ,ntekair ............................................................................................... 1%13. +ami&din .............................................................................................. 1%2%. Riairin ................................................................................................ 1%25. =eli&din .............................................................................................. 1%3. Im&noterai ................................................................................................... 1%%1. e?interferon L-2 ................................................................................. 1%%


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2. e?interferon L -2a ................................................................................ 1%5. !&trisi Dan ;eatorotektor ........................................................................... 1%6- Al&min 20/ 25 ...................................................................................... 1%6d. >aksin ............................................................................................................ 1%#- >aksin ;eatitis B .................................................................................. 1%#e. Anti ;iertensi ortal ..................................................................................... 1%#1. roanolol ............................................................................................. 1%#2. ID! ...................................................................................................... 1%#

3. '&rosemid ............................................................................................ 1%#%. ironolakton ........................................................................................ 1%#7III. KARDI"$"4I ....................................................................................................... 1%$a. Antian?ina .................................................................................................... 1%$1. Atenolol ................................................................................................. 1%$2. Bisorolol '&marat ................................................................................. 1%$3. Diltiaem ;7l ........................................................................................ 1%"%. Isosorid Dinitrat .................................................................................... 1505. )etorolol =atrat ................................................................................... 1516. !itro?liserin ............................................................................................ 152. Antidisritmia ................................................................................................... 1521. Amiodaron ;7l ...................................................................................... 1522. Diltiaem ;7l ........................................................................................ 153

3. +idokain ................................................................................................. 153%. roranolol ;7l ..................................................................................... 15%5. >eraamil ;7l ....................................................................................... 155. Antihiertensi ................................................................................................. 156- olon?an A7,-Inhiitor ........................................................................ 1561. Imidaril .......................................................................................... 156i FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM2. Katoril ......................................................................................... 1563. Ramiril ........................................................................................... 156- olon?an en4ekat Beta ....................................................................... 1561. Atenolol ........................................................................................... 1562. Bisorolol '&marat ......................................................................... 1563. Bisorolol ;emif&marat 2/5 m? dan ;idroklortiaid 6/25 m?

Bisorolol ;emif&marat 5 m? dan ;idroklortiaid 6/25 m? .............. 156%. Karedilol ........................................................................................ 1565. roanolol ;7l ............................................................................... 156- olon?an Anta?onis Kalsi&m ................................................................ 1561. Amlodiin Besilat ............................................................................ 1562. Diltiaem ;7l .................................................................................. 1563. 'elodiin .......................................................................................... 15#%. !ifediin .......................................................................................... 15#5. !imodiin ........................................................................................ 15#- olon?an Alfa Bloker ............................................................................. 15#1. Doksaosin )esilat ......................................................................... 15#2. raosin ;7l ................................................................................... 15#3. =eraosin ;7l .................................................................................. 15#

- olon?an Anta?onis An?iotensin II ....................................................... 15#1. Iresartan ........................................................................................ 15#2. Iresartan dan ;idroklortiaid ......................................................... 15#3. 7andesartan .................................................................................... 15#%. +osartan .......................................................................................... 15#5. =elmisartan ...................................................................................... 15#6. >alsartan ......................................................................................... 15#- olon?an +ain-+ain ................................................................................ 15$1. Klonidin ;idroklorida ....................................................................... 15$2. )etildoa Anhidrat ........................................................................... 15$d. Di&retik ......................................................................................................... 15$1. '&rosemid ............................................................................................. 15$2. ;idroklortiaid ....................................................................................... 15$

3. Klortalidon ............................................................................................. 15$%. )anitol .................................................................................................. 15$FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM 5. ironolakton ........................................................................................ 15$e. likosida Jant&n? ......................................................................................... 15$- Di?oksin ................................................................................................. 15$f. (at an? )emen?ar&hi Darah ................................................................... 15"1. Asetosal ................................................................................................ 15"2. Diiridamol ............................................................................................ 15"3. !a ;earin ............................................................................................. 15"


8/84

%. Kloido?rel ........................................................................................... 15"5. tretokinase ........................................................................................ 15"6. arfarin ................................................................................................. 15"?. (at *nt&k 4ok ........................................................................................... 15"1. Do&tamin ;idroklorida ......................................................................... 1602. Doamin ;idroklorida ............................................................................ 160h. >asokonstriktor ............................................................................................. 1611. ,fedrin ;7l ........................................................................................... 161

2. ,inefrin ;7l ........................................................................................ 1623. !oreinefrin ........................................................................................... 162i. >asodilator ..................................................................................................... 1631. 'l&nariin .............................................................................................. 1632. !aftidrof&ril (ksalat ............................................................................... 1633. entoksi< lin ........................................................................................... 163%. ildena< l ................................................................................................ 1635. itikolin ................................................................................................... 1636. >ardena< l ............................................................................................... 163I8. %IK""MATIK ................................................................................................... 16%a. Antiansietas dan Antiinsomnia ........................................................................ 16%1. Alraolam ............................................................................................. 16%2. B&siron ................................................................................................ 165

3. Diaeam .............................................................................................. 165%. Kloaam .............................................................................................. 1665. +oraeam ............................................................................................ 16#. Antideresi dan Antimania ............................................................................ 16$1. Amitritilin ;7l ........................................................................................ 16$i FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM2. Imiramin ............................................................................................... 16$. Antisikosis ................................................................................................. 16"1. ;aloeridol ............................................................................................. 16"2. &liride ................................................................................................ 1#03. =ri &oerain ;7l ................................................................................... 1#1d. Anal?esik !arkotik .......................................................................................... 1#21. Kodein 'osfat ........................................................................................ 1#2

2. )or< n ..................................................................................................... 1#23. etidin ;7l ............................................................................................. 1#2e. (at Dementia ............................................................................................... 1#21. Doneeil ............................................................................................... 1#22. alantamin ;Br ..................................................................................... 1#23. Riasti?min ............................................................................................ 1#2f. >asodilator .................................................................................................... 1#21. ildena< l ............................................................................................... 1#22. >ardena< l ............................................................................................... 1#23. =adala< l ............................................................................................... 1#2?. >itamin dan )ineral ...................................................................................... 1#31. Asam Askorat ...................................................................................... 1#32. >itamin B1 100 m?/ >itamin B6 200 m?/ >itamin B12 200 m? ............ 1#%

3. )ekoalamin ....................................................................................... 1#%%. >itamin B1 .............................................................................................. 1#55. >itamin B6 ............................................................................................. 1#56. >itamin A ............................................................................................... 1#6#. >itamin , 8D-a-=okoferil Asetat ............................................................ 1#6h. 7airan dan ,lektrolit ..................................................................................... 1##1. !a7l 0." H ............................................................................................ 1##2. !a7l 3H ............................................................................................... 1##3. Dekstrose 5H/ 10H ................................................................................ 1#$%. Rin?er Asetat ......................................................................................... 1#$5. Rin?er +aktat .......................................................................................... 1#"FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM ii8. %#$M"N"$"4I .................................................................................................. 1#"

a. Antiasma ........................................................................................................ 1#"1. Amino< lin ............................................................................................... 1#"2. B&desonid ............................................................................................. 1$03. er Dosis B&desonid $0 m?/ 'ormoterol %/5 m?er Dosis B&desonid 160 m?/ 'ormoterol %/5 m? ............................ 1$0%. Deksametason 8Am: !a 'osfat ........................................................... 1$05. ,fedrin ;7l ............................................................................................ 1$06. ,inefrin ;7l ......................................................................................... 1$0#. Iratroi&m Bromida .............................................................................. 1$0$. Klen&terol ;idroklorida ........................................................................ 1$0


9/84

". rokaterol ;7l ........................................................................................ 1$010. al&tamol ............................................................................................. 1$011. er 2/5 ml: Iratroi&m Bromida 0/5 m?/ al&tamol &lfat 2/5 m? ..... 1$012. er Disk&s 100: almeterol Finafoat 50 m? G 'l&tikason roionat 100 m?/er Disk&s 250: almeterol Finafoat 50 m? G 'l&tikason roionat 250 m?/er Disk&s 500: almeterol Finafoat 50 )? G 'l&tikason roionat 500 m? ... 1$013. =eo< lin .................................................................................................. 1$01%. =er&talin &lfat ..................................................................................... 1$1

15. =iotroi&m .............................................................................................. 1$1. Antit&erk&losis ............................................................................................ 1$11. ,tam&tol ;7l ....................................................................................... 1$12. Isoniaid ................................................................................................. 1$23. irainamid ............................................................................................ 1$2%. Rifamisin .............................................................................................. 1$25. 3fd: Rifamisin 150 m?/ I!; #5 m?/ irainamid %00 m? ................... 1$%6. tretomisin &lfat ................................................................................ 1$%. Antit&sif ......................................................................................................... 1$51. Dekstrometorfan ;idroromida ............................................................. 1$52. Kodein .................................................................................................... 1$6d. ,ksektoran .................................................................................................. 1$6- (at Bat&k ;itam ................................................................................... 1$6

iii FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM8I. RE#MAT"$"4I .................................................................................................... 1$#a. Anal?esik !arkotik ......................................................................................... 1$#1. Kodein 'osfat ......................................................................................... 1$#2. )or< n ...................................................................................................... 1$#3. etidin ;7l ............................................................................................. 1$$. Anal?esik !on !arkotik dan Anti-In amasi !on-teroid ................................ 1$"1. )etamiron ............................................................................................ 1$"2. Asam )efenamat ................................................................................... 1$"3. Diklofenak ............................................................................................. 1"0%. elekoksi ............................................................................................ 1"15. I&rofen ............................................................................................... 1"16. Ketorolak =rometamin ............................................................................ 1"2

#. )eloksikam ........................................................................................... 1"3$. arasetamol ......................................................................................... 1"%". =ramadol ;7l ......................................................................................... 1"5. Antirematik/ Antiirai ..................................................................................... 1"51. Alo&rinol ............................................................................................... 1"52. Aatiorin ............................................................................................... 1"63. Klorok&in ............................................................................................... 1"#%. Kolkisin .................................................................................................. 1"$5. )etotreksat ........................................................................................... 1""6. )ikofenolat mofetil ................................................................................. 1""#. roenesid ............................................................................................ 200$. iklofosfamid .......................................................................................... 201". iklosforin ............................................................................................... 201

10. &lfasalain ............................................................................................ 20211. )etilrednisolon 8Intraartik&lar ............................................................. 203d. Anestetik +okal .............................................................................................. 203- +idokain ;7l .......................................................................................... 203e. (at )etaolisme =&lan? dan (tot ................................................................ 20%1. Alendronat ............................................................................................. 20%2. Risedronat !a ........................................................................................ 205FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM if. >itamin dan )ineral ....................................................................................... 2051. Kalsitriol ................................................................................................. 2052. Kalsi&m .................................................................................................. 2063. l&kosamin ............................................................................................ 2068II. TR"%IK INFEKI .................................................................................................. 20#

a. Antelmintik M Antelmintik Intestinal ................................................................ 20#1. Alendaol ............................................................................................. 20#2. )eendaol ............................................................................................ 20$3. irantel amoat ..................................................................................... 20$. Antiakteri olon?an enisilin ....................................................................... 20"1. Amoksisilin ............................................................................................. 20"2. Amoksisilin Kla&lanat .......................................................................... 20"3. Amisilin ............................................................................................... 210%. Amisilin &laktam ............................................................................... 2115. enisilin Benil Benatin ........................................................................ 211


10/84

6. enisilin Benil rokain ......................................................................... 212#. &lenisilin Dinatri&m ............................................................................. 213. Antiakteri olon?an Amino?likosida ........................................................... 2131. Amikasin ............................................................................................... 2132. entamisin &lfat ................................................................................. 21%3. Kanamisin &lfat ................................................................................... 215d. Antiakteri olon?an Kloramfenikol ............................................................. 2161. Kas&l: Kloramfenikol. ir&: Kloramfenikol almitat etara Den?an

Kloramfenikol. In@eksi: Kloramfenikol !atri&m &ksinat etara Den?anKloramfenikol ........................................................................................ 2162. =iamfenikol ............................................................................................ 216e. Antiakteri olon?an K&inolon ...................................................................... 21#1. +eo oksasin ........................................................................................ 21#2. ( oksasin ............................................................................................... 21$3. iro oksasin ........................................................................................ 21"f. Antiakteri olon?an )akrolid ...................................................................... 2201. Aitromisin ............................................................................................. 2212. ,ritromisin tearat ................................................................................. 221 FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM3. Klindamisin ............................................................................................. 222?. Antiakteri olon?an efalosorin ................................................................ 223

1. efadroksil ............................................................................................. 2232. efaolin ................................................................................................ 2233. efeim .................................................................................................. 22%%. e< ksim ................................................................................................. 2255. efoeraon ........................................................................................... 2256. efotaksim ............................................................................................. 226#. eftriakson .............................................................................................. 22#h. Antiakteri olon?an =etrasiklin ..................................................................... 22$1. Doksisiklin .............................................................................................. 22$2. (ksitetrasiklin ........................................................................................ 22"3. =etrasiklin ;7l ........................................................................................ 22"i. Anti Bakteri olon?an +ain-+ain .................................................................... 2301. 'osfomisin ............................................................................................. 230

2. )eroenem ............................................................................................ 2313. Kotrimoksaol ........................................................................................ 231%. )etronidaol .......................................................................................... 2325. >ankomisin ............................................................................................ 233

@. Antif&n?i ......................................................................................................... 2331. Amfoterisin B ......................................................................................... 2332. 'l&konaol ............................................................................................. 23%3. Itrakonaol ............................................................................................ 235%. !istatin ................................................................................................... 236k. Antimalaria .................................................................................................... 23#1. ArtemeterC+&mefantrin ........................................................................... 23#2. Artes&natCamodiak&in ............................................................................ 23$3. Klorok&in 'osfat ..................................................................................... 23$

%. K&inin ..................................................................................................... 23"5. irimetamin ............................................................................................ 2%06. rimak&in .............................................................................................. 2%0#. &lfadoksin dan irimetamin ................................................................. 2%1FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM il. Antiir&s ....................................................................................................... 2%21. Adefoir Diioksil .................................................................................. 2%22. Asikloir ................................................................................................. 2%23. +ami&din .............................................................................................. 2%2%. ansikloir ............................................................................................. 2%35. =eli&din .............................................................................................. 2%36. Riairin ................................................................................................ 2%3#. ,ntekair ............................................................................................... 2%%

m. Antiretroiral ................................................................................................... 2%%1. Aakair ............................................................................................... 2%%2. Didanosin ............................................................................................... 2%%3. ,a< ren ............................................................................................... 2%%%. +ami&din .............................................................................................. 2%%5. +oinairCRitonair ................................................................................. 2%%6. !eirain ............................................................................................... 2%%#. ta&din ................................................................................................. 2%%$. =enoo< r ................................................................................................ 2%%". ido&dinCAidotimidin ........................................................................... 2%%


11/84

n. Antisetik ....................................................................................................... 2%51. Alkohol ................................................................................................... 2%52. ,takridin +aktat ..................................................................................... 2%53. ;idro?en eroksida ............................................................................... 2%5%. oidon Iodin .......................................................................................... 2%55. Kali&m erman?anat ............................................................................. 2%6o. Desinfektan ................................................................................................... 2%61. 'ormalin ................................................................................................ 2%6

2. Klorheksidin l&konat ........................................................................... 2%6. Im&noterai ................................................................................................... 2%#1. e?interferon L-2 ................................................................................ 2%#2. e?interferon L -2a ................................................................................ 2%#N. >aksin ............................................................................................................ 2%#1. >aksin Difteri =etan&s ............................................................................ 2%#2. >ir&s ;eatitis A Inaktif .......................................................................... 2%#ii FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM3. Anti?en 8Rekominan ;eatitis B Den?an Kem&rnian =in??i .............. 2%#%. &adrialent ;&man aillomair&s =4es 86/ 11/ 16/ 1$Reominant >aine. 1 Dosis 80.5 ml )en?and&n? kira-kira +1rotein ;> =ie 6820 m?/ =ie 11 8%0 m?/ =ie 16 8%0 m?Dan =ie 1$ 820 m? ............................................................................ 2%$

5. &ri< ed lit Inatiated In &ena >ir&s ............................................... 2%$6. >aksin )enin?itis )enin?okokkal .......................................................... 2%$#. olisakarida Dari 23 erotie tre. ne&monia 4an? Dim&rnikan ...... 2%$$AM%IRAN1$AM%IRAN$ampiran IKonsens&s/ (at =amahan di +&ar 'orm&lari&m esialistik Ilm& en4akit Dalam .... 251$ampiran IIen??&naan (at &nt&k Kelomok asien =ertent& ...................................................... 26#Indeks !ama (at ......................................................................................................... 2$1FORMULARIUM SPESIALISTIK ILMU PENYAKIT DALAM iii

BAB IK,=,!=*A! *)*)

KETENT#AN #M#M/. "bat Esensial

(at esensial adalah oat terilih 4an? alin? di&t&hkan &nt&k ela4anan kesehatan/ menak&&a4a dia?nosis/ ro< laksis/ terai dan rehailitasi/ 4an? di&a4akan tersedia di fasilitaskesehatan ses&ai den?an f&n?si dan tin?katn4a.

-. %emilihan "bat

a. Kriteria %emilihan "bat Esensialemilihan oat esensial didasarkan atas kriteria erik&t :1 )emiliki rasio manfaat-risiko 8benef t-risk ratio 4an? alin? men?&nt&n?kan enderita.2 )&t& ter@amin/ termas&k stailitas dan ioaailailitas.3 raktis dalam en4imanan dan en?an?k&tan.% raktis dalam en??&naan dan en4erahan 4an? dises&aikan den?an tena?a/ sarana danfasilitas kesehatan.5 )en?&nt&n?kan dalam hal keat&han dan enerimaan oleh enderita.6 )emiliki rasio manfaat-ia4a 8benef t-cost ratio 4an? tertin??i erdasarkan ia4a lan?s&n?dan tidak lan?s&n?.# Bila terdaat leih dari sat& ilihan 4an? memiliki efek terai 4an? ser&a/ ilihan di@at&hkanada :

- (at 4an? sifatn4a alin? an4ak diketah&i erdasarkan data ilmiahO

- (at den?an sifat farmakokinetik 4an? diketah&i alin? men?&nt&n?kanO- (at 4an? stailitasn4a leih aikO- )&dah dierolehO- (at 4an? telah dikenal.

$ (at @adi kominasi teta/ har&s memen&hi kriteria erik&t :- (at han4a ermanfaat a?i enderita dalam ent&k kominasi tetaO- Kominasi teta har&s men&n@&kkan khasiat dan keamanan 4an? leih tin??i dariada

masin?-masin? komonenO- erandin?an dosis komonen kominasi teta mer&akan erandin?an 4an? teat &nt&k

sea?ian esar enderita 4an? memerl&kan kominasi terse&tO


12/84

- Kominasi teta har&s menin?katkan rasio manfaat - ia4a 8benef t – cost ratioO- *nt&k antiiotik kominasi teta har&s daat mene?ah ata& men?&ran?i ter@adin4a

resistensi dan efek mer&?ikan lainn4a.b. %etun(uk Tingkat %embuktian dan Rekomendasi

=in?kat em&ktian dan rekomendasi diamil dari US Aenc! "or #ea$t% &are Po$ic! an'Researc%( sea?ai erik&t:TIN4KAT %EM*#KTIAN +STATEMENTS OF EVIDENCE

Ia 'akta dieroleh dari meta analisis &@i klinik aak den?an kontrol.

I 'akta dieroleh dari sek&ran?-k&ran?n4a sat& &@i klinik aak den?an kontrol.IIa 'akta dieroleh dari sek&ran?-k&ran?n4a sat& st&di den?an kontrol/ tana aak/ 4an?

diranan? den?an aik.II 'akta dieroleh dari sek&ran?-k&ran?n4a sat& st&di N&asi-ekserimental @enis lain 4an?

diranan? den?an aik.III 'akta dieroleh dari st&di deskritif 4an? diranan? den?an aik/ seerti st&di komaratif/

st&di korelasi/ dan st&di kas&s.I> 'akta 4an? dieroleh dari laoran ata& oini Komite Ahli danCata& en?alaman klinik dari

akar 4an? dise?ani.9. Formularium pesialistik

'orm&lari&m esialistik mer&akan s&at& &k& 4an? erisi informasi len?ka oat-oat 4an?alin? di&t&hkan oleh dokter sesialis idan? tertent&/ &nt&k en?elolaan asien den?an indikasien4akit tertent&. 'orm&lari&m esialistik dis&s&n &nt&k menin?katkan ketaatan ara dokter

sesialis R&mah akit terhada 'orm&lari&m R&mah akit 4an? selama ini masih san?at rendah.Bidan? sesialisasi tertent& isa sa@a mem&n4ai an4ak s&sesialisasi/ misaln4a idan?sesialisasi Ilm& en4akit Dalam/ mer&akan idan? sesialisasi 4an? mem&n4ai an4aks&sesialisasi/ sehin??a daat dis&s&n daftar oat esensial kh&s&s.en4&s&nan 'orm&lari&m esialistik meliatkan aik asosiasi rofesi dokter sesialis terkaitma&&n masin?-masin? s&sesialisasin4a. Den?an keik&tsertaan serta eran aktif ara sesialisdiharakan ara sesialis terse&t merasa memiliki sehin??a en??&naan oat rasional daatditerakan den?an aik.

:. Re;isi Formularium'orm&lari&m esialistik Ilm& en4akit Dalam 4an? ar& dis&s&n ini kelak erl& direisi dandisem&rnakan seara erkala. Reisi tidak han4a &nt&k men4es&aikan den?an kema@&an ilm&en?etah&an/ tetai @&?a &nt&k keraktisan dalam en??&naan dan en4erahan 4an? dises&aikanden?an ke&t&han tena?a kesehatan dan fasilitas ela4anan kesehatan 4an? ada.

en4em&rnaan form&lari&m dilak&kan seara ter&s mener&s den?an &s&lan materi dari fasilitasela4anan kesehatan/ endidikan/ dan enelitian kesehatan/ aik emerintah ma&&n s9asta/disamaikan keada Direktorat Jenderal Bina Kefarmasian dan Alat Kesehatan/ KementerianKesehatan.


13/84

BAB IIK,=,!=*A! R,DAKI(!A+

KETENT#AN REDAKI"NA$/. Tata Nama

a. !ama oat dit&liskan ses&ai den?an 'armakoe Indonesia edisi terakhir. Jika tidak ada dalam'armakoe Indonesia maka di?&nakan Internationa$ Non-*ro*rietar! Na)es 8I!! 8nama?enerik 4an? diteritkan ;(.

. (at 4an? s&dah laim di?&nakan dan tidak mem&n4ai nama I!! 8?enerik dit&lis den?an

nama laim.. (at kominasi 4an? tidak mem&n4ai nama I!! 8?enerik dieri nama 4an? diseakati

sea?ai nama ?enerik &nt&k kominasi dan dit&liskan masin?-masin? komonen aterkhasiatn4a disertai kek&atan masin?-masin? komonen.

-. %engertian dan ingkatana. %engertian

/ IndikasiIndikasi adalah t&@&an emakaian oat dalam terai. Diant&mkan @enis-@enis en4akit 4an?diindikasikan dan aakah oat terse&t &nt&k en4em&han/ ene?ahan ata&emeliharaan/ dll.


14/84

- Kontra IndikasiKontra Indikasi adalah keadaan-keadaan tertent& dimana oat tidak oleh dierikan.)isaln4a ada enderita den?an en4akit tertent&.

9 %eringatan dan %erhatian)en@elaskan akiat-akiat 4an? m&n?kin ter@adi dan har&s dierhatikan ada emakaianoat/ ter&tama ada keadaan tertent&/ serta an@&ran &nt&k tidak men??&nakan oatterse&t ada keadaan-keadaan tertent& &nt&k men?hindari efek-efek 4an? tidakdikehendaki.

: DosisDosis oat erisi ara emakaian/ @&mlah/ frek&ensi dan lama emakaian.7ara emakaian men&n@&kkan a?aimana oat terse&t mas&k ke dalam t&&h/ misaln4ain@eksi intraena/ oral ata& 4an? lain.

J&mlah emakaian men4atakan takaran 4an? laim di?&nakan dan atas-atas &nt&k kondisitertent&.'rek&ensi emakaian adalah @&mlah emerian dalam sat& hari ata& tia eeraa lamaoat it& dierikan.+ama emakaian men4e&tkan eraa lama oat it& har&sColeh dierikan/ eraa lamaemakaian har&s dihentikan seel&m diakai kemali ata& eraa lama oat it& minimalhar&s di?&nakan.

Interaksi obatKe@adian di mana s&at& at memen?ar&hi aktiitas oat. ,fek-efekn4a isa menin?katkanata& men?&ran?i aktiitas/ ata& men?hasilkan efek ar& 4an? tidak dimiliki.

? ediaanediaan adalah ent&k dan kemasan 8ila ada oat 4an? eredar.Bent&k sediaan adalah ent&k oat ses&ai roses em&atan oat terse&t dalam ent&kseerti 4an? akan di?&nakan/ misaln4a talet sal&t enterik/in@eksi intraena dan sea?ain4a.Kek&atan sediaan adalah kadar at erkhasiat dalam sediaan oat @adi/ misaln4a: etam&toltalet 250 m?/ klorok&in talet 150 m?.Kemasan adalah 9adah terkeil 4an? erh&&n?an lan?s&n? den?an oat.

b. ingkatan

am : am&ltl : otol&D + &ontro$$e' 'oseFD& + Fi,e' Dose &o)binationin@ : [email protected]. : intram&sk&lari.. : intraenas.k. : s&k&tankal : kaletkas : kas&l)A( : monoamin oksidasesah : sahetsir : sir&

: sistem saraf &satta : talettts : tetes

BAB IIIDA'=AR (BA= '(R)*+ARI*) ,IA+I=IK I+)*,!AKI= DA+A)

DAFTAR "*AT F"RM#$ARI#M %EIA$ITIK I$M# %EN&AKIT DA$AMI. A$ER4I DAN IM#N"$"4Ia. ANTIA$ER4I DAN "*AT #NT#K ANAFI$AKI$i%at $a)*iran I %a$a)an ./01/. DIFEN!IDRAMIN !3$

IndikasiAler?i/ ma&k er@alanan/ antiarkinson.Kontra Indikasi;iersensitiitas/ i& men4&s&i/ terai antiiotik ototoksik.Dosis


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*nt&k en?oatan antialer?i: 3-% kaliChari 1-2 ta/ *nt&k ma&k er@alanan 2 ta/ dimin&m 30menit seel&m makanCeran?kat.E=ek amping)en?ant&k/ retensi &rin/ m&l&t kerin?/ ?an??&an enernaan/ sedasi.

-. K$"RFENIRAMIN MA$EATIndikasi)erin?ankan ?e@ala aler?i seerti ada: rhinitis/ &rtikaria/ ha4 feer.Kontra Indikasienderita eilesi/ infeksi sal&ran ernaasan a?ian a9ah.%eringatan dan %erhatianelama min&m oat ini tidak oleh men?em&di ata& men@alankan mesin.DosisDe9asa: 1 ta 3-% kaliChari.E=ek ampingKadan?-kadan? tim&l erasaan men?ant&k/ les&/ m&al/ enin?/ m&l&t kerin?/ erdear/ ?emetar/dan ?an??&an enernaan.Interaksi "batKlorfeniramin daat men?halan?i metaolisme fenitoin.

9. $"RATADINIndikasi)en?&ran?i ?e@ala-?e@ala 4an? erkaitan den?an rhinitis aler?ik/ seerti ersin-ersin/ ilek/ rasa

?atal ada hid&n? serta rasa ?atal dan terakar ada mata. )en?&ran?i ?e@ala-?e@ala den?antanda-tanda &rtikaria kronik serta en4akit dermatolo?ik aler?i lain.Kontra Indikasiasien 4an? men&n@&kkan hiersensitif ata& idiosinkrasi terhada komonenkomonenn4a.%eringatan dan %erhatianasien den?an ?an??&an hati erat har&s dierikan dosis erm&laan 4an? leih rendah/dian@&rkan dosis a9al 5 m? sehari ata& 10 m? setia 2 hari. Khasiat dan keamanan loratadin adaanak P 2 tah&n el&m ditetakan. ;an4a dierikan selama kehamilan ila otensi manfaat leihesar dari risiko terhada @anin. ;ati-hati ila dierikan ada 9anita men4&s&i karena terekskresike AI.DosisDe9asa 1 ta 10 m? 82 sendok takar sehari.E=ek amping

+elah/ sakit keala/ somnolen/ m&l&t kerin?/ ?an??&an enernaan/ m&al/ ?astritis dan ?e@alaaler?i 4an? men4er&ai r&am. ernah dilaorkan aloesia/ ana< laksis/ f&n?si hati anormal dantakiaritmia s&raentrik&ler 9ala&&n @aran?.Interaksi "batKetokonaol/ eritromisin/ simetidin. (at-oat 4an? men?hamat metaolisme hati. ;ar&sdihentikan Q %$ @am seel&m rosed&r &@i k&lit.

:. ETIRI5IN !3$IndikasiRhinitis aler?i/ &rtikaria idioatik kronis.Kontra Indikasi;iersensitiitas/ i& men4&s&i.%eringatan dan %erhatiananita hamil/ laktasi.

DosisDe9asa - 1 kal 1 kaliChari. enderita ?an??&an f&n?si ?in@al daat dierikan kal 1 kaliChari.E=ek amping)en?ant&k/ &sin?/ sakit keala/ ?elisah/ m&l&t kerin? dan ?an??&an sal&ran erna. Reaksihiersensitif ada k&lit dan an?ioedema.Interaksi "bat(at sedatif dan alkohol.

b. ANTID"T DAN "*AT $AIN #NT#K KERA3#NAN K!##/. ATR"%IN

IndikasiKera&nan or?anofosfat dan karamat.%eringatan dan %erhatian+an@&t &sia/ indrom Do9n/ ?la&koma s&d&t tert&t&/ miastenia ?rais/ ?an??&an sal&ran erna/

emesaran rostat.DosisKera&nan or?anofosfat de9asa 2 m? setia 5-10 menit seara i.. ata& i.m. hin??a k&lit terlihatkerin? dan &shin?/ &il dilatasi/ dan m&lai ter@adi takikardi

-. KA$I#M 4$#K"NATIndikasi

=erai hiokalsemia.Kontra IndikasiKeadaan 4an? erkaitan den?an hierkalsemia dan hierkalsi&ria.%eringatan dan %erhatian


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anta& kadar lasma kalsi&m/ ?an??&an f&n?si ?in@al/ sarkoidosis/ ri9a4at nefrolitiasis.DosisDe9asa 1 ? i.. erlahan diik&ti % ?Chari i.. kontin&.

9. NATRI#M *IKAR*"NATIndikasiAsidosis metaolik/ kera&nan arit&rat/ salisilat.Kontra IndikasiAlkalosis dan hiernatremia.

%eringatan dan %erhatian)onitor ser&m iono?ram dan keseiman?an asam asa.DosisDosis indiid&al.Interaksi "batKalsi&m dan ma?nesi&m.

@. ANTID"T DAN "*AT $AIN #NT#K KERA3#NAN #M#M/. KAR*"N AKTIF TI%E ?

IndikasiAntidiare/ antidot&m 8adsoren era?ai ra&n oat dan toksin.DosisDe9asa 3-% ta 3 kaliChari.Interaksi "bat

)en?adsorsi oat 4an? dierikan ersamaan sehin??a men&r&nkan efek oat terse&t.ediaan

=a 250 m?.d. ANTIRETR"7IRA$$i%at $a)*iran I %a$a)an ./.1e. K"RTIK"TER"ID DAN K"RTIK"TR"%IN/.. DEKAMETA"N

Indikasiea?ai oat anti-in amasi misaln4a ada artritis/ &nt&k en4akit aler?i seerti en4akit ser&mdan asma/ &nt&k ?an??&an ada darah misaln4a le&kemia ak&t dan en4akit lain 4an? resonsif terhada ?l&kokortikoid.Kontra Indikasienderita &lk&s etik&m/ t&erk&losa aktif/ infeksi @am&r sistemik dan heres simleks ada

mata.%eringatan dan %erhatianenderita en4akit @ant&n?/ D)/ ?in@al. ;amil trimester I. en??&naan @an?ka an@an?. anitamen4&s&i. enderita den?an kolitis &lseratif non sesi


17/84

en?hentian oat ini setelah en??&naan @an?ka an@an? har&s ertaha. ;indari aksinasiselama men??&nakan oat. emerian oat ini daat men&t&i ?e@ala infeksi. emerian ada i&hamil har&s memertiman?kan manfaat dan risikon4a. ;ati-hati en??&naan ada enderitakolitis &lseratif non sesi


18/84

)&al/ m&ntah/ diare/ sakit keala/ insomnia/ alitasi/ takikardi/ aritmia entrik&ler/ takinea/r&am/ hier?likemia.Interaksi "baten??&naan ersama en4ekat eta/ rearat antin 4an? lain. imetidin/ sirooksasin/klaritromisin/ nor oksasin/ eritromisin/ troleandomisin/ kontrasesi oral/ rifamisin/ eraamil/diltiaem.

-. *#DE"NIDIndikasien?oatan asma ronkial.Kontra Indikasi;iersensitif terhada &desonid ata& komonen lain dalam oat.%eringatan dan %erhatianasien 4an? eralih dari ?l&kokortikosteroid sistemik ke ?l&kokortikosteroid inhalasi. Dosiserleihan dan en??&naan @an?ka an@an? ?l&kokortikosteroid. asien enderita t&erk&losis.DosisRes&le: a9al 1-2 m? 2 kaliChari. emeliharaan 1 m? 2 kaliChari. =&r&haler: 200-1200 m?Chari/dalam dosis tera?i 2-%. emeliharaan: 200-%00 m? 8a?i dan malam/ daat ditin?katkansamai 1200 m? ada asma erat.E=ek ampingerak/ iritasi ten??orokan/ iritasi lidah dan m&l&t/ m&l&t kerin?/ kandidiasis oral dan at&k. R&am/dermatitis/ &rtikaria/ an?ioedema dan ronkosasme. e@ala sikiatrik. Iritasi k&lit 9a@ah.

Kandidiasis orofarin?.Interaksi "baten?hamat 73A/ simetidin.

9. %er dosis *#DE"NID m@g, F"RM"TER"$ :,< m@g. B *#DE"NID /> m@g,F"RM"TER"$ :,< m@g.

Indikasi =erai re?&ler asma 4an? ses&ai diterai den?an kominasi 8inhalasi kortikosteroid dan eta-a?onis ker@a lama.Kontra Indikasi;iersensitif 8aler?i terhada &desonid/ formoterol ata& laktose terinhalasi.%eringatan dan %erhatianasien 4an? eralih dari ?l&kokortikosteroid sistemik ke ?l&kokortikosteroid inhalasi. en??&naan?l&kokortikosteroid @an?ka an@an?. asien den?an ?an??&an kardioask&lar erat/ D)/

hiokalemia 4an? tidak teroati dan tirotoksikosis.Dosis

=erai ereda dan emeliharaan: 2 inhalasiChari 8a?i dan malam/ ata& tia a?iCmalam.)aksim&m % inhalasiChari. enilaian &lan? terhada asien 4an? memerl&kan enin?katan @&mlahinhalasi. Dosis total harian de9asa maksim&m 12 inhalasi 8&nt&k ked&a kek&atan. =eraiemeliharaan: 1-2 inhalasi 2 kaliChari.E=ek ampingakit keala/ alitasi/ tremor/ kandidiasis orofarin?/ iritasi rin?an ada ten??orokan/ at&k/ serak.Interaksi "baten4ekat eta-adrener?ik 8termas&k tts mata. Ketokonaol dan en?hamat 73A% lainn4a.

:. DEKAMETA"N +Amp' Na Fos=atIndikasiArtritis re&matoid/ dermatitis dan &rtikaria/ asma ronkial serta ?e@ala aler?i lainn4a.

Kontra Indikasienderita heres simleks ada mata/ t&kak lam&n?/ osteoorosis/ D)/ infeksi @am&r sistemik.%eringatan dan %erhatian;ati-hati ila dierikan ada enderita en4akit @anSt&n?/ hiertensi/ ?la&koma/ kelainan mental/en4akit ?in@al kronik. ;ati-hati ila dierikan ada t&erk&losis 8tes k&lit ositif. adaen??&naan @an?ka an@an?/ hindari en?hentian emerian seara tia-tia.Dosis(ral 0/5 m? ta 2-% kaliChari. In@ 0/5-" m?Chari. )aksim&m $0 m?Chari.E=ek amping

=&kak lam&n?/ osteoorosis/ kelemahan otot/ moon fae/ m&al/ m&ntah/ ?la&koma/ retensi !adan airan/ kelainan / hiersensitiitas ada k&lit.


19/84

E=ek amping&s&nan saraf &sat/ misaln4a sakit keala/ insomnia/ ?elisah/ eksitasi. Aritmia entrik&ler.Interaksi "bat

Jan?an dierikan ersama )A( inhiitor ata& ?&anetidin.>. E%INEFRIN !3$

IndikasiReaksi ana< laktik erat/ an?ioedema erat/ henti @ant&n?%eringatan dan %erhatian;iertensi/ hiertiroidisme/ D)/ en4akit @ant&n?/ aritmia/ lansia.DosisAna< laksis: In@ einefrin 1:1000 i.m.Cs.k.E=ek amping

=akikardia/ aritmia/ hiertensi/ tremor/ m&al/ m&ntah.Interaksi "batDaat men?akiatkan hiertensi erat ada asien 4an? menerima en4ekat eta

?. I%RATR"%I#M *R"MIDAIndikasiBronkosasme 4an? erh&&n?an ada en4akit ostr&ksi ar& kronis termas&k ronkitis kronis/em< sema.Kontra Indikasi;iersensitiitas terhada atroin ata& t&r&nann4a/ ata& komonen lain ada oat. Inhaler:

ri9a4at hiersensitiitas terhada lesitin kedelai ata& rod&k lain 4an? men?and&n? kaan? dankedelai.%eringatan dan %erhatianla&koma s&d&t semit/ hiertro< rostat/ ostr&ksi leher kand&n? kemih/


20/84

De9asa: 1 inhalasi disk&s 100/ 250 ata& 500 2 kaliChari. (K: 1 inhalasi disk&s 250 ata& disk&s500/ sem&a dosis 2 kaliChari.E=ek amping

=remor/ alitasi/ sakit keala/ s&ara serak/ kandidiasis m&l&t dan ten??orokan/ ronkosasme.Interaksi "batelektif dan non selektif en4ekat eta

/. TE"FI$INIndikasi)erin?ankan dan men?ontrol seran?an asma ronkial.Kontra Indikasi;iersensitif terhada teo< lin dan deriat antin. asien den?an t&kak lam&n? dan D).%eringatan dan %erhatian

=idak oleh dierikan ada masa kehamilan dan men4&s&i/ ke&ali atas saran dokter. en??&naanersama efedrin akan menin?katkan toksisitas. asien den?an ?an??&an f&n?si hati/ eilesi/hioksemia/ hiertensi ata& asien den?an ri9a4at t&kak lam&n?. Jan?an dierikan meleihidosis 4an? dian@&rkan. asien T 55 tah&n/ kh&s&sn4a ria dan asien den?an en4akit ar&-ar&kronik.DosisDe9asa: 1 ta 2 kaliChari/ a?i dan malam. =a tidak oleh dik&n4ah ata& dihan&rkan.E=ek amping)&al/ m&ntah/ sakit keala/ diare/ alitasi/ insomnia. ada dosis tin??i: iritasi lam&n?/ kon&lsi/

toksisitas ak&t seerti aritmia/ ada anak m&ntah 4an? ter&s-mener&s men@adi hematemesis/stim&lasi / diaforesis dan demam. alitasi/ takikardi/ aritmia entrik&lar/ takinea/ r&am/hier?likemia.KontraIndikasi+iti&m dan antikoa?&lan/ simetidin/ alo&rinol/ eritromisin/ kontrasesi oral/ antin/ rifamisin.

//. TER*#TA$IN #$FATIndikasiea?ai ronkodilator/ di?&nakan &nt&k merin?ankan seran?an asma ronkial/ ronkitis dan em<sema.Kontra Indikasienderita 4an? hiersensitif terhada ter&talin s&lfat.%eringatan dan %erhatian;ati-hati emerian ada asien hiertensi/ ?an?

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