Dita Maria Virginia

Osteoarthritis

ARTHRITIS
Rheumatoid

arthritis

Osteoporosis
Gout

/ hiperuricemia

 common

condition that causes pain and

inflammation within a joint

Klasifikasi:

Rheumatoid-arthritis (RA)
Osteo-arthritis (OA)

 Genetik/family
Wanita
Merokok
Usia

history HLA class II

 Rheumatoid

factor (RF) detectable in 60% to

70%.
Anticyclic citrullinated peptide (anti-CCP)
antibodies have similar sensitivity to RF (50%
to 85%) but are more specific (90% to 95%)
and are present earlier in the disease.
Elevated erythrocyte sedimentation rate
and C-reactive protein
Normocytic normochromic anemia is
common as is thrombocytosis.

Patofisiologi:
body's immune system attacks and destroys
the affected joints, causing pain and swelling
to occur. This can lead to a reduction in
movement and the breakdown of bone and
cartilage.

Rheumatoid nodules

Vasculitis

Pulmonary complication

Ocular manifestation

Cardiac involvement

 Exercises:
Weight
Surgery

walking, swimming

reduction

 DMARD

Methotrexat
Sulfasalazine
Biologic agent

Anti TNF
: infliximab
Antagonis receptor IL-1 : Antakira

NSAIDs
Corticosteroid

Menurunkan faktorfaktor proinflamasi

Pembentuk panus

 Obesitas
Umur
Hormonal
Genetik
Injury,overloading

of joints, muscle
weakness, or joint deformity

 Primary
Secondary
Errosive

reflects a failure of the chondrocyte to maintain

proper balance between cartilage formation and
destruction.
This leads to loss of cartilage in the joint, local
inflammation, pathologic changes in underlying
bone, and further damage to cartilage triggered
by the affected bone

 Cold

or warm

 There

is no cure for osteoarthritis, but the

symptoms can be eased with several
different treatments.

Treatment

options may include:

non-drug treatments, such as physiotherapy and weight

loss
medications, such as painkillers
surgery in a small number of cases, such as a knee or hip
replacement

patah tulang punggung

Rasa sakit dari sisi belakang tubuh. Setelah bertahuntahun, patah tulang belakang yang berulangkali dapat
menyebabkan nyeri punggung kronis dan tulang belakang
tidak tegak lagi /melengkung, yang menyebabkan bungkuk
pada punggung.

patah karena tekanan

Patah tulang yang terjadi selama aktivitas normal

patah tulang pinggul

Patah tulang panggul biasanya terjadi sebagai akibat jatuh
atau kecelakaan yang tidak parah. Patah tulang pinggul
juga akan sulit untuk disembuhkan setelah bedah karena
kualitas tulang yang buruk.

Tujuan utama manajemen osteoporosis adalah pencegahan, dengan mengoptimasi

perkembangan skeletal dan massa tulang puncak akrual saat masa kanak-kanak,
remaja dan awal dewasa akan menurunkan insiden osteoporosis di masa mendatang.

Inhibisi resorbsi
Agonis Estrogen/ Selective Estrogen Receptor Modulators
(SERMs) raloxifene
Bisfosfonat - alendronate
Estrogen

RANK-L inhibitor denoxumab

Meningkatkan formasi tulang - Teriparatide
Mineralisasi:
Kalsitonin
Kalsium
Vitamin D

 Akut

gout monoarticular

Tophaceus

gout ada tophy

Intercritical
Nefrolitiasis
Nefropati

gout asimptomatik

Tujuan terapi untuk menghilangkan rasa nyeri serangan akut, mencegah

serangan berulang dari arthritis gout, mencegah terjadinya komplikasi,
dan mengurangi kadar serum uric acid

NSAIDs
Colchicine
Corticosteroid
Uric

Acid Lowering Therapy

Xantin oxidase Inhibitor = Allopurinol

Uricosuric agents = Probenesid

phar.uokufa.edu.iq

www.cram.com

DiPiro, J.T., et al., 2009, Pharmacotherapy Handbook, Seventh edition, McGraw-Hill,

New York, pp.1516-1581.
Khanna, D., et al., 2012, 2012 American College of Rheumatology Guidelines for
Management of Gout. Part 1: Systematic Nonpharmacologic and Pharmacologic
Therapeutic Approaches to Hyperuricemia, Arthritis Care & Research, Vol. 64, No.
10, pp 14311446 DOI 10.1002/acr.21772
Mazzioti, G., Canalis, E., Giustina, A., 2010, Drug induced osteoporosis: mechanism and
clinical implication, The American Journal of Medicine, pp. 877-884.
McAlindon, T.E., 2014, OARSI guidelines for the non-surgical management of knee
osteoarthritis, Osteoarthritis and Cartilage, 22,pp363-388,
http://oarsi.org/sites/default/files/docs/2014/non_surgical_treatment_of_knee_oa
_march_2014.pdf
Singh, J.A., et al., 2015, 2015 American College of Rheumatology Guideline for the
Treatment of Rheumatoid Arthritis, Arthritis Care & Research, DOI
10.1002/acr.22783
Beberapa slide merupakan hasil translasi yang diambil dari makalah/tugas
Farmakoterapi 2 angkatan 2012