Professional Documents
Culture Documents
Nama
NIM
Etiologi
Etiology Examples
Biliary obstruction Biliary atresia/neonatal hepatitis, congenital biliary cysts, cystic
fibrosis
Infection Brucellosis, congenital or tertiary syphilis, echinococcosis,
schistosomiasis
Drugs and toxins Alcohol, methotrexate, isoniazid, methldopa, organic hydrocarbons
Immune-mediated Primary biliary cirrhosis, porphyria, α1-antitrypsin deficiency,
Wilson’s disease
Cardiovascular Chronic right heart failure, Budd-Chiari syndrome, veno-occlusive
disease
Cryptogenic Unknown
Other Nonalcoholic steatohepatitis, sarcoidosis, gastric bypass
Patofisiologisirosis(deskriptifatau diagram)
Child-Pugh Classification
Parameter 1 2 3
Ascites Tidakada Sedikit Sedang-besar
Encephalopathy Tidakada Derajat 1-2 Derajat 3-4
Albumin >3,5 2,8-3,5 <2,8
Bilirubin <2 2-3 >3
Prothrombin time <4 detik 4-6 detik >6 detik
INR <1,7 1,7-2,3 2,3
Child-Pugh Score
Komplikasisirosis
Komplikasi Tandadangejala
Ascites Penumpukancairanlimfapadarongga peritoneal
Encephalopathy Gagalginjal fulminant akutdankelainan mental
Variceal bleeding Muntah darah, tinja berdarah, tekanan darah rendah, denyut jantung cepat, lightheadedness,
syok
Portal hypertension Tinja berdarah, ascites, encephalopathy, berkurangnya kadar platelet
a. Ascites
b. Encephalopathy
Tujuanterapi
Kondisi Tujuanterapi
menangani komplikasi; melindungi liver dari kerusakan lain; meringankan gejala dan
memperbaiki abnormalitas darah; menentukan apakah transplantasi hati diperlukan atau tidak
Ascites Untuk mengontrol ascites; untuk mencegah atau mengurangi gejala ascites seperti dispnea,
abdominal pain, dan abdominal distention; serta untuk mencegah komplikasi seperti SBP dan
hepatorenal sindrom
Encephalopathy Lactosa
Mengatur pola makan
Menghindari alkohol
Duration: 2 hr (IV); 6-
8 hr (PO)
Metabolisme di hati
Amilorid Direct effect on renal distal convoluted Half-Life: 6-9 hr Hypersensitivity Hyperkalemia
tubule to inhibit Na+ reabsorption from (10%)
the lumen Duration: 24 hr to amiloride
Anorexia (3-8%)
Onset: initial effect: 2- Hyperkalemia
3 hr, max effect: 6-10 (K+ >5.5 mEq/L Diarrhea (3-8%)
hr
[5.5 mmol/L])
Peak Plasma Time:
3-4 hr
Bioavailability: 30-
90%
Vd: 350-380 L
Metabolism: NOT
metabolized in the
liver; no active
metabolites
Metolazon Inhibits reabsorption of sodium in distal Bioavailability: 40- hypersensitivity to Chest pain
tubules, causing increased excretion of 65% metolazone or
water and of sodium, potassium, and sulfonamides Depression
hydrogen ions Onset: Diuresis, 1 hr
Anuria Dizziness
Duration: 24 hr
Half-life: 20 hr
Excretion: Urine
(80%), bile (10%)
Half-life: 25-75 hr
(neonates); 8 hr
(others); prolonged in
patients with hepatic
impairment
Excretion: Urine
(77%); feces (14%)
Neomisin Interferes with bacterial protein synthesis Half Life: 3 hr Hypersensitivity Diarrhea
by binding to 30S ribosomal subunits,
thus reducing the number of ammonia- Peak Plasma Time: Ulcerative bowel Nausea/vomiting
producing bacteria in the intestine oral: 1-4 hr; IM ~2 hr disease
Irritation or
Absorption: oral, Intestinal soreness of mouth
percutaneous: poor obstruction or rectal area
(3%)
Metabolism: slightly
hepatic
Excretion: Urine
(32%)
Portal Octreoide Somatostatin analog; decreases GH Absorption rapid and Hypersensitivity Gallbladder
Hipertension secretion, secretion of gastrin, VIP, complete (SC) problems (>60%):
glucagon, secretin, serotonin release and Decreased
pancreatic polypeptide Bioavailability: SC, gallbladder
100%; IM, 60% contractility,
gallstones,
Peak plasma time: IV, cholecystitis,
immediately after cholestatic hepatitis
injection; SC, 15-30
Excretion: Urine
(32%)
Duration: 6-12 hr
(immediate release);
24-27 hr (extended
release)
Half-life: Children,
3.9-6.4 hr; adults,
3.9-6.4 hr (immediate
release) or 8-10 hr
(extended release)
Onset (antidiuretic
activity): IM/SC, 2-8
hr
Onset (pressor
activity) IV, 30-60 min
Nitroglycerin PO Organic nitrate which causes systemic onset: within 1- hr4 Hypersensitivity Headache
venodilation, decreasing preload
Duration antianginal glaucoma Hypotension
effects: Up to 12 hr
Tachycardia
Bioavailability: 38.5%
Vd: 3 L/kg
Metabolism: Liver,
extrahepatic sites:
vascular wall, RBC
Metabolites: 1,3-
glyceryl dinitrate, 1,2-
glyceryl dinitrate, &
glyceryl mononitrate
(inactive)
Clearance: 5.5-11
L/min
Excretion: urine