Professional Documents
Culture Documents
Fathiyah Safithri
Laboratorium Farmakologi
Fakultas Kedokteran UMM
2009
DEFINITION
Complement Immunoglobulins
Natural Killer Cells T Lymphocytes
Phagocytic cells
Immunofarmakologi : ilmu yang mempelajri
tentang bagaimana mengontrol (menekan /
meningkatkan ) respon imun dengan
mediator biologis ataupun khemis
Obat Immunosupressan : mempelajari obat
yg digunakan pd keadaan overaktivasi sistem
imun (penyakit autoimun, post transplantasi)
Obat Immunostimulan : mempelajari obat
yang dapat meningkatkan status imun pada
keadaan immunodefisiensi, HIV-AIDS, kanker
Obat Sistem Imun
HISTAMIN
5 4
1 3
N N
H
2
Histamine
Interaksi :
Obat dg efek sedatif (benzodiazepin, alcohol).
Obat yg menghambat metab di hepar (ketakonazol)
kdr AH 1 lethal arrhythmia (terfenadin).
ANTI
ANTI LEUKOTRIEN
LEUKOTRIEN
Newton, Thorax
2000;55:603-613
Hypothalamic-Pituitary Adrenal (HPA) Axis
Adrenal cortex
Glucocorticoids
Cortisol (95%)
Corticostrone
Cortisone
90% bound to
plasma proteins
Circadian release
Of GCs; highest in
the early morning
and lowest in the
evening.
Disorders of the Adrenal Cortex
Primary Adrenocortical Insufficiency (Addisons Disease)
Destruction of the adrenal cortex leads to inadequate production of
cortisol and aldosterone.
Tuberculosis, cancer, hemorrhage
Atrophy of the adrenal cortex
Autoimmune disease
Prolonged corticosteroid treatment (Long-term admin)
Surgical excision of the adrenal glands
Anti-inflammatory effect
Antiproliferative effect
Immunosuppressive effect
Penggunaan Kortikosteroid
Mechanism of Action for
Anti-Inflammatory Steroids
Mekanisme Kerja
Steroid sbg Anti-Inflammasi
Menghambat aktivasi T-cell dan produksi sitokin.
Local (Preferred)
Intra-articular, IA
Intrabursal, IB
Intralesional, IL
Intrasynovial, IS
Soft tissue, ST
Intrarectal, IR
Topical
Nasal
Inhaled
Systemic
Oral, PO
Intramuscular, IM
Intravenous, IV
Farmakokinetik GC
Pemberian corticosteroids pd konsentrasi fisiologis
selama minimal 2 minggu akan menekan HPA axis,
shg terjadi penurunan endogenous hormones.
Recovery setelah 9-12 bulan.
Metabolisme Hepar :
Hepar : tempat inaktivasi / metabolisme utama GC. GC
dimetabolisme oleh enzim cytochrome P450 3A4
25% GC diekskresi bersama empedu & feces .
Renal Clearance
75 % metabolit GC diekskresi bersama urine .
Dampak Pemberian Kortikosteroid pada
Cortisol Release
Mineralocorticoid actvity
Corticosteroids control symptoms and DO NOT stop progression (cure) of the disease
Anti-inflammatory Drugs
Glucocorticoids
Inhaled
Beclomethasone
Budesonide
Flunisolide
Fluticasone propionate
Triamcinolone acetonide
Metered Dose
Inhaler
Also, Dry-powder inhalers
Oral (Quick relief of asthmatic symptoms) and Nebulizers
Prednisone
Prednisolone
* Unresponsive to 2 agonists
Inhaled Glucocorticoids:
Long-term control of Chronic Asthmatic Symptoms
Wheeze
Stridor
Cyanosis
Skin Pallor*
Prominent Tachycardia**
Therefore: