PENDAHULUAN

Inflamasi merupakan reaksi imun

tubuh terhadap rangsangan dari
luar misalnya adanya organisme
patogen.(virus, bakteri, protozoa
dan jamur).
 Obat-obat antipiretik adalah obat-
obat yang dapat menurunkan suhu
tubuh pada penderita demam
menjadi normal, sedangkan suhu
tubuh yang normal tidak dipengaruhi
 PENGGOLONGAN
NSAID
1. Golongan asam salicylate
Contoh : Aspirin/acetozal, sodium
salicylate, benorylate, choline
magnesium trisalicylate, saisalate dan
diflunisal.
( methampyrone ).
2. Golongan pyrazolone
Contoh: Phenylbhutazone,
oxyphenbutazone, antipyrine,
aminopyrine (pyramidon ), dipyrone

3. Golongan indol
Indomethacine
sulindac
4. Golongan pripionic acid (organic
acid).
Contoh : Ibuprofen, ketoprofen,
fenoprofen, naproxen, flurbiprofen

5. Golongan anthranicil acid

Contoh : Mefenamic acid,
flufenamic acid
6. Golongan arylacetic acid
Contoh : Fenclofenac, diclofenac

7 Golongan aniline
Contoh : Paracetamol, phenacetine
Mekanisme kerja NSAID

KERUSAKAN MEMBRAN SEL

PHOSPHOLIPIDS

PHOSPHOLIPASE

ARACHIDONIC ACID

Obat-oabt
CYCLOOXIGENASE

( AINS )

PROSTAGLANDIN
( PGE2, PGF2, ALPHA )
EFEK FARMAKOLOLOGI
ANALGESIK
INFLAMASI
ANTIPIRETIK
FARMAKODINAMIK
1. EFEK ANALGESIK
OBAT MIRIP ASPIRIN
NYERI RENDAH SEDANG
SAKIT KEPALA
MIALGIA
ATRALGIA
 EFEK SAMPING
INDUKSI TUKAK LAMBUNG ANEMIA
GG. FUNGSI TROMBOSIT OK.
HAMBATAN BIOSINTESA
TROMBOKSAN A2
GG. HOMEOSTATIS GINJAL
GAGAL GINJAL
RINITIS VASOMOTOR, UDEM,
ANGIO NEUROTIK
URTIKARIA, ASMA, HIPOTENSI.
 SALISILAT

FARMAKOKINETIK
P.O LAMBUNG, USUS, HALUS
JARINGAN DAN CAIRAN
TRANSELULAR BIOTR.
( HATI ). EKS. MILL GINJAL,
EMPEDU, KERINGAT.
INDIKASI
1. ANTIPIRETIK
P.O 325 - 650 MG
3-4 JAM
ANAK-ANAK 15 20 MG /KG BB
2. ANALGESIK
SAKIT KEPALA, NYERI SENDI, NYERI
HAID NEURALGIA, MIALGIA
DOSIS = ANTIPIRETIK
3. DEMAM REUMATIK AKUT
DEWASA : 5 8 GR/HARI (
SEMINGGU DITURUNKAN
SAMPAI 60 MG / KG / HARI )
ANAK-ANAK 100 125 MG / KG BB.
4. ARTRITIS REUMATOID
DOSIS : 4 6 GR / HARI
I. M. A.
DOSIS : 325 MG / HARI
PARA AMINO FENOL

ACETAMINOFEN ( PARASETAMOL )

FENASETIN
FARMAKOKINETIK
ABS DI SALURAN CERNA BAIK
KONSENTRASI DALAM PLASMA
JAM
WAKTU PARUH 1 3 JAM
METABOLISME DI HATI
EKS. MLL URIN
FARMAKODINAMIK
U/ NYERI RINGAN - SEDANG
PENGHAMBAT BIOSINTESIS P.G.
LEMAH
EFEK LAMBUNG, PERNAP., KES.
ASAM BASA
INDIKASI
LAMA NEFROPATI ANALGESIK
NYERI RINGAN - SEDANG
SEBAGAI ANALGETIK & ANTIPIRETIK
DEWASA : 300 1 GR PER KALI MAX 4 GR /
HARI
ANAK-ANAK 6 12 TH : 150- 300 MG /
KALI
MAX 1,2 GR / HARI
ANAK-ANAK 1 6 TH : 60 120 MG / KALI
EFEK SAMPING
ERITEMA, URTIKARIA, DEMAM
METHEMOGLOBINEMIA
ANEMIA HEMOLITIK (
FENASETIN )
 PIRAZOLON

ANTIPIRIN, AMINOPIRIN,
DIPIRON
DIPIRON HANYA SEBAGAI
SUNTIKAN.
ANAL & ANTI. DOSIS : 0,3 1
GRAM / HARI.
S.E:

AGRANULOSITOSIS, AN.
APLASTIK TROMBOSITO PENIA.
FENILBUTAZON DAN
OKSIFENBUTAZON

FARMAKOKINETIK
P.O
ABS. DALAM SAL. CERNA
JARINGAN MET. DI HATI
EKSRESI MLL GINJAL.
FARMAKO DINAMIK
EFEK ANTI INFLAMASI
SALISILAT
EFEK ANAL. NON REUMATIK <
SALISILAT
EFEK URIKOSURIK
RETENSI NATRIUM & CLORIDA
UDEM
 ANT.P ANAL. NF. GAS

ASPIRIN + + + ++

SALICYL +< +< +

AMIDE

PHENYL.B ++ ++

ANTIPYRIN + + + +<

AMINO PYRIN + + + +<

(PIRAMIDON )

DIPYRON + ++ + +<

PARASETAMOL + - -
 COX-2 SELECTIVE
INHIBITOR
1. Celecoxib
- As effective as other NSAID
- Fewer endoscopic ulcer than NSAID
- No more edema or renal effects
2. Etoricoxib
- a second-generation COX-2
- 60 mg once daily for
acuteosteoarthritis
- 120 mg for acute gouty arthritis
3. Meloxicam
- Therapeutic dose 7,5 mg/d
- For treatment of rheumatic diseases,
osteoarthritis, rhematoid arthritis
4. Rofecoxib
For treatment of rheumatic diseases,
osteoarthritis, rhematoid arthritis, analgesic
and antipyretic
5. Valdecoxib
A new highly selective cox-2 inhibitor
Dosage is 20 mg twice daily
No effect on platelet aggregation or bleeding
time
DRUGS USED IN
GOUT
 GOUT
FOOD CONTAIN A HIGH PURINE
CONTENT
METABOLISM OF NUCLEIC ACID
OVERPRODUCE URIC ACID OR DO
NOT EXCRETE IT EFFICIENTLY
 DRUGS USED IN GOUT

ACUTE/CHRONIS

INFLAMASI (-) URICOSURIC DRUGS PRODUKSI (-)

COLCHICINE
NSAID PROBENECID ALLOPURINOL
GLUCOCORTICOID SULFINPYRAZONE
 COLCHICINE
MECHANISM OF ACTION:
REDUCES LEUKOCYTE MIGRATION AND
PHAGOCYTOSIS
PHARMACOKINETICS AND CLINICAL
USE:
PREVENT ATTACK OF GOUT
FEVER
USED ORALLY OR PARENTERALLY
TOXICITY:
GASTROINTESTINAL DISTURBANCE
LIVER, KIDNEY, AND BONE MARROW
 URICOSURIC AGENT
PROBENESID, SULFINPYRAZONE
MECHANISM OF ACTION:
COMPETE WITH URIC ACID FOR REABSORPTION IN
THE MIDDLE SEGMENT OF THE PROXIMAL RENAL
TUBULE
PHARMACOKINETICS AND CLINICAL USE:
BEST WITHELD FOR 1-2 WEEKS AFTER AN ACUTE
EPISODE
TOXICITY:
PRECIPITATE AN ATTACK OF ACUTE GOUT
ALLERGIC REACTION
GASTROINTESTINAL DISTURBANCE
 ALLOPURINOL
Mechanism of action
Inhibiting xanthin oxidase
Pharmacokinetics
80% absorbed after oral administration
Metabolised by xanthine oxidase
Pharmacodynamics
inhibited xanthine or hypoxanthine,
there is a fall in the plasma urate level
and a decreased in the size of the urate
pool
Dosage
The initial dose: 100 mg/d. It may be
titrated to 300 mg/d
Indications
- in chronic tophaceous gout
- When probenecid or sulfinpyrazone cannot
be used
- For recurrent renal stone
- in patients with renal functional impairment
- When serum urate levels are grossly
elevated
Treatment of gout will be continued for
years if not for life
Adverse effects
Gastrointestinal intolerance, neuritis,
necrotizing vasculitis, depression of
bone marrow, aplastic anemia, hepatic
toxicity, nepritis, allergic reaction