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PENGGUNAAN OBAT
PADA
KEHAMILAN DAN MENYUSUI
ALYYA SIDDIQADEPARTEMEN FARMAKOLOGIFK UPN VJ
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Tragedi Thalidomide !"hg# $%&'(a)al $%*'+
( O,a" -eda"i.
( Pem,eria# !ada )a#i"a hamil a)al#/a
dia#gga! 0ama#1
( Ter2adi m3l"i!le -"r34"3re mal.orma"io# !ada
2a#i# 5
( amelia6 !ho4omelia( 7elai#a# 2a#"3#g6 ga#gg3a# !e#gliha"a#
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8&9 mi#3m o,a" mi#imal -e7ali -elama
hamil da# *9 mi#3m o,a" !ada "rime-"er
!er"ama "ida7 "erma-37 :a" ,e-i6 a-am
.ola" da# ;i"ami#+a-!ada "erhada! !a-ie# )a#i"a 3-ia
!rod37"i.a#am#e-i- 7em3#g7i#a#
7ehamila#
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Kara7"eri-"i7 Pla-e#"a 5
Ke"e,ala#A)al 7ehamila# "e,al
Kemam!3a# me"a,oli-me
Da!a" "er,e#"37 me"a,oli" "o7-i7 mi-< e"a#ol6
,e#:!/re#e-
Tra#-!or"er !la-e#"ae.l37- o,a"
P(g! me#/e,a,7a# e.l37- o,a" -e!er"i o,a"
7a#7er
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How Drugs Cross the Placeta
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O,a" mele)a"i !la-e#"a de#ga# 4ara 5
Di.3-i !a-i.
Tra#-!or a7"i.a-am ami#o6 ;i"ami#6 io#
7al-i3m6 io# ,e-i6 me"ildo!a6 .l3oro3ra-il
Tra#-!or "er.a-ili"a-igl37o-a6 -e.ale7-i#
Pi#o-i"o-i-im3#oglo,3li#
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PENGARU? O@AT PADA FETUSTERGANTUNG 5
( J3mlah o,a" /a#g me#4a!ai !la-e#"a( uterine blood flow
( 7o#-e#"ra-i o,a" dalam !em,3l3h darahma"er#al
( S"r37"3r da# -i.a" ,io7imia !la-e#"a
( Si.a" o,a"
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Fa7"or(.a7"or /a#g mem!e#gar3hi "ra#-.er
o,a" melal3i !la-e#"a 5
Kelar3"a# dalam lema7
O,a" lar3" lema7 4e#der3#g m3dah ,erdi.3-i @era" mole73l &''
No#(io#i:ed
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Administration of drug to mother(oral, IV, IM)
mother
Free drugMetabolit
hepatic
metabolism
Uterine blood fow
placenta
Placental determinants- Area exchange- Thickness membranes
- Enzymes systems
Drug deterninantsMolecular weight < !!"ipid soluble
#on$charged
%etusFree drugMetabo
lit
hepatic
metabolism
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!AKTO" YANG MENENTUKAN E!EK OBAT
PADA #ANIN
$< >a7"3 !a2a#a# -"adi3m !er7em,a#ga# .e"3-+
( A)al ge-"a-i
( Ma-a orga#oge#e-i- da# di.ere#-ia-i
( Periode .e"oge#i7
B< S3-4e!"i,ili"a- ge#e"i7
8< Do-i- "era"oge#
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$< STADIUM PERKEM@ANGAN FETUS
. A)al ge-"a-i 5
?373m all or none< Cell dea"h or #o e..e4"
. Di.ere#-ia-i da# orga#oge#e-i- 5
( 7elai#a# a#a"omi-
( "erga#"3#g -"age em,rioge#e-i- -aa"
!em,eria# o,a". Periode .e"oge#i7 5 growth retardation, functional
disturbances
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>a7"3 !a2a#a# "era"oge# B mi#gg3 7o#-e!-imal.orma-i (+6 all or
#o#e
Mi#gg3 7e( -am!ai $'orga#oge#e-i--"r37"3r a#a"omi ma/or+ !eriode !ali#g
re#"a# "er2adi mal.orma-i
Trime-"er B68
CNS6 !er3,aha# a"a37er3-a7a# -"r37"3r da# .3#g-i6 4o#"oh#/a
!er"3m,3ha# 2a#i# "erham,a" IUGR+ARFARIN+ Pem,eria# !ada "rime-"er I6 ,er-i.a"
"era"oge#i7 5 mi7ro-e.ali7
Pem,eria# !ada a7hir 7ehamila# da!a"me#/e,a,7a# !erdaraha# re"ro!la-e#"a6
!erdaraha# !d 2a#i#
