Bismillahirrohmanirrohim

INTERAKSI &
EFEK SAMPING OBAT
(1)
Fajar Prasetya
Fakultas Farmasi
Universitas Mulawarman
Risk Factors for Drug
Interactions
 High Risk Patients
• Elderly, young, very sick, multiple disease
• Multiple drug therapy
• Renal, liver impairment
 High Risk Drugs
• Narrow therapeutic index drugs
• Recognised enzyme inhibitors or inducers
 Some drugs with a low therapeutic index
 

Lithium (antimania) Digoxin (inotropik)

Carbamazepine (epilepsi) Cyclosporin

(imunosupresan)
Phenytoin (antiepilepsi) Phenobarbitone
(antikonvulsan, hipnotik)
Theophylline Warfarin
(Aminophylline) (antikoagulan)
 
Pharmacodynamic Drug
Interactions
One drug causes a change in patient
response to another drug without altering
that drug’s pharmacokinetics

 Eg increase toxicity of digoxin caused by diuretic

induced hypokalaemia
 Additive effects of alcohol and benzodiazepines
 Beta-blocker given with beta-agonist
Pharmaceutical Interactions
Interactions that occur prior to systemic
administration.
 For example incompatibility between two
drugs mixed in an IV fluid. These
interactions can be physical (e.g. with a
visible precipitate) or chemical with no
visible sign of a problem
Pharmacokinetic
Drug Interactions
 One drug alters the rate or extent of
absorption, distribution, metabolism or
excretion of another drug.
 A change in blood concentration causes a
change in the drug’s effect.
Altered Absorption (Availability)
 Change in gastrointestinal pH
• Ketoconazole needs acidic conditions in
gut
 Drug binding in GI tract
• E.g. tetracycline and calcium 
 Change in gastrointestinal motility
• Metoclopramide and digoxin
Interaksi Obat (Stockley)
Sebuah interaksi dikatakan terjadi
ketika efek dari satu obat berubah
oleh adanya obat lain, jamu,
makanan, minuman atau oleh
beberapa agen kimia
 Tugas
 Setiap orang membuat sebuah
presentasi interaksi tentang obat
dengan  obat, makanan, minuman,
obat tradisional (jamu)
See you next week . . .

Matur Tenkyu