ppt hipotiroid

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    FARMAKOTERAPI II“ HIPOTIROID “

    ANDRI ARFALDI1301005

    S1 - VIA

    Dosen : Husnawa! M"S!# A$

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    H!$o!%o!&'e%u$a(an suau$en)a(! )an*&!se+a+(an o,e*an**uan $a&asa,a sau !n*(a

    &a%! a(s!s)$oa,a'us-!$o.s!s-!%o!& “en&o%*an/# &en*ana(!+a e%a&!n)a&e.s!ens! o%'one

    !%o!& aau$un*an**uan %es$on a%!n*an e%a&a$o%'one !%o!&2a!!#4014"

    2a!!#4014"

    H!$o!%o!& 'e%u$a(an*an**uan $a&a (e,ena% !%o!&+e%u$a $enu%unan $%o&u(s! &an

    se(%es! o%'one !%o!&" Ke,ena%!n! +e%$e%an 'e,e$as(ano%'one !%o!& (ese,u%u u+u'e,a,u! $e'+u,u &a%a" Pa&a(asus !$o!%o! e%a&!*an**uan s!nes!s &an se(%es!

    o%'one !%o! se!n**a (a&a%o%'one !%o!& 'ena&! %en&a&an 'en*a(!+a(an $enu%unan,au 'ea+o,!s' u+u "

    Soewon&o&an6a)anu%#4007"

    DEFINISI

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    ETIOLOGI

    Secara klinis dikenal 3 hipotiroidisme,

    yaitu :

    1. Hipotiroidisme sentral, karena

    kerusakan hipofisis atau hypothalamus

    2. Hipotiroidisme primer apabila yang

    rusak kelenjar tiroid

    3. Karena sebab lain, seperti

    farmakologis, defisiensi yodium,

    kelebihan yodium, dan resistensi

     perifer.

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    K,as!.(as!

    'enu%u$en)e+a+n)a H!$o!%o!&

    +e%&asa%(an(a&a% TSH• H!$o!%o!&!s

    'e $%!'e%!%o!&a,

    • H!$o!%o!&!s'e sen%a,!$o!%o!&!'ese(un&e%8$!u!a%!

    • H!$o!%o!&!s'e e%s!e%!$oa,a'us

    'enu%u us!a

    • K%e!n!s'eH!$o!%o!&!s'e(on*en!a,

    • H!$o!%o!&!s'e u9en!,!s

    • H!$o!%o!&!s

    'e'!(se&e'a&ewasa

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    Epidemiologi Hipotiroid

    E$!&e'!o,o*!

    • 1 : 5000 &a%! (e,a!%an !&u$• Pe%e'$uan : ,a(!-,a(! 4 : 1• 75ua !n**a, &! ,!n*(un*an (u%an*

    )o&!u'# 40ua *on&o(# 4;0"000(%ea!n!s'e

    Da'$a(

    • Pa&a an!n aau +a)! +a%u ,a!%  

    (e,a!nan !ne,e(ua, &an aau 2un*s!neu%o,o*!( )an* 'enea$• < 3 aun  $e%u'+uan ,a'+a• Ko'$,!(as! Ko'a '!(se&e'a

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    Patofsiologi Hipotiroid

    H!$o!%o!& &a$a &!se+a+(an o,e *an**uan s!nes!s o%'on!%o!& aau *an**uan $a&a %es$on a%!n*an e%a&a$ o%'on!%o!&" S!nes!s o%'on !%o!& &!au% se+a*a! +e%!(u:

    H)$oa,a'us 'e'+ua T)%o%o$!n Re,eas!n* Ho%'onTRH )an* 'e%an*san* !$o.se ane%!o%" H!$o.se ane%!o%'ens!nes!s )%o%o$!n T)%o!& S!'u,a!n* Ho%'on8TSH)an* 'e%an*san* (e,ena% !%o!&" Ke,ena% !%o!& 'ens!nes!so%'on !%o!& T%!!o&o)%on!n8T3 &an Te%a!o&o)%on!n8T=

    )an* 'e%an*san* 'ea+o,!s' a%!n*an )an* 'e,!$u!#(onsu's! o(s!*en# $%o&u(s! $anas u+u# 2un*s! s)a%a2#'ea+o,!s' $%oe!n# (a%+o!&%a# ,e'a(# &an 9!a'!n-9!a'!nse%a (e%a o%'on-o%'on ,a!n

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    Maniestasi klinis Hipotiroid Penu%unan ,au 'ea+o,!s'e +asa, >MR

    Sens!!9!as e%a&a$ (ae(o,a'!n 'enu%un

    Ka&a% (o,ese%o, &a%a 'en!n*(a

    Pa&a 2un*s! (a%&!o9as(u,a% e%a&! $enu%unan ?u%a anun* &an +%a&!(a%&!

    Pa&a 2un*s! *as%o!nes!na, 'en*a,a'! (ons!$as! &an $enu%unan na2su 'a(an

    Pa&a 2un*s! %es$!%as! 'en*a,a'! !$o9en!,as!

     Tonus oo &an %[email protected]( 'enu%un

    Ino,e%ans! e%a&a$ &!n*!n

    Penu%unan (e%!n*a

    Ku,! &an %a'+u (asa%

    >e%a +a&an 'en!n*(a"

    Pe%!,a(u u'u' )an* 'un?u, $a&a $en&e%!a &!ana%an)a (e'un&u%an 'ena, &an .s!(&an so'no,en"

    a'+a% u'u' &a%! $en&e%!a &!ana%an)a sua%a se%a(# *an**uan $e%u'+uan $a&aana(-ana( &an '!(se&a'aosa"

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    Pemeriksaan Diagnostik Hipotroid

    Pe'e%!(saan %a&!o,o*! %an*(a

    Ron*eno*%a.

    S(!!*%a.

    E,e(%o(a%&!o*%a'

    E,e(%oense2a,o*%a' se%!n* 'enunu((an 9o,ase )an*%en&a" Pa&a ana( &! aas u'u% 4 aun# (a&a% (o,ese%o,se%u' +!asan)a 'en!n*(a"

    Pe'e%!(saan ,a+o%ao%!u'

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    Penaa,a(sanaan

    H!$o!%o!& $a&a&ewasa

    •  Te%a$! su,! o%'one!%o!& se?a%a+e%aa$

    • Pe'+e&aan e(s!s!#(e'oe%a$! aau%a&!as! !(a e%&a$au'o% (e,ena% !%o!&

     

    H!$e%!%o!&

    $a&a Ana(

    Pe'+e%!an ,e9o!%o(s!no%a, S)n%o!&# )an*&!'u,a! &en*an &os!sse&an* &an se?a%a+e%aa$ &!na!((an!n**a 'en?a$a! &os!s)an* ?u(u$ unu(

    %u'aan seu'u% !&u$

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    Le9o)%oB!ne

     T!%o(s!n &!*una(an unu( 'en)usu(an u(u%an s%u'a &en*an'ene(an TSH se%en&a 'un*(!n

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    Ko'$,!(as!

    Ko'$,!(as!

    Pen)a(! anun*Pen)a(! anun*

    Ko'a'!(se&e

    'a

    Ko'a'!(se&e

    'a

    an**uan$e%u'+uan

    &an$e%(e'+an*a

    n(%e!n!s'e

    an**uan$e%u'+uan

    &an$e%(e'+an*a

    n(%e!n!s'e

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    Su+e(!2 

    Na'a $as!en : N)"S'! Cen!s (e,a'!n : $e%e'$uan

    s!a : 35 aun

    Ke,uan : >e%a +a&an 'en!n*(a sea( 'e,a!%(an&an +e,u' 'a'$u +e%a,an" Na'un &!a ea$ 'ena*a

    (a,o%!# &!e e%(on%o," D!a 'e%asa &!n*!n se$anan*wa(u# +a(an &! a%! )an* $anas se%a %a'+u'en!$!s" D!a !&a( 'e'!,!(! ene%*!# se&an*(anse+e,u' (e,a!%an $u%!n)a &!a se%!n* $e%*! ae%o+!(se!&a(n)a !*a (a,! se'!n**u"

    O+e(!2 : -

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    Kasus

    M%s" S'! # )an* +e%us!a 35 aun # &aan* (e a$oe(An&a &en*an $u%!n)a +e%us!a 1 aun &an

    'e'+e%!(an %ese$ unu( ,e9o)%oB!ne a+,e 50 -'!(%o*%a' unu( sau a%! " In! a&a,a $e%a'a(a,!n)a &!a 'en**una(an o+a !u " D!a e,a'en&a$a(an +an)a( +e%a +a&an sea( (e,a!%an$u%! &an +e,u' 'a'$u 'enu%un(an +a(an &en*anea$ +e%$e*an* (a,o%! # &!e e%(on%o, # &!a 'e%asa&!n*!n se$anan* wa(u # +a(an &! a%! )an* $anas&an %a'+u 'en!$!s " D!a !&a( 'e'!,!(! ene%*! sa'ase(a,! # $a&aa, se+e,u' (e,a!%an $u%!n)a !a $e%*!unu( (e ae%o+!( se!&a(n)a !*a (a,! se'!n**u "

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    Asses'en :

    >e%&asa%(an *ea,a )an* &!a,a'! $as!en# $as!en &! &!a*nosa'en&e%!a !$o!%o!& %!n*an se!n**a $e%,u &!+e%!(an e%a$!

    P,ann!n* :

    • >e%&asa%(an *ea,a )an* &!!'+u,(an 'a(a &!+e%!(an,e9o!%o(s!n 50 '!(%o*%a' sea%! sau a+,e $a&a saa$e%u (oson* +e%uuan unu( 'en*!,an*(an *ea,a

    (,!n!s se%a 'en?a$a! aau 'e'$e%aan(an (a&a% TSH$a&a $a%u +awa %enan* (a&a% TSH no%'a, aau se(!a%0#=-4#5 '8L" Dos!s a%us &!sesua!(an se!a$ =-7 '!n**usa'$a! $as!en 'ena&! eu!%o!&"

    • D!,a(u(an $e'e%!(saan $enunan* ,a!n unu( 'e,!a$en*a%u !$o!%o!&!s'e $a&a +e+e%a$a o%*an 'e,!$u!$e'e%!(saan ,a+o%ao%!u' %u!n# %a&!o,o*! &ane,e(%o(a%&!o*%a. se%a &!,a(u(an $e'e%!(saan (a&a% T3&an TSH se%u' unu( 'enenu(an (ae*o%! !$o!%o!&"

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     Te%!'a Kas!