DOSIS OBAT INTERNA
(Sumber referensi obat: UKDI CORNER)
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| SKDI | DIAGNOSIS | KETERANGAN | TATALAKSANA |
|---|---|---|---|
| INFEKSI TROPIS | |||
| 4 | Leptospirosis | Ringan | Doksisiklin 2 x 100 mg |
| Ampisilin 4x 500 mg | |||
| Amoksisilin 4 x 500 mg | |||
| Berat | Penicilin G 1.5 jt unit/6 jam IV | ||
| Ampisilin 1gr/6 jam IV | |||
| Ceftriaxon 1gr/hari IV | |||
| Profilaksis | Doksisiklin 200 mg/minggu | ||
| Demam Tifoid | Kloramfenikol 4x500 mg 10 hari | ||
| Ampisillin 2 gr/hr 10 hari (ACC bumil) | |||
| Ciprofloxacin 2x500 mg 7 hari (X anak) | |||
| Carier/Rawat inap | Ceftriaxon 1gr/hari IV | ||
| HIV tanpa komplikasi | ARV (2 NRTI + 1 NNRTI) ~TEL/TNL | ||
| *NNRTI : Efavirenz, Nevirapine | |||
| *NRTI : Zinofudine, Lamifudine, Stavudine | |||
| Profilaksis | Dewasa : Kotrimoksazol 960 mg u/AIDS, CD <200 | ||
| Anak : Kotrimoksazol 4-6 mg/kgBB | |||
| Profilaksis bayi dari Bumil HIV + | ASI : Zidovudin + Nevirapin 6 minggu | ||
| Tanpa ASI : Zidovudin 6 minggu | |||
| Helminthiasis | Ascaris LumbricoidesAnkylostoma | 1. A : Albendazol 400 mg SD | |
| 2. M : Mebendazol 500 mg SD/2x100 3hr | |||
| 3. P: Pirantel Pamoat 3x10 mg/kgbb u/< 1 thn & bumil | |||
| Enterobius Vermicularis | P-M-A | ||
| Trichuris Trichura | M-A | ||
| Strongyloides | Albendazol 400 mg 3 Hr | ||
| Taeniasis | Praziquantel 10mg/kgBB SD Albendazol 400 mg 3 Hr Mebendazol 3x100 mg 2-4 minggu |
||
| Taeniasis + Kesmen (Neurosistercosis) | Albendazol 2 x 400 mg 8-30 Hr + steroid | ||
| Scistosomiasis J | Praziquantel 3x20 mg/kgBB/hr (60 mg) | ||
| Scistosomiasis M-H | Praziquantel 2x20 mg/kgBB/hr (40 mg) | ||
| Filariasis | Akut | DEC (DietilCarbamazin) 6 mg/kgbb (3x100 mg) 12 hari | |
| ko infeksi loa loa | tambah Ivermectin 150µg/kgbb SD | ||
| Kronik/Profilasis massal | Albendazol 400 mg SD + DEC/Ivermektin per tahun selama 5 thn | ||
| Malaria | Falciparum | Lini 1: ACT 3 Hr + Primakuin 1 Hr | |
| Lini 2: KINA+Doksi/Tetra 7 Hr + Primakuin 1 Hr | |||
| Vivax/Ovale | Lini 1: ACT 3 Hr + Primakuin 14 Hr | ||
| Lini 2: KINA+Doksi/Tetra 7 Hr + Primakuin 14 Hr | |||
| Malareae | Lini 1: ACT 3 Hr | ||
| Lini 2: KINA+Doksi/Tetra 7 Hr | |||
| ACT (Combine) | Artesunat + Amodiakuin | ||
| Dihidroartemisin + Piperakuin | |||
| Malaria Berat | Artesunat IV Hari 1: 2.4 mg/BB pada jam 0,12,24. Lanjut 2.4 mg/24 jam sampai pasien sadar |
||
| tdk bisa infus/di RS perifer/puskesmas | Artemeter IM Hari 1: 3.2 mg/BB dlm 2 dosis (1.6mg/BB/12 jam) Lanjut 1.6 mg/BB/24 jam selama 4 hari |
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| KINA HCL 10 mg/kgBB dalam 500cc D5% 8 jam | |||
| Malaria Profilaksis | Max. 3 bulan | Doksisiklin 100mg/hr (2 hr sblm - 4 minggu setelah) | |
| Bumil/Anak | Klorokuin 500mg/minggu (1 minggu sblm - 4 minggu setelah) | ||
| Resisten Klorokuin | Meflokuin 250 mg | ||
| DBD | Derajat 1 | 3-5 ml/kgBB/jam | |
| Derajat 2 | 6-7 ml/kgBB/jam | ||
| Derajat 3 | 10-20ml/kgBB dalam 30 menit | ||
| Derajat 4 | 20-30 ml/kgBB bolus! | ||
| RHEUMATOID | |||
| 4 | Gout Arthritis | Akut < 3hr | Kolkisin 0.6-1.2 mg/jam (Maks 8 mg) |
| > 3hr | Indometasin 150-200 mg/hr | ||
| Kronik | Allopurinol 3 x 100 mg | ||
| Probenesid | |||
| 3A | OA | Grade 1 | NSAID |
| Grade 2/3 | Inj. Kortiko + As. Hyaluronat intraarticular | ||
| Grade 4 | Total Knee Arthroplasty | ||
| 3A | RA | Awal | NSAID (Meloksikam, Na.Dic) |
| Tepat | DMARDS (Metotreksat/Klorokuin/Sulfasalazin) | ||
| 3A | SLE | Awal/Induksi | Metilprednisolon 8 mg (High dose) |
| Tepat | DMARDS (Metotreksat/Klorokuin) | ||
| 1 | Polimyalgia rheumatoid | Kortikosteroid dosis rendah (Prednison 15 mg/hr) | |
| GINJAL | |||
| 4 | Sistitis Non Komplikata | (Wanita + tdk hamil only) | Cotrimoxazole 2x960 / Ciprofloxacin 2x250 mg 3hr |
| Amoksiklav 2x625 mg 7 Hr | |||
| Sistitis Komplikata | Ciprofloxacin 2x500 7 hr | ||
| Anak | Kotrimoksasol 10mg/kgBB | ||
| Bumil | Nitrofurantoin 2x100, Amoksisilin 3 x 500 mg 3 hari | ||
| Pyenonefritis | IV 10-14 Hr | Fluorokuinolon: Ciprofloxacin/Levofloxacin | |
| TMP-SMX : Cotrimoxazole | |||
| Bumil | Cefadroxil 2 x 500 mg 7 hari | ||
| 3A | Sindrom Nefrotik | Continous Day Prednison 2 mg/kgBB (Maks. 60 mg )(1 bln)->Alternating dose 1.5 mg/BB (Selang-seling 1 bln) | |
| 3A | AKI | Ur>200 Uremic Syndrome | Rehidrasi, koreksi elektrolit + HD Cito! |
| ENDOKRIN | |||
| 4 | DM | Sekretegague | Sulfonilurea : Glibenklamid/Glimepirid 1x2 mg/Gliclazide/Glipizide/Gliquidone (Ginjal aman) |
| Non Sulfonilurea : Glinid | |||
| Biguanid | Metformin 3x500 mg | ||
| Thiazolidinedion | Pioglitazon | ||
| Alfa glukosidase inh. | Acarbose | ||
| SGLT 2 Inh. | Canagliflozin | ||
| Agonis GLP-1 | Liraglutide | ||
| DPP4 Inhibitor | Sitagliptin | ||
| Sesuai Indikasi | Insulin 0.5 IU/KgBB 60% prandial-40% basal | ||
| KAD/HONK | Insulin drips 0.1 IU/KgBB | ||
| Prandial (Analog) | Novorapid (Aspart) / Apidra (Glulisin) | ||
| Basal (Analog) | Lantus (Glagrin) / Levemir (Detemir) | ||
| Neuropati Diabetik | Awal/simptomatik | Pregabalin (Lyrica) 2x75 mg PO naik bertahap | |
| Tepat | Mecobalamin (Vit B12) | ||
| 4 | Hipoglikemia | Ringan | Larutan gula 15-20 gr dalam 15 menit (2-3 sdm) |
| 3B | Berat | Bolus D40% 1 flakon (25 cc) / D10% 150 ccLanjut D10% 100cc/jam | |
| 4 | Dislipidemia | u/ Hiperkolesteromia | Statin (Malam hari) |
| Ada TG >500 | Gemfibrozil 2 x 600 mg/ Fenofibrat 300 mg | ||
| u/ HDL <40 only | Asam Nikotinat (Niasin) 500-750 mg | ||
| 4 | Obesitas | Non farmako | Defisit kalori 500-1000 kkal/hariAktivitas fisik (sesuai kondisi pasien) |
| Farmako | Orlistat | ||
| Bedah | Restrictive/Hybrid Bariatric Surgeries u/ IMT > 35 | ||
| 3A | Hipertiroid | Mild | Metimazol 3 x 5 mg/hr |
| Moderate | Metimazol 3 x 10 mg/hr | ||
| Severe | Metimazol 3 x 20 mg/hr | ||
| Bumil Trimester I | PTU 3x100-200 mg (300-600 mg/hr) | ||
| Krisis Tiroid | PTU 600-1000 mg / Metimazol 6x20 mg + loading cairan ! | ||
| Lugol/iodide 6-8 tetes/jam | |||
| Propanolol IV / 60 mg oral | |||
| Radioterapi (Pre-Op) | Radioaktif : I 131 | ||
| 3A | Hipotiroid | Levotiroksin 1x25-50 mcg/hr | |
| Koma Mixedem | Levotiroksin 1x200-500 mcg IV, lanjut 100 mcg/hr sampai stabil | ||
| 2 | Hipoparatiroid | Ca Glukonas 1000 mg + Vit D | |
| 13B | Hipoadrenal | Addison Disease | Hidrokortison 10-25 mg |
| Krisis Adrenal | Awal : Infus Nacl | ||
| Hidrokortison 100 mg bolus -> 100mg/4-6jm | |||
| GEH | |||
| 4 | Dispepsia | Step Up | Antasida/Ranitidin --> PPI |
| Epigastric Pain | PPI (ROLE-P) | ||
| Robeplazole 10 mg | |||
| Omeprazole 20 mg | |||
| Lansoprazole 30 mg | |||
| Esomeprazole 40 mg | |||
| Pantoprazole 40 mg | |||
| Post Prandial Fullness | Prokinetik : Domperidone/Metoklopramid 3x10 mg | ||
| Bumil | Antasida/Rani only | ||
| Up Faktor Defensif | Sucralfat, Misoprostol | ||
| GERD | Untuk PPI Test | PPI dosis ganda 1-2 mg | |
| Step down | PPI dosis tunggal 4 mg--> Antasida/Ranitidin | ||
| Ulkus Gaster/ Peptik/Duodenal | Step down | PPI --> Antasida/Ranitidin | |
| Gastritis (H.Pylori) | Triple Therapy | 1st Line: O-K-A (Ome 2x20 +Klaritromisin 2x500+Amox 2x1000) | |
| Quadripel | 2nd Line: Ter Bom(Tetra 4x250 +Bismuth 2x2 + Ome+ Metro) | ||
| 3rd Line: M-OKA(Metro 3x500 +OKA) | |||
| 3A | Ulkus Gaster/ Peptik/Duodenal | Step down | PPI --> Antasida/Ranitidin |
| 3A | IBS | Tipe Diare | Loperamid (Agonis opioid) |
| (+infeksi/berdarah) | Atapulgit 600 mg (New Diatabs) | ||
| Tipe Konstipasi | Bisacodyl (Dulcolax), Proetilen Glikol (PEG), Sodium biphosphate enema | ||
| Tipe Nyeri Perut | Papaverin, Hyosine Butylbromide | ||
| 4 |
Diare | Giardiasis | Metronidazol 3x250 mg 5 hari |
| Kolera | Tertrasilklin 3x500 mg 2 hari/ Doksi 300 mg SD/ Azitro 1 gr SD Anak: Azitro 15 mg/kgbb hari 1, 2-5 hari berikutnya 7.5/kgbb |
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| ETEC/EPEC | Ciprofloksasin 2x500 5 hr | ||
| Disentri | EHEC/EIEC/Shigellosis | Ciprofloksasin 2x500 5 hr | |
| Amoebiasis | Metronidazol 4x500 mg 5 hari | ||
| Balantidiasis | Tetrasiklin 4x500 mg | ||
| Metronidazol 3x500 mg 5 hari | |||
| 3B | Inf. Clostridium | C. Botulinum | Human Botulism Ig 50mg/kg SD |
| C. Perfringens | Penicilin G 2-4 jt unit/6 jam IV | ||
| C. Dificille/colitis pseudomembran | Stop Antibiotik Metronidazol 4 x 250-500mg 7-14 hr |
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| HEPATOBILIER | |||
| 2 | Kolelitiasis | Ursodiaxy Colic Acid (Urdafalk) 250 mg | |
| 4 3A |
Hepatitis | Hepatoprotektor | Curcuma |
| Hep A | Simptomatik | ||
| Hep B | ARV : Lamivudin | ||
| Hep c | ARV : Ribavirin+Interferon | ||
| 3A | Abses Hepar | Piogenik | Penicillin |
| Aspirasi abses jika > 5cm | |||
| Amobeik | Metronidazol 3x750 mg | ||
| 2 | Serosis hepatis | Hematemesis/melena | Somatostatin |
| Profilaksis Ensefalopati | Lactulosa (u/turunkan kadar amonia) | ||
| Profilaksis ruptur varises esofagus | Propanolol | ||
| HOM | |||
| 4 3A |
Anemia Mikrositik | Def. FE | Fe Elemental 3 x 60 mg |
| Ferro glukonat 4 x 1 tab (12% elemntal) | |||
| Ferro sulfat 3 x 1 tab (20% elemntal) | |||
| Ferro Susinat 3 x 1 tab (22% elemntal) | |||
| Ferro fumarat 2 x 1 tab (33% elemntal) | |||
| Thalasemia | PRC : Hb target-Hb skrng x 3 x BB | ||
| Deferoxamin (u/kelasi besi) | |||
| 3A | Anemia Normositik | Hemolitik | Steroid |
| 3A | Anemia Megaloblastik | Def. B12 | Vit B12 (Cyanocobalamin) IM |
| Def. Asam Folat | B9 (As. Folat) 1 mg/hari | ||
| 2 | Polisitemia Vera/Kriptogenik | Flebotomi (Target Ht < 45%) | |
| Aspirin 40-80 mg/hr | |||
| Hidroksiurea 2x500 mg | |||
| 1 | Von Willebrand Disease | Desmopressin 0.3 mcg/kgIVkonsentrat vWF, kriopresipitat | |
