Ppt Penatalaksanaan Parkinson's Disease
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Transcript of Ppt Penatalaksanaan Parkinson's Disease
7/23/2019 Ppt Penatalaksanaan Parkinson's Disease
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REFERATPENATALAKSANAAN
PARKINSON’S DISEASE
Putri Nisrina Hamdan
1102011213
Pembimbin!dr. M. Tri Wahyu Sp. S, M. Kes
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PARKINSON’S DISEASE
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Par"is#nisme Sindr#m trem#r$a"tu istira%at& riiditas& bra"inesia&dan %i'ann(a re)e* +#stura' "adard#+amine,
Pen(a"it Par"ins#n deenerasian'ia basa'is terutama disubstansia nira +ars "#m+a"ta adan(a in"'usi sit#+'asma eusin#-'disebut denan Le$( .#dies,
7/23/2019 Ppt Penatalaksanaan Parkinson's Disease
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Eti#'#i
/siaFa"t#reneti
"
Fa"t#rLin"un
an
TraumaKe+a'a
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ETIOPATOFISIOLOGIStr!e
As"!sia#ip$%i!e&ia
Sia'ida, (O, MPTP
Ga'$$ua'&eta)%is&e
'eur'
Me!a'is&ee*+itt*i+i
ty
O*idatie stress
APOPTOSIS NEKSROSIS
DEGENERASI S-STANSIA NIGRA
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Kerusa"an +ada substansia nira SN,
Tan+a d#+amin& sin(a' tida" da+atdisam+ai"an dari SN "e baian 'ain di
#ta", Semua unsi neur#n di SSPmenurun,
Kadar d#+amin menurun,
kelambatan gerak (bradikinesia),
kelambatan bicara dan berpikir
(bradifrenia), tremor dan kekauan
(rigiditas).
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GE/ALA KLINIS
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PEMERIKSAAN PEN-N/ANG
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DIAGNOSIS
P!di Me&e't Disrders PERDOSSI
Kriteria K%i'is
Kriteria K%%er
Kriteria #u$hes
• P#ssib'e ! 1 dari 3e4a'a utama
• Pr#bab'e! ada 2dari 5 e4a'am#t#ri"
•
De-nite! ada 3e4a'a utama
•
Ada 3 ma6am dian#sis se+erti "riteria %u%es• De-nit ada tanda "riteria dian#sis +#ssib'e dan "#n-rmasi %ist#+at#'#i
Kriteria Ge%) da'%a0a'ya
Dida+at"an 2 dari 3anuan m#t#ri6 ! trem#r&
riiditas& bra"inesia, dari 5 anuan m#t#ri6 !
rem#r& riiditas& bra"ibesia&+#stura' instabi'itas,
7 2 dari 3 tanda 6ardina' anuanm#t#ri" ! trem#r saat istira%at atauanuan re)e"s +#stura'& riiditas&bradi"inesia (an ber'ansun 1 ta%unatau 'ebi%,
7 Res+#ns tera+i 'e8#d#+a (an diberi"ansam+ai +erbai"an sedan minima' 1,000
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PENATALAKSANAAN
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FAR:AKOLOIK
DA1er$i!
L7d#+a
D#+a7de6arb#*('asein%ibit#r 6arbid#+a
• Sinemet• .en;era;ide• :ad#+ar
:AO dan <O:Tin%ibit#r
D#+amin a#nis
Er#t!•.r#m#6ri+tine•<aber#'ine•Lisuride•Per#'ide
N#n7er#t!•Prami+e*#'e•Ra+inir#'e• Ta'i+e*#'e
A'ti!%i'er$i! • T%ri%e*(+%enid(' artane• .en;tr#+in 6#nentin
G%uta&at a'ta$'is
• Amantadine• :emantadine• Rema6emide
Pe%i'du'$ 'eur'
• Neur#t%r#+i6 a6t#r• Anti7e*#t#*in• Anti #"sidan• .i#enereti6 su++'ement•
Immun#su+ressant
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a,Anti"#'ineri" 1
.eruna untu" menenda'i"an e4a'a dari +en(a"it +ar"ins#n,
/ntu" mena'us"an +erera"an,
b,<arbid#+a9'e8#d#+a
Le8#d#+a meru+a"an +en#batan utama untu" +en(a"it +ar"ins#n,Le8#d#+a menurani trem#r& "e"a"uan #t#t dan mem+erbai"i
era"an,
Di da'am #ta" 'e8#d#+a diruba% men4adi d#+amine, L7d#+a a"andiuba% men4adi d#+amine +ada neur#n d#+amineri" #'e% L7
ar#mati" asam amin# de"arb#"si'ase d#+a de"arb#"si'ase,
<arbid#+a dan bensera;ide ada'a% d#+a de"arb#"si'ase in%ibit#r&
membantu men6ea% metab#'isme L7D#+a sebe'um men6a+aineur#n d#+amineri", 3
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Ee" sam+in 'e8#d#+a !
1Neusea& munta%& distress abd#mina'
2Hi+#tensi +#stura'
3Sese"a'i a"an dida+at"an aritmia 4antun&5Dis"inesia,era"an m#t#ri" tida" ter"#ntr#' +ada an#ta
era" mau+un tubu%,
=Abn#rma'itas 'ab#rat#rium, ranu'#sit#+enia&unsi %ati abn#rma' dan ureum dara% (anmenin"at meru+a"an "#m+'i"asi (an 4aranter4adi +ada tera+i 'e8#d#+a,
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Masa
Pe'$)ata'
Dsis Fre!ue'si Pe&)eria'
Mi'$$u !e 2 12= m 2*se%ari
Mi'$$u !e 3 12= m 5*se%ari
Mi'$$u !e 4 2=0m 5*se%ari
Mi'$$u !e 5 =00m 3* se%ari
Mi'$$u !e 6 =00m 5* se%ari
Mi'$$u !e 7 =00m =* se%ari
Mi'$$u !e 8 1 r 3* se%ari
Mi'$$u !e 9 1 r 3* se%ari > =00 m di ma'am %ari
Tabe', Ped#man D#sis Le8#d#+a /ntu" Pasien Ra$at ?a'an 5
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6,<O:T in%ibit#rs
Enta6a+#ne <#mtan& T#'6a+#ne Tasmar, /ntu" men#ntr#')u"tuasi m#t#r +ada +asien (an menuna"an #bat 'e8#d#+a,
d,A#nis d#+amin
Obat ini be"er4a denan meransan rese+t#r d#+amin& a"anteta+i #bat ini 4ua men(ebab"an +enurunan rese+t#r d#+aminse6ara +r#resi (an se'an4utn(a a"an menimbu'"an
+enin"atan e4a'a Par"ins#n, 5
Obat ini da+at beruna untu" men#bati +asien (an +erna%mena'ami seranan (an ber)u"tuasi dan dis"inesia sebaaia"ibat dari 'e8#d#+a d#sis tini, A+#m#r-n da+at diin4e"si"ansub"utan, D#sis renda% (an diberi"an setia+ %ari da+atmenurani )u"tuasi e4a'a m#t#ri", 3
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e,:AO7. in%ibit#rs
Se'ei'ine E'de+r('& Rasaa'ine A;i'e6t,
In%ibit#r :AO didua beruna +ada +en(a"itPar"ins#n "arena neu#transmisi d#+amineda+at ditin"at"an denan men6ea%+erusa"ann(a,
,Amantadine S(mmetre'
.eruna untu" +era$atan a"inesia&
d(s"inesia& "e"a"uan& emetaran
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Fen#mena On-Of
Saat on , +enderita da+at berera" denan muda%& terda+at+erbai"an +ada e4a'a trem#r dan "e"a"uann(a,
Saat of , +enderita sanat su'it berera"& trem#r dan"e"a"uan tubu% menin"at,
Wearing of ada'a% Peri#de of (an mun6u' se4a" a$a'+emberian 'e8#d#+a dan ta" da+at diatasi denanmenin"at"an d#sis. Pema"ai 'ama 'e8#d#+a da+atmenimbu'"an e4a'a dis"inesia,
Wearing of dan dis"inesia "adan7"adan tida" da+at
di"#ntr#' denan tera+i medi"ament#sa dan +er'u+embeda%an,
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NON7FAR:AKOLOIK
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TERAPI REHA.ILITASI
Lati%an (an di+er'u"an me'i+uti 'ati%anfsioterapi, okupasi, psikoterapi
Lati%an -si#tera+i me'i+uti !
Lati%an e'an ba%u denan t#n"at
Lati%an e"stensi trun"us
Lati%an Fren"'e @ ber4a'an denan mena+a""an
"a"i +ada tanda7tanda di 'antaiLati%an is#metri6 untu" #t#t "uadrise+ em#risdan #t#t e"stens#r +anu' aar memuda%"annai" tana dan ban"it dari "ursi
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TERAPI REHA.ILITASI
Lati%an #"u+asi (an memer'u"an+en"a4ian a"ti8itas "e%idu+an se%ari7%ari&'in"unan tem+at tina' dan +e"er4aan
Psi"#tera+i untu" men"a4i unsi "#niti&"e+ribadian& status menta' +asien dan"e'uara
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PENAKIT PARKINSON
NON7FAR:AKOLOIS FAR:AKOLOIS
Neur#+r#te"si
Disabi'itas unsi
A TIDAK
L7d#+a 7 DDI
Hi'ann(a ee"ti-tas
><O:TI > A#nis DA
D#sis L7d#+aB > a#nis
DA
> <O:TI
D#sis L7d#+a B
L7d#+a>DDI><O:TI
Hi'ann(a ee"ti-tas
D#sis L7d#+a B > a#nis DA
A#nis DA
A#nis DA diuba%
L7d#+a>DDI
> <O:TI
D#sis L7d#+a B
Hi'ann(a ee"ti-tas
L7d#+a 7 DDI
D#sis L7d#+a B
K#ndisi memburu" +r#resi
OPERASI
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TERI:A KASIHC,