tag:blogger.com,1999:blog-26292342332033174952024-03-04T22:33:34.565-08:00obat Anestesi IndahJadilah orang yang selalu konsisten dalam menjalankan suatu pekerjaan....Indah Gusrainihttp://www.blogger.com/profile/17828686704963904043noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-2629234233203317495.post-41560105522753891032010-12-05T05:21:00.001-08:002011-01-11T04:41:45.845-08:00OBAT ANESTESIA<div align="center"><m:smallfrac m:val="off"> <m:dispdef> <m:lmargin m:val="0"> <m:rmargin m:val="0"> <m:defjc m:val="centerGroup"> <m:wrapindent m:val="1440"> <m:intlim m:val="subSup"> <m:narylim m:val="undOvr"> </m:narylim></m:intlim> </m:wrapindent><style>
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<m:smallfrac m:val="off"><m:dispdef><m:lmargin m:val="0"><m:rmargin m:val="0"><m:defjc m:val="centerGroup"><span style="font-family: inherit;"><span style="font-size: large;"><span style="color: red;">Website My Campus</span></span></span></m:defjc></m:rmargin></m:lmargin></m:dispdef></m:smallfrac><m:smallfrac m:val="off"><m:dispdef><m:lmargin m:val="0"><m:rmargin m:val="0"><m:defjc m:val="centerGroup"><span style="font-family: inherit;"><span style="color: #0b5394;"><span style="font-size: large;"> </span></span></span></m:defjc></m:rmargin></m:lmargin></m:dispdef></m:smallfrac><br />
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<m:smallfrac m:val="off"><m:dispdef><m:lmargin m:val="0"><m:rmargin m:val="0"><m:defjc m:val="centerGroup"><span style="font-family: inherit;">Istilah <span style="color: red;">anestesia</span> di kemukakan pertama kali oleh <span style="color: red;">O. W Holmes</span> yang artinya tidak ada sakit.Anastesia di bagi menjadi dua kelompok yaitu : </span></m:defjc></m:rmargin></m:lmargin></m:dispdef></m:smallfrac><br />
<div class="MsoListParagraph" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="font-family: inherit;"> </span><span style="font-family: inherit;">1. <span style="color: lime;">Anestesia umum</span> yaitu rasa sakit hilang disertai dengan kehilangan kesadaran</span><span style="font-family: inherit;"> </span></div><div class="MsoListParagraph" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="font-family: inherit;">2. <span style="color: lime;">Anestesia local</span> yaitu menghilangkan rasa sakit tanpa disertai hilang kesadaran</span><br />
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<div class="MsoListParagraph" style="margin-left: 0.25in; text-align: justify; text-indent: -22.5pt;"><span style="color: blue;"><b><span style="font-family: inherit;">1.</span><span style="font-family: inherit;"> </span></b><b><span style="font-family: inherit;">Anestesia Umum</span></b></span></div><div class="MsoNormal" style="text-align: justify;"><b><span style="font-family: inherit;">Pengertian</span></b></div><div class="MsoNormal" style="text-align: justify; text-indent: 0.5in;"><span style="font-family: inherit;">Tindakan anestesia sudah dikenal sejak dahulu untuk mempermudah tindakan operasi. Orang-orang mesir menggunakan </span><i><span style="font-family: inherit;">canabis indica</span></i><span style="font-family: inherit;">, dan pemukulan kepala dengan tongkat kayu untuk menghilangkan kesadaran seseorang.</span></div><div class="MsoNormal" style="text-align: justify; text-indent: 0.5in;"><span style="font-family: inherit;">Tahun 1776 ditemukan anestesia gas yang pertama yaitu N</span><sub><span style="font-family: inherit;">2</span></sub><span style="font-family: inherit;">O, karena dirasa kurang efektif dicarilah zat yang lain. Tahun 1795 eter ditemukan sebagai anestesia inhalasi.</span></div><div class="MsoNormal" style="text-align: justify; text-indent: 0.5in;"><span style="font-family: inherit;">Anestesia suntikan intra vena (i. v) biasa dipakai untuk taraf induksi kemudian dilanjutkan dengan anestetik inhalasi untuk mempertahankan keadaan keadaan tidak sadar. Dalam proses anestesia terdapat taraf-taraf narkosa tertentu yaitu penekanan system saraf sentral secara bertingkat dan berturut-turut sebagai berikut :</span></div><div class="MsoNormal" style="text-align: justify;"><b><span style="font-family: inherit;">Taraf – taraf Narkose</span></b></div><div class="MsoNormal" style="text-align: justify; text-indent: 0.25in;"><span style="font-family: inherit;">Anestesia umum dapat menekan susunan saraf sentral secara berurutan, yaitu :</span></div><div class="MsoListParagraphCxSpFirst" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="font-family: inherit;">·</span><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Taraf analgesia, yaitu keadaran dan rasa nyeri berkurang</span></div><div class="MsoListParagraphCxSpLast" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="font-family: inherit;">·</span><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Taraf eksitasi, yaitu kesadaran hilang seluruhnya dan terjadi kegelisahan</span></div><div class="MsoNormal" style="text-align: justify;"><span style="font-family: inherit;">Kedua taraf ini disebut taraf induksi</span></div><div class="MsoListParagraphCxSpFirst" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="font-family: inherit;">·</span><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Taraf anestesia, yaitu reflex mata hilang, mata hilang, nafas otomatis dan teratur seperti tidur serta otot-otot melemas (relakasi)</span></div><div class="MsoListParagraphCxSpLast" style="text-align: justify; text-indent: -0.5in;"><span style="font-family: inherit;">·</span><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Taraf pelumpuhan sum-sum tulang, kerja jantung dan pernafasan terhenti</span></div><div class="MsoNormal" style="text-align: justify; text-indent: 0.5in;"><span style="font-family: inherit;">Tujuan narkosa adalah untuk mencapai taraf anestesia dengan sedikit mungkin kerja ikutan atau efek samping, oleh karena taraf pertama sampai ketiga adalah yang paling penting sedangkan taraf ke empat harus dihindari. Pada proses recovery (sadar kembali) terjadi dengan urutan taraf terbalik dari taraf ketiga sampai ke satu.</span></div><div class="MsoNormal" style="text-align: justify;"><b><span style="font-family: inherit;">Persyaratan Anestesia Umum</span></b></div><div class="MsoNormal" style="text-align: justify; text-indent: 0.25in;"><span style="font-family: inherit;">Beberapa syarat penting yang harus dipenuhi oleh suatu anestesia umum adalah :</span></div><div class="MsoListParagraphCxSpFirst" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><img alt="*" height="13" src="file:///C:/DOCUME%7E1/INDAHC%7E1/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Berbau enak dan tidak merangsang selaput lendir.</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><img alt="*" height="13" src="file:///C:/DOCUME%7E1/INDAHC%7E1/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Mula kerja cepat tanpa efek samping.</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><img alt="*" height="13" src="file:///C:/DOCUME%7E1/INDAHC%7E1/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Sadar kembalinya tanpa kejang.</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><img alt="*" height="13" src="file:///C:/DOCUME%7E1/INDAHC%7E1/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Berkhasiat analgetik baik dengan melemaskan otot –otot seluruhnya.</span></div><div class="MsoListParagraphCxSpLast" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><img alt="*" height="13" src="file:///C:/DOCUME%7E1/INDAHC%7E1/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image001.gif" width="13" /><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Tidak menambah pendarahan kapiler selama waktu pembedahan.</span></div><div class="MsoNormal" style="text-align: justify; text-indent: 0.25in;"><span style="font-family: inherit;">Guna mencapai narkosa umum yang cukup dalam dan lama digunakan suatu anestesia pokok dengan penambahan suatu obat pembantu, yaitu bertujuan untuk menghindarkan atau memperkecil kerja ikutan dan memperkuat salah satu khasiat anestetikanya, seperti :</span></div><div class="MsoListParagraphCxSpFirst" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="font-family: inherit;">©</span><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Sebelum narkose (premediksi), diberikan obat-obat sedative (klorpromazin, morfin, dan pethidin) guna meniadakan kegelisahan dan obat-obat parasimpatolitik (atropine) guna menekan sekresi ludah yang berlebihan.</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="font-family: inherit;">©</span><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Selama narkose, diberikan obat-obat relaksasi otot (tubokurarin, galamin, dll).</span></div><div class="MsoListParagraphCxSpLast" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="font-family: inherit;">©</span><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Setelah narkose (post medikasi), diberikan obat-obat analgetika (methampyron, dll), sedative (lminal, dll) dan anti emetika (klorpromazin HCL).</span></div><div class="MsoNormal" style="text-align: justify;"><b><span style="font-family: inherit;"><span style="color: red;">Efek Samping</span></span></b></div><div class="MsoNormal" style="text-align: justify; text-indent: 0.25in;"><span style="font-family: inherit;">Hampir semua anestesia inhalasi mengakibatkan sejumlah efek samping, yang terpenting diantaranya :</span></div><div class="MsoListParagraphCxSpFirst" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><img alt="*" height="13" src="file:///C:/DOCUME%7E1/INDAHC%7E1/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image002.gif" width="13" /><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Menekan pernafasan, paling kecil pada N</span><sub><span style="font-family: inherit;">2</span></sub><span style="font-family: inherit;">O, eter dan trikloretikan.</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><img alt="*" height="13" src="file:///C:/DOCUME%7E1/INDAHC%7E1/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image002.gif" width="13" /><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Mengurangi kontraksi jantung, selama halotan dan metoksifluran yang paling ringan pada eter.</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><img alt="*" height="13" src="file:///C:/DOCUME%7E1/INDAHC%7E1/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image002.gif" width="13" /><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Merusak hati, oleh karena tidak digunakan lagi seperti senyawa klor (kloroform).</span></div><div class="MsoListParagraphCxSpLast" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><img alt="*" height="13" src="file:///C:/DOCUME%7E1/INDAHC%7E1/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image002.gif" width="13" /><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Meusak ginjal, khususnya metoksifluran.</span></div><div class="MsoNormal" style="text-align: justify;"><b><span style="font-family: inherit;">Penggolongan</span></b></div><div class="MsoNormal" style="text-align: justify; text-indent: 0.25in;"><span style="font-family: inherit;">Menurut penggunaanya anestesia umum dapat digolongkan menjadi 2 yaitu :</span></div><div class="MsoListParagraphCxSpFirst" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><img alt="*" height="13" src="file:///C:/DOCUME%7E1/INDAHC%7E1/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image003.gif" width="13" /><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Anestesia injeksi, contohnya diazepam, barbital ultra short acting (thiopental dan heksobarbital), dll.</span></div><div class="MsoListParagraphCxSpLast" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><img alt="*" height="13" src="file:///C:/DOCUME%7E1/INDAHC%7E1/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image003.gif" width="13" /><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Anestesia inhalasi, diberikan sebagai uap melalui saluran pernafasan, contohnya eter, dll.</span></div><div class="MsoNormal" style="text-align: justify;"><b><span style="font-family: inherit;">Tehnik Pemberian</span></b></div><div class="MsoNormal" style="text-align: justify;"><span style="font-family: inherit;"> Pemberian anestesia inhalasi dibagi menjadi 3 cara, yaitu :</span></div><div class="MsoListParagraphCxSpFirst" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><img alt="*" height="13" src="file:///C:/DOCUME%7E1/INDAHC%7E1/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image004.gif" width="15" /><span style="font-family: inherit;"> </span><span style="font-family: inherit;">System terbuka, yaitu dengan penetesan langsung ke atas kain kasa yang menutupi mulut atau hidung penderita, contohnya eter dan trikloretilen.</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><img alt="*" height="13" src="file:///C:/DOCUME%7E1/INDAHC%7E1/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image004.gif" width="15" /><span style="font-family: inherit;"> </span><span style="font-family: inherit;">System tertutup, yaitu dengan menggunakan alat khusus yang menyalurkan campuran gas dengan oksigen dimana sejumlah CO</span><sub><span style="font-family: inherit;">2</span></sub><span style="font-family: inherit;"> yang di keluarkan dimasukkan kembali (bertujuan memperdalam pernafasan dan mencegah berhentinya pernafasan atau apnoe yang dapat terjadi bila diberikan dengan system terbuka). Karena pengawasan penggunaan anestesia lebih teliti maka cara ini banyak disukai, contohnya siklopropan, N</span><sub><span style="font-family: inherit;">2</span></sub><span style="font-family: inherit;">O dan halotan.</span></div><div class="MsoListParagraphCxSpLast" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><img alt="*" height="13" src="file:///C:/DOCUME%7E1/INDAHC%7E1/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image004.gif" width="15" /><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Insuflasi gas, yaitu uap atau gas ditiupkan kedalam mulut, batang tenggorokan atau trachea dengan memakai alat khusus seperti pada operasi amandel. </span></div><div class="MsoNormal" style="text-align: justify;"><b><span style="font-family: inherit;">Sediaan, Indikasi, Kontra Indikasi, dan Efek Samping</span></b></div><div class="MsoListParagraphCxSpFirst" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="color: purple;"><i><span style="font-family: inherit;">1)</span><span style="font-family: inherit;"> </span></i><i><span style="font-family: inherit;">Dinitrogen Monoksida (N</span><sub><span style="font-family: inherit;">2</span></sub><span style="font-family: inherit;">O, gas gelak/gas tertawa)</span></i></span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Indikasi : Anestesi inhalasi</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Kontra indikasi : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Efek samping : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Sediaan : -</span></div><div class="MsoListParagraphCxSpMiddle" style="text-align: justify;"><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><i><span style="font-family: inherit;"><span style="color: purple;">2)</span></span><span style="font-family: inherit;"> </span></i><i><span style="font-family: inherit;"><span style="color: purple;">Enfluran</span></span></i></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Indikasi : Anestesi inhalai (untuk paien yang tidak tahan eter)</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Kontra indikasi : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Efek samping : Menekan pernafasan, geliah dan mual</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Sediaan : -</span></div><div class="MsoListParagraphCxSpMiddle" style="text-align: justify;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEij6mWH4EUcuLzaTf1ZkWcR0HrqYrFpEDHNCbUNgUUKOeSMUxbY6oscj2mVx2QaV0HUMetLwTcxEs1257pOO-h-V8kwBQubxYejYDLeXK_bTzofq7N2QrsclzBANi-nEAlFh4-XTscukDrO/s1600/Obat+enfluran.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="88" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEij6mWH4EUcuLzaTf1ZkWcR0HrqYrFpEDHNCbUNgUUKOeSMUxbY6oscj2mVx2QaV0HUMetLwTcxEs1257pOO-h-V8kwBQubxYejYDLeXK_bTzofq7N2QrsclzBANi-nEAlFh4-XTscukDrO/s320/Obat+enfluran.jpg" width="320" /></a></div><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><i><span style="font-family: inherit;"><span style="color: purple;">3)</span></span><span style="font-family: inherit;"> </span></i><i><span style="font-family: inherit;"><span style="color: purple;">Halotan</span></span></i></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Indikasi : Anestesi inhalasi</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Kontra indikasi : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Efek samping : Menekan pernafasan, aritmia dan hipotensi</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Sediaan : -</span><br />
<div align="justify" class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgmAeq9q67lb0c_u2-VvPdYrANV4TX8Ju7pVxrIo3TihH5iSjWoj3omGd3I29OaeBncDMUqLRS0FpemXEg0qRzbcXR-dpOnh59ahV2FnoalmUDkhle5NuOdw6fJfhIlQP9WL8dQpq0QbCka/s1600/halotan.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgmAeq9q67lb0c_u2-VvPdYrANV4TX8Ju7pVxrIo3TihH5iSjWoj3omGd3I29OaeBncDMUqLRS0FpemXEg0qRzbcXR-dpOnh59ahV2FnoalmUDkhle5NuOdw6fJfhIlQP9WL8dQpq0QbCka/s200/halotan.jpg" width="200" /></a><span style="color: red;">Halotan</span></div></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><i><span style="font-family: inherit;"><span style="color: purple;">4)</span></span><span style="font-family: inherit;"> </span></i><i><span style="font-family: inherit;"><span style="color: purple;">Droperidol</span></span></i></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Indikasi : Anestesi inhalasi</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Kontra indikasi : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Efek samping : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Sediaan : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;"><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhqKZwuZVsvHRA-NqJRkbSJK1VOOuqOZcoj0sIIuGmEre2S7X-q4zVHMjHW8JmtVUEQJo0lAD8HcpTGIe63js8BuoaiXoVHBeHjpTZB1-tl-fJvhQT34POsnS9sn4eAWATXIPXQx3mVRqfO/s1600/Droperidol+1.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="149" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhqKZwuZVsvHRA-NqJRkbSJK1VOOuqOZcoj0sIIuGmEre2S7X-q4zVHMjHW8JmtVUEQJo0lAD8HcpTGIe63js8BuoaiXoVHBeHjpTZB1-tl-fJvhQT34POsnS9sn4eAWATXIPXQx3mVRqfO/s200/Droperidol+1.jpg" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="color: red;">Gambar 2</span></td></tr>
</tbody></table><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhqKZwuZVsvHRA-NqJRkbSJK1VOOuqOZcoj0sIIuGmEre2S7X-q4zVHMjHW8JmtVUEQJo0lAD8HcpTGIe63js8BuoaiXoVHBeHjpTZB1-tl-fJvhQT34POsnS9sn4eAWATXIPXQx3mVRqfO/s1600/Droperidol+1.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><span style="color: red;"><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCbe_XhBoDoxb1y2NmIlfQA47C7a6oZlXXxLOqddLzUuNbLT8ecau24GwGDz7ZL9KL1A-Q3pg_M_h5YeczU78AppLH6NcacGXMNDb64dE45nOxRLpV4ZQTnlDQlG7Ypo1Zj-MibNasWIIy/s1600/Droperidol.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="150" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCbe_XhBoDoxb1y2NmIlfQA47C7a6oZlXXxLOqddLzUuNbLT8ecau24GwGDz7ZL9KL1A-Q3pg_M_h5YeczU78AppLH6NcacGXMNDb64dE45nOxRLpV4ZQTnlDQlG7Ypo1Zj-MibNasWIIy/s200/Droperidol.jpg" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="color: red;">Gambar 1</span></td></tr>
</tbody></table><span style="color: purple;"><i><span style="font-family: inherit;">5)</span><span style="font-family: inherit;"> </span></i><i><span style="font-family: inherit;">Eter</span></i></span><i><span style="font-family: inherit;"> </span></i></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Indikasi : Anestesi inhalasi</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Kontra indikasi : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Efek samping : Merangsang mukosa saluran pernafasan</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Sediaan : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgIyGxC5XWgbmFHJpthGHE94U2QsZU_eiP5geuLuxM4LNZzQIQMW5_AyDdxoLHdqjdzwh0s_TM0qxxt6vKwVqqL5ww6-ukzTciUF1soGfsPliHvIpc0sLEUUg741VEkd-xjazjGzgVaIuUg/s1600/Eter.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgIyGxC5XWgbmFHJpthGHE94U2QsZU_eiP5geuLuxM4LNZzQIQMW5_AyDdxoLHdqjdzwh0s_TM0qxxt6vKwVqqL5ww6-ukzTciUF1soGfsPliHvIpc0sLEUUg741VEkd-xjazjGzgVaIuUg/s200/Eter.jpg" width="135" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="color: red;">Eter</span></td></tr>
</tbody></table><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="color: purple;"><i><span style="font-family: inherit;">6)</span><span style="font-family: inherit;"> </span></i><i><span style="font-family: inherit;">Ketamin Hidroklorida</span></i></span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Indikasi : Anestesi inhalasi</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Kontra indikasi : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 112.5pt; text-align: justify; text-indent: -94.5pt;"><span style="font-family: inherit;">Efek samping : Menekan pernafasan (dosis tinggi), halusinasi dan tekanan darah naik</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Sediaan : -</span></div><div class="MsoListParagraphCxSpMiddle" style="text-align: justify;"><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="color: purple;"><i><span style="font-family: inherit;">7)</span><span style="font-family: inherit;"> </span></i><i><span style="font-family: inherit;">Thiopental</span></i></span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjRxoqsa_9Km_bD776B3Oo-1JhKx382jU98wbOzvE118QN5MTZ47iqMSROpyZrMKAk7vEf48VVHL2-_Sr0Le74WhcNEdM7yqeclcIm8orua3CTTo6IMoD05Ykqjl5V3G4LB22wBz1KJAVDp/s1600/Thiopental.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="198" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjRxoqsa_9Km_bD776B3Oo-1JhKx382jU98wbOzvE118QN5MTZ47iqMSROpyZrMKAk7vEf48VVHL2-_Sr0Le74WhcNEdM7yqeclcIm8orua3CTTo6IMoD05Ykqjl5V3G4LB22wBz1KJAVDp/s200/Thiopental.jpg" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="color: red;">Thiopental</span></td></tr>
</tbody></table><span style="font-family: inherit;">Indikasi : Anestesi injeksi pada pembedahan kecil seperti di mulut</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Kontra indikasi : Insufisiensi sirkulasi jantung dan hipertensi</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Efek samping : Menekan pernafasan</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Sediaan : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="text-align: justify;"><b><span style="font-family: inherit;">Spesialite obat – obat anestesia umum</span></b></div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: medium none; margin-left: 5.4pt;"><tbody><span style="font-family: inherit;"> </span>
<tr><span style="font-family: inherit;"> </span><td style="border: 1pt solid black; padding: 0in 5.4pt; width: 45pt;" valign="top" width="60"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><b><span style="font-family: inherit;">No</span></b></div></td><span style="font-family: inherit;"> </span><td style="border-color: black black black -moz-use-text-color; border-style: solid solid solid none; border-width: 1pt 1pt 1pt medium; padding: 0in 5.4pt; width: 189pt;" valign="top" width="252"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><b><span style="font-family: inherit;">Generik</span></b></div></td><span style="font-family: inherit;"> </span><td style="border-color: black black black -moz-use-text-color; border-style: solid solid solid none; border-width: 1pt 1pt 1pt medium; padding: 0in 5.4pt; width: 1.75in;" valign="top" width="168"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><b><span style="font-family: inherit;">Dagang</span></b></div></td><span style="font-family: inherit;"> </span><td style="border-color: black black black -moz-use-text-color; border-style: solid solid solid none; border-width: 1pt 1pt 1pt medium; padding: 0in 5.4pt; width: 113.4pt;" valign="top" width="151"><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><b><span style="font-family: inherit;">Pabrik</span></b></div></td><span style="font-family: inherit;"> </span></tr>
<span style="font-family: inherit;"> </span>
<tr><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 45pt;" valign="top" width="60"><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">1</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 189pt;" valign="top" width="252"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">Diaethyl Aether</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 1.75in;" valign="top" width="168"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">Aether Anaestheticus</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 113.4pt;" valign="top" width="151"><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">Kimia Farma</span></div></td><span style="font-family: inherit;"> </span></tr>
<span style="font-family: inherit;"> </span>
<tr><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 45pt;" valign="top" width="60"><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">2</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 189pt;" valign="top" width="252"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">Ketamin Hidroklrorida (Ketamini Hydrochloridium)</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 1.75in;" valign="top" width="168"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">Ketalar</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 113.4pt;" valign="top" width="151"><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">Pfizer</span></div></td><span style="font-family: inherit;"> </span></tr>
<span style="font-family: inherit;"> </span>
<tr><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 45pt;" valign="top" width="60"><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">3</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 189pt;" valign="top" width="252"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">Tiopental Natrium (Thiopentalum Natricum)</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 1.75in;" valign="top" width="168"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">Pentothal Sodium </span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 113.4pt;" valign="top" width="151"><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">Abbot</span></div></td><span style="font-family: inherit;"> </span></tr>
<span style="font-family: inherit;"> </span>
<tr><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 45pt;" valign="top" width="60"><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">4</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 189pt;" valign="top" width="252"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">Enflurane</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 1.75in;" valign="top" width="168"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">Etharane</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 113.4pt;" valign="top" width="151"><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">Abbot</span></div></td><span style="font-family: inherit;"> </span></tr>
<span style="font-family: inherit;"> </span>
<tr><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 45pt;" valign="top" width="60"><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">5</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 189pt;" valign="top" width="252"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">Halothanum</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 1.75in;" valign="top" width="168"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">Halothane MD</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 113.4pt;" valign="top" width="151"><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin: 0in 0in 0.0001pt; text-align: justify;"><span style="font-family: inherit;">Dexa Medica</span></div></td><span style="font-family: inherit;"> </span></tr>
<span style="font-family: inherit;"> </span></tbody></table><div class="MsoListParagraphCxSpMiddle" style="text-align: justify;"><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="text-align: justify;"><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -22.5pt;"><span style="color: blue;"><b><span style="font-family: inherit;">2.</span><span style="font-family: inherit;"> </span></b><b><span style="font-family: inherit;">Anestesia Lokal</span></b></span></div><div class="MsoListParagraphCxSpMiddle" style="text-align: justify;"><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0in; text-align: justify;"><b><span style="font-family: inherit;">Pengertian</span></b></div><div class="MsoListParagraphCxSpMiddle" style="text-align: justify;"><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: 0.25in;"><span style="font-family: inherit;">Obat anestesia lokal yang pertama di kenal adalah </span><i><span style="font-family: inherit;"><span style="color: red;">kokain</span></span></i><span style="font-family: inherit;"> yang diperoleh dari </span><i style="color: black;"><span style="font-family: inherit;"><span style="color: red;">Erythroxylon coca</span></span></i><b><span style="font-family: inherit;"> </span></b><span style="font-family: inherit;">yang dapat memberikan rasa nyaman dan mempertinggi daya tahan tubuh. </span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0in; text-align: justify;"><b><span style="font-family: inherit;">Penggunaan</span></b></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: 0.25in;"><span style="font-family: inherit;">Anestesia lokal umumnya digunakan secara parental misalnya pembedahan kecil dimana pemakaian anestesia umum tidak dibutuhkan. Anestesia lokal dibagi menjadi 3 jenis, yaitu :</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><img alt="*" height="13" src="file:///C:/DOCUME%7E1/INDAHC%7E1/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image005.gif" width="13" /><span style="font-family: inherit;"> </span><span style="font-family: inherit;"><span style="color: blue;">Anestesia permukaan</span>, digunakan secara lokal untuk melawan rasa nyeri dan gatal, misalnya larutan atau tablet hisap untuk menghilangkan rasa nyeri di mulut atau leher, tetes mata untuk mengukur tekanan okuler mata atau mengeluarkan benda asing di mata, salep untuk menghilangkan rasa nyeri akibat luka bakar dan suppositoria untuk penderita ambeien/wasir.</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><img alt="*" height="13" src="file:///C:/DOCUME%7E1/INDAHC%7E1/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image005.gif" width="13" /><span style="font-family: inherit;"> </span><span style="font-family: inherit;"><span style="color: blue;">Anestesia filtrasi</span>, yaitu suntikan yang diberkan ditempat yang dibius ujung-ujung sarafnya, misalnya pada daerah kulit dan gusi (pencabutan gigi).</span></div><div class="MsoListParagraphCxSpLast" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><img alt="*" height="13" src="file:///C:/DOCUME%7E1/INDAHC%7E1/LOCALS%7E1/Temp/msohtmlclip1/01/clip_image005.gif" width="13" /><span style="font-family: inherit;"> </span><span style="color: blue;"><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Anestesia blok atau penyaluran saraf</span></span><span style="font-family: inherit;">, yaitu dengan penyunikan disuatu tempat dimana banyak saraf terkumpul sehingga mencapai daerah anestesi yang luas, misalnya pada pergelangan tangan atau kaki.</span></div><div class="MsoNormal" style="text-align: justify;"><b><span style="font-family: inherit;">Persyaratan Anestesia Lokal</span></b></div><div class="MsoNormal" style="margin-left: 0.25in; text-align: justify; text-indent: 0.25in;"><span style="font-family: inherit;">Anestesia lokal dikatakan ideal apabila memiliki beberapa persyaratan sebagai berikut :</span></div><div class="MsoListParagraphCxSpFirst" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="font-family: inherit;">ü</span><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Tidak merangsang jaringan .</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="font-family: inherit;">ü</span><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Tidak mengakibatkan kerusakan permanen terhadap susunan saraf sentral.</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="font-family: inherit;">ü</span><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Toksisitas sistemisnya rendah. </span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="font-family: inherit;">ü</span><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Efektif pada penyuntikan dan penggunaan lokal.</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="font-family: inherit;">ü</span><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Mula kerja dan daya kerjanya singkat untuk jangka waktu cukup lama.</span></div><div class="MsoListParagraphCxSpLast" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="font-family: inherit;">ü</span><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Larut dalam air dengan menghasilkan larutan yang stabil dan tahan pemanasan (proses sentralisasi).</span></div><div class="MsoNormal" style="text-align: justify;"><b><span style="font-family: inherit;"><span style="color: red;">Efek Samping</span> </span></b></div><div class="MsoNormal" style="margin-left: 0.25in; text-align: justify; text-indent: 0.25in;"><span style="font-family: inherit;">Efek samping pengguna anestesia lokal terjadi akibat khasiat dari kardio depresifnya (menekan fungsi jantung), mengakibatkan hipersensitasi berupa dermatitis alergi.</span></div><div class="MsoNormal" style="text-align: justify;"><b><span style="font-family: inherit;">Penggolongan </span></b></div><div class="MsoNormal" style="margin-left: 0.25in; text-align: justify; text-indent: 0.25in;"><span style="font-family: inherit;">Secara kimiawi anestesia lokal dibagi 3 kelompok, yaitu :</span></div><div class="MsoListParagraphCxSpFirst" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="font-family: inherit;">Ø</span><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Senyawa ester, contohnya prokain, benzokain, buvakain, tetrakain, dan oksibubrokain.</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="font-family: inherit;">Ø</span><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Senyawa amida, contohnya lidokain, prilokain, mevipikain, buplivikain, cicnhokain dll.</span></div><div class="MsoListParagraphCxSpLast" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="font-family: inherit;">Ø</span><span style="font-family: inherit;"> </span><span style="font-family: inherit;">Serba-serbi, contohnya jokain dan benzilalkohol.</span></div><div class="MsoNormal" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Selain kokain, semua obat tersebut di atas dibuat sintesis.</span></div><div class="MsoNormal" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;"><br />
</span></div><div class="MsoNormal" style="text-align: justify;"><b><span style="font-family: inherit;">Sediaan, Indikasi, Kontra Indikasi, dan efek Samping</span></b></div><div class="MsoListParagraphCxSpFirst" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="color: purple;"><i><span style="font-family: inherit;">1)</span><span style="font-family: inherit;"> </span></i><i><span style="font-family: inherit;">Bupivikain</span></i></span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Indikasi : Anestesia lokal</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Kontra indikasi : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Efek samping : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Sediaan : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="color: purple;"><i><span style="font-family: inherit;">2)</span><span style="font-family: inherit;"> </span></i><i><span style="font-family: inherit;">Etil Klorida</span></i></span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Indikasi : Anestesia lokal</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Kontra indikasi : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Efek samping : Menekan pernafasan, gelisah dan mual</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Sediaan : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="color: purple;"><i><span style="font-family: inherit;">3)</span><span style="font-family: inherit;"> </span></i><i><span style="font-family: inherit;">Lidokain</span></i></span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiH4YNRrNly6mUvMHcuN9fyX4a5b8aMHiais_pkBWLQiYfb5CjhzVFBOAwrtrI472wV0p_H1cPE-HO2HkKAAiEB8J54mRjt9j5-OoaIfTFiukFI9JvThJjm0dBBa8hcMoJxshCS3hjHuHlL/s1600/lidokain.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiH4YNRrNly6mUvMHcuN9fyX4a5b8aMHiais_pkBWLQiYfb5CjhzVFBOAwrtrI472wV0p_H1cPE-HO2HkKAAiEB8J54mRjt9j5-OoaIfTFiukFI9JvThJjm0dBBa8hcMoJxshCS3hjHuHlL/s200/lidokain.jpg" width="182" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="color: red;">Lidokain</span></td></tr>
</tbody></table><span style="font-family: inherit;">Indikasi : Anestesi filtrasi dan anestesi permukaan, antiaritmia</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Kontra indikasi : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Efek samping : Mengantuk</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Sediaan : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="color: purple;"><i><span style="font-family: inherit;">4)</span><span style="font-family: inherit;"> </span></i><i><span style="font-family: inherit;">Benzokain</span></i></span><i><span style="font-family: inherit;"> </span></i></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj_USGgrT_BdSnP2b6rWP4UwI2fFDYencpUKvBA2Dl7CoxrtXFbmSBE3SU2XBpMGtm15MnUUsirPUXiJJ5j4vVZ2W7EC9hIAPMjaXaE4kZZ6TrCXqRHiPtO4TKuIXTZ1tbMKPrHblPbnxCE/s1600/benzokain.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj_USGgrT_BdSnP2b6rWP4UwI2fFDYencpUKvBA2Dl7CoxrtXFbmSBE3SU2XBpMGtm15MnUUsirPUXiJJ5j4vVZ2W7EC9hIAPMjaXaE4kZZ6TrCXqRHiPtO4TKuIXTZ1tbMKPrHblPbnxCE/s1600/benzokain.jpg" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="color: red;">Benzokain</span></td></tr>
</tbody></table><span style="font-family: inherit;">Indikasi : Anestesi permukaan dan menghilangkan rasa nyeri dan </span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -1in;"><span style="font-family: inherit;"> gatal </span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Kontra indikasi : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Efek samping : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Sediaan : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="color: purple;"><i><span style="font-family: inherit;">5)</span><span style="font-family: inherit;"> </span></i><i><span style="font-family: inherit;">Prokain (Novokain)</span></i></span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Indikasi : Anestesi filtrasi dan permukaan</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Kontra indikasi : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Efek samping : Hipersensitasi dan kematian</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Sediaan : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="color: purple;"><i><span style="font-family: inherit;">6)</span><span style="font-family: inherit;"> </span></i><i><span style="font-family: inherit;">Tetrakain</span></i></span><i><span style="font-family: inherit;"> </span></i></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Indikasi : Anestesi filtrasi </span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Kontra indikasi : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Efek samping : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Sediaan : obat tetes mata dan tablet hisap</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"><span style="color: purple;"><i><span style="font-family: inherit;">7)</span><span style="font-family: inherit;"> </span></i><i><span style="font-family: inherit;">Benzilalkohol</span></i></span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Indikasi : Menghilangkan rasa gatal, sengatan matahari dan gigi</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><div class="separator" style="clear: both; text-align: center;"></div><br />
<span style="font-family: inherit;">Kontra indikasi : infisiensi sirkulasi jantung dan hipertensi</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Efek samping : Menekan pernafasan</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><span style="font-family: inherit;">Sediaan : -</span></div><div class="MsoListParagraphCxSpMiddle" style="margin-left: 0.25in; text-align: justify;"><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijnq5tdp0SBtMspY-ROJMUCN-xMSOwRZqqYrzS8A_3Y-EaX7QpH7TmDFGPSbh79FgoBq7rd7H4PbGp1drGKE7RlOQYkmf1EM5vQsUIeo_b2OdcVilyW-ZnZ_AcHSUWkDd_UuUCRCnTNvkE/s1600/Benzilalkohol.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijnq5tdp0SBtMspY-ROJMUCN-xMSOwRZqqYrzS8A_3Y-EaX7QpH7TmDFGPSbh79FgoBq7rd7H4PbGp1drGKE7RlOQYkmf1EM5vQsUIeo_b2OdcVilyW-ZnZ_AcHSUWkDd_UuUCRCnTNvkE/s1600/Benzilalkohol.jpg" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="color: red;">Benzil Alkohol</span></td></tr>
</tbody></table><span style="font-family: inherit;"><br />
</span></div><div class="MsoListParagraphCxSpLast" style="margin-left: 0.25in; text-align: justify;"><b><span style="font-family: inherit;">Spesialit obat – obat anesteia lokal</span></b><b><span style="font-family: inherit;"> </span></b><br />
<b><span style="font-family: inherit;"> </span></b></div><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: medium none; margin-left: 9.9pt;"><tbody><span style="font-family: inherit;"> </span>
<tr><span style="font-family: inherit;"> </span><td style="border: 1pt solid black; padding: 0in 5.4pt; width: 31.5pt;" valign="top" width="42"><div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt; text-align: justify;"><b><span style="font-family: inherit;">No</span></b></div></td><span style="font-family: inherit;"> </span><td style="border-color: black black black -moz-use-text-color; border-style: solid solid solid none; border-width: 1pt 1pt 1pt medium; padding: 0in 5.4pt; width: 193.6pt;" valign="top" width="258"><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin: 0in 0in 0.0001pt 0.25in; text-align: justify;"><b><span style="font-family: inherit;">Generik</span></b></div></td><span style="font-family: inherit;"> </span><td style="border-color: black black black -moz-use-text-color; border-style: solid solid solid none; border-width: 1pt 1pt 1pt medium; padding: 0in 5.4pt; width: 109.25pt;" valign="top" width="146"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt 0.25in; text-align: justify;"><b><span style="font-family: inherit;">Dagang</span></b></div></td><span style="font-family: inherit;"> </span><td style="border-color: black black black -moz-use-text-color; border-style: solid solid solid none; border-width: 1pt 1pt 1pt medium; padding: 0in 5.4pt; width: 108.45pt;" valign="top" width="145"><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin: 0in 0in 0.0001pt 0.25in; text-align: justify;"><b><span style="font-family: inherit;">Pabrik</span></b></div></td><span style="font-family: inherit;"> </span></tr>
<span style="font-family: inherit;"> </span>
<tr><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 31.5pt;" valign="top" width="42"><div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt; text-align: justify;"><span style="font-family: inherit;">1</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 193.6pt;" valign="top" width="258"><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin: 0in 0in 0.0001pt 0.25in; text-align: justify;"><span style="font-family: inherit;">Lidokain Hidroklorida (Lidocaini Hydrochloridum)</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 109.25pt;" valign="top" width="146"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt 0.25in; text-align: justify;"><span style="font-family: inherit;">Pehacain</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt 0.25in; text-align: justify;"><span style="font-family: inherit;">Extracain</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt 0.25in; text-align: justify;"><span style="font-family: inherit;">xylocain</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 108.45pt;" valign="top" width="145"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt 0.25in; text-align: justify;"><span style="font-family: inherit;">Phapros</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt 0.25in; text-align: justify;"><span style="font-family: inherit;">Ethica</span></div><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin: 0in 0in 0.0001pt 0.25in; text-align: justify;"><span style="font-family: inherit;">Zenecca</span></div></td><span style="font-family: inherit;"> </span></tr>
<span style="font-family: inherit;"> </span>
<tr><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 31.5pt;" valign="top" width="42"><div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt; text-align: justify;"><span style="font-family: inherit;">2</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 193.6pt;" valign="top" width="258"><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin: 0in 0in 0.0001pt 0.25in; text-align: justify;"><span style="font-family: inherit;">Bupivacain Hidroklorida</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 109.25pt;" valign="top" width="146"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt 0.25in; text-align: justify;"><span style="font-family: inherit;">Bupivakain</span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt 0.25in; text-align: justify;"><span style="font-family: inherit;">Marcain</span></div></td><span style="font-family: inherit;"> </span><td style="border-color: -moz-use-text-color black black -moz-use-text-color; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 108.45pt;" valign="top" width="145"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin: 0in 0in 0.0001pt 0.25in; text-align: justify;"><span style="font-family: inherit;">Ethica</span></div><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin: 0in 0in 0.0001pt 0.25in; text-align: justify;"><span style="font-family: inherit;">Astra Zaneka</span><span style="font-family: inherit;"> </span><span style="font-family: inherit;"> </span><span style="font-family: inherit;"> </span></div></td> </tr>
</tbody></table></div>Indah Gusrainihttp://www.blogger.com/profile/17828686704963904043noreply@blogger.com0