S T U D Y K A S U S

F A R M A S I K L I N I S

“ E P I L E P S I ”
P E N G E R T I A N

 D i a g n o s i s e p i l e p s i t i d a k s e l a l u m u d a h , t e r d a p a t
b e g i t u b a n y a k d i a g n o s i s b a n d i n g t e r h a d a p
s u a t u k e j a n g b a i k k e j a n g e p i l e p s i m a u p u n
b u k a n e p i l e p s i . D i a g n o s i s e p i l e p s i s e n d i r i
t e r n y a t a m e m i l i k i k r i t e r i a t e r s e n d i r i y a n g
m e m b u t u h k a n t a t a la k s a n a s e r t a p r o g n o s i s
b e r b e d a .

 K e j a n g e p i l e p t i k a d a l a h k e j a d i a n k l i n i s y a n g
d i t a n d a i a k t i v i t a s s i n k r o n i s a s i s e k u m p u l a n
n e u r o n o t a k y a n g a b n o r m a l , b e r l e b i h a n , d a n
b e r s i f a t t r a n s i e n . A k t i v i t a s b e r l e b i h a n t e r s e b u t
m e n y e b a b k a n d i s o r g a n i s a s i p a r o k s i s m a l p a d a
s a t u a t a u b e b e r a p a fu n g s i o t a k y a n g d a p a t
b e r m a n i f e s t a s i e k s i t a s i p o s i t i f (m o t o r i k ,
s e n s o r i k , p s i k i s ) , n e g a t i f (h i l a n g n y a k e s a d a r a n ,
t o n u s o t o t , k e m a m p u a n b i c a r a ) , a t a u g a b u n g a n
k e d u a n y a .
 D i a g n o s i s e p i l e p s i d a p a t d i t e g a k k a n
a p a b i l a t e r d a p a t d u a a t a u le b i h e p i s o d e

k e j a n g t a n p a p r o v o k a s i d e n g a n in t e r v a l

2 4 ja m a t a u le b i h a t a u a p a b i l a t e r d a p a t

m a n i f e s t a s i k h a s s u a t u s i n d r o m

e p i l e p s i .

 K e j a n g t a n p a p r o v o k a s i a d a l a h k e j a n g

y a n g t i d a k d i c e t u s k a n o l e h d e m a m ,

g a n g g u a n e l e k t r o l i t a t a u m e t a b o l i k

a k u t , t r a u m a , a t a u k e l a i n a n

in t r a k r a n i a l a k u t la i n n y a .
  N a m a P a s i e n : A n . M C

 U m u r : 9 t a h u n

 N o . R M : A - 7 - X - X - X - X

 R u a n g : K e m u n i n g

 B B (K g ) / T B (C m ) : 2 6 k g / c m

 D i a g n o s a U t a m a : E p i l e p s i
I D E N T I T
 P J P U t a m a : d r . A . , S p . A
A S
 T a n g g a l M a s u k R S : 2 8 / 1 2 / 2 0 2 0
P A S I E N
 T a n g g a l K e l u a r R S : 3 1 / 1 2 / 2 0 2 0

 R i w a y a t P e n y a k i t D a h u l u :

R i w a y a t k e j a n g k u r a n g le b i h 1
t a h u n y a n g la l u .

 R i w a y a t P e n y a k i t K e l u a r g a : (- )
 I D E N T I T A S P A S I E N
( L A N J U T A N )

 R i w a y a t P e n g g u n a a n O b a t : (- )

 R i w a y a t P e n g g u n a a n

S u p l e m e n / J a m u , K o p i , R o k o k : (- )

 R i w a y a t A l e r g i : ( - )

 K U M R S : R i w a y a t k e j a n g 2 k a l i

, k u r a n g l e b i h 1 0 m e n i t s e j a k

t a d i p a g i . S a a t i n i a n a k g e l i s a h

t i d a k b i s a t i d u r .

 S t a t u s P a s i e n : B P J S
 R E K O N S I L I A S I
O B A T
 1 . O B A T D I B A W A P A S I E N M A S U K IG D / M A S U K
R A W A T IN A P D A R I P O L I K L I N I K
O B A T D I L A N J U T K A N S A A T
M A S U K
F R E K U E N S R U T
N O N A M A O B A T
I E
Y A T I D A K

N I H I L

 2 . D A T A O B A T S E L A M A P E R A W A T A N D I IG D

O B A T D I L A N J U T K A N S A A T
F R E K M A S U K
N R U
N A M A O B A T U E N S
O T E Y A T I D A K
I

2 0
1 . In f u s R L Iv √
T P M

k / p 8
2 . In j . D i a z e p a m Iv √
m g

In j . S i b i t a l
L o a d i n g 5 0 0
3 . D r i p √
d a la m 2 0 m g

m e n it

In j . S i b i t a l 2 x 6 5
4 . Iv √
m a i n t e n a n c e m g
R E K O N S I L I A S I O B A T
( L A N J U T A N )

3 . D A T A O B A T S E L A M A P E R A W A T A N D I R A W A T IN A P

O B A T D I L A N J U T K A N
N N A M A F R E K U E R U S A A T P U L A N G

O O B A T N S I T E
Y A T I D A K

1 . In f u s R L 1 0 tp m Iv √
m a k r o

2 . In j . 8 m g Iv √
D i a z e p a m k / p

3 . In j . S i b it a l 2 x 6 5 Iv √
m g

4 . A s a m 2 x 2 5 0 P o √
V a l p r o a t m g

S y r
P E M E R I K S A A N T A N D A - T A N D A
V I T A L

R U A N G
IG D
K E M U N I N G

P A R A M E T
N
E R 2 8 / 1 2 2 9 / 1 2 3 0 / 1 3 1 / 1
O
T T V /2 0 /2 0 2 / 2 0 2 / 2 0

Te k a n a n
1 . D a r a h - - - -

(m m H g )

D e n y u t
N a d i
2 . 8 8 9 8 9 0 8 0
(k a l i / m e n i t
)

P e r n a p a s a
n
3 . 2 6 2 8 2 5 2 0
(k a l i / m e n i t
)

4 . S u h u (° C ) 3 6 .3 3 6 .8 3 6 .4 3 6 .7
 D A T A N I L A I IG D
N O
L A B O R A T O R I U M N O R M A L

1 0 .8 – 15 .6
1 H E M O G L O B I N 1 1 .7
g / d L

4 .0 0 0 – 1 3 0 0 0
2 L E U K O S I T 1 0 5 1 0
/u L

1 5 0 – 4 0 0
3 T R O M B O S I T 2 5 0
ri b u / u L

4 .5 – 6 .0
4 E R I T R O S I T 4 .1 4
ju t a / u L

5 H E M A T O K R I T 3 7 – 54 % 3 3 .8

6 M C V 8 0 – 9 3 fL 8 1 .5
D A T A
7 M C H 2 2 – 34 p g 2 8 .3

L A B O R A T 8 M C H C 3 2 – 36 g / d L 3 4 .7

O R I U M 9 R D W - C V 1 1 – 16 % 1 2 .6

1 0 B a s o f il 0 – 1 % 0 .5

1 1 E o s in o f il 2 – 4 % 2 .3

1 2 N e u t r o f il 5 4 – 7 3 % 6 2 .6

1 3 L im f o s it 1 8 – 34 % 2 9 .0

1 4 M o n o s it 2 – 8 % 5 .6

1 3 6 – 1 4 5
1 5 N A T R I U M (N a ) 1 4 4 .8
m m o l / L

1 6 K A L I U M (K ) 3 .6 - 5 .0 m m o l/ L 4 .4 1

9 8 – 10 8
1 7 K L O R I D A (C l) 1 0 9 .2
m m o l / L

1 8 K A L S IU M 8 – 1 0 m m o l/ L 9 .0 4

1 9 G D S 6 0 - 1 0 0 m g / d L 1 0 3
 R U A N G K E M U N I N G
IG D
N N A M A F R E K U R U
O O B A T E N S I T E
2 8 / 1 2 2 9 / 1 3 0 / 1 2 / 3 1 / 1 2 /
/2 0 2 / 2 0 2 0 2 0

1 0 tp m
1 . In f u s R L Iv √ √ √ √
m a k r o
D A T A
P E N G O B A 2 .
In j . 8 m g
Iv √ - - -
D i a z e p a m k / p

T A N
2 x 6 5
3 . In j . S i b i t a l Iv √ √ S T O P
m g

V a l p r o i c 2 x 2 5 0
4 . Iv - - √ √
A c i d S y r m g
 R U A N G K E M U N I N G
IG D
N
K e l u h a n
O
2 8 / 1 2 9 / 1 2 3 0 / 1 2 / 2 3 1 / 1 2 / 2

2 / 2 0 /2 0 0 0

1 . K e ja n g + + + - - -

P R O G R E S
S N O T E
 N O N A M A O B A T F R E K U E N S I R U T E

O B A T
P U L A N G 1 . A s a m V a l p r o a t S y r 2 x 2 5 0 m g P o
T A N G G A L S O A P

2 8 / 1 2 / 2 0 • K E J A N G • N A D I 8 8 T I D A K • M E L A N J U T K A N
+ + + • P E R N A P A S A N 2 6 D I T E M U K A N T E R A P I D P J P

• D E M A M - • S U H U 3 6 . 3 D R P • P A N T A U T T V
D A N K O N D I S I
P A S I E N

2 9 / 1 2 / 2 0 • K E J A N G - • N A D I 9 8 T I D A K • M E L A N J U T K A N
• D E M A M - • P E R N A P A S A N 2 6 D I T E M U K A N T E R A P I D P J P

• S U H U 3 6 . 8 D R P • P A N T A U T T V
D A N K O N D I S I
P A S I E N

3 0 / 1 2 / 2 0 • K E J A N G - • N A D I 9 0 A D A N Y A D R P : • D I K O N S U L T A S I
• D E M A M - • P E R N A P A S A N 2 5 • D O S I S A S A M K A N D E N G A N

• S U H U 3 6 . 4 V A L P R O A T D P J P
B E L U M • D O S I S 3 9 0 M G
S E S U A I D A P A T

• D E N G A N B B D I B E R I K A N 1 ½
2 6 K G C T H S E H A R I

D I P E R L U K A N S E K A L I
D O S I S 3 9 0 M G

3 1 / 1 2 / 2 0 • K E J A N G - • N A D I 8 0 A D A N Y A D R P : • D I K O N S U L T A S I
• D E M A M - • P E R N A P A S A N 2 0 • D O S I S A S A M K A N D E N G A N

• S U H U 3 6 . 7 V A L P R O A T D P J P
B E L U M • D O S I S 3 9 0 M G
S E S U A I D A P A T

• D E N G A N B B D I B E R I K A N 1 ½
2 6 K G C T H S E H A R I

D I P E R L U K A N S E K A L I
D O S I S 3 9 0 M G
N a m a o b a t K a s u s R e f e r e n s i K e t e r a n g a n

D i a z e p a m in j 8 m g ji k a k e j a n g • U s i a ≥ 5 ta h u n : d o s i s 1 m g , in j e k s i S e s u a i
p e l a n se t i a p 2 − 5 m e n i t , h i n g g a
m e n c a p a i d o s i s to t a l m a k s i m a l 1 0
m g , d a p a t d i u l a n g s e t i a p 2 − 4 ja m

b i l a p e r l u
• D o s i s 0 , 2 − 0 , 3 m g / k g , a t a u 1
m g / t a h u n u s i a

S i b i t a l 2 x 6 5 m g A n a k - a n a k u s i a 6 – S e s u a i
in j 1 2 t a h u n : 4 - 6

m g / k g B B o b a t m i n u m

a t a u s u n t i k a n I V , 1 – 2
k a l i s e h a r i .

• D i k a s u s 6 5 m g 
5 m g / k g b b

A s a m 2 x 2 5 0 m g T a r g e t a w a l 1 5 - 2 5 T i d a k
v a l p r o a t m g / k g / h a r i s e s u a i

s y r 1 5 x 2 6 k g = 3 9 0 m g
T E R I M A K A S I H