GAGAL ADSENSE (SEDIH..)

Ini adalah perjuangan yang nyebelin tentang perburauan untuk mendapatkan Google Adsese yang udah lama diidam-idamkan.
Dimulai dari jam 5 Subuh. Buru-buru ane bangun, sholat, n pantengin komputer imut ane. Sampe pembantu sebelah rumah aja jadi heran. kenapa si Gun bisa tumben bangun subuh-subuh gitu.

Dari jam setengah 6. Ane upload semua file bahasa inggris yang udah ane olah sedemikian rupa. ngarangnya udah dari jaman dahulu kala. karena ane punya file yang lengkap dalam bahasa inggris. Isinya mengenai kesehatan. Ya seperti yang agan semua bisa liat di Blog ane ini lah.

Dari jam segitu nyiapin segala macem. Menyempurnakan ilmu buat meningkatkan indeks blog, sampe segudang tips agar diterima di Google Adsense...

Setelah jam 11 Siang.. semua macem atribut perlengkapan perang buat merayu Tim Google Adsense udah siap. Sekarang tinggal daftar, dan menunggu untuk di Approve atau gak...

Dan saat jam 12 Teng.... Ane cek Monetize nya....
yang ada adalah gambar sebagai berikut :

Gila.. Masih 0 Rupiah.... Padahal udah capek.. Lelah.. Nahan Laper gara2 gak sarapan....
dan setelah di cek ke E mail Pesen nyebelin nya berbunyi kayak gini ... :

Sialaaann.. !!!!

hadoooh...... Ternyata perjuangan seharian ini.. di tambah dengan Menghimpun pengetahuan, bertapa di kamar selama se minggu ternyata sia-sia....

Oh My God.... !!!!

NURSING ETHICS

Advancement of knowledge and technology in the health sector have a major impact on improving the quality of nursing services. Nursing services performed by skilled professional nurses, in carrying out their duties to work independently and can also cooperate with other professions.

Nurses are required to implement nursing care to patients / clients, both individuals, families, groups and communities with regard people as a comprehensive biopsychosocial spiritual.

This paper describes the nursing code of ethics, values​​, rights and obligations of patients and nurses. Accountability and responsibility of nurses in fulfilling their tasks, the harmonious relationship between nurses with patients, partners, and other professions.

The paper is expected to help students, especially in the subjects of ethics and etiquette of the nursing profession.

A. Nursing Ethics

Ethics are the rules or norms that can be used as a reference for one's behavior related to good and bad acts, committed by a person and is an obligation and moral responsibility.

Nursing ethics is a facility that directs the moral responsibility of the underlying equations of nursing practice.

Ethics of nursing is also owned and conducted olehs emua keprawatan members, namely nurses.

B. Nursing Ethics Objectives

The general objective of nursing ethics is to create and maintain trust Klian / patients to nurses, trust among fellow nurses, and public confidence in the profession of nursing.

According to the American Bureau of Teaching Ethics Commission, the purpose of nursing ethics is able to:

1. Recognize and identify elements of morality in the practice of nursing
2. Establish strategies / methods and analyze the moral problems that occur in nursing practice
3. Connecting the principle of moral / lesson of good and accountable to yourself, family, community and to God.

C. Responsibility of Nurses

1. To the client / patient

- Nurses, may exercise his devotion

- Nurses can carry out its obligations on individuals, families and communities

- Nurses keja relationship with inidvidu, families and communities.

2. To Task

-         The nurse maintains the high quality of nursing services with honesty, professionalism

-         The nurse must keep secret everything he knows in connection with the duties entrusted to him

-         Nurse in performing tasks and kwajibannya, always try and full awareness

-         Nurse prioritizes the protection and safety of patient / client in carrying out her nursing duties.

3. To the Profession

-         The nurse seeks to enhance the professional skills individually and / or jointly

-         Nurses uphold the good name of the nursing profession

-         Nurses natural berperand determine standardization of education and nursing service

-         Nurses jointly develop and maintain the quality of nursing organizations.

D. Nursing Code of Ethics

Nursing code of ethics is part of the medical ethics that apply ethical values ​​to the field of maintenance or public health services.

Code of ethics of nursing Indonesia consists of 4 Chapters and 16 Articles. Chapter 1, consists of four chapters, describes the responsibilities of nurses on individuals, families and communities. Chapter 2 consists of five chapters, describes the responsibilities of nurses on duty. Chapter 3 consists of two chapters, describes the responsibilities of fellow nurses and other health professionals. Chapter 4 terdirid ari four chapters, describes the responsibilities of nurses towards the nursing profession. Chapter 5 consists of two chapters, describes the responsibilities of nurses in the government, nation and homeland.

E. The purpose of the Code of Nursing

The general objective of nursing code of ethics is to create and maintain client trust the nurse, trust among fellow nurses and public confidence in the profession of nursing.

F. Rights and Obligations of Nurses.

1. Right to Nurse

-         Nurses are entitled to legal protection

-         Nurses have the right to reject the wishes of patients / clients as opposed to the legislation and professional codes of ethics

-         Nurses are entitled to obtain complete information from the patient / client or his family about his health complaints

-         Nurses have the right to increase the scientific knowledge based on science and technology in the field of nursing / health

-         Nurses are entitled to be treated fairly and honestly by the institutions and services by patients / lien

-         Nurses have the right to privacy and the right to sue if his good name be stained

-         Nurses are entitled to an award of just compensation and professional services

2. Nurse Liability

-         Nurses Mandatory compliance with all regulations of the institution concerned

-         Mandatory nurse providing care or nursing care

-         Mandatory nurse respects the rights of patients / clients

-         Mandatory nurse provides the opportunity for patient / client to connect with family

-         Nurses Mandatory follow the development of science and technology

-         Nurses Mandatory keep secret everything he knows about the client / patient

-         Mandatory Nurses collaborate with other medical personnel

-         Nurses Mandatory provide accurate information about nursing actions given to the patient / client

-         Nurses Mandatory documentation of nursing care

G. Patient Rights and Responsibilities

1. Right Psien

-         Patients have the right to nursing care and appreciate mempertimbangankan

-         Patients have the right to obtain complete information from doctors relating to diagnosis, treatment and prognosis

-         Patients are entitled to confidentiality of all forms of communication

-         Patients have the right to obtain information on hospital relationships with other agencies

-         Patients have the right to know and accept the explanation of the costs necessary

2. Patient Liability

-         Patients must obey all the rules and regulations that exist in health institutions

-         Patients are required to comply with all existing policies

-         Patients and families are obliged to provide complete and honest about her illness

-         The patient or his family is obliged to fulfill everything that is required in accordance with the agreement.

H. Employment Relations Nurses with Patients

Patient / client is the focus of the efforts of nursing care provided by nurses, as health workers salahs atu component. Basis of the relationship between nurse and patient is a mutually beneficial relationship (mutual humanity)

A good relationship between the nurse with the patient / client will occur when:

1. There is a sense of trust between perwat and patients.
2. Nurses really understand about the rights that may occur in individual patients.
3. Nurses should be sensitive to changes that may occur in individual patients.
4. Nurses must understand the existence of the patient.
5. Nurses may be responsible for any risks that may arise during patient care.
6. Nurses as much as possible try to avoid conflict between personal values ​​with the values ​​of personal patient / client.

HUMAN RESOURCE MANAGEMENT

CHAPTER I

INTRODUCTION

A. Background

Human resources (HR), is salahs atu resources contained within the organization, including all the people doing the activity.

HRM tasks revolve around the effort to manage the human element with all its potential as effective as possible so as to obtain human resources and content satisfactory to the organization.

B. Problem formulation

One important aspect that will determine the success or failure in the organization is HRM itself. Broadly speaking, the HRM function can be divided two parts, namely:

- The function of managerial

- Function operasif

 

CHAPTER II

DISCUSSION

Management comes from the verb to manage (English), which means taking care of, manage, implement, and manage.

Human Resources (HR), is one of the resources contained within the organization, including all those who do the activity. In general, the resources contained within an organization can be grouped into two types namely:

1. Non-human Resources (Non-Human Resources)

Which includes non-human resources, among others, capital, machinery technology, materials (materials), and others.

2. Human Resources (Human Resources)

HRM tasks revolve around the effort to manage the human element with all its potential as effective as possible so as to obtain human resources who are satisfied (satisfied) and satisfactory (satisfactory) for the organization.

HRM is a part of general management that focuses on the elements of human resources. This attention includes operational functions, and the role and position of human resources in achieving organizational objectives in an integrated manner.

A. Definition of HRM (Human Resource Management)

HRM is a specialized field of management study of human relationships and roles within the company organization. HRM is the human element which is the company's workforce.

To be more clear understanding of this HRM, below is quoted definition put forward by Drs. Malayu.S.P Hasibuan:

HRM is the science and art of governing the relationship and the role of labor in order to effectively and efficiently assist the realization of corporate goals, employees and communities.

B. The role of HRM

HRM is a duty to manage the human element as effective as possible in order to obtain a unit of labor contented and satisfied.

There are three main aspects of HRM, namely:

1. Managerial functions consisting of:

 Planning

 Organizing

 Direction

 Control

2. Operational functions which consist of:

 Procurement

 Development

 Compensation

 Integration

 Maintenance

 Termination of employment

3. The role or position in the achievement of organizational goals in an integrated enterprise.

C. HRM function

One important aspect that will determine the success or failure in the organization is HRM itself. Broadly speaking, the HRM function can be distinguished in two ways parts, namely:

 Managerial Functions

 function is operative

When viewed from managerial functions are at least four functions, namely:

 Planning (planning)

 mobilization (directing)

 Development (Supervising)

 Control (controlling)

However, if viewed from the operative functions, HRM (Human Resource Management) includes six basic functions, namely:

 The function of procurement

 The function of the development

 Functions compensation

 The function of integration

 Function care

 Functions termination of employment

D. Selection

Choosing the right employee is important merupakanhal. First, the good achievement of organizational goals to subordinates. Professional employees will work best for the organization. Employees who are not professionals, are able to do the job effectively and objectives of the work will not be achieved so that the organization will incur a loss. Employee screening performed prior to entry, not after they entered organiasasi.

E. Destination Selection

The selection aims at selecting the desired workforce. Selection is the process whereby organizations offering employment positions with appropriate compensation, while prospective applicants evaluate the organization and the attractiveness of positions and rewards the organization offers. But in fact the selection process is still a one-way process the organization offers.

However, if there is a shortage of labor then labor will have many options in choosing a job.

Thus, organizations must offer a more attractive offer and provide incentives or incentive on applicants.

CHAPTER III

CLOSING

Conclusion

Management comes from the verb to manage (English), which means taking care of, manage, implement, and manage.

Human Resources (HR), is one of the resources contained within the organization, including all those who do the activity.

HRM is a specialized field of management study of human relationships and roles within the company organization. HRM is the human element which is the company's workforce.

To be more clear understanding of this HRM, below is quoted definition put forward by Drs. Malayu.S.P Hasibuan:

HRM is the science and art of governing the relationship and the role of labor in order to effectively and efficiently assist the realization of corporate goals, employees and communities.

ANTIBIOTIC

CHAPTER I

INTRODUCTION

1.1 Background

Antibiotics (antimicrobials) is very important in this present life. Where as now many people are unknowingly always associated with bacteria. Many bacteria are good for the human body, but did not rule out bad bacteria, which is detrimental to humans that can inhibit important activities supporting life.

To kill bacteria that enter the human body, the need for drug compounds to kill / weaken growth. In this paper, will be mentioned several examples of antibiotics that can suppress the growth of bad bacteria in the human body.

1.2 Objectives and Benefits

The objectives and benefits of writing this paper is to inform the reader about the various antibiotics that are around us that can kill / weaken the growth of bad bacteria in the body.

CHAPTER II

DISCUSSION

2.1 Definition of Antibiotics

Antibiotics are a useful drug compounds to kill / weaken the growth of bad bacteria in the body. Antibiotics are often called anti - bacteria.

Anti - bacteria work by a number of mechanisms:

1.   Damage or interfere with bacterial cell wall synthesis (eg penicillins, cephalosporins, vancomycin).

2.   Disrupt bacterial protein synthesis by the ribosome (eg Amino-glokosida, chloramphenicol, erythromycin, clindamycin, tetracycline).

3.   Disrupt the synthesis of bacterial DNA in the nucleus (eg Griseofulvin, nalidixic acid).

4.   Disrupt the synthesis of an essential element for bacteria (eg, trimethoprim and sulphonamides)

2.2 Penicillin

Penicillin was isolated from Penicillium nonatum by Fleming in 1929. Semi-synthetic penicillin is made by adding different side chains at the core of penicillin and has the properties and antibacterial activity distinct.

Penicillin is bakterisid and affect the bacterial wall. At low doses, p enisilin is bacteriostatic. Penicillins interfere with bacterial cell wall synthesis that are growing and dividing, thus forming organisms with fragile walls are easily damaged.

2.2.1 Natural Penicillin

Natural penicillins include benzipenisilin and phenoxymethylpenicillin. Natural penicillin is particularly effective against gram-positive bacteria, and some gram-negative gonococci and meningococci.

Benzipenisilin

Unstable at low pH (acidic) and easily deactivated by gastric acid, and therefore not effective for oral integral. 1M injections are usually given in the form, but can also be IV.

Phenoxymethylpenicillin

Not destroyed in the stomach and rapidly absorbed in the small intestine. Higher blood levels when taken on an empty stomach, one hour before or three hours after meals.

2.2.2 Penicillin Resistant - semisynthetic penicillinase

Included in this class is methicillin, cloxacillin, flucloxacillin. There resesten organisms to penicillin because it has the enzyme penicillinase (beta-lactamase) that destroys penicillin.

Methicillin is less profitable because the acid-labile (not acid resistant) and must be given parenterally. The injection of penicillin in this group can be slowly (IV) into a vein that flows smoothly.

2.2.3 Broad spectrum semisynthetic penicillins

Including this group are ampicillin, amoxicillin, episilin, carbenicillin, ticarcillin, piperacillin, azlosilin, mezlosilin. Active against both gram-positive organisms as well as negative.

·        Ampicillin and amoxicillin used to treat urinary tract infection (UTI), bronchitis, exacerbation of chronic bronchitis, otitis media or acute sinusitis, and venereal disease.

·        Episilin used to treat respiratory tract infections, gastrointestinal tract, urinary tract, and soft tissue.

·        Amoxicillin (clavulanic acid) is used orally to treat acute sinusitis or acute otitis media, acute exacerbations of chronic bronchitis, pneumonia, UTI, or infection of skin and soft tissue.

·        Azlosilin, mezlosilin, and now replaces carbenicillin and piperacillin ticarcillin in the treatment of infections caused by aerobic gram-negative bacilli.

2.3 cephalosporin

Cephalosporins have a beta-lactam ring, as it covers sefamisin (eg sefoksitin) and oksa-beta-lactam (eg latamoksef). Affect the bacterial cell wall to be easily damaged. Gram-negative bacteria are less sensitive to cephalosporins. These agents not active against organisms producing Pseudomonas betalaktamase and auruginosa.

2.4 Monolaktam and Karbapenem

2.4.1 aztreonam

Aztreonam an monolaktam synthesis, strong activity against gram-negative organisms, termauk auruginosa Pseudomonas, Haemophilus influenza, Nisseria meningitidis, Neisseria gonorhoeae. IV or 1M. The dose is 1 g every 8 hours or 2 g every 12 hours.

2.4.2 imipenem

Imipenem are derivatives karbapenem semisintetis. Resistant to beta-lactamase, imipenem given with cilastatin. Imipenem with cilastatin is used to treat severe infections of the lower respiratory tract, skin and soft tissue, gynecologic, bone and joint pain, UTI, septicemia and endocarditis.

2.5 Tetracycline

Members of the widely used tetracycline is klortetrasiklin, demeklosiklin, doxycycline, minocycline, oxytetracycline and tetracycline. Tetracyclines are bacteriostatic, so it does not formed polypeptide. Spetrum antimicrobial tetracyclines have fairly broad, and is active against most gram-positive organisms, gram-negative are also given. Used for an exacerbation of bronchitis, acne vilgaris.

Tetracycline when given along with milk, antacids containing aluminum, magnesium or calcium, and Besai, will reduce the absorption in the gastrointestinal tract because of forming an insoluble substance. Doxycycline is a tetracycline choice to impaired renal function.

2.6 Aminoglycosides

This drug group includes amikacin, gentamicin, kanamycin, neomycin, netilmisin, streptomycin, and tobramycin. Bakterisid nature, inhibit bacterial protein synthesis. Used to treat severe infections. Locally it is effective for outer ear infections and eye conjunctiva. By mouth and are used for bowel sterilization prior to surgery for digestive disorders. Aminoglycosides should not be given to pregnant women because it is through the placental barrier and nerve damage to the fetus-8.

2.7 macrolide

This drug group includes erythromycin, azithromycin, clarithromycin, and spiramycin. Classified as high-dose drug is bacteriostatic bakteriosid. Erythromycin inhibits protein synthesis and organisms, resistance rarely occurs. Used for infection with streptokok and patients who are allergic to penicillin. Erythromycin for respiratory infections, pertussis, chlamydia and mycoplasma. Can be applied by mouth or injection. Oral medication should be "enteric coated" because it destroyed alambung acid (acid-labile).

2.8 Clindamycin

Klndamisin inhibit bacterial protein synthesis. Used for bone infections caused stafilokok Atasu joints, peritonitis, and endocarditis prophylaxis, and topically for severe acne. The side effects include abdominal discomfort, nausea, vomiting, diarrhea, pseudomembranous colitis, jaundice, and blood disorders. Oral doses of 150-450 mg every 6 hours.

2.9 sulphonamides and trimethoprim

The combination of trimethoprim with sulfamethoxazole one part five. Kontrimoksazol (Bactrim, Altrim, Primazole, Kaftrim) is used for urinary tract infection (UTI) caused by susceptible bacteria such as Escherichia coli, Klebsiella and Enterobacter, prostatitis, chronic bronchitis caused by Streptococcus pneumoniae and Haemophilus influenza, and fever caused by Salmonella entetik. High doses for Pneumocytis carinii infection. Because soluble, there is danger of precipitate (crystalluria) in urine. Can damage the kidneys due to settle in the tubuli. Crystalluria can result in pain and hematuria occurred. Trimethoprim side effects may include nausea, vomiting, pruritus, and rash.

2:10 Metronidazole and tinidazole

Metronidazole is used since 1959 to treat protozoal infections caused by Trichomonas vaginalis and amoebiasis. Now also against Bacteroides fragilis (anaerobic)

2:11 4 - quinolones

Antibiotics are the original quinolones nalidixic acid, which has dozens of years, is bakterisid. These agents work by inhibiting DNA gyrase emzim required by bacterial DNA, is very active against gram-negative bacteria, slightly less active against gram-positive bacteria and less active against anaerobes.

2:12 Pharmacokinetics

4-quinolones are well absorbed after oral administration. Antacids reducing absorption. Eliminated through 3 ways:

 secreted into the lumen of the intestine and excreted through the feces

 is metabolized by the liver

 excreted as intact drug through the kidneys

Adverse reactions from these agents is generally about the CNS, such as headache, dizziness, sleep disturbances, and sometimes anxiety, hallucinations, confusion. Caution in patients with epilepsy as it can trigger seizures. Gastrointestinal disturbances including nausea, vomiting, abdominal pain, and diarrhea. Maybe an allergic reaction, photosensitivity reaction, blood dikrasia, rising levels of urea, and creatinine blood, arthralgia, and mialigia.

CHAPTER III

CLOSING

3.1 Conclusion

Antibiotics are compounds that exist in medicine. Antibiotic medications are generally bakterisid and affect bacterial wall where the wall of the bacteria occurs bacterial cell growth and division.

3.2 Advice

       Suggestion that the writer can provide in this paper is that the readers get the information about antibiotics - antibiotics that can kill bacteria that are often found in the body so that people can live much more healthy.

PHARMACOLOGY

CHAPTER I

INTRODUCTION

A. Background

Talking about public health problem it can not be separated from matters relating to the ways of healing and medicine that can be used or distributed to the public.

We all know that with the development of civilization has brought us to the all advanced civilizations ranging from media to transport.

Maybe people do not realize the impact so that they assume that the disturbances in the respiratory tract only a minor annoyance to be underestimated by most. And without knowing the impact will be greater on other body systems.

Eg means of transport that are biased so that air pollution causes respiratory harm, that without us knowing it is very harmful effects.

For example from the transport of smoke has caused air pollution would interfere with the disruption of the respiratory tract and respiratory tract can cause asthma (shortness of breath) or if the respiratory tract we have too often distracted may mislead TB (tuberculosis).

That is what lies behind us to lift the title "Respiratory".

B. Destination

As our goal in making this paper are:

a. As a teaching

b. As the literature

c. As a means of discussion in order to satisfy the system of teaching and learning activities.

CHAPTER II

DISCUSSION

1. Dextromethorphan

Item:

Sanadryl DMP (Sanbe Farma)

Composition

Each teaspoon (5 m) syrup containing dextromethorphan hydrobromide 10 mg

Each film coated tablet contains 15 mg of dextromethorphan hydrobromide

Indication

Dextromethorphan is effective for the treatment of chronic dry cough and cough due to throat and bronchial irritation.

How it Works Drugs

Dextromethorphan is a non-narcotic antitussive works by suppressing the cough reflex cough center in the brain. Dextromethorphan has activity as strong as codeine, but not addictive or drowsiness.

Dosage and Administration

Children 2-6 years: ½ teaspoons or ¼ - ½ tablets, 3-4 times a day.

Children 6-12 years: 1 teaspoon or ½ - 1 tablet, 3-4 times a day.

Adults and children above 12 years: 2 teaspoon or 1-2 tablets, 3-4 times a day.

Warning and Caution

Not recommended for the treatment of cough with phlegm and the situation where there is respiratory tract disorders such as bronchial asthma.

Not recommended for children under the age of 2 years. Except on doctor's instructions.

Side Effects

Mild and infrequent, such as nausea, dizziness, and constipation. In large doses can cause respiratory depression, but no report is fatal.

Contra Indications

Patients who experienced respiratory failure, liver disease (liver disease) and patients who are hypersensitive to Dextromethorphan.

Drug Interactions

Do not be used in conjunction with MAO inhibitors.

Storage Method

In a tightly closed container, protected from light. Store in a cool and dry.

2. Salbutamol

Item:

Lasal (LAPI), Ventolin (Galxo Smith Klim)

Composition

Each tablet contains Salbutamol Sulphate equivalent to Salbutamol 2 mg.

Each tablet contains Salbutamol Sulphate equivalent to Salbutamol 4 mg.

Indication

To relieve symptoms of shortness of breath in patients with bronchial asthma, chronic bronchitis and emfisem.

How it Works Drugs

Salbutamol is a drug that stimulates beta receptors simpatomimtik-arenergik by stimulating the production of excitatory mediators (cyclic AMP) by activating the enzyme adenyl cyclase. Salbutamol stimulates beta adrenergic receptors strongly in the bronchi, so that the reaction will occur in bronchial smooth muscle and bronchial dilatation. Besides the effect of Salbutamol also inhibited the release of histamine thus preventing the occurrence of asthma attacks.

Dose

Children 2-6 years: 1-2 mg, 3-4 times a day

Children 6-12 years: 2 mg, 3-4 times a day

Adults and children above 12 years: 2-4 mg, 3-4 times a day

Warning and Caution

Careful administration in patients with hiperriroidisme, diabetes mellitus, hypertension, heart disease and patients who are sensitive to simpatomimetikamina.

Safety in patients younger than 6 years and in pregnant women is not known with certainty.

Usage in nursing mothers should consider the benefits to the mother and risks to infants who received breast milk.

Side Effects

Relatively rare, such as arrhythmias, palpitations, tremors, nausea, vomiting, anorexia, dyspepsia, dizziness and vertigo.

Contra Indications

Patients who are hypersensitive to salbutamol.

Drug Interactions

The joint use of other sympathomimetics may cause cardiovascular disorders.

Use caution with MAO inhibitors and tricyclic antidepressants.

Storage Method

Store in a cool and dry

3. Ambroxol

Item:

Epexol (Sanbe Farma)

Composition

Tablets: Each tablet contains 30 mg ambroksol Hydroxide

Syrup: IAP teaspoon (5 ml) containing 15 mg ambroksol hydroxide.

Indication

Indicated for acute illness and chronic respiratory tract which are accompanied by abnormal bronchial secretions. Especially in acute attacks of chronic bronchitis, bronchial asthma, bronchitis asmatik, treatment before and after surgery and in intensive care to avoid lung complications.

How it Works Drugs

Ambroxol relieve airway from alveoli to the trachea with the following mechanism:

• Restoring production of mucus as in normal circumstances. Ambroxol regulate the secretion of mucus in the bronchi and normalize the physical properties of mucus. Mucus secretion is stimulated so that the viscosity of sputum is reduced.

• Increase activity and transport function of cilia. Ambroxol restore trakeabronkus area cleaning mechanism by stimulating ciliated epithelial cells. Increased cilia movement, morphologically visible increase in the number of "microvilli" of the ciliated epithelial cells.

• Stimulate the production of surfactant (phospholipid "surface active") the lung. Hence the anti-adhesive effect of surfactants, the adhesion between particles lenders with reduced bronchial wall, as well as between the particles of mucus which can cause clots lenders.

Ambroxol well absorbed in the gastrointestinal tract. The half-life between 90-10 hours. On repeated administration in therapeutic doses. Does not show the occurrence of hoarding.

Ambroxol is metabolized into inactive metabolites and eliminated as glucuronide conjugates are soluble in water.

Ambroxol has a good tolerance, allowing for use in the long term.

Warning and Caution

Not recommended in the first trimester of pregnancy

Side Effects

Ambroxol is generally well tolerated. Reported side effects are mild gastro-intestinal tract and allergies in some patients.

Drug Interactions

Ambroxol allows for combination with other drugs, especially with corticosteroids, bronchodilators and antibiotics.

Storage Method

Store in a cool, dry place, protected from light.

CHAPTER III

CLOSING

1. Conclusion

The conclusion that can be drawn writers is do not underestimate a disease that is small, as small as possible from the disease that will cause a very big danger for us.

2. Suggestion

By knowing about the pharmacology expected to increase the reader's knowledge. In the drug are advised to always read and know first about the pharmacology of drugs listed on the label.

Congestive heart failure (CHF)

A. Idea of ​​the real

Heart failure is a global term for the physiological state in which cardiac output is insufficient for the needs of the body.

This happens most often during low cardiac output (often called "congestive heart failure").

Conversely, it can also occur when the body's need for oxygen and nutrients are increased, and demand exceeded what the heart can provide, (dubbed the "high output cardiac failure"). This can occur in the context of severe anemia, Gram-negative septicemia, beriberi (vitamin B 1 / thiamine deficiency), thyrotoxicosis, 'Paget's disease, arteriovenous fistula or arteriovenous malformations.

Excess fluid is a common problem for people with heart failure, but not identical with it. Patients with heart failure treated will often euvolaemic (the term for normal fluid status), or less frequently, dehydration.

1. Causes of Chronic Heart Failure

The dominance of the causes of heart failure is difficult to analyze because of challenges in diagnosis, differences in the population, and causes changes in prevalence with age.

Causes of failure jantug include:

• Viral Myocarditis (infection of the heart muscle)

• Infiltration of muscles such as amyloidosis

• HIV cardiomyopathy (caused by Human Immunodeficiency Virus)

• Connective tissue diseases such as systemic lupus erythematosus

• Abuse of drugs such as alcohol

• Pharmaceutical drugs such as chemotherapeutic agents.

• Arrhythmia

Apnea sleep disordered breathing conditions overlap with obesity, hypertension and diabetes and is regarded as an independent cause of heart failure.

2. Symptom

Symptoms of heart failure has traditionally and somewhat arbitrarily divided into "left" and "right" side, admitted that the left and right ventricular cardiac different parts of the supply of circulation. However, heart failure is not exclusive mundur''kegagalan''(in the circulation that flows into the ventricles).

There are some exceptions to a simple left-right division of heart failure symptoms. Maju''sisi''kegagalan time overlaps with the kanan''mundur''kegagalan. In addition, the most common cause of heart failure right-sided heart failure is left sided. The result is that patients usually present with both sets of signs and symptoms.

B. Pathophysiology

Heart failure is caused by conditions that reduce the efficiency of the myocardium, or heart muscle, through damage or overloading. Thus, it can be caused by a diverse array of conditions as myocardial infarction (in which the heart muscle deprived of oxygen and die), hypertension (which increases the strength of contractions needed to pump blood) and amyloidosis (in which the protein is stored in the heart muscle, causing it to be stiff). During this time an increase in workload will result in a change in his own heart:

• Reduce the power of contraction, due to overloading of the ventricles. In healthcare, improve the charging results in increased ventricular contractility (Frank-Starling law of the heart) and thus an increase in cardiac output. In heart failure this mechanism fails, because the ventricle is loaded with blood to the point where the contraction of heart muscle becomes less efficient. This is caused by reduced ability to cross-link actin and myosin filaments in cardiac muscle stretch-over.

• A reduced stroke volume, as a result of the failure of systole, diastole or both. Increase in end systolic volume is usually caused by reduced contractility. Decrease in the volume of impaired ventricular end-diastolic filling - as occurs when ventricular compliance decreased (ie, when the rigid wall).

• Reduce backup capacity.

• Increased heart rate

• hypertrophy (increase in physical size) of the myocardium, due to the terminally differentiated cardiac muscle fiber size increases in an effort to improve contractility.

• Enlarged ventricles, contributing to the enlargement and spherical shape of heart failure.

Systolic dysfunction

Heart failure caused by systolic dysfunction is more easily recognized. It can be simplistically described as a failure of cardiac pump function. It is characterized by decreased ejection fraction (less than 45%). Strength of ventricular contraction is attenuated and insufficient to create an adequate stroke volume, so cardiac output is inadequate.

Diastolic dysfunction

Heart failure caused by diastolic dysfunction is generally described as the failure of the ventricle to relax and usually indicates adequate ventricular wall stiffness. This leads to inadequate ventricular filling, and thus results in stroke volume is not adequate. The failure of ventricular relaxation also results in increased end-diastolic pressure, and the end result is identical to the case of systolic dysfunction (pulmonary edema in the left heart failure, peripheral edema in right heart failure.)

Diastolic dysfunction can be caused by processes similar to those that cause systolic dysfunction, particularly those affecting the causes cardiac remodeling.