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Co Intoxication

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    1

    Fundamental of Biomedic Science 2

    CO Intoxication

    Ayu Insafi M

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    Mr.A 27 y.o, presented to emergency unit falling

    fall, 4 hour after he took a dinner with his friends.

    He had been smoking shisha with three other

    friends and had neck stiffness after a fall. Those

    three other friends experience dizziness, nause

    and vomiting without falling. He had retrograde

    amesia. He complained dizziness

    2Topic discussionCase review

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    Physical examination

    Temperature : 38oC

    Pulse : 110 bpm

    Laboratory finding

    CoHb : 27,8%

    3Topic discussionCase review

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    asic sciences

    oRedox

    Definition

    Example redox reaction

    oOxidative phosporylation

    Structure of mitochondria

    Transfer electron and OP mechanismInhibitors in mitochondrias complex

    CO binding

    4

    Topic discussionCase review

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    asic sciences

    oBioenergetics

    Thermodynamics law I

    Thermodynamics law II

    Example

    oFree radical

    DefinitionExamples

    Mechanism

    5

    Topic discussionCase review

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    asic sciences

    oCO

    Source (endogen and exogen)

    6

    Topic discussionCase review

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    oBHP and IIMC

    oPathomechanism

    7

    Topic discussionCase review

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    redoks

    Redoks adalah istilah yang menjelaskan

    berubahnya bilangan oksidasi atom-atom dalam

    sebuah reaksi kimia

    8

    Reduksi Oksidasi

    Melepas O2 Menerima O2

    Menerima H+ Melepas H+

    Menerima e-

    Melepas e-

    Endergonik Eksergonik

    Free radicalBioenergeticsOxidative phosporylationRedox

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    redoks

    Example

    9

    Free radicalBioenergeticsOxidative phosporylationRedox

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    redoks

    NAD+ reduction on glycolysis

    10

    Free radicalBioenergeticsOxidative phosporylationRedox

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    redoks

    NAD+ oxidation on electron transfers

    NADH + 5H++ QNAD++ QH2 +

    4H+

    11

    Free radicalBioenergeticsOxidative phosporylationRedox

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    Transfer elektron

    redox reaction on electron transfer

    NADH + H++ O2+NAD++ H2O

    12

    Free radicalBioenergeticsOxidative phosporylationRedox

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    Nadh dan fadh

    10 NADH dan 2 FADH

    13

    2NADH, 2 ATP

    Glikolisis

    2 NADH, 2 CO2

    Dekarboksilasi oksidatif

    2 ATP, 6 NADH, 2 FADH, 4 CO2

    TCA

    FO

    Free radicalBioenergeticsOxidative phosporylationRedox

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    mitokondria

    14

    Radikal bebasBioenergeticsFosforilasi oksidatifRedoks

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    Transfer elektron

    15

    Free radicalBioenergeticsOxidative phosporylationRedox

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    Sintesis atp

    ADP + Pi + H+PATP + H2O + H+N

    16

    Free radicalBioenergeticsOxidative phosporylationRedox

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    inhibitor

    17

    Golongan barbiturat : piercidin,rotenone, amytal

    KompleksI

    Carboxin dan TTFA

    Malonate

    Kompleks

    II

    Antimycin

    Dimecarpol

    KompleksIII

    CO

    Sianida

    H2S

    KompleksIV

    Radikal bebasBioenergeticsFosforilasi oksidatifRedoks

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    CO binding

    18

    CO binds to cytochrome aa3

    Disrupting oxidativemetabolism

    Free radicals (peroxynitrite)

    Impaired electron transport

    ATP

    Free radicalBioenergeticsOxidative phosporylationRedox

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    Thermodynamics law

    e.g

    ADP + Pi + H+

    PATP + H2O + H+N

    ADPHeat

    19

    Energy can be changedfrom one form to another,but it cannot be created or

    destroyed.

    Free radicalBioenergeticsOxidative phosporylationRedox

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    Thermodynamics law

    G (< 0) : exergonic. spontanG (> 0) : endergonic

    G (= 0) : equilibrium

    e.g : Glucose + ATPglucose-6-phosphate

    20

    G = HT. S

    Free radicalBioenergeticsOxidative phosporylationRedox

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    Free radical

    21

    Free radicalBioenergeticsOxidative phosporylationRedox

    Unpaired electron

    Reactive

    Denaturation ofcell

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    examples

    22

    Free radicalBioenergeticsOxidative phosporylationRedox

    H2O2O2

    .Endogen

    UV

    NO, SOExogen

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    examples

    Superoxide

    Hydroxyl

    Peroxide

    23

    Free radicalBioenergeticsOxidative phosporylationRedox

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    Mechanism of action

    24

    Free radicalBioenergeticsOxidative phosporylationRedox

    Initation

    Propagation

    Termination

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    Mechanism of action

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    Free radicalBioenergeticsOxidative phosporylationRedox

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    antioxidant

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    Free radicalBioenergeticsOxidative phosporylationRedox

    Preventive

    Chain breaking

    Vitamins

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    Sources of CO

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    Free radicalBioenergeticsOxidative phosporylationRedox

    Endogen

    Polution

    CigaratteEksogen

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    pathomechanism

    28

    CO poisioning

    NO Cytochrome

    binding

    Hemeglobin,myoglobin

    binding

    POdisturbance

    ATP -

    ADP kalorFebris

    Hipoksia

    anaerob

    ATP -

    Fall

    Suplai keotak

    takikardi

    Amnesia

    retrograde

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    HP

    Pengelolaan informasi :

    Bahaya merokok

    Bahaya sisha

    Konseling :

    Menyarankan untuk mengurangi merokok

    29

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    IIMC

    Dan Kami tidaklah menganiaya mereka tetapi

    merekalah yang menganiaya diri mereka

    sendiri, karena itu tiadalah bermanfaat

    sedikitpun kepada mereka sembahan-sembahan yang mereka seru selain Allah, di

    waktu azab Tuhanmu datang. Dan

    sembahan-sembahan itu tidaklah menambahkepada mereka kecuali kebinasaan

    belaka.(QS. Huud : 101 )

    30

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