Download - Co Intoxication

8/10/2019 Co Intoxication

1/31

1

Fundamental of Biomedic Science 2

CO Intoxication

Ayu Insafi M


2/31

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


3/31

Physical examination

Temperature : 38oC

Pulse : 110 bpm

Laboratory finding

CoHb : 27,8%

3Topic discussionCase review


4/31

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


5/31

asic sciences

oBioenergetics

Thermodynamics law I

Thermodynamics law II

Example

oFree radical

DefinitionExamples

Mechanism

5



6/31

asic sciences

oCO

Source (endogen and exogen)

6



7/31

oBHP and IIMC

oPathomechanism

7



8/31

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


9/31

redoks

Example

9



10/31

redoks

NAD+ reduction on glycolysis

10



11/31

redoks

NAD+ oxidation on electron transfers

NADH + 5H++ QNAD++ QH2 +

4H+

11



12/31

Transfer elektron

redox reaction on electron transfer

NADH + H++ O2+NAD++ H2O

12



13/31

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



14/31

mitokondria

14

Radikal bebasBioenergeticsFosforilasi oksidatifRedoks


15/31

Transfer elektron

15



16/31

Sintesis atp

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

16



17/31

inhibitor

17

Golongan barbiturat : piercidin,rotenone, amytal

KompleksI

Carboxin dan TTFA

Malonate

Kompleks

II

Antimycin

Dimecarpol

KompleksIII

CO

Sianida

H2S

KompleksIV

Radikal bebasBioenergeticsFosforilasi oksidatifRedoks


18/31

CO binding

18

CO binds to cytochrome aa3

Disrupting oxidativemetabolism

Free radicals (peroxynitrite)

Impaired electron transport

ATP



19/31

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.



20/31

Thermodynamics law

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

G (= 0) : equilibrium

e.g : Glucose + ATPglucose-6-phosphate

20

G = HT. S



21/31

Free radical

21


Unpaired electron

Reactive

Denaturation ofcell


22/31

examples

22


H2O2O2

.Endogen

UV

NO, SOExogen


23/31

examples

Superoxide

Hydroxyl

Peroxide

23



24/31

Mechanism of action

24


Initation

Propagation

Termination


25/31

Mechanism of action

25



26/31

antioxidant

26


Preventive

Chain breaking

Vitamins


27/31

Sources of CO

27


Endogen

Polution

CigaratteEksogen


28/31

pathomechanism

28

CO poisioning

NO Cytochrome

binding

Hemeglobin,myoglobin

binding

POdisturbance

ATP -

ADP kalorFebris

Hipoksia

anaerob

ATP -

Fall

Suplai keotak

takikardi

Amnesia

retrograde


29/31

HP

Pengelolaan informasi :

Bahaya merokok

Bahaya sisha

Konseling :

Menyarankan untuk mengurangi merokok

29


30/31

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


31/31

31