Fundamental of Biomedic Science 2

CO Intoxication

Ayu Insafi M

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

Case review

Topic discussion
2

Physical examination
Temperature
: 38oC
Pulse
: 110 bpm
Laboratory finding
CoHb
: 27,8%

Case review

Topic discussion
3

Basic sciences
oRedox
Definition
Example redox reaction
oOxidative phosporylation
Structure of mitochondria
Transfer electron and OP mechanism
Inhibitors in mitochondrias complex
CO binding
Case review

Topic discussion
4

Basic sciences
oBioenergetics
Thermodynamics law I
Thermodynamics law II
Example
oFree radical
Definition
Examples
Mechanism
Case review

Topic discussion
5

Basic sciences
oCO
Source (endogen and exogen)

Case review

Topic discussion
6

oBHP and IIMC

oPathomechanism

Case review

Topic discussion
7

redoks
Redoks adalah istilah yang menjelaskan
berubahnya bilangan oksidasi atom-atom dalam
sebuah reaksi kimia
Reduksi

Oksidasi

Melepas O2

Menerima O2

Menerima H+

Melepas H+

Menerima e-

Melepas e-

Endergonik

Eksergonik

Redox

Oxidative phosporylation
8

Bioenergetics

Free radical

redoks
Example

Redox

Oxidative phosporylation
9

Bioenergetics

Free radical

redoks
NAD+ reduction on glycolysis

Redox

Oxidative phosporylation
10

Bioenergetics

Free radical

redoks
NAD+ oxidation on electron transfers

NADH + 5H+ + Q NAD+ + QH2 +

4H+

Redox

Oxidative phosporylation
11

Bioenergetics

Free radical

Transfer elektron
redox reaction on electron transfer

NADH + H+ + O2 +NAD+ + H2O

Redox

Oxidative phosporylation
12

Bioenergetics

Free radical

Nadh dan fadh

Glikolisis

2NADH, 2 ATP
Dekarboksilasi oksidatif
2 NADH, 2 CO2
TCA
2 ATP, 6 NADH, 2 FADH, 4 CO2

10 NADH dan 2 FADH

Redox

Oxidative phosporylation
13

Bioenergetics

FO
Free radical

mitokondria

Redoks

Fosforilasi oksidatif
14

Bioenergetics

Radikal bebas

Transfer elektron

Redox

Oxidative phosporylation
15

Bioenergetics

Free radical

Sintesis atp

ADP + Pi + H+P ATP + H2O + H+N

Redox

Oxidative phosporylation
16

Bioenergetics

Free radical

inhibitor
Kompleks
I

Golongan barbiturat : piercidin,

rotenone, amytal

Kompleks
II

Carboxin dan TTFA

Malonate

Kompleks
III

Antimycin
Dimecarpol

Kompleks
IV

CO
Sianida
H2S

Redoks

Fosforilasi oksidatif
17

Bioenergetics

Radikal bebas

CO binding
CO binds to cytochrome aa3

Disrupting oxidative
metabolism
Free radicals (peroxynitrite)
Impaired electron transport
ATP

Redox

Oxidative phosporylation
18

Bioenergetics

Free radical

Thermodynamics law
Energy can be changed
from one form to another,
but it cannot be created or
destroyed.
e.g
ADP + Pi + H+P ATP + H2O + H+N
ADP Heat
Redox

Oxidative phosporylation
19

Bioenergetics

Free radical

Thermodynamics law
G = H T. S
G (< 0) : exergonic. spontan
G (> 0) : endergonic
G (= 0) : equilibrium
e.g : Glucose + ATP glucose-6-phosphate
Redox

Oxidative phosporylation
20

Bioenergetics

Free radical

Free radical
Unpaired electron
Reactive

Denaturation of
cell
Redox

Oxidative phosporylation
21

Bioenergetics

Free radical

examples
Endogen

Exogen

Redox

H2O2
O2.
UV
NO, SO

Oxidative phosporylation
22

Bioenergetics

Free radical

examples
Superoxide
Hydroxyl
Peroxide

Redox

Oxidative phosporylation
23

Bioenergetics

Free radical

Mechanism of action

Initation
Propagation
Termination
Redox

Oxidative phosporylation
24

Bioenergetics

Free radical

Mechanism of action

Redox

Oxidative phosporylation
25

Bioenergetics

Free radical

antioxidant
Preventive
Chain breaking
Vitamins

Redox

Oxidative phosporylation
26

Bioenergetics

Free radical

Sources of CO
Endogen

Polution
Eksogen Cigaratte

Redox

Oxidative phosporylation
27

Bioenergetics

Free radical

pathomechanism
Hemeglobin,
myoglobin
binding

CO poisioning

NO

Cytochrome
binding

Hipoksia

anaerob

PO
disturbance

ATP ATP -

Fall
Febris

ADP kalor

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Suplai ke
otak
Amnesia
retrograde

takikardi

BHP
Pengelolaan informasi :
Bahaya merokok
Bahaya sisha
Konseling :
Menyarankan untuk mengurangi merokok

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IIMC
Dan Kami tidaklah menganiaya mereka tetapi
merekalah yang menganiaya diri mereka
sendiri, karena itu tiadalah bermanfaat
sedikitpun kepada mereka sembahansembahan yang mereka seru selain Allah, di
waktu azab Tuhanmu datang. Dan
sembahan-sembahan itu tidaklah menambah
kepada mereka kecuali kebinasaan
belaka.(QS. Huud : 101 )
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