Post on 24-Feb-2018
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Medical Faculty of
Trisakti University
Jakarta
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Many substances that may cause someoneexperiencing a poisoned until it brings adeath.
Substances that active chemically andphysiology in one body, at the point ofcertain dose toxic! "ill bring anunhealthiness or may cause a death.
Forensic discuss about toxic substancefrom its varies, symptoms caused, andmethod forensic examination to handleeither for alive or dead victims.
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Toxicology de#nition and factors that a$ecttoxicity
%pidemiology, signs and symptoms,pharmacokinetic, laboratory examination,and treatment&therapy of cyanide poisoning
Forensic examination of patient thatexperiencing common poison and cyanidepoison
medikolegal aspects of deliberate poisoningor unintentionally
%xample case of cyanide poisoning
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(s a part of medical science that focusedon toxic
Study about nature and mechanism of
toxic e$ect, varies substance to"ardsliving things and other biologic system
( study about source, characteristic anda savor from toxic, indication andtreatment against poisoning and otherabnormality found in dead victim
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( substance that may cause bad e$ect
"hen it gets into a body of a living things,either intentionally or unintentionally
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)rigin*
+lants opium, cocaine, curare, aatoxin!
(nimals poison&snake toxin,
spider&marine animals! Mineral arsenic, plumbum, and things
that made from synthetic!
-eroin
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enue* /ature0free poison gas in nature, household! +oison agriculture insecticides, herbesida, pe
sticides! Toxic industrial laboratories and industry
acid and strong base, heavy metals! Toxic food1/ in cassava, botulinus toxic,
preservative, additives substance and toxic inthe form of medicine e.g. sedative hypnotic!
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)rgans that a$ected*2 -epatotosik2 /ephrotoxic
3ork mechanism*2 Toxic that bind sulfhydryl group +b!2 %$ect on (T+0ase2 Forming methemoglobin nitrate and nitrite!
The e$ects*2 4ocal2 Systemic2 local0systemic
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%xposureto toxic substances on humans andliving things*
regular consumption
exposure from "ork
environmental exposure andpoisoning, either intentionallyor unintentionally
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-o" to enter*
(ge
5ody condition
-abits
6diosinkrasi and allergic to vitamin %,penicilin, streptomycin dan procaine
Time delivery
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( deadly toxic substance2 %$ects arevery fast and can cause death "ithin afe" minutes2 -ydrogen cyanide formonitrile!2 6n the form of li7uid 08prussit acid and hydrocyanic acid
2 4i7uids can also be colorless or pale blue atthe temperature of normal room2 volatile and ammable
2 di$use either by air and explosives2 ery easy to mix "ith "ater2 )therforms* sodium cyanide and potassium cyanidepo"der and "hite!
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a ma9or contributorto morbidity and mortality, observed in approximately:,;;; to in >;;@! and>: of>A= in >;;=! casesof cyanide poisoning is deliberate exposure as reported to the (merican (ssociation
of +oison 1ontrol 1enters fatal suicide in adult patients may easily be
associated "ith sudden death frommyocardial infarction, pulmonary embolism, or ventricular dysrhythmias
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4o"0dose in nature and in every product that"e usually eat or use
1yanide canbe produced by bacteria, fungi and algae
1yanide is found in cigarettes, motor vehiclefumes, and food and the synthetic product
1yanide in seed plants,especially grains cassava "ild, "ild tubers, 6ntersection bu$oonery,
"ild cherry, plum, apricot, "ild amigdalin,9etberry bush, etc.!
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Fog Inhalation
Intentional poisoning (suicide)
Industry exposure
Iatrogenic exposure
Consumptionof Supplements Containing Cyanide
(Uncommon)
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1yanide in thebody "ill inactive some oxidative enBymes radically the"hole system, especially cytochrome oxidase by bindingto the ferric heme group from the oxygen carried by blood
The process of oxidation and reduction occurs as follo"s*
1ytochrome oxidase Fe C C Fe C C C cytochrome oxidaseC 1/ &0000 Fe C C C cytochrome oxidase0cyanide0
)xidiBe cyanide d in the body get into
cyanates and sulfosianat and expelled from the bodythrough urine.Toxic dose orally for -1/ is D;0E; mg,"hile doses toxic to 1/ or /a1/ is >;; mg.
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Main e$ects* hypoxia system arise progressivelySymptoms and physical signs that found are depend on the2 The dose of cyanide2 /umber of exposures2 Type of exposure2 Types of cyanide component
symptoms in the body*2 blood pressure, vision, lung, central nerve, heart,endocrine system, autonomic system and metabolic system2 sore eyes because of irritation and diGculty breathing dueto irritate the respiratory tract mucosa
2 highconcentrations only "ithin
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2 %xposure of hydrogen cyanidemay cause irritation against eyesand skin immediately after exposure or at
least A; to D; minutes 6n lo" concentrations, the
e$ects of cyanide emerging about
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2 cyanosis of the face, the foam out from
the mouth,rapid and "eak pulse, rapid breathing
and sometimes irregular, dilated pupils a
nd slo"er reex, air breathing smellstonsil, the vomit also smells2 5y the death, cyanosis more realand arise t"itch muscles
and convulsions "ith urinaryincontinence and alvi
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26nhalation* palpitations, diGculty tobreath, nausea, vomiting,
headache, salvasi,lakrimasi, mouth and throat irritation, diBBiness and "eaknessof extremities arise 7uickly and thencollapse, convulsions, coma and death2 1hronic poisoning victim looks pale, cold
s"eats, diBBiness, discomfort in thestomach, nausea and colic, feel pressed onthe chest and shortness of breath.2 Signs the end*coma and dilated pupils, tremors, arrhythmi
as, convulsions, coma emphasis on therespiratory center, respiratory failure untilthe heart stop beating2 color skin looks Hcherry0redH
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+aper #lter test
Ieaksi Schonbein +agenstecher IeaksiKua9acol!
+russian 5lue reaction
Micro Method Kittler L Kolabaum
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+oisoned by 1/ inhalation*08move victim to the place "here clean air isavailable, give0amyl nitrite"ith inhalation, < ampoule ;.> ml! every: minu
tes, stop giving "henthe systolic blood pressure is less than=; mm-g08 give arti#cial respiration "ith
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1/ poisoning ingested2 do an
emergency action "ith inhalation of amylnitrite, one ampoule ;.> ml,"ithin Aminutes! every : minutes2 Kive arti#cialrespiration "ith
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cases of deaths due to poisoning*2 %xamination at the place of incident2 )utdoor examination
0 smell0 1lothes0 5ruises corpse0 1hanges in skin color
0 /ails0 -air0 sclera
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)penchest and abdominal cavity, specify "hether there is an unusual smell smell
of poison!2 1onsider the color of blood and thecolor of organs is bro"nreddish
2 6n lung, there is an acute damming
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Taking blood fromthe heart separately from theright and left respectively for about :; ml
2 5lood side for about A;0:; ml, takenfrom of iliac vein2 Urine and gastric "ashings all of takenfrom the bladder
2 )rgan liver should be takenafter reserved for pathologyanatomy examination
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2 idneys should be taken both
2 5rain, lipoid system inside2 another "ay to take samples*Ket the place "here toxic getsin stomach, the in9ection site!
5lood)ut point urine, bile!
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pemeriksaan bagian luar 9enaBah
tercium bau amandel
Sianosis pada "a9ah dan bibir, busa keluar
dari mulut, dan lebam mayat ber"arnaterang
pemeriksaan bedah 9enaBah tercium bau
amandel yang khas pada "aktu membuka
rongga dada, perut dan otak sertalambung, darah, otot dan penampangtubuh dapat ber"arna merah terang
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%xamination of the exterior of the body"afted of tonsils
1yanosis of the face and lips foam out of
the mouth and bruised corpse lightcolored
Surgical examination of the corpse "afted of the spesi#c tonsils distinctive"hen opening the chest cavity stomach,brain and also blood, muscle, and bodysections color seems red bright
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KUH !
(rticle >;:
(rticle A:E
(rticle AD;
KUH"
(rticle
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#a$ %um&er ' ear *** "&out
Consumer rotection! (rticle :
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Six eople is &eing poisoned &y Cyanide"cid in 5i$ul (a food from cassa.a 6our)
Tue, January ;?!, (( A!, ( :!, M-
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#eaf
andCassa.a
5u&er
;e
poisoned
Case
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Toxicology can be de#ned as
a substance that can cause bad e$ect "hen itgets into a livingbody, either accidentally or "ith intent.2 )ne typeof poisoning that occurs is cyanide poisoning, because the cyanide salt in a small dose isenough to cause death in someone 7uickly like asuicide.2 +oisoning can through parenteral administration,
inhalation, ingestion or skin absorption dermal!.2 Signs and symptoms depend on the mechanism,source and 7uantity of cyanide that gets into thebody.
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2 Forensic through the post0
mortem examination and toxicologytests can prove the existenceof cyanide in thebody, or any changes and abnormalities c
onsistent "ith cyanide poisoning.2 (spect medikolegal about cyanide poisoning regulated in U-+ articles>;:, A:E, AD;O U-(+
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5udiyanto (, 3idiatmaka 3, Sudiono S,et al. Ilmu Kedokteran
Forensik. Jakarta * 5agian edokteran Forensik Fakultas edokteranUniversitas 6ndonesia.