BAB 9 TOKSIKOLOGI.doc

8/17/2019 BAB 9 TOKSIKOLOGI.doc

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BAB 9

TOKSIKOLOGI

(KERACUNAN, TRAUMA INHALASI, GIGITAN HEWAN BERBISA)

A. KERACUNAN

TUJUAN

1. Mengetah! "#!n$!" "enata%a&$anaan nt& &e#a'nan a&anan an te#&ena *at

#a'n, te#a$& &!!a an +ahan+ahan &a$t!&.

-. eng!ent!!&a$! et/e 0ang !"a&a! nt& e!n!a%!$!# "en0e#a"an /+at.

. ene$!"$!&an te#a"! $"e$!!& nt& &e#a'nan.

2. enata $+e#$+e# 0ang te#$e!a nt& +e#&/n$%ta$! a%a "enata%a&$anaan

ana& engan &e#'nan ata te#&ena *at #a'n.

3EN4AHULUAN

4! Ae#!&a, 5 "engn6ng UG4 aa%ah &a#ena &e#a'nan. 78 5 $a"a! 85

%a"/#an 0ang !te#!a /%eh 3/!$/n C/nt#/% Cente#$ ! US aa%ah ana& +e## : tahn

ata %e+!h a. Ang&a /#ta%!ta$ an /#+!!ta$ te#t!ngg! !te"at! /%eh ana&ana& an

"a$!en e;a$a, nan ana& 0ang %e+!h a a"at "%a %e+!h "a#ah. Ka#ena

&eng&!nan &eat!an ata 'a'at 0ang +e#at, "enanganan 0ang te"at an ee&t! a&anengha$!%&an ha$!% 0ang /"t!a%. T/&$!n a"at en0e+a+&an +an0a& ge6a%a an &/n!$!.

Ke#'nan a"at te#6a! &a#ena te#a&an *at #a'n, "en0e#a"an #a'n %e;at &%!t an

te#h!$a" *at #a'n. Wa%a"n +an0a& "a$!en 0ang enge%h&an te#a&an *at #a'n, 0ang

%a!n ena"a&&an ge6a%a ata tana 0ang t!a& a"at !6e%a$&an an t!a& e!%!&!

#!;a0at &e#a'nan 0ang $"e$!!&.

3ATO


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(a$eta!n/en), ata a#ah (%/ga +e#at). 3#/$e$"#/$e$ "at/%/g!& 0ang +!$a !$e+a+&an

/%eh +ahan 0ang +e#+aha0a $angat +an0a&.

3ENILAIAN AWAL

3en!%a!an a;a% /%eh "etga$ ee#gen$! ha#$ $e'e"atn0a !%a&&an +!%a h!"

ana& +e#aa a%a +aha0a.

3e#hat!an te#haa" $tana# ABC "aa #e$$!ta$! $e%a% en6a! "#!/#!ta$ taa.

E=a%a$! "e#naa$an 0ang ae&at, an !!&t! "eng&#an en0t na!, "eng!$!an &a"!%e#,

an te&anan a#ah. 3e#hat!an te#haa" "aten$! 6a%an naa$ 6ga e#"a&an ha% 0ang

"ent!ng. Be#!&an +antan 6a%an naa$ +!%a aa !n!&a$!, te#a$& "e+e#!an /&$!gen.

Ke!an, +at%ah $aha nt& eng!ent!!&a$! 6en!$ #a'n 0ang $"e$!!&. Jangan te#%a%

/'$ nt& en'a#! ant!/te. Tangan!%ah "a$!en, 6angan #a'nn0a. J!&a "e#%, "a$ang%ah

!n$e engan 'a!#an R!nge# La&tat ata %a#tan !$!/%/g!$. Be#!&an /&$!gen +!%a aa

tanatana ganggan "e#naa$an ata $0/&.

Na%/?/ne (8.1 g@&g) an g%&/$a (8.-: 8.: g@ Kg ata e&$t#/$a -:5 a%a

a!#) !+e#!&an "aa ana&ana& engan &eaaan &/a. 3e+e#!an Na%/?/ne !%a!

engan 1 g nt& ana&ana& +e## %e+!h a#! 1 tahn, an -2 g nt& ana&

+e## 2 tahn ata %e+!h.

La&&an anane$!$ 0ang eta!% a#! "a$!e, &e%#aga, tean, "en/%/ng ata /#ang

0ang +e#aa !e&at "a$!en "aa $aat &e6a!an. 3/!n 0ang "ent!ng aa%ah nt&

eng!ent!!&a$! *at #a'n 0ang te#a&an, 6%ah *at an %aan0a, t!+%n0a a%e#g! ata

"en0a&! "en0e#ta, an "e#/%/ngan "e#taa 0ang te%ah !%a&&an. Ke%a#ga, tean ata

"/%!$! +!$a &e+a%! &e#ah nt& en'a#! *a #a'n. 3en!%a!an te#haa" "a&a!an "a$!en

nt& en'a#! *at #a'n an !ent!!&a$! e!$.

La&&an "ee#!&$aan !$!&, te#taa "aa $!$te $0a#a, 6antng an "a#.

Meng!ent!!&a$! ge6a%a &e#a'nan 0ang 6e%a$ +!%a n'%.

3en!%a!an te#haa" $tat$ enta% enggna&an G%a$g/; C/a S'a%e ata $0$te

A3U , a"at engh!tng t!ng&at &e$aa#an (%!hat Ba+ 7 T#aa Ke"a%aD). 3e#hat!&an

ha% 0ang a"at en0e+a+&an te#6a!n0a "en#nan $tat$ enta%, $e"e#t! ganggan

eta+/%!' ata t#aa, an $aha&an t!a& te#6a!.


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3a$!en engan ganggan $0$te $0a#a "$at an &a#!/"%/ne# ee#%&an

"eantaan engan /n!/#. J!&a te#6a! ganggan !#aa 6antng ata "a$!en !&etah!

te#a&an #a'n 0ang +e#$!at &a#!/t/&$!& $e"e#t! Ant!e"#e$an T#!$!&%!&, "a$ang%ah EKG

1 %ea an $e%a% !%a&&an /n!t/# te#haa" en0t 6antng, en0t na! an te&anan

a#ah.

J!&a te#6a! "en#nan &e$aa#an ata ganggan "e#naa$an, 6aga%ah 6a%an naa$

an %a&&an #/entgen t/#a&$. 3ne/n!t!$ a$"!#a$! aa e "a# n/n &a#!/gen!& +!$a

ta"a&. 3e+e#!an /+at/+atan $e"e#t! +e$! ata %/ga +e#at 0ang %a!n an &a"$% $a%t

$e%a"t, a"at 6ga te#%!hat a%a #/entgen "e#t.

3en!%a!an te#haa" e%e&t#/%!t an Ana%!$a Ga$ a#ah a"at e+e#!&an !n/#a$!

0ang +e#ha#ga tentang &eng&!nan #a'n ata $e+a+$e+a+ eta+/%!'. J!&a An!/n Ga"

(Na C% F CO-) 1- ata &#ang, !n! enana&an te%ah te#6a!n0a a$!/$!$ eta+/%!'.

J!&a O$/%a# Ga" (O$/% te#&# /$/% te#h!tng) %e+!h a#! 18, enana&an "a$!en

&e#a'nan ethan/%, ethan/%, !$/"#/"an/%/% ata e!%en g%!&/%. O$/% Te#h!ng !a"at&an

a#! #$ - Na F G%&/$a@1 F BUN@-..

S!n!ng *at #a'n a#! a#ah an #!n +e#&/nt#!+$! "aa "enata%a&$anaan a;a%.

In! ee#%&an a&ae!$! ata !n!&a$! /#en$!'. J!&a !'#!ga! !$e+a+&an /%eh /+at

/+atan te#tent, &/n!&a$!&an%ah &e"aa "ega$ %a+/#at/#!. Ha$!% t/&$!&/%/g! 0ang

negat!=e t!a& $e%a% en0!ng&!#&an &eng&!nan 6en!$ *at t/&$!n.

3ee#!&$aan !$!& an =!ta% $!gn a"at e+ant nt& eng!ent!!&$a! g#"

/&$!n. T!ga $!n#/ t/&$! 0ang negan'a ha#$ !"!&!#&an &a#ena !"e#%&an te#a"!

0ang $"e$!!& (ta+%e 91). H!"e#ten$! !&a#ena&an a"heta!ne, "hen'0'%!!ne, /=e#/$!$

/+at $!"at/!et!&, ata &etag!han na#&/t!&a an /+at/+atan $eat!=e. H!"/ten$!

!$e+a+&an /%eh +eta+%/&e#, /+at/+atan $eat!=e, h!"n/!&, ata na#&/t!&. Ta&!&a#! a"at

!$e+a+&an &a#ena /+at/+atan 0ang en0e+a+&an h!"e#ten$!. B#a!&a#! a"a

!h+ng&an engan "ea&a!an !g!ta%!$, +eta+%/&e#, 'a%'! 'hanne% antag/n!$t, ata

h!"/e#!a. 4ea a"at te#6a! &a#ena $a%!$!%at, /#gan//$at, ata &etag!han a%'/h/% an

na#&/t!&.

3e#naa$an a"at te#te&an &a#ena /+at/+atan h!"n/t!& $eat!=e an na#&/t!&,

nan en!ng&at "aa &a$$ a$"!#a$! "ne/n! (h!#/&a#+/n), e "%/na%

(te#h!$a" a$a", na#&/t!&, $a%!$!%at), an a$!/$!$ eta+/%!' (et!%en g%!&/%, ethan/%,


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$a%!$!%at). U&#an ""!% an tana 0ang ta"a& "aa &%!t a"at 6ga e+ant nt&

eng!ent!!&a$! 6en!$ *at t/&$!n.

Ta+%e 91 A'te L!eTh#eaten!ng T/?!' S0n#/e

T/?!n S0n#/e S"e'!!' Inte#=ent!/n

O"!/!Gaga% naa$K/a

M!/$!$

Na%/?/ne

Ant!e"#e$an T#!$!&%!&

K/a

Ke6ang

Ganggan !#aa 6antng

RS 188 $e'

Nat#! +!&a#+/nat

O#gan//$at, Ca#+aat

H!"e#$a%!=a$!

H!"e#%a!a$!4!a/#e$!$

M!/$!$

B#/n&/##hea

B#/n&/$"a$e

At#/"!ne

3ENATALAKSANAAN

3enata%a&$anaan !a$a#&an "aa 2 "#!n$!" a$a#

1. Meneta"&an "enanganan $"/#t! (ABC$)

-. Men'egah ata e!n!a%!$!# "en0e#a"an

. Men!ng&atan "enge%a#an

2. Men'a#! ant!/te

Mencegah atau meminimalisir penyerapan

Zat kontak $ege#a ''! &%!t 0ang te#&ena, #a+t, ata engan a!# 0ang +an0a&.

Be#$!h&an &%!t an #a+ engan $a+n ata $ha"//, &h$$n0a a"aa *at*a %!"/!%!&

$e"e#t! "e$t!$!a an "e%a#t /#gan!'. Unt& "en/%/ng, ha#$ enggna&an $a#ng tanganan "a&a!an 0ang a"at e%!nng! a#! *at #a'n.

Zat Inhalan 6ah&an "a$!en a#! "a"a#an, an %!nng! 6ga "en/%/ng a#! "a"a#an *at.

Zat Ingestan $!#" 0ang a"at en0e+a+&an ntah t!a& !"a&a! ! UG4 nt& "a$!en

engan &e#a'nan a&t. B!%a$ %a+ng !!n!&a$!&an han0a nt& "a$!en &e#a'nan 0ang

atang &#ang a#! 1 6a $ete%ah &e#a'an te#6a! ata *at #a'n 0ang te#a&an te#%a%


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+an0a& $eh!ngga t!a& +!$a !!&at /%eh &a#+/n a&t!. 3enanganan %!n! "e#taa 0ang

!%a&&an $aat !n! aa%ah "e+e#!an &a#+/n a&t! a%a a!#. 4/$!$n0a -::8 g#a "aa

ana& &e'!% a#! 7 tahn an :8188 g "aa ana& $!a !ata$ 7 tahn an "aa e;a$a.

NGT 6ga !"e#%&an. 3ea&a!an /+at/+atan h!"e#/$/%a# ($/#+!t/%) t!a& enn6&&an

ha$!% 0ang ena$&an +ah&an !%a#ang nt& ana& +e## &#ang a#! 7 tahn &a#ena

a"at e0e+a+&an &et!a&$e!+angan 'a!#an an e%e&t#/%!t.

Ka#+/n a&t! e"e#%!ha&an &entngan 0ang $!gn!!&an nt& &e#a'nan 0ang

te%ah te#6a! $e%aa 2 6a ata %e+!h. T!a& aa &/nt#a!n!&a$! nt& !n!. Nan, /+at !n!

t!a& ee&t! nt& *at*at 0ang te#a"at "aa ta+%e 9-.

Ta+%e 9-. *at*at 0ang t!a& a"at !$e#a" /%eh &a#+/n a&!

S!"%e I/n$ (+e$!, %!th!, $!an!a)

S!"%e A%'/h/%$ (Ethan/%, Methan/%)A$a an Ba$a Kat (HC%, NaOH)

I#!ga$! $$ +!$a !%eng&a"! engan "ea&a!an %a#tan +!%a$ e%e&t#/%!t "/%0eth0%ene g%0'/%

(C/%0te, G/%0e%0) engan NGT. In! a&an eng!#!ga$! $a%#an "en'e#naan an

!!n!&a$!&an nt& &e#a'nan +e$! ata /+at/+atan %e"a$ %a+at a%a 6%ah 0ang

+an0a&. La#tan 0ang !"a&a! $e+na0a& :88 %@6a nt& ana& "#a$e&/%ah an 1- L@

6a nt& #ea6a an e;a$a. B!a$an0a "#/$e$ !n! ea&an ;a&t +e+e#a"a 6a.

3#/$e# !n! !h!na#! nt& /#ang/#ang engan !%e$, /+$t#&$!, "e#/#a$! an

"e#a#ahan $a%#an 'e#na 0ang +an0a&.

Peningkatan pengeluaran racun

Aa +e+e#a"a te&n!& 0ang !"a&a! nt& en!ng&at&an e&$e$! #a'n, an +e+e#a"a

!!n!&a$!&an han0a "aa +e+e#a"a $!ta$!

Ion trapping: te/#!n0a, a$!!!a$! an a%&a%!n!$a$! #!n a"at en!ng&at&an e&$e$! +a$a

%eah an a$a %eah. 3#/$e# 0ang "e#taa !h!na#! &a#ena &eng&!nan en6a!

a$e!e!a, $ean&an a%&a%!n!$a$! #!n a"at !gna&an nt& en!ng&at&an e&$e$!$a%!$!%at, ant!e"#e$an t#!$!&%!t, an &e#a'nan en/+a#+!ta%.

Neutral Diuresis: en!ng&a&an a%!#an #!n engan e+e#!&an 'a!#an !$ta%/!

!nt#a=ena a"a !"a&a! nt& &e#a'na %!th! an +#/!e. Ue "a#, e /ta& an

gaga% g!n6a% e#"a&an &/nt#a!n!&a$! nt& te&n!& !n!.


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Muliple-dose charcoal: te/#!n0a, te&n!& !n! en!ng&at&an e&$e$! t/&$!n engan

enggna&an e"!te% $a%#an "en'e#naan $e+aga! e+#ane !a%0$!$. Kentngan !n!

+e% !+&t!&an, an &/"%!&a$! !at#/gen!& te%ah !%a"/#&an (a$"!#a$! &a#+/n, an

$+atan $$). Te&n!& !n! t!a& !#e&/ena$!&an.

Hemodialisis: te&n!& !n! !!n!&a$!&an nt& &e#a'nan ethan/%, eh0%en g%0'/%, INH,

an &e#a'an $a%!$!%at an %!th! a%a 6%ah 0ang +e$a#.

Charcoal hemoperfusion: te&n!& !n! 6a#ang !!n!&a$!&an. Te&n!& !n! !"a&a! nt&

&e#a'nan te/!%!n a%a 6%ah 0ang +e$a#.

Pemakaian Antidot

Ant!/t an *at antag/n!$ te#$e!a han0a nt& +e+e#a"a &e#a'nan. Jen!$ ant!/te ata

!%!hat ! ta+%e 9.

Ta+e%9. Ant!/t

Ra'n Ant!/t

A'eta!n/"hen Na'et0%'$te!ne

Ant!&/%!ne#g!& 30$/$t!g!ne

Ant!&/%!ne$e#a$e, !n$e&t!$!a At#/"!ne

Ben*/!a*e"!ne


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!"a&a! "aa 6%ah 0ang t!a& enn6&&an ee& t/&$!&. Ke#a'nan /+at !n! "aa ana&

e#"a&an a$a%ah 0ang $angat $e#!$, "en!%a!an an "enata%a&$anaan $angat "ent!ng

nt& ha$!% 0ang +ag$.

A'eta!n/"hen !$e#a" $e'a#a 'e"at $ete%ah !a&an, engan &aa# "%a$a

"n'a& !'a"a! a%a $etengah $aa"a! $at 6a. O+at !n! !eta+/%!$e ! hat! an -5

!e&$#e$!&an tan"a !+ah e%a%! #!n. 3aa ana& 0ang %e+!h +e$a#, 925 !eta+/%!$e

en6a! +ent& g%'/#/nat an &/n6ga $%at, an 25 e%e;at! $!t// /&$!a$!

$0$te 32:8 (e"#/&$! eta+/%!t #ea&t!). Ket!&a "en0e!"anan g%tat!/n ha"!#

ene&at! 85 n/#a%, eta+/%!' 0ang $angat a&t! +e#!&atan engan he"at!' a'#/

/%e'%$, an en0e+a+&an &e#$a&an hat!.

Se'a#a &%!n!$ a"at !"e%a6a#! en6a! 2 taha"

'ahap *: taha" !n! te6a! -2 6a $ete%ah &e#a'nan te#6a!. Ana& 0ang a ng&!n

ntah, nan 0ang %e+!h ta +!$a a%, ntah, a%a!$e an !a/#e$!$. Rata#ata ge6a%a

te#6a! $ete%ah 7 6a engan 785 "a$!en t!a& ena"a&&an ge6a%a a%a 12 6a. En*!

hat! an ;a&t "#/t#/+!n n/#a%.

'ahap +: "a$!en t!a& ena"a&&an ge6a%a $e%aa -2 6a. En*! hat! +!$a en!ng&at.

'ahap , "aa /=e#/$!$ 0ang $e#!$, "n'a& a#! ge6a%a +!$a te#%!ha a%a 2 $a"a! 97

6a $ete%ah &e#a'nan e#6a!. K/n$ent#a$! Se# a$"a#tae t#an$a!na$e (AST) +!$a

en!g&at h!ngga -8.888 8.888 IU@L. Kaa# 0ang enana&an te%ah te#6a!n0a "#/$e$

he"at/t/&$!& +!%a &aa# t#an$a!na$e e%e+!h! 1.888 IU@L. Keat!an a"at te#6a! "aa

taha" !n! !$e+a+&an &a#ena &egaga%an hat! an "e+e&an a#ah.

'ahap : taha" !n! te#6a! ha#! $ete%ah &e#a'nan. Ke#$a&an hat! $ah e+a!&

"aa "a$!en 0ang +!$a +e#tahan, an +!a$an0a &e#$a&an hat! t!a& e!%!&! $e&e%e.

Ke#a'nan a'eta!n/"hen +!a$an0a t!a& !$e#ta! engan "en#nan &e$aa#an

a%a -2 6a $ete%ah &e#a'nan. 3e#hat!&an &eaaan&eaan !ana "a$!en enga%a!

"ene&anan "aa $0$te $0a#a "$at +!a$an0a !$e+a+&a &a#ena "a$e!n ea&a! +an0a&

/+at. Inte#"#eta$!&an anane$!$ engan $angat hat!hat! &h$$n0a "aa ana&ana&.

B!a$an0a $angat $%!t nt& e+ea&an ana#a /=e#/$!$ 0ang +e#$!at t/&$!& an

n/nt/&$!& "aa anane$!$ 0ang !%a&&an &e"aa "a$!en. 3e#!&$a%ah &aa#

a'eta!n/"hen a#ah "a$!en 0ang !ta&t&an enga%a! a$a%ah /=e#/$!$ 0ang $e#!$.


8/28

Sete%ah !%a&&an "en!%a!an, "e+e#!an &a#+/n a&t! engan a!# +!$a !+e#!&an 2

6a $ete%ah e#6a!n0a &e#a'nan. 3enggnanan /$!$ 0ang +e$a# $e"e# 188g, +!$a

!"e#%&an eng!ngat +an0a&n0a 6%ah a'eta!n/"hen 0ang !a&an. 3aa "#a&te&n0a,

"en0e#a"an &a#+/n a&t! engan "e+e#!an Na'et0%$!$te!n (NAC) +!a$an0a t!a&

!te#a"&an &a#ena ;a&t 0ang !%a%! a%a "e+e#!an &a#+/n a&t! h!ngga "engetahan

engena! &aa# &/n$ent#a$! "%a$a. Se+aga! '/nt/h, "a$!en 0ang !a"at! $eta%ah - 6a

te#6a!n0a /=e#/$!$, +a# +!$a ena"at&an $a"%e a#ahn0a $ete%ah - 6a an ha$!%n0a

a&an a&an &e%a# a%a +e+e#a"a 6a. Se%aa 6a, &a#+/n a&t! a&an en!ngga%&an

$a%#an "en'e#naan.

Sete%ah !&etah! &aa# /+at a%a "%a$a, a$&&an%ah &ea%a Matthe;$

Ra'& n/#/g#a nt& enent&an a"a&ah te#a"at h+ngan anta#a &aa# an

;a&t $eh!ngga en6a! t/&$!&. J!&a &aa#n0a t!a& a"at !tent&an a%a 1- 6a

$ete%ah &e#a'nan, +e#!&an te#a"! a;a% engan NAC $ete%ah +e#&/n$%ta$! engan 3/!$/n

C/nt#/% Cente# ana.

NAC 0ang !"a&a! $e'a#a /#a% te#$e!a engan &/n$ent#a$! -85. Ban0a &at

$e"e#t! +e%e#ang 0ang &e+an0a&an "a$e!n t!a& a ene#!an0a. La#t&an NAC h!ngga

en6a! &/n$ent#a$! :5 (6!&a ana e&a!a %a#tan engan &/n$ent#a$! -85, %a#t&an

engan "e#+an!ngan 1). O+at !n! +!$a !'a"# engan 6$ 6e#& ata !nan

+e#$/a nt& en!ng&at&an #a$an0a. B!$a 6ga !"a&a! 'ang&!# +e#tt" engan %+ang

nt& $e/tan nt& engh!na#! +an0a 0ang en0engat. 4/$!$ a;a% nt& NAC

aa%ah 128 g@KgBB (-88 g +!%a !+e#!&an +e#$aaan engan &e#+/n a&t!) an /$!$

+e#!&tn0a 8 g@KgBB engan 6a#a& 2 6a. La%&&an 6ga &/n$%ta$! engan "$at

"eng&a6!an A'eta!n/"hen na$!/na% engan engh+ng!. 1@88@:-:711:, 0ang +!$a

e%a0an! -2 6a.

3e+e#!an NAC $e'a#a !nt#a=ena te%ah !%a&&an ! E#/"a an Kanaa an

!gna&an 6ga ! Ae#!&a Se#!&at. O+at !n! !+e#!&an a%a t!ga /$!$ te#"!$ah 1:8

g@KgBB a%a 78 en!t, :8 g@KgBB a%a 2 6a, an 188 g@Kg++ a%a 17 6a.

Be#!&an !n$an a;a% $e%aa 78 en!t +&an 1: en!t nt& eng#ang! #e$!&/ 0ang

t!a& !!ng!n&an $e"e#t! &ee#ahan, gata% an +eng&a&. Kentngan "ea&a!an te#a"!

!nt#a=ena &a#ena e#"a&an "#t/t/&/% 0ang $!ng&at, an t!a& aa "enga#h ntah an


9/28

"ea&a!an &a#+/n a&t! a%a en#n&an +!/a=a!%a+!%!ta$ a#! ant!/te !n!, $e#ta 'a#a

"ea&a!an 0ang ah. E!&a$! a#! &ea "#/t/'/% aa%ah $aa.

Sangat%ah "ent!ng nt& e/n!t/# "a#aete# %a+/#at/#! a%a &a$$

&e#a'nan 0ang +e#at. ang !"anta aa%ah 3#/th#/+!n T!e (3T), AST, Se# A%an!n

T#an$a!na$e, B!%!#+!n, E%e&t#/%!t, BUN, an K#eat!n!n. Ke+an0a&an "a$!en (995)

%a! ena"a&&an "e#+a!&an a%a ;a&t $e!ngg. 3a$!en 6ga ee#%&an

/n!t/#!ng 0ang 'e#at an $e+a!&n0a "a$!en !tata%a&$ana&an ! "$at "enangg%angan

"en0a&!t ana& te#$!e#.

A.)H).

!thanol: &e#a'nan ethan/% +!a$an0a te#6a! "aa ana& 0ang $ah +e$a#, nan

a"at 6ga te#6a! "aa +a%!ta. Ke#a'nan !n !tana! engan +a &ha$ "aa %t an

&aa# ethan/% a%a $e#. B!a$an0a &e#a'nan !n! te#6a! &a#ena eng&/n$$! /+at

engan 'a"#an ethan/%. Kaa# ethan/% a%a a#ah 188 g@L enana&an &e#a'nan

te%ah te#6a! an &aa# ethan/% 0ang ene&at! :88 g@L +!$a eat!&an. B!a$an0a,

"enata%a&$anaan +e#$!at $"/#t! an te#a$& "ea&a!an =ent!%at/#. Ana& 0ang &e'!%

e"n0a! &e'ene#ngan 0ang +e$a# nt& te#&ena h!"/g%!&e! a&!+at &e#a'an

ethan/% !n!.

Methanol dan !thylen %lycol: &ea *at engan 6%ah 0ang $angat $e!&!t +!$a

engan'a 6!;a. Kea *at !n! a&an en0e+a+&an "e#+ahan "aa /$/%a# ga" an

an!/n!' ga" $eh!ngga en0e+a+&an eta+/%!' a$!/$!$. at !n! 6ga a&an en0e+a+&an

&e+taan an gaga% g!n6a% a&t. Ha% !n! a"at te#6a! e%a% "#/&$! a#! eta+/%!t 0ang

+e#$!at t/&$!& ! ha%ang! /%eh ethan/%. 3enata%a&$anaann0a e%!"t! "e+e#!an ethan/%

h!ngga &aa# &/n$ent#a$! ethan/% 188 g@KgBB (+a$an0a /$!$ 0ang !"a&a! aa%ah

8.7g@KgBB I $e%aa 8 28 en!t) an he/!a%!$!$.


10/28

an &entang, an /+at/+atan $e"e#t! "ea&a!an ant!h!$ta!n an ant!e"#e$an t#!$!&%!&.

Ke+an0a&an ge6a%a /=e#/$!$ 0ang !$e+a+&an &a#ena /+at/+atan ant!&/%!ne#g!& t!a&

$e%a% ena"a&&an ha$!% $e+aga! $!n#/ ant!&/%!ne#g!& 0ang #n!. Ha% !n!

!&h$$&an nt& ant!e"#e$an t#!$!&%!& 0ang engan'a 6!;a 0ang a"at en0e+a+&an

"ene&anan a&t!=!ta$ 0/'a#! $e'a#a %ang$ng. Te#a"! taa +e#$!at $#"/#t!. 3aa

&a$$ &e#a'nan ant!&/%!ne#g!& 0ang +e#at, "e#t!+ang&an nt& "ea&a!an

"h0$/$t!g!ne. O+at !n! !!n!&a$!&an "aa ag!ta$! 0ang +e#at, ha%$!na$!, ata &e6ang

0ang ta& te#&/nt#/%. Be#!&an 8.: g nt& ana& 0ang a$!h a an 1 - g nt&

ana& +e$a# $e%aa - en!t.

CA#&'IC A%!N'&

at !n! te#a$& "e+e#$!h, ta+%et '%!n!te$t, "e+e#$!h /=en, an ete#gen nt& "en''!

"!#!ng /t/at!$. at !n! +!$a te#te%an /%eh ana&ana&. 3enata%a&$anaan a;a% e%!"t!

"engen'e#an $e'a#a 'e"at engan a!#. Ana&ana& engan %t 0ang te#+a&a# ata engan

#!;a0ata &e#a'an 0ang t!a& 6e%a$ ee#%&an e$/ag/$&/"!, $e+a!&n0a a%a 1- 6a

$eta%ah te#6a!. Sete%ah te#te%an 'a!#an "e+e#$!h, &e#$a&an e$/ag/$ a"at te#6a! tan"a

aan0a &e#$a&an &/$a /#/a#!ng. B!%a$ %a+ng e#"a&an &/nt#a!n!&a$! an

"e+e#!an &a#+/n a&t! t!a& e+e#!&an ha$!% ea$&an.

CLONI4INE

C%/n!!ne e#"a&an /+at ant!h!"e#ten$! 0ang +e&e#6a $e'a#a $ent#a%. O+at !n!

en$t!%a$! #e$e"t/# Pa#ene#g!& ! /ta& 0ang e+at /+at !n! ee&t! nt&

en#n&an te&anan a#ah. O+at !n! +!a$an0a !+e#!&an nt& /#ang e;a$a engan

h!"e#ten$! 0ang /n!&. Se!aan /+at !n! a%a +ent& ta+%et 0ang &e'!% (8.1, 8,-, an 8,

g) e+at /#ang ta $&a# nt& e%!hat /+atn0a an e+at ana& &e'!% ga"ang

nt& ene%an. O+at !n! 6ga te#$e!a a%a +ent& te"e% 0ang a$!h enganng /+at

;a%a"n $ah $e%e$a! !gna&an. Ana&ana& +!$a te#&ena engan engh!$a" /+at

te"e%.

Ge6a%a a#! &e#a'an /+at !n! aa%ah "en#nan te&anan a#ah, "en#nan

&e$aa#an, an ganggan "e#naa$an. Ana&ana& at!ng &e Un!t Ga;at 4a##at engan

#e&en$! naa$, te&anan a#ah, an en0t na! &#ang a#! :85 #e&en$! n/#a% nt&


11/28

&e%/"/& $!a. Ana&ana& engan &e#a'nan '%/n!!ne a%a /$!$ +e$a# a"at atang

engan h!"e#ten$! a%a ;a&t $at 6a ata &#ang. Ka#ena /ta& ne0aa#! te%ah te#6a!

h!"e#ten$!, "$at "engat#an $!"at/%!t!& a&an en/!na$! an "a$!en a&an en6a!

h!"/ten$!. In! !#!" engan 'a#a &e#6a '%/n!!ne. 3enggnaan /+at/+atan ant!h"e#ten$!

t!a& !an6#&an "aa &eaaan !n! &a#ena $!at h!"e#ten$! 0ang $eenta#a.

3enata%a&$anaan +!a$an0a +e#ha$!% an ee&t!. Men$t!%a$! ana& $e'a#a !$!&

nt& ana& engan "en#nan &e$aa#an nt& en!ng&at&an en0t 6antng an

#e&en$! naa$. Be#!&an 6ga /&$!gen. 3/$!&an ana& ! "/$!$! t#ee%en+e#g. 3a$ang%ah

6a%# !nt#a=ena nt& e+e#!&an +/%$ -8 ''@KgBB %a#tan R!nge# La'tat ata %a#tan

!$!/%/g!$. O+at/+atan !n/t#/"!& 6a#ang !+e#!&an nan ee&t!. J!&a #e&en$! naa$

t!a& en!ng&at, %a&&an =ent!%a$! engan +ag=a%=ea$&. Be+e#a"a ana& ee#%&an

!nt+a$! an =ent!%a$! e&an!& $a"a! ee& /+at h!%ang, +!a$an0a a%a ;a&t -2 6a

ata &#ang.

Ka#ena ana&ana& engan &e#a'nan '%/n!!ne &e%!hatan $e"e#t! ana& engan

&e#a'na na#&/t!&, $e"e#t! &#an ""!% 0ang enge'!%, a&a "e+e#!an na%/?/ne +!$a

!%a&&an. 3aa ana&ana& 0ang $ah !&etah! &e#a'nan '%/n!!ne, na%/?/ne 0ang

!+e#!&an han0a $e!&!t &a#ena t!a& +e#gna "aa &a$$&a$$ 0ang #!ngan, t!a& a&an

eng&/#e&$! &a$$ 0ang +e#at nan han0a e#!ngan&an, an t!a& a&an e+ant +!%a

te#6a! h!"/ten$!. Ana& 0ang e!%!&! ge6a%a &e#a'nan !/+$e#=a$! ! #ah $a&!t $e%aa

1- $a"a! 7 6a $eang&an a$a "a#h '%/n!!ne aa%ah 1- 17 6a. Han0a 1 /#ang

ana& 0ang !%a"/#&an en!ngga% &a#ena &e#a'nan '%/n!!ne.

&IANIDA

Ke#a'nan $!an!a a"at te#6a! &a#ena te#"a"a# %e;at &%!t ata te#a&an "e%a#t

"e#a&, %aet#!%e, +e+e#a"a !n$e&t!$!a, +!+!t t+han, an &/$et!& 0ang enganng

a'et/n!t#!%e. 3a#"a# te#&ena +!a$an0a "aa &e+a&a#an #ah (ga$ $!an!a te#%e"a$ a#!

+ena+ena $!ntet!& 0ang te#+a&a#)Q ;a$"aa! "aa &/#+an&/#+an 0ang te#h!$a" a$a"

&e+a&a#an. Keat!an a"at te#6a! a%a 11: en!t. K/#+an&/#+an 0ang a"at +e#tahan

h!ngga $a"a! ! n!t ga;at a##at, ena"a&&an ge6a%a &e6ang, $0/& ata &/a.

Kee#ahan +!a$an0a en6a! tana 0ang n!&. Jangan "e#nah e%a&&an #e$$!ta$! a#!

%t &e %t &a#ena "en/%/ng 6ga +!$a &e#a'nan. Tata%a&$ana 0ang 'e"at !%a&&an


12/28

engan e+e#!&an /&$!gen 1885, a!% n!t#!t, nat#! n!t#at an &e!an t!/$%at

('!an0e ant!/te &!t) !+th&an nt& "a$!en. Saa#!%ah +ah;a $e!aan nat#! n!t#at

!a%a &!t e#"a&an /$!$ nt& e;a$a an +!%a !+e#!&an "aa ana&ana&, 1885

a&an en0e+a+&an ethe/g%/+!ne!a an &eat!an. 4/$!$ nat#! n!t#at nt& ana&

ana& aa%ah 18 g@&gBB, ata 8, % %a#tan nat#! n!t#at 5 @&gBB.

ANTI4E3RESAN SIKLIK

Me&an!$e a#! &e#a'nan ant!e"#e$an $!&%!& te#a$& "ene&anan !/&a#!a% $e'a#a

%ang$ng "engha+atan "enga+!%an n/#e"!ne#!n an a&t!=!ta$ ant!&/%!ne#g!&.

Ke#a'nan a"at en0e+a+&an ganggan $!$te $a#a "$at an ganggan

&a#!/=a$&%e# 0ang engan'a 6!;a. Ge6a%a 0ang !te&an aa%ah e%!#!, &/a,

&e6ang, h!"/ten$! an !$#!t!a. Inte#=a% RS 188 $e', e#"a&an #e$!&/ t!ngg! nt&

te#6a! !$#!t!a.

Tangan! h!"/ten$! engan 'a!#an !$ta%/!. J!&a t!a& +e#ha$!%, +e#!&an

=a$/"#e$/#. O+at "!%!han "e#taa nt& !$#!t!a aa%ah nat#! +!&a#+/nat, an !nte#=a%

RS 0ang %e+a# enana&an +!&a#+/nat $ah +!$a !"a&a!. H!"e#=ent!%a$! +!$a

en/%/ng, nan "h0$/$t!g!n t!a& +e#"enga#h.

3a$!en engan ge6a%a 0ang 6e%a$ ee#%&an t!na&an 0ang !nten$! nan

/n!t/#!ng "a$!en 0ang t!a& ena"a&&an ge6a%a 0ang 6e%a$ t!a& !"e#%&an. Unt&

"a$!en engan &eaaan &e$aa#an 0ang n/#a%, =!ta% $!gn an EKG n/#a% !"anta

$et!a" 7 6a. A"a+!%a n/#a%, +!$a !%an6t&an engan "eantaan $et!a" 1- 6a.

HI4ROKARBON

H!#/&a#+/n !te&an "aa "e%a#t, !n0a&, an e#"a&an *at ta+ahan "aa

"e+e#$!h #ah tangga. at !n! +e#$!at #a'n &a#ena e!%!&! te&anan "e#&aan 0ang

&e'!% an te&anan a", 0ang e+atn0a +!$a te#$e+a# ! a#ea 0ang %a$, '/nt/hn0a "aa

"a# 0ang en0e+a+&an "ne/n!t!$ &!!a. 3a$!en engan &e#a'nan h!#/&a#+/n +!$a

te#'e&!&, +at&, an +!$a ntah $ete%ah te#&ena. A$"!#a$! a#! *at !n! a"at en0e+a+&an

"ne/n!t!$ a$"!#a$!. Te%ah !"e#'a0a +ah;a a$"!#a$! a#! *at !n! &e "a#"a#, eng!&t!

ntah 0ang +e#h+ngan engan &e#a'nan $e+aga! tana &e#a'nan "a#"a#. Te%ah

!"e#%!hat 6ga +ah;a aan0a *at !n! ! h!"/a#!ng a"at en0e+a+&an "ne/n!t!$ &!!a


13/28

&a#ena *at !n! %e&at ! $a%#an naa$. Se%a!n tean ge6a%a "a#, +!$a 6ga te#%!hat ge6a%a

ganggan $!$te $a#a "$at 0ang e#"a&an a&!+at $e&ne# a#! "en0e#a"an

h!#/&a#+/n $e'a#a $!$te!&. Hat!, g!n6a%, /t/t 6antng +!$a $a6a te#&ena nan 6a#ang.

J%ah h!#/&a#+/n 0ang e#a'n! ana&ana& +!a$an0a $%!t !n!%a! $e'a#a

&ant!ta$. K#ang a#! 1 % *at $e"e#t! !ne#a% $ea% /!%, 0ang a"a+!%a %ang$ng te#h!$a"

&eaa%a t#a&ea a"at en0e+a+&an "ne/n!t!$ 0ang +e#at +ah&an &eat!an. Sen0a;a

0ang %a!n $%!t nt& !a$"!#a$! an t!a& +ag$ "en0e#a"ann0a ! t#a&t$ ga$t#/!nte$t!na%.

Se'a#a , $en0a;a $e"e#t! a$"a% ata ta#, /%! ($e"e#t! /%! /t/#, !n0a& #ah

tangga), an !n0a& !ne#a% t!a& en!+%&an &e#a'nan +!%a te#te%an.

R/ntgen t/#a&$ !!n!&a$!&an "aa "a$!en engan ge6a%a ganggan "e#naa$an.

Ana&ana& 0ang t!a& ena"a&&an ge6a%a an "ee#!&$aan !$!& 0ang n/#a%

$e+a!&n0a !/+$e#=a$! $e%aa 27 6a ! IG4. B!%a teta" n/#a%, "a$!en +!$a

!"%ang&an engan 'atatan ha#$ !+a;a &e+a%! 6!&a ea, naa$ 'e"at an +at&.

3aa a$a#n0a, "enanganan nt& "ne/n!t!$ 0ang !$e+a+&an h!#/&a#+/n

+e#$!at $"/#t!. Ant!+!/t!' $e+a!&n0a t!a& !gna&an $e+aga! "#/!%a&t!&. 3enggnaan

&/#t!&/$te#/! $e+aga! "enanganan a#! a$"!#a$! h!#/&a#+/n !h+ng&an engan

en!ng&atn0a ang&a /#+!!ta$ an !n! t!a& !#e&/ena$!&an.

3e+e#!an &a#+/n a&t! t!a& !!n!&a$!&an &e'a%! +!%a te#te%an $en0a;a$en0a;a

0ang !ta&t&an +!$a n0e+a+&an te#6a!n0a &e#a'nan $!te!&, '/nt/hn0a "aa

&e#a'nan "e$t!$!a. Sen0a;a h!#/&a#+/n 0ang %a!n $e"e#t! +en$!n, !n0a& tanah,

!n0a& %a", an !n0a& !ne#a% +!a$an0a t!a& en0e+a+&an ge6a%a $!$te!& $ete%ah

te#te%an.

BESI

4/$!$ %eta% a#! +e$! aa%ah -88-:8 g@&gBB, ;a%a"n ge6a%a $a%#an "en'e#naan +!$a

!%!hat "aa "e+e#!an /$!$ 1:8 g@&gBB. Ket!&a engh!tng /$!$ +e$! 0ang

te#te%an, !ngat%ah +ah;a e%een +e$! "e# n!t /$!$ han0a +ag!an a#! t/ta% +e#at ta+%et.


14/28

6%ah 0ang +an0a& ena"a&&an ge6a%a ga$t#/!nte$t!na% a%a ;a&t 7 6a $ete%ah

te#te%an.

Unt& "a$!en &e#a'nan +e$!, "at/!$!/%/g! an ge6a%a &%!n!$ a"at !+ag! a%a 2

taha"

1. Taha" ga$t#/!nte$t!na% tana "e#taa a#! &e#a'nan +e$! aa%ah ge6a%a

ga$t#/!nte$t!na%. Ge6a%an0a te#a$& ntah, !a#e a%a ;a&t 'e"at, &/%!&

a+/en, an "e#a#ahan ga$t#/!nte$t!na%. Be$! enghan'#&an &/$a $a%#an

'e#na $e'a#a %ang$ng. Ke#$a&an !n! a"at en6a! "a#ah an a"at

en0e+a+&an &eh!%angan a#ah 0ang +an0a& $e#ta "e#a#ahan. Ke#$a&an

ga$t#/!nte$t!na% +!$a +e#"e#an a%a enga&!+at&an h!"/=/%e!& $!$te!&.

-. Re%at!=e $ta+!%!t0 $tage ge6a%a $a%#an 'e#na +!$a e+a!& $e+e% n'%n0a

$0/&. 4a%a +e+e#a"a &eaaan aa taha" !ana te#6a! $ta+!%!ta$ 0ang #e%at!=e.

Keaan !n! t!a& a&an %aa an "a$!en t!a&%ah a%a &eaaan n/#a%. 3en!%a!an

0ang hat!hat! +!$a e+&t!&an te#6a!n0a "en#nan "e#$! an a$!/$!$.

. Sh/'& $tage taha" &et!ga !n! !tana! engan &egaga%an $!#&%a$!, te#6a!n0a

$0/& an a$!/$!$ an e#"a&an $e+a+ &eat!an 0ang taa "aa &eat!an +e$!.

S0/& te#6a! &a#ena +an0a& a't/# te#a$& h!"/=/%e!&, &egaga%an !$t#!+$! an

"ene&anan &e#6a /t/t 6antng. Se+a+ taa te#6a!n0a a$!/$!$ aa%ah &a#ena

h!#a$! a#! +e$! 0ang +e+a$ a%a $!#&%a$! engan a$!/$!$ %a&tat. 4an $e'a#a

$e&ne# !$e+a+&an &a#ena a't/# &/nt#!+$!. 3ea&a!an nat#! +!&a#+/nat

a%a 6%ah 0ang +an0a& +!a$an0a !"e#%&an.

2. He"at/t/?!'!t0 $tage he"at/t/&$!& te#6a! "aa 2 6a "e#taa an

&en'%ann0a +e#h+ngan engan t!ng&at &e"a#ahan. In! e#"a&an $e+a+

&ea 0ang enga&!+at&an &eat!an.

Ja#!ngan "a#t "aa $a%#an 'e#na e#"a&an an!e$ta$! %a+at "aa &e#a'nan +e$!,

te#6a! -7 !ngg $ete%ah "ene%anan, enga&!+at&an /+$t#&$! %a+ng nanhan0a

$e+ag!an &e'!% a#! $$ &e'!% 0ang te#"enga#h!.

TATALAKSANA KERACUNAN BESI


15/28

J%ah a#! +e$! 0ang te#te%an +!a$an0a $&a# nt& !n!%a! an &aa# &eaanan !n!a%

+e% !teta"&an. Kaa# $e# +e$! +!a$an0a +e#h+ngan engan te#6a!n0a ge6a%a.

B!a$an0a &aa# +e$! !+a;ah 88 g@% $ete%ah -7 6a "ene%anan !"#e!&$! t!a& te#6a!

ge6a%a. 3a$!en engan &aa# +e$! 88:88 g@% +!a$an0a enn6&&an ge6a%a "aa a$e

$at 0ang #!ngan, nan +!$a en6a! ge6a%a 0ang $e#!$. Kaa# :88 g@% enn6&&an

a't/# 0ang $!gn!!&an nt& ge6a%a a$e . Baga!ana"n &aa# +e$! $e# t!a& $e%a%

te#$e!a "aa $tatD +a$!$.

3en!%a!an &%!n!$ !"a&an engan /t/ a+/en an &aa# +e$! $e# e#"a&an

"enanganan 0ang taa "aa "a$!en &e#a'nan +e$!. (%!hat ta+%e 92). Ra!g#a! +!a$an0a

!gna&an nt& eng&/n!#a$! "ene%anan ata en!agn/$!$ a$$a "aat. R/ntgen

negat!=e "aa "a$!en tan"a ge6a%a t!a& te#a$& "aa "ene%anan 0ang +an0a&.

3en6e%a$an nt& #/ngen 0ang negat!=e aaa%ah (1) +e$! t!a& te#te%an, (-) +e$! 0ang

te#te%an te%ah !a+$/#+$!, () +e$! 'a!# 0ang te#te%an, an (2) ene%an %t!=!ta!n

"e!at#!& !ta+ah *at +e$! engan 6%ah +e$! 0ang $angat $e!&!t a%a t!a" ta+%et.

ang te#a&h!# +e#h+ngan engan ge6a%a 0ang #!ngan.

I"e'a' an "e+!%a$an %a+ng t!a& +e#gna. Be$! t!a& !a+$/#+$! &e /%eh

&a#+/n a&t! . I#!ga$! $$ $e%#hn0a e#"a&an te&n!& "!%!han an ga$t#/t/! $eha#$n0a

!%a&&an "aa /=e#/$!$ 0ang a$!. Net#a%!$a$! !nt#aga$t!& engan +!&a#+/nat, /$at,

ata ee#/?a!ne $eha#$n0a !h!na#! &a#ena t!a& ee&t! an +e#+aha0a

3a$!en 0ang atang engan ge6a%a a;a% &e#a'nan +e$! 0ang +e#at, $e"e#t! ntah,

!a#e, "e#a#ahan ga$t#/!nte$t!na%, "en#nan &e$aa#an, ata ganggan $!#&%a$!

ee#%&an te#a"! 0ang 'e"at an !nten$! ! n!t ga;at a##at. 3#!/#!ta$ taa aa%ah

ena"at&an a&$e$ =ena. 4a#ah ha#$ !a+!% nt& "ee#!&$aan h!tng $e% a#ah

%eng&a", g%&/$a a#ah, e%e&t#/%!t, BUN, te$ ng$! hat!, +e$! $e#, an '#/$$at'h.

3a$!en 0ang $0/& ha#$ !+e#! %a#tan n/#a% $a%!ne ata #!nge# %a&tat an t#an$! a#ah

+!%a aa !n!&a$!. 3a$!en +!$a $angat a$!$/$!$ an ee#%&an nat#! +!&a#+/nat a%a

6%ah 0ang +an0a&. Te#a"! &e%a$! &h$$ engan ee#/?a!ne !nt#a=ena $e+a!&n0a

!%a&&an $e'e"at ng&!n "aa "a$!en"a$!en engan &e#a'nan 0ang "a#ah.

Se+a%!&n0a, "a$t!&an e?"an$! a#! #ang !nt#a=a$'%a# $e+aga! "a$!en engan "en#nan

'a!#an &a#ena ee#/?a!ne e!%!&! #!$!&/ 0ang t!ngg! nt& gaga% g!n6a% a&t.


16/28

Te#a"! &e%a$! enggna&an ee#/?a!ne en!g&at&an e&$e$! a#! +e$!.

In!&a$! a#! te#a"! &e%a$! aa%ah +!%a te#a"at an!e$ta$! &%!n!$ an &aa# +e$! $e#

%e+!h a#! 288 g@%. 4/$!$ a#! ee#/?a!n aa%ah 1: g@KgBB@6a $a"a! !n!

"e+e#!an 7 g#@ha#!. Te#a"! +e#ha$!% +!%a ge6a%a h!%ang, "e#+a!&an a#! a$!/$!$ an +!%a

t/ta% /$!$ te%ah !+e#!&an.

3#/+%e 0ang +!a$a !te&an aa%ah h!"/ten$!, eta+/%!' a$!/$!$, h!"/ ata

h!"e#g%!&e!a, ane!a an &eh!%angan &/%/! &a#ena "e#a#ahan $a%#an 'e#na, gaga%

g!n6a% &a#ena $h/'&, an gaga% hat! 0ang !h+ng&an engan "e#a#ahan. 3e#hat!an

te#haa" "enge%a#an #!n nt& en'egah te#6a!n0a gaga% g!n6a% an nt& e%!hat

e&$e$! a#! &/"%e&$ +e$! ee#/?a!ne.

O3IOI4

3a$!en"a$!en engan "en#nan $tat$ enta% 0ang !$e+a+&an &a#ena $e+a+ 0ang t!a&

6e%a$ $e+a!&n0a !+e#!&an +/%$ !nt#a =ena na%/?/n (8,1 g@&gBB ata 12 g). t#!a$

&%a$!& a#! /=e#/$!$ /"!/! aa%ah "en#nan &e$aa#an, "ene&anan "$at naa$ an

""!% "!n"/!nt. J!&a !"e#%&an, na%/?/n +!$a !%an6t&an engan e+e#!&an !n$e

!nt#a=ena. 4!"hen/?0%ate, "#/"/?0"hene, an &e#a'na etha/ne +!$a ee#%&an

n/%/?/ne engan /$!$ 0ang +e$a# an te#a"! 0ang %aa.

ORGANO


17/28

0ang ea$&an. Ke#a'nan !n$e&t!$!a /#gan//$at, "e+e#!an &/%!ne$te#a$e

#egene#at/# $e"e#t! -3AN ("#/t/"a) +!$a !"e#%&an nt& en6aga ha$!% 0ang

ea$&an. Nan /+at !n! t!a& !#e&/ena$!&an nt& &e#a'nan !n$e&t!$!a

&a#+aat.

SALISILAT

Ge6a%a an tana a#! &e#a'nan $a%!$!%at aa%ah a%, ntah, h!"e#=ent!%a$!, ea

t!ngg!, t!n!t$, /%!g#!a, !$/#!enta$!, &/a, &e6ang an h!"e#g%!&e!a (h!"/g%!&e!a "aa

ana&ana&). Ge6a%a 0ang 6a#ang $e"e#t! e"#e$! "e#naa$an, e "%/na%, a&t t+%a#

ne/$!$, he"at/t/&$!$!ta$, an $!n#/ / !na"#/"!ate $e'#et!/n / ant!!#et!' h/#/ne

(SIA4H). 3aa &e#a'nan a&t, &aa# $a%!$!%at enn6&&an "#/gn/$!$ nan t!a&

+e#gna nt& &e#a'nan $a%!$!%at /n!&. The /ne n/#/g#a (ga+a# 9-) !gna&an

nt& en!%a! $e6ah ana &e"a#ahan. Un0a "ene%anan 1:8 g@&gBB aa%ah

#!nganQ 1:888 g@&gBB aa%ah $eangQ 88:88 g@&gBB $e#!$, an :88 g@&gBB

+e#at.

Tata%a&$ana te#a$& a%a "#!n$!" "enata%a&$anaan &e#a'nan $e'a#a .

M/n!t/# nat#! $e'a#a hat!hat! !n! +!a$an0a t#n. Unt& &e#a'nan 0ang $eang

$a"a! +e#at 6a%# !nt#a=ena $e+a!&n0a !"a$ang, &e!an !%an6t&an engan "e+e#!an

e?t#/$e :5 !a%a a!# engan :8 e> nat#! +!&a#+/nat "e# %!te# !+e#!&an 181:

%@&gBB $e%aa 1- 6a. T6an a#! a%&a%!n!$a$! aa%ah nt& en6aga "H #!n !ata$ ,

$e+a%!&n0a ha% !n! t!a& a&an a"at te#6a! tan"a "e+e#!an nat#! 0ang ag#e$!. Ana%!$a

ga$ a#ah a"at !gna&an nt& enent&an e#a6at a$!/$!$. B!%a "H ,1: +e#!&an 1-

e>@&gBB +!&a#+/nat $e%aa 1- 6a. H!na#! "ea&a!an +!&a#+/nat $e'a#a 'e"at &a#ena

a"at en0e+a+&an a$!/$!$ $0$te $a#a "$at 0ang #e%at!=e an &e6ang. 3aa &a$$

0ang +e#at, a$!/$!$ 0ang "e#$!$ten ee#%&an 1- e>@&gBB $et!a" - 6a.

He/!a%!$!$ ata he/"e#$! +!$a !"e#%&an "aa a$!/$!$ 0ang t!a& #e$"/n$!=e

("H,1), gaga% g!n6a%, &e6ang 0ang #e$!$ten engan "e+e#!an 'a%'! g%&/na$ an ant!

&e6ang ata "en0a&!t 0ang +e#ta+ah "a#ah $ete%ah !'/+a engan te#a"! $tana#.

4IS3OSITION


18/28

Sete%ah !/+$e#=a$! $e%aa 27 6a, +e+e#a"a "a$!en 0ang te%ah ene%an *at*at +e#a'n,

+a!& !t tan"a ge6a%a ata engan ge6a%a +!$a !"%ang&an engan !n$t#&$! &e+a%! +!%a

!"e#%&an. Ka#ena &e#a'nan +e#%ang te#6a! "aa 18:85 ana&ana&, "a$!en 0ang

!"%ang&an +e$e#ta &e%a#gan0a $e+a!&n0a !+e#!&an !n$t#&$! tentang te&n!& nt&

en'egah &e#a'nan. Ana&ana& 0ang ene%an 6%ah #a'n 0ang +an0a& ata

!ta&t&an te#6a! !nt/&$!&a$! /%eh *at*at 0ang e!%!&! ee& %a+at ee#%&an

"e#a;atan ! #ah $a&!t. Ke#a'nan 0ang $"e$!!& an e#a6at "en#nan !$!/%/g!

enent&an +ah;a !"e#%&ann0a "enanganan "e!at#!' !nten$!=e 'a#e n!t. Sea

"a$!en engan /=e# /$!$ $e+a!&nn0a ena"at&an "en!%a!an a#! "$!&!at#!.

TER3A3AR AT KIMIA BERBAHAA

Te#"a"a# *at &!!a 0ang +e#+aha0a te#a$& &/nta& %ang$ng engan &%!t ata ata

ata te#h!$a" ga$ga$ +e#a'n. Re$!&/ 6!&a +e#&/nta& engan &%!t +!a$an0a te#6a! &a#ena

a$a ata a%&a%! 0ang ga"ang te#+a&a# 6!&a te#6a! &/nta& %ang$ng. Se+a%!&n0a,

&e#a'nan $!$te!& ng&!n te#6a! "aa $!ta$! 0ang e%!+at&an *at*at 0ang +e#$!at

%!"/!%!&.

3A3ARAN TERHA4A3 KULIT 4AN MATA

3en!%a!an te#!#! a#! !n$"e&$! $e'a#a %ang$ng te#haa" +ag!an t+h 0ang te#&ena +ahan

"e+a&a# an &/#/$!. La&&an !#!ga$! "aa a#ea 0ang te#"a"a# engan a!# ata n/#a%

$a%!ne. L&a +a&a# &a#ena &!!a !tangan! $e+aga! %&a +a&a# &a#ena "ana$.


19/28

Inha%a$! a$a" e#"a&an "en0e+a+ &eat!an $ete%ah %&a +a&a#. 3a"a#an te#haa" *at

0ang +e#a'n "aa at/$e# +!$a $e'a#a %ang$ng en'ee#a! a%at "e#naa$an ata $e'a#a

t!a& %ang$ng engha$!%&an !nt/&$!&a$! $!$te!&. 3en0a&!t te#6a! te#gantng &e"aa

$+e#, !nten$!ta$, an #a$! "a"a#an. B!a$an0a agen 0ang en0e+a+&an %a! a#!

$en0a;a tngga%, h!ngga *at &!!a 0ang !&ena% %a$ $e"e#t! h0#/gen $!an!a 0ang

en0e+a+&an t/&$!$!ta$ $!$te!& 0ang "a#ah +!%a te#h!#", 0ang te#!#! a#! &/"%e&

/#gan!' an &!!a an/#gan!&, ga$ga$ 0ang e+at at/$e# en6a! "ana$ an ga$ga$

0ang !"#/&$! a#! "e+a&a#an t!a& $e"#na.

3ATO


20/28

Ka#+/n /n/&$!a e#"a&an a$!&$!a 0ang "a%!ng +an0a&. Ga$ !n! t!a&

+e#;a#na, t!a& +e#+a, an a!n!ta$n0a engan he/g%/+!n -:8 &a%! !+an!ng&an

/&$!gen. Be#!&atnn0a CO engan he/g%/+!n eng#ang! &a"a$!ta$ ang&t /&$!gen /%eh

he/g%/+!n &a#ena he/g%/+!n en6a! &a#+/&$!he/g%/+!n (H+CO) an engge$e#

&#=a /&$!he/g%/+!n &e &!#!. Ta+ahan aa +&t! 0ang en0ata&an +ah;a CO

e"enga#h! eta+/%!$e /&$!gen $e%%e#. O&$!gen 0ang te#%a#t t!a& !"enga#h! /%eh

CO $eh!ngga 3aO- +!$a te#&# n/#a% engan /&$!et#! ;a%a"n "aa $aat !t $at#a$!

/&$!gen +e#&#ang.

K/n$ent#a$! CO $a"a! :5 "aa a#ah =ena !te&an "aa !n!=! n/#a%.

K/n$ent#a$! -85 $e#!ng&a%! en!+%&an ge6a%a ne#/%/g!$ 0ang $!gn!!&an, teta"! "aa

%e=e% tngga% ng&!n t!a& +e#h+ngan an!e$ta$! &%!n!$. K/n$ent#a$! 785 $e#!ng&a%!

+e#h+ngan enagn &eat!an ata /#+!!ta$ ne#/%/g!$. 3aa $e+ag!an "a$!en, &aa#

H+CO &#ang "ent!ng "aa "enata%a&$anaan a#!"aa #!;a0at "a"a#an an &/n!$!

"a$!en.

Ta+ahan "aa a"! ! #ah tangga, ana&ana& te#"a"a# "aa +e+e#a"a $+e#

CO, te#a$& /+!% 0ang t!a& !"e#+a!&! an "e#a%atan "eana$ #ah tangga 0ang

a%ng$!. 3aa &a$$ 0ang 6a#ang, ana&anaa& te#"a"a# a$!&$!an 0ang %a!n, $e"e#t! HCN

ata H-S "aa #ang te#tt" ata &et!&a +e#a!n ! a#ea !n$t#!.

/ahan partikel

Bahan "a#t!&e% te#taa te#!#! a#! &a#+/n. 3a#t!&e% +e$a# (:g) !$!"an a%a t#a&ea

an +#/n&$, an 0ang +e#&#an 1 en'a"a! a%=e/%! "a#. Wa%a"n &a#+/n $e'a#a

!$!/%/g! !ne#t an +!$a !%!"t! /%eh +ahan &!!a 0ang +e#$!at t/&$!& 0ang e#"a&an

"#/& a#! "e+a&a#an $e"e#t! a'#/%e!n, h!#/'%/#!e a'! ata a#/at!' h!#/ 'a#+/n.

Inha%a$! a#! e+ &a#+/n te%ah !+&t!&an a"at en0e+a+&an h!"e##ea&t!=!ta$ 6a%an

naa$.

Iritan Paru

I#!tan "a# te#a$& g#" hete#/gen $e"e#t! a!n/n!a, $%# /&$!a, n!t#/gen /&$!a,

a$a ha%/gen (HC%), ga$ &%/#!n, a%eh! (a'#/%e!n), &et/n, an 3h/$gene. Bahan+ahan

&!!a !n! +e#+ent& ga$ ata"n +e#!&atan engan "e#&aan "a#t!&e% &e'!% an a"at

enga&!+at&an eea "a# an &e#$a&an &/$a.


21/28

MANI


22/28

0ang %a!n an $e%an6tn0a 6angan te#gantng "aa "ee#!&$aan !n!. Ja! ana%!$a ga$ a#ah

+e#gna nt& enete&$! h!"/&$e!a, !$e+a+&an &a#ena 'ee#a "a# an a$!/$!$

eta+/%!& 0ang !$e+a+&an &a#ena !nt/&$!&a$! CO 0ang "a#ah nan t!a& $e%a% en!%a!

&aa# CO. 3aa $h &aa#, ;a&t "a#h H+CO &!#a&!#aa 2 6a. Wa&t "a#h !n! a"at

+e#&#ang en6a! 78 en!t +!%a ana& ena"at&an

;a%a"n &aa# H+CO #enah &et!&a !+a;a &e UG4. Kaa# H+CO 0ang n/#a% &et!&a

!+a;a &e UG4 0ang t!a& en'e#!n&an &e#a'nan CO, nan 6!&a #!;a0atn0a 6e%a$,

ha% !n! teta" !angga" t!a& n/#a%. R/ntgen t/#a&$ $angat "ent!ng a%a "e+e%a6a#an

&$$n0a "aa "a$e!n engan #!;a0at te#"a"a# a"!. B!a$an0a n/#a% "aa a;a%n0a,

nan &aang&aang te#a"at +!nt!&+!nt!& +!%ate#a% an a#ea +%at +e#+ata$ tega$ 0ang

/"a&. 3ee#!&$aan %a+/#at/#! 0ang %a!n +!$a !"a&a! te#a$& h!tng CBC, #!na%!$!$,

e%e&t#/%!t, BUN, et!n!n an te$ ng$! hat!.

3ENATALAKSANAAN

3enanganan ana& engan 'ee#a !nha%a$! $e$a! engan #tan t!na&an ee#gen$!,

a!#;a0, +#eath!ng, '!#'%at!/n. Be#!&an 1885 /&$!gen an %a&&an "enga;a$an 0ang &etat

"aa 6a%an naa$, ana&ana& engan #e$!&/ 'ee#a "ana$ "aa $a%#an naa$ +ag!an ata$

(%&a +a&a# "aa ;a6ah, %t an a#!ng, $a#a $e#a&, $t#!/#) ee#%&an +#/n&/$&/"!

$ege#a nt& enge=a%a$! &eng&!nan te#6a!n0a /+$t#&$! $a%#an naa$ 0ang

engan'a 6!;a. Tentn0a, &et!&a tana /+$t#&$! 6a%an naa$ $ah "a#ah ata &et!&a

e 6a%an naa$ te#6a! $e'a#a %a+at, !nt+a$! $ege#a !"e#%&an an a"at en'egah

te#6a!n0a &eh!%angan "aten$! 6a%an naa$ 0ang +e$a#. EKG $e+a!&n0a !%a&&an nt&

enete&$! te#6a!n0a !$&e!& !/&a# ata !na#&. 4!agn/$t!' an a%g/#!taa%g/#!ta

"enata%a&$anaan +!$a !%!hat "aa ga+a# 9 an 92.

O&$!gen e#"a&an te#a"! a;a% 0ang !+e#!&an "aa &e#a'nan !nha%a$!. Se"e#t!

0ang !n0ata&an $e+e%n0a, /&$!gen eng#ang! a$$a "a# H+CO an e"e#'e"at

"en#nan &aa#n0a. O&$!gen !+e#!&an 1885 $a"a! &aa# H+CO :5, an "a$!en

te%ah e!%!&! ng$! ne#/%/g!' 0ang n/#a%. Aa +&t! 0ang en0ata&an +ah;a

6a#!ngan 0ang te#+a&a# /%eh CO a"at +e#!&atan engan $!$te $!t// $e%%a# ;a%a"n

&/n$ent#a$! H+CO ! a%a a#ah te%ah en'a"a! n/#a% an "e+e#!an /&$!gen 1885


23/28

"aa &/n!$! 0ang h!"e#+a#!& (- at) +!$a e"e#'e"at e&/nta!na$! 6a#!ngan. Ja!

&et!&a aa #!;a0at te#"a"a# engan CO, ana& engan !$ng$! ne#/%/g!' 0ang atang &e

UG4 $e+a!&n0a !#6& &e a$!%!ta$ h!"e#+a#!& ;a%a"n &aa# H+CO a#ah te%ah

&e+a%! &e n/#a%. Ket!&a enn6&&an !$ng$! ne#/%/g!& eneta" "aa $aat

&e+a&a#an, aa &eng&!nan 0ang &at +ah;a !nt/&$!&a$! CO te%ah te#6a! (ng&!n

te#6a! +e#$aa h!"/&$e!a). 3aa &/nte&$ !n!, #6&an $ege#a &e a$!%!ta$ h!"e#+a#!& a#!

te"at &e+a&a#an $angat%ah $e$a! $e+e% "enentan &aa# H+CO. Aa +&t! 0ang

enn6&&an +ah;a "ea&a!an /&$!gen h!"e#+a#!& $e'a#a 'e"at a"at en0e%aat&an

n0a;a an eng#ang! &eng&!nan nt& te#6a!n0a 'ee#a ne#/%/g!' 0ang +e#at.

Sangat%ah "ent!ng nt& e#6& $ea ana& nt& ena"at&an te#a"! h!"e#+a#!& +!%a

&aa# H+CO te#&# -:5 "aa $aat te#"a"a#, ;a%a"n +e% aa ganggan ne#/%/g!.

Wan!ta ha!% 6ga !#6&.

Ke"t$an nt& e#6& &e a$!%!ta$ h!"e#+a#!& a"at +e#gantng "aa

te#$e!an0a a$!%!ta$ !n!. 4! +e+e#a"a te"at &aa# h!"e#+a#!& te#$e!a an a" nt&

!%a&&ann0a '#!t!'a% 'a#e a%a &/n!$! h!"e#+a#!&. 3e+e#!an =ent!%a$! an "engaatan

he/!na!& t!a& en'egah te#a"! h!"e#+a#!&. Set!a" UG4 $e+a!&n0a engaa&an

&e#6a $aa engan "$at h!"e#+a#!& #eg!/na% ata %/&a%. 3a$!en 0ang '#!ga te#"a"a# HCN

!tangan! $e"e#t! 0ang !n0ata&an a%a &e#a'nan $!an!a "aa +ag!an 0ang %a%.

Tata%a&$ana nt& H-S aa%ah $aa &e'a%! "ea&a!an t!/$%at 0ang t!a& !+th&an.

Tata%a&$ana a#! $e&e%e 'ee#a !nha%a$! 0ang %a!n eng!&t! "#!n$!" $tana#

tata%a&$ana ga;at a##at. Gaga% naa$ !tangan! engan "e+e#!an =ent!%a$!,

e+e#!&an "/$!t!=e en e?"!#at/#0 "#e$$#e (3EE3) . +#/n&/!%at/# +!$a +e#gna,

nan "e+e#!an ant!+!/t!' an &/#t!&/$te#/! $e'a#a e"!#!$ t!a& +e#gna. Tata%a&$ana

a#! 'ee#a &a#ena a"! !+aha$ $e'a#a eta!% "aa +a+ , %&a +a&a# t#aa "ana$ an

%!$t#!&.

C0%I%I'AN H!1AN /!"/I&A

T6an

1. Meng!nent!!&a$! ge6a%a a;a% a#! g!g!tan %a# "!t =!"e#.

-. Me+e#!&an "enanganan $"/#t! a;a% a#! g!g!tan "!t =!"e#

. Mene$!"$!&an "enggnaan ant!=en!n 0ang $e$a! nt& g!g!tan "!t =!"e#


24/28

2. Mene$!"$!&an g!g!tan '/#a% $na&e an %a+a%a+a +%a'& ;!/; an +aga!ana

enge=a%a$!n0a.

PI' 2IP!" 3Crotalidae4

G!g!tan "!t =!"e# $angat%ah 6a#ang nan e#"a&an $e+a+ 0ang "ent!ng nt&

/#+!!ta$ an /#ta%!ta$ ! US. Ket!&a &e"a#ahan g!g!tan +e#=a#!a$! $e$a! engan

$"e$!e$, 0ang te#a$& g/%/ngan !n! !te&an ! Ae#!&a Uta#a 0ang a"at

en0e+a+&an &e#$a&an 0ang "a#ahh an ee#%&an "enanganan. ang te#a$&

g/%/ngan !n! aa%ah #att%e $na&e, ;ate# /''a$!n$ an '/""e# hea$.

Patofisologi

Ra'n "!t =!"e# a"at +e#=a#!a$! a%a 6%ah 0ang #e%at!, te#a$& en*! !/ne/t!&,

ne#/t/&$!n, he/t/&$!n an ne#/t/&$!n. Ka#ena =a#!a$! !n!, ge6a%a &%!n!$n0a 6ga

+e#=a#!a$!. Se%aa te#6a!n0a "#/$e$ en=en/a$!, #a'n a&an en0e+a+&an &e+/'/#an

&a"!%e# an ne/$!$ 6a#!ngan %/'a%.

Sete%ah en=en/a$! 0ang "a#ah, "e%e"a$an $en0a;a =a$/!%ata$!, h!"/=/%e!a

0ang !$e+a+&an &a#ena en/te% &a"!%e# 0ang +/'/#, an "e#a#ahan a"at +e#&/nt#!+$!

nt& te#6a!n0a $0/& $!#&%a$! $e'a#a 'e"at.

Penilaian

Se+aga!ana &a$$ ga;at a##at 0ang %a!n, "e#taa teta" "e#hat!&an $!$te $!#&%a$! an

$!$te #e$"!#a$! 0ang ae&at. a#!a$! e/g#a! an tean !$!& $e+a!&n0a 6ga

!"e#hat!&an, nt& engh!%ang&an ge6a%a 0ang engan'a 6!;a $e'a#a 'e"at, nt&

en!%a! &e"a#ahan a#! g!g!tan.

In/#a$! en'a&" &#an an $"e$!e$ %a# (6!&a ng&!n), ha%ha% 0ang

+e#h+ngan engan g!g!tan, 6%ah g!g!tan, "e#t/%/ngan "e#taa 0ang $ah !%a&&an,

;a&t g!g!tan an ;a&t t#an$"/#ta$! $angat !+th&an. Ke"a#ahan a#! g!g!tan +!$a

!&%a$!!&a$!&an (%!hat ta+%e 9:). 3e#t/%/ngan "e#taa $e+a!&n0a 6ga !t6&an nt&

ana& $"a0a t!a& te#6a! !$e!na$! a#! #a'n &a#ena "en!ng&atan an "e#ge#a&an.

T#an$"/#ta$! &e UG4 $e+a!&n0a !%a&&an $e'e"at ng&!n. Mengh!$a" #a'n

enggna&an $'t!/n a"at engh!%ang&an $e6%ah &e'!% #a'n an t!a& +e#+aha0a.

Me%a&&an !n$!$! "aa %&a, "e+e#!an e$ an "ea&a!an t/#n!>et a#te#! an =ena t!a&

!an6#&an.


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3a#a "en/%/ngn0a +!$a 'ea$ +!%a ana& t!a& e!%!&! en=en/a$!. Ke+an0a&an

g!g!tan %a# "aa ana&ana&, !"a$t!&an, !/+$e#=a$! $e'a#a hat!hat!, "eng&#an +e#&a%a

an "enanganan $"/#t! $angat%ah "ent!ng

'atalaksana

K/#e&$! a;a% nt& h!"/=/%e!a engan "e+e#!an 'a!#an !$ta%/! -8 %@&gBB. B/%$

&ea -8 %@&gBB +!$a !+e#!&an 6!&a "e#%. H!"/ten$! 0ang "e#$!$ten ee#%&an

/n!t/#!ng 0ang !n=a$! an "e+e#!an !n/t#/"!& +!$a !ta+ah&an a%a "e+e#!an

"/%!=a%en ant!=en!n. 4!"e#%&ann0a &a6!an %a+/#at/#! 0ang $e$a! te#a$& h!tng

a#ah %eng&a", ;a&t "#/t#/+!n, !+#!n/gen eg#aat!/n "#/'t$, h!tng t#/+/$!t,

BUN, eat!n &!na$e, an #!na%!$!$. K#$$ +a$!' an a=an'e %!e $""/#t +!$a

!"e#%&an. Jaga e&$t#!!ta$ $eta#a engan 6antng. 4a"at&an a#ah nt& &a6!an %a+/#

an "a$ang - !n$ !nt#a=ena. 3aa g!g!tan 0ang $eang $a"a! +e#at, a+!% a#ah nt&

t#an$! ('#/$$at'h) $e+e% !%a&&an "e+e#!an ant!=en!n.

3aa en=en/a$! an en=en/a$! 0ang #!ngan, +e#$!h&an a#ea %&a. Be#!&an

"#/!%a& nt& tetan$ "aa $ea g!g!tan. Cegah !ne&$! $e&ne# engan e+e#!&an

ant!+!/t!' $"e't# %a$ 0ang '/'/& &h$$n0a 6!&a &!ta ea&a! a%ata%at 0ang t!a&

$te#!%. 4! %t %a# +!a$an0a te#a"at +a&te#! g#a negat!.

Jangan enggna&an a$"!#!n. Gna&an a$eta!n/en ata /"!at nt& n0e#!.

Jangan enggna&an /+at/a+t $eat!, e$ ata t/#n!>et. U&# %!ng&a#an "aa

e&$t#!!ta$ $et!a" 1:8 en!t $e%aa 7 6a an &e!an !"anta $et!a" 2 6a h!ngga

t/ta% -2 6a. Ue 0ang "#/g#e$! 0ang te#6a! "aa te"at g!g!tan +!$a enana&an

"ea&a!an ant!=en!n $ete%ah 1- 6a. U%ang! "ee#!&$aan %a+/# $et!a" 7 6a, an 6!&a

te#6a! "e#+ahan 0ang $!gn!!&an tangan! "a$!en engan ant!=en!n "/%0=a%ent.

Penggunaan anti5enin crotalidae

3aa &a$$ en=en/a$! 0ang $eang $a"a! +e#at, +e#!&an "a$!en ant!=en!n "/%0=a%ent.

G!g!tan '/""e# hea +!a$an0a t!a& !tangan! engan "e+e#!an ant!=en!n. Teta"! #att%e

$na&e !a/n +a'& en=en/a$! $angat +e#+aha0a. Se+an0a& : =!a% a#! ant!=en!n

!gna&an "aa ana&ana&. 3aa n0a ana& e+th&an 6%ah t/ta% 0ang %e+!h

6!&a !+an!ng&an engan e;a$a. J!&a te#6a! g!g!tan 0ang +an0a&, t!ng&at&an ant!=en!n

$e+an0a& :85.


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J!&a !"t$&an "e+e#!an te#a"! ant!=en!n, "a$!en ha#$ ! $&!n te$t

enggna&an $e# &a $e'a#a !nt#a e#a%. J!&a te#6a! $&!nte$t 0ang "/$!t!, a;a%!

tata%a&$ana engan ant!=en!n han0a "aa !nten$!=e 'a#e an !a;a%! engan "e+e#!an

ant!h!$ta!n an a#en/&/t!&/$te#/! an han0a !gna&an nt& en=en/a$! 0ang +e#at.

4/$!$ a;a% a#! ant!=en!n !a$a#&an "aa #an&!ng en=en/a$!

1. N/ en=en/at!/n t!a& !%a&&an te$ &%!t, t!a& !+e#!&an ant!=en!n

-. M!% en=en/at!/n : =!a%

. M/e#ate en=en/at!/n 18 =!a%

2. Se=e#e en=en/at!/n 1: =!a%

Set!a" =!a% !'a"# engan 18 % $a%!ne, &e!an 6%ah t/ta% (: =!a% (:8 L))

!en'e#&an 12 engan $a%!ne ata #!nge# %a&tat. M%a! "e+e#!an "aa 1- L@6a an

/+$e#=a$! nt& #ea&$! +e#at. J!&a t!a& aa, na!&&an &e'e"atan %e+!h a#! "e#!/e 8

en!t $a"a! a&$!a% 1:8 L@6a. 3aa ana& &e'!% (!+a;ah 18 &g), gna&an =/%e

t/ta% 188 L, +e#!$! : =!a%, "aa &e'e"atan a&$!a% 78 L@6a.

Sete%ah "e+e#!an $e6%ah ant!=en!n +e#a$a#&an e#a6at en=en/a$! (!n!a% :

=!a%), n!%a! &e+a%! "a$!en, te#a$& "ee#!&$aan %a+/#. Lan6t&an engan en!%a!

&e$&$e$an engan en!%a! ge6a%a %/'a% an $!$te!& a"a&ah !"e#%&an ta+ahan

ant!=en!n ata t!a&. B!a$an0a, /$!$ a;a% !%ang! engan en!%a! &e+a%! taha"taha"

0ang te%ah !%a%!. T!a& aa /$!$ a?!. 4/$!$ t/ta& aa%ah 6a%h /$!$ 0ang

!+th&an nt& enet#a%!$!# #a'n 0ang !&# engan e%!hat "e#+a!&an &%!n!$. 3aa

"a$!en 0ang &e'!% (2: Kg), /$!$ ant!=en!n +!$a !t!ng&at&an :85, t!a& $e"e#t! /$!$

nt& ana& 0ang %a!n.

Tangan! ge6a%a 0ang #!ngan $e"e#t! #t!&a#!a an &ee#ahan engan eng#ang!

/$!$ ant!=en!n an gna&an 6ga !enh!#a!n. 3aa &eaaan ana!%a&t!& 0ang +e#at

0ang e+th&an "enghent!an "enggnaan ant!=en!n, &/n$%ta$!&an &e "$a

"engena%!an #a'n ! ae#ah ana.

Disposisi

3a$!en 0ang t!a& ena"a&&an ge6a%a $e+a!&n0a !/+$e#=a$! an !n!%a! $e'a#a hat!hat!

$e%aa %e+!h &#ang 1- 6a.


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3a$!en 0ang ena"at&an ant!=en!n, ee#%&an /n!t/#!ng 0ang +e#&e%an6tan. In!

a$& a&a% eng!ngat "e+e#!an /$!$ !n!$!a% ant!=en!n ee#%&an /n!t/#!ng $"e#t! !

UG4. 3aa +e+e#a"a "a$!en 0ang e+th&an ant!=en!n ta+ahan &a#ena te#6a!n0a

"en!ng&atan a#! ge6a%a, ata "aa en=en/a$! 0ang +e#at engan ge6a%a $!$te!&,

"!&!#&an nt& !"!nah&an "a$!en &e ICU "e!at#!' ata a$!%!ta$ te#$!e#. Ren'ana&an

/%%/; " :12 ha#! nt& e%!hat &eng&!nan te#6a!n0a $e# $!'&ne$$ &a#ena

"ea&a!an $e# &a.

CORAL SNAKE (ELA3I4AE)

Te#a"at - 6en!$ $"e$!e$ '/#a%$na&e ! Ae#!&a 0a!t The Ea$te#n (!te&an ! $e%atan)

an The S/n/#an (!te&an ! A#!*/na an Ne; Me?!'/). Kean0a han0a

en0e+a+&an te#6a!n0a 15 g!g!tan ! ae#!&a Uta#a. 3an6angn0a - &a&! an e!%!&!

/n'/ng 0ang +e#;a#na h!ta. Wa#na "t!h 0ang %e+a# $e#ta h!ta 0ang !$e%!ng! engan

;a#na &n!ng, !ena% ng&a"an #e /n 0e%%/;, &!%% a e%%/;D #e /n +%a'&, =en/ %a'&D.

Penilaian

U%a# !n! e!%!&! - ta#!ng, en!ngga%&an - %&a t$& $ea%a 1 '. N0e#! an +eng&a&

0ang !t!+%&an $angat !n!a%.

3a#e$te$! an &e%eahan !!&t! /%eh !"%/"!a, an tana +%+a# $e"e#t! !$ag!a an

!$/#!a. Kegaga%an "e#naa$an 6ga a"at te#6a!.

'atalaksana

3eng&#an %/'a% t!a& e+ant. 3enanganan $"/#t! $e+a!&n0a !$en!a&an +!%a aa

!n!&a$!. Te#$e!an ant!=en!n 0ang $"e$!!& nt& 6en!$ The Ea$te#n, 0ang 'ene#ng

en6a! $angat t/&$!&, nan t!a& te#$e!a nt& 6en!$ The S/n/#an.

3a$!en ha#$ ! /%%/;" $e'a#a 'e#at $ete%ah ena"at&an te#a"! nt& e;a$"aa!

ge6a%age6a%a $e#$!'&ne$$.

/.AC 1ID)1 &PID!"

Me#"a&an %a+a%a+a +et!na a#! gen$ Lactrodectus 0ang te#&ena% &a#ena #a'nn0a an

&ea"ann0a nt& e+e#!&ann0a $e'a#a &/nta& &e an$!a. Ra'n a#! %a+a%a+a


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!n! te#!#! a#! "e"t!e 0ang a"at en0e+a+&an "e%e"a$an a$et!%&/%!n ! 0/ne#a%

6n't!/n 0ang a&an en0e+a+&an te#6a! &/nt#a&$! /t/t. N/#e"!ne#!n 6ga !%e"a$&an

/%eh #a'nn0a.

Penilaian

G!g!tan %a+a%a+a +%a'& ;!/; +!$a !&etah! "a"a#ann0a "aa "a$!en ana&, an +!a$an0a

te#a"at a$a%ah 0ang ta& !&etah! engan ge6a%a &%!n!$ 0ang ta& +!a$a. 3e#hat!an "aa

ana& engan !#!ta+!%!ta$ an &e&a&an /t/t $e'a#a t!+at!+a &h$$n0a "aa /t/t/t/t

a+/en, engan +e#&e#!ngat an "en!ngg!an =!ta% $!gn $e'a#a #!ngan &h$$n0a

h!"e#ten$! ee!%!&! &eng&!nan 0ang t!ngg! te%ah te#6a!n0a en=en/a$! %a+a%a+a

+%a'& ;!/;. Tean 0ang %a!n te#a$& &e&a&an /t/t ! $at ata %e+!h e&$t#!!ta$,

!$t#e$$ "e#naa$an, "a#a%!$!$ /t/t !a#aga, an "e+eng&a&an "e#!/#+!ta 0ang t!a&

!h+ng&an engan ang!/e. Ke6ang a"at te#6a! nan 6a#ang. Ka#ena !#!ta+!%!ta$

0ang e&$t#! "aa ana&ana& an &e&a&an /t/t/t/t a+/en e#e&a, &eng&!nan

nt& !ne&$! $0$te $a#a "$at ata "#/$e$ !nt#a a+/en 0ang a&t +!$a !"!&!#&an.

3e+eaan !agn/$!$ !n! e+th&an h!tng $e% a#ah %eng&a", "ee#!&$aan a+/en

an "ng$! %+a%. J!&a !a"at&an aa #!;a0at &/nta& engan %a+a%a+a +%a'& ;!/;, te$

!n! t!a&%ah "ent!ng. Ana%!$a ga$ a#ah !!n!&a$!&an "aa ana&ana& engan &e&a&&an

/t/t 0ang +e#at an e"#e$! naa$.

'atalaksana

3a$!en e+th&an a=an'e %!e $""/#t ata "e+e#!an ant!=en!n $e+a!&n0a !+e#!&an

"aa a$!%!ta$ &e$ehatan te#$!e#. 3e+e#!an +en*/!a*e"!ne ata 'a%'! a"at

eng#ang! &e&a&an /t/t an $"a$e. Ke+an0a&an "a$!en +!$a !tata%a&$ana engan

/+$e#=a$! #a;at !na" an !/n!t/#.

BAB 9 TOKSIKOLOGI.doc

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