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All Journal Medula Jurnal Medika Hutama
Reghina Pratiwi Hidayat
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Biochemistry, Genetics & Molecular Biology Education Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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N-ACETYLCYSTEINE SEBAGAI TERAPI TOKSISITAS ACETAMINOPHEN Reghina Pratiwi Hidayat
Jurnal Medika Hutama Vol. 2 No. 01 Oktober (2020): Jurnal Medika Hutama
Publisher : Yayasan Pendidikan Medika Indonesia

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Abstract

Acetaminophen is an effective oral analgesic, with few side effects when used at the recommended dosage. However, acetaminophen poisoning is common and potentially fatal. Acetaminophen is the most widely used analgesic but also the leading cause of acute liver failure. Liver toxicity can occur even at therapeutic doses especially in alcoholic patients, in subjects with chronic liver disease, NAFLD, cardiopulmonary disease, malnutrition, or when acetaminophen is used concurrently with other drugs that stimulate the CYP pathway. Acetaminophen (APAP) is a drug that is widely used in the community with few side effects. Therefore, some patients affected by APAP hepatotoxicity have an excessive intake of APAP doses. This breakdown is mainly produced by one of the APAP metabolites: N-acetyl-para-benzo-quinone imine (NAPQI), which is highly toxic. The dose of drug taken and the length of time taken from APAP to N-acetylcysteine ​​(NAC) therapy are the most important determinants of the development and severity of APAP hepatotoxicity. NAC is an antidote to APAP poisoning, and can be given orally or intravenously. Finally, a multidisciplinary approach with support from the Psychiatry, Intensive Care Unit and the Department of Gastroenterology and Digestion will be needed, especially in the case of autolysis trials and severe liver failure.
Hernia Umbilikalis: Ulasan Singkat Reghina Pratiwi Hidayat; Perwisa, Inna Rahmayanti; Satria, Muhammad
Medula Vol 13 No 7 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i7.880

Abstract

An abnormal protrusion of an organ in the fascia of the abdominal wall is called a hernia. An umbilical hernia indicates that there is a protrusion in the anterior abdominal wall. Congenital umbilical hernias occur more frequently due to failure to obliterate the umbilical blood vessels into ligaments after birth. However, congenital umbilical hernia can completely close 85-90% by the age of 5 years. Adult umbilical hernias are usually associated with increased intra-abdominal pressure, such as chronic coughing, frequent straining and large abdominal tumors, requiring surgical treatment. The clinical manifestation of an umbilical hernia is usually a protrusion in or near the navel, but if it is incarcerated or strangulated, symptoms of nausea, vomiting, difficulty defecating and abdominal pain will appear. On physical examination, you will find a lump in the navel with skin color even red to black if strangulation has occurred. In addition, to the touch it will feel warm. The most severe clinical manifestations can be symptoms of sepsis such as hypotension and tachycardia. The necessary supporting examinations include initial imaging such as ultrasound and the most sensitive, namely an abdominal CT scan. Surgical treatment for adult umbilical hernias can be done with suture or mesh repairs, while pediatric umbilical hernias can be repaired with non-absorbable sutures and umbilicoplasty for aesthetic improvement. Complications of umbilical hernia are usually related to post-surgery such as hematoma, post-operative wound infection. The prognosis for an umbilical hernia is good after surgery.
Co-Authors Perwisa, Inna Rahmayanti Satria, Muhammad