Peran Fomepizole dalam Penanganan Toksisitas Etilen Glikol dan Dietilen Glikol

Lewi Tigor Simorangkir, Suharjono Suharjono

Abstract


Etilen glikol dan Dietilen glikol merupakan alkohol yang bersifat toksik yang dapat meningkatkan mortalitas dan morbiditas. Pada tahun 1997 FDA menyetujui penggunaan fomepizole (4-methylpyrazole) sebagai tatalaksana toksisitas etilen glikol yang dapat di kombinasi dengan terapi hemodialisa. Fomepizole adalah inhibitor kompetitif alcohol dehydrogenase sama seperti etanol sehingga dapat menghambat pembentukan metabolit toksik dari etilen glikol. Fomepizole memiliki afinitas 8.000 kali lebih besar terhadap alcohol dehydrogenase dibandingkan etanol serta  farmakokinetik fomepizole dapat di prediksi dan efek samping lebih ringan. Pedoman saat ini dari beberapa literatur menyarankan terapi hemodialisa pada toksisitas etilen glikol jika konsentrasi serum etilen glikol dalam darah > 50 mg/dL, asidosis berat, gagal ginjal, dan kadar asam glikolat > 10 mmol/L. Sedangkan fomepizole dapat indikasikan jika konsentrasi plasma Etilen Glikol > 20 mg/dL, riwayat penggunaan penggunaan etilen glikol dan dietilen glikol dengan osmolal GAP > 10 mOsm/L atau kecurigaan penggunaan etilen glikol dan dietilen glikol dengan PH arteri < 7,3, CO2 < 20 mmol/L dan osmolar GAP > 10 mOsm/L 

Keywords


Fomepizole, Etilen Glikol, Dietilen Glikol

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DOI: https://doi.org/10.18860/jip.v8i1.20790

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