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| apt. Engrid Juni Astuti, S.Farm, M.Farm (Photo: Special) |
Following the release of the documentary "Ice Cold: Murder, Coffee, and Jessica Wongso," the public was reminded of the cyanide coffee death case in 2016. One of the matters that attracted attention was cyanide and its effects. Responding to the release of the documentary, UMM Pharmacy lecturer apt. Engrid Juni Astuti, S.Farm., M.Farm., explained that cyanide is a highly toxic chemical that can disrupt the entire body system.
Cyanide contains CN-containing ions that can form acids and salts. This compound is often used in various industries and as a reagent in chemicals. In addition, cyanide salt is also often used by the community to catch fish. "People usually recognize cyanide salt as potash. The potash is thrown into the sea so that it causes the fish to die and is easy to catch," she added.
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She explained that cyanide is also naturally found in some plants, such as cassava, almonds and apple seeds. However, as long as it is not consumed in large quantities and processed properly, then the effect is not harmful.
Then, how can cyanide be poisonous and deadly if consumed by humans? Engrid, her nickname, explained that the lethal dose of cyanide is 2 mg/kgBB or approximately 50–75 mg. The cyanide content is divided into three categories: mild, moderate, and severe. Mild content is around 0.5–1 ppm (mg/l), moderate is 1–2.5 ppm, and more than 2.5 ppm is included in the severe category and can cause death.
Cyanide poisoning is caused by the inability of cells to use oxygen, instead of by a lack of oxygen delivery or supply. Cyanide prevents cells from using oxygen by inhibiting the oxidative function of mitochondrial cytochrome oxidase, an enzyme in the electron transport chain. Cytochrome oxidase normally converts oxygen to water at the end of the electron transport chain.
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Oxidative metabolism creates a large amount of ATP which is the main source of cellular energy. Cyanide, which has a chemical structure similar to oxygen, binds to the iron portion of cytochrome oxidase. Cyanide binding inhibits the ability of cytochrome oxidase to use oxygen and thus reduces ATP production. The reduced availability of ATP leads to cellular dysfunction and death.
The early signs and symptoms of acute cyanide poisoning reflect the respiratory, neurological and cardiovascular systems' reflective efforts to cope with decreased oxygen levels within the body tissues. Transient increases in blood pressure and heart rate, hyperventilation, shortness of breath, palpitations and headaches are common early signs and symptoms of acute cyanide poisoning.
Late or severe symptoms of poisoning reflect neurological, respiratory, and cardiovascular depression as tissues fail to compensate for their inability to use oxygen. Coma, seizures, decreased consciousness, and respiratory cardiac arrest are common signs of late or severe poisoning.
Cyanide poisoning can only be treated with medical assistance. In general, patients will be given breathing apparatus as well as drugs containing amyl nitrite and sodium nitrite to prevent the more severe effects of poisoning. "Due to the rapidly progressive nature of cyanide toxicity, medical assistance is ideally carried out at the scene of the poisoning," she concluded. (*sep/wil/fajr)
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