LAPORAN KASUS TERAPI DETOKSIFIKASI D ETOKSIFIKASI PADA PADA PENGGUNA NAPZA
DI SUSUN OLEH KOMALA SARI HAKIM 1102008324
BLOK ELEKTIF DRUG ABUSE KELOMPOK 1 TUTOR: PROF.dr. Hj. Q!"r#"$. RS. MS. PKK% AIFM
FAKULTAS KEDOKTERAN UNI&ERSITAS 'ARSI 2013(2014
A)*+r", Latar belakang: P-//"" NAPA d# Id-*#" *-!",# !-#/,"+. P"d" """ !-r-," 5)"(5)" *"!6"# ",$#r" !-r-," ,-5"d". U+, #+ 6-r" +-r"6# d-+,*#7#,"*# 6"d" 6-//" NAPA +, !-/$#"/," r"5(r"5 "/ "d" d# d""! +)$. Presentasi kasus: Rd# !-//"," "r,)" *-j", )-r!r 18 +"$ ,"r-" d# "j", -$ +-!"". K## Rd# )-r"d" d# R!"$ S",#+ K-+-r/"+/" )"+ RSKO9 #))r *-"!" 14 $"r#. D" !-d"6"+," 6-r""+" d-+,*#7#,"*#. S-,"r"/ d#" *"d"r% "6" "/ d#" ",," *-"!" ## *""$. U+, #+ d#" )-r*"$" +, *-!)$ d-!# ,-"r/"". Diskusi: !-#/,"+" 6-//" "r,)"% *-!",# )"", 6" "/ !-!)+$," +-r"6#. I# d# ,"r-"," *-*-r"/ "/ #/# 5)"(5)" ,-!d#" !-r"*" ,-+"/#$" "+" ,-5"d". K"r-" +-r"6# *""$ *"+ )"/#" "/ 6-+#/ +, ,-*-!)$" 6"d" 6-//" NAPA. S""$ *"+ +-r"6# "/ d# /"," "#+ d-+,*#7#,"*#. Kesimpulan: P-//" "r,)" d# Id-*#" *-!",# !-#/,"+. I# d# *-)")," ,"r-" 6*#,/#* r-!"j" !"*#$ ")#. S-$#//" $" ## d# /"," -$ ,!(,! "/ +#d", )-r+"/// j"") +, !-j-r!*," !-r-,". U+, #+ +-r"6# d-+,*#7#,"*# *"/"+ )-r6-r" 6-+#/ d""! 6r*-* 6--)$" 6"d" 6-//" NAPA. +, !-/$#"/"," r"5 NAPA d"r# +)$ 6"*#- 6-""$/"" NAPA. S"r": K-rd : dr/ ")*-% d-+,*#7#,"*#
Latar elakang NAPA N"r,+#,"% P*#,+r6#," d" "+ "d",+#7 "#9 "d""$ )"$";<"+;)"+ "/ )#" !"*, ,d""! +)$ !"*#" "," !-!6-/"r$# +)$ +-r+"!" +",;**" *"r"7 6*"+% *-$#//" !--)")," /"//" ,-*-$"+" 7#*#,% 6*#,#* d" 7/*# **#"" ,"r-" +-rj"d# ,-)#"*""% ,-+"/#$""d#,*#9 *-r+" ,-+-r/"+/" d-6-d-*#9 +-r$"d"6 NAPA. S-!",# !-r"j"-"" "r,)" )," $"" *-5"r" "/*/ !-r*", 7#*#, d" !-+" 6"r" 6-//"% "," +-+"6# d"!6"," d"6"+ !-/-5"! 6-r,-!)"/" -,!# d" ,-!"j" **#". U+, #+ +-r"6# j/" *"/"+ d# )+$," 6"d" 6-//" "r,)". U+, # + )#*" d#",," )-r)"/"# +-r"6#. S""$ *"+" +-r"6# d-+,*#7#,"*#. T-r"6# d-+,*#7#,"*# ## +, !-/$#"/," r"5(r"5 "/ "d" d# +)$ 6-//" NAPA. M",# !-r-)"," ,"** 6-""$/"" "r,)" d# Id-*#"% !-dr/ r-=#*# UU A+#( N"r,+#,". S-$#//" !5"$ UU A+#(N"r,+#," N. 22 +"$ 1>>?% !-* d# )"+ UU P*#,+r6#," N!-r @ T"$ 1>>?. D""! Ud"/(Ud"/ +-r*-)+ d# "+r 6"*"(6"*" ,-+-+" 6#d"" +-r$"d"6 6-", ,-j"$"+" "r,+#,"% d-/" 6-!)-r#" *",*# +-r)-r"+ )-r6" $,!" !"+#. N"! $,!" !"+# )," $" "/ !-",+," )"/# 6"r" ,r#r d" )"d"r "r,)"% ,"r-" d"r# ,-+/" )-r#6"+ /"d" d"6"+ d#/"," +, !-"6 6-+/"*. Presentasi kasus Rd# "!" *"!"r"9 "/ )-r"*" d"r# M-d"% *-,"r"/ )-r!r 34 +"$. D#" *d"$ !-#,"$ d" !-!6"# 2 "",. Rd# !-/-" "r,)" * -j", r-!"j". ",+ #+ d#" )-r!r 18 +"$. K"r-" ,-+#d",+"$" +-+"/ )"$"" "r,)" ",$#r" d#" !-5)" "r,)". A" !" !-//"," "r,)" d"r# +-!"". ",+ #+ d#" d# )-r#," *-5"r" /r"+#* -$ +-!"". P-r+"!" ,"# !-//"," $-r#d. B#"*"" !-//"," 2(3 *-$"r#. K-r-" d#" d"r# ,-"r/" -,!# d# "+"* r"+"(r"+". M"," d-/" !d"$ d#" )#*" !-d"6"+," "r,)". S-+-"$ #+ Rd# !-!6"# 6"5"r. D"r# 6"5"r""$ d# !-/-+"$# -,*+"*#. A,$#r" d#" !-//"," -,*+"*#. K"r-" d-/" 6"5"r" 6+*. Rd# !-/""!# d-6r-*#. D" ",$#r" d#" !-//"," *")(*") *"!6"# *""+ ##. Rd# 6 +-r+"/,"6 !-//"," *")(*"). D" d#" d# )"" ,- BNN L#d. D# BNN d#" d#*-r"$," ,R!"$ *",#+ ,-+-r/"+/" )"+ RSKO9 #))r. S-,"r"/ d#" !-j""," +-r"6# d-+,*#7#,"*#. D# RSKO d# !-r"*"," 6-r)"$" 6*#+#7. D" !-"d"r# )"$" "6" "/ d#" ",," *-"!" ## *""$. A,$#r" d#" )-r*"$" +, *-!)$ d-!# ,-"r/"". Diskusi N"r,)" N"r,+#,"% P*#,+r6#,"% A,$% "+ "d",+#7 "#"9 "d""$ )"$" ; <"+ "/ d"6"+ !-!6-/"r$# ,d#*# ,-j#"" 6#,#r"% 6-r"*"" d" 6-r#",9% *-r+" d"6"+ !-#!)," ,-+-r/"+/" *-5"r" 7#*#, d" 6*#,/#*. P-""$/"" "r,)" "d""$ 6-!","#" "r,)" j/" d#*-)")," ,"r-" 6-//"" +-r* !--r*% !--)")," ,-+-r/"+/"% d" !-#!)," /"//" 7#*#,% !-+" d" **#".
N"r,+#," "d""$ <"+ "+" )"+ "/ )-r"*" d"r# +""!" "+" )," +""!" )"#, *#+-+#* !"6 *-!# *#+-+#* "/ d"6"+ !--)")," 6-r" "+" 6-r)"$" ,-*"d"r"% $#"/" r"*" -r# d" d"6"+ !-#!)," ,-+-r/"+/" Ud"/(Ud"/ N 22 +"$ 1>>?9. '"/ +-r!"*, j-#* "r,+#," "d""$ *-6-r+# +""!" 6"6"=-r% 6#! !-+"$% 6#! !"*", 5"d% j#5#/% j#5#/,9% 6#! )"+% !r7#"% ,,"#"% -,/#"% +""!" /"j" d" d" !"r /"j". G"r"!(/"r"! d" +r"( +r" d"r# !r7#" d" ,,"#"% *-r+" 5" !6r"(5"!6r" d" *-d#"(*-d#" "/ !-/"d/ )"$" d# "+"*. S+r"+-/# "/ +-"$ d#+-!6$ 6-!-r#+"$ d" !"*"r","+ d""! !--," 6-""$/"" "r,)"% d#"+"r"": 1. P-5-/"$" U6"" +, !-5-/"$ +-rj"d#" 6-""$/"" d" 6-r-d"r" /-"6 "r,)"% d-/" 6""(6"" "/ )-r)"*#* !"*"r","+% !-dr/ d" !-///"$ ,-*"d"r"% ,-6-d#" d" 6-r" ",+#7 *-r$ ,!6- !"*"r","+% ,"r-" C!-5-/"$ -)#$ )"#, d"r# 6"d" !-/)"+#. 2. P--/"," H,! U6"" +-r6"d d""! 6-!)-r"+"*" "r,)" *-5"r" ,!6r-$-*#7 +-r$"d"6 r/"#*"*# ,-j"$"+" "r,)" d-/" !--r"6," d"/(d"/ d" 6-r"+r"(6-r"+r" *-5"r" +-/"* ,*#*+-% d" d#",," d-/" *//$(*//$% *-r+" "d"" ,-rj"*"!" " +"r #*+"*# d" ,-rj"*"!" #+-r"*#" "/ *"#/ !-/+/,". 3. T-r"6# d" R-$")##+"*# U6"" "/ d#",," +, !-/)"+# 6"r" 6-//" "r,)" d-/" !-",," 6-/)"+" *-5"r" !-d#*% **#" d" *6#r#+". 4. P-/-!)"/" S#*+-! I7r!"*# N"r,)" U6"" +, !--d#"," d" !-"j#," d"+" "/ -/,"6 d" ,!6r-$-*#7 +-+"/ 6-""$/"" d" 6-r-d"r" /-"6 "r,)"% )"#, *-5"r" #+-r"*#" !"6 "*#". H" +-r*-)+ d"6"+ d#/"," *-)"/"# d"*"r 6-*" ,-)#j"," d" *+r"+-/# d""! 6-5-/"$" d" 6-!)-r"+"*" 6-""$/"" "r,)". T"$"6" r-$")##+"*# "r,)" d# )"/# !-j"d# 2 +"$"6 "#+: 1. T"$"6 T-r"6# 6-/)"+"9 T-r"6# +-r$"d"6 6-""/"" NAPA +-rd#r# d"r# 2 +"$"6" "#+ d-+,*#7#,"*# d" 6"*5" d-+,*#7#,"*# 6-!"+"6"9 "/ !-5",6 ,!6-(,!6- *-)"/"# )-r#,+: ". T-r"6# !-d#,(6*#,#"+r#, d-+,*#7#,"*#% 6*#,7"r!","% d" 6*#,+-r"6#9 T-r"6# d-+,*#7#,"*# "d""$ )-+, +-r"6# +, !-/$#"/"," r"5 NAPA d"r# +)$ 6"*#- 6-""$/"" NAPA. D""! d-+,*#7#,"*# d#/"," )"+()"+" "/ +-r// !"jr +r"*##<-r "/ d#+j," +-r$"d"6 /"//" *#*+-! -r(+r"*!#+-r **" *"r"7 6*"+. S-"# #+ j/" d"6"+ d#/"," ""/-+#," 6#"+ "#+ )"+ "+# -r# "/ 6+-*# d" -7-,+#=#+"*" *-+"r" d-/" 6#"+ +-+"6# +#d", !-/"d/ 6#"+ d" +r"" d" +#d", !-#!)," ,-+-r/"+," d" ,-+"/#$". D"6"+ 6" d#/"," !-+d- *)*#+*# d-/" +r" 6#"+ +-+"6# d-/" d*#* "/ *-d#,#+ d-!# *-d#,#+ d#+r,". Ad"6 !-+d- d-+,*#7#,"*# "/ !-!","# *#*+-! ), ++" ")*+#-+#" ++"#*9% "r+#" 6"*#- d-/" 6-""$/" NAPA +#d", )-$ !-//"," NAPA "+" +r""% d" j/" +#d", !-//"," )"+()"+" *-)"/"# 6-//"+# *)*#+*#". S-+-"$ !-j""# +-r"6# d-+,*#7#,"*# 6r*-* !-+" "d#,+#7 !"*#$ )-rj""% "r+#" r"*" #/# !"*#$ )-! $#"/% *-$#//" ,-,"!)$" !"*#$ d"6"+ +-r"/ ,-!)"#. U+, !-/"+"*# /"//" +-r*-)+ d#/"," )"+()"+" "/ )-r,$"*#"+ !-!6-r)"#,# /"//" d" !-!#$," 7/*# -r(+r"*!#+-r 6"d" **" *"r"7 6*"+. S-"# !-/"" )"+()"+" //" !"jr +r"*##<-r j/" !-//"," j-#* )"+ "+# d-6r-**"+. O)"+ ## 6-r d#)-r#," ,"r-" d-/" d#6+*,"" NAPA 6"d" 6"*#- *-r#/ ,"# !-#!)," /-j"" d-6r-*#. D-/" +-r"6# 6*#,7"r!"," )"#, d"r# //" !"jr +r"*##<-r !"6 "+# d-6r-**"+ +"d#% !"," /"//" !-+" d" d-6r-*# d"6"+ +-r"+"*#. ). T-r"6# !-d#,(*!"+#, ,!6#,"*# !-d#,9 '"/ d# !",*d d-/" +-r"6# !-d#, *!"+#, "d""$ 6-//"" )"+()"+" "/ )-r,$"*#"+ +-r$"d"6 ,-"#" 7#*#, )"#, *-)"/"# ",#)"+ +-r"6# d-+,*#7#,"*# "#+ /-j""
6+* )"+ !"6 ,!6#,"*# !-d#, )-r6" ,-"#" r/" +)$ ",#)"+ 6-""$/"" NAPA . P"d" !!" 6"*#- 6-""$/" NAPA ,d#*# 7#*#, "+" /#<#" +#d", )"#,% -$ ,"r-" #+ 6-r d#)-r#," !","" d" !#!" "/ )-r,"r# d" )-r/#<# +#//#% d#*-r+"# d-/" +-r"6# 7#*#, !#*"" "$r"/" +, !-!#$," *+"!#" "+" d"" +"$" +)$ 6"*#-. 5. T-r"6# 6*#,**#" '"/ d# !",*d d-/" +-r"6# 6*#,**#" "d""$ 6"" +, !-!#$," ,-!)"# ,-!"!6" "d"6+"*# d"r# 6"*#- d""! ,-$#d6" *-$"r#($"r#. D-/" +-r"6# 6*#,**#" d#$"r"6," 6-r#", "+#**#" d"6"+ )-r)"$ !-j"d# 6-r#", "d"+#= )-$"=#r. d. T-r"6# 6*#,r-#/#* U*r "/"!" d""! +-r"6# )"/# 6"r" 6"*#- 6-""$/"" NAPA !-!6"# "r+# 6-+#/ d""! !-5"6"# ,-)-r$"*#" 6--!)$". U*r "/"!" "/ !-r-," +-r#!" "," !-!#$," d" !-!6-r,"+ r"*" 6-r5"" d#r#% $"r"6" d" ,-#!"". 2. T"$"6 R-$")##+"*# R-$")##+"*# "d""$ 6-!#$" ,-6"d" ,-6-dd," "+" ,-"d"" "/ d"$ "+" *-!"% 6-r)"#," "//+" +)$ "/ 5"5"+ d" *-)"/"#" "+"* #d#=#d *6"" !-j"d# !"*#" "/ )-r/" d" !-!##,# +-!6"+ d# !"*"r","+. R-$")##+"*# "d""$ 6-!#$" ,-)-+, "+" 7/*# "/ r!" *-+-"$ +-rj"d# ," "+" *",#+% 6-!#$" 6"*#- "/ *",#+ "+" ," +, d"6"+ !"d#r# "," !-d"6"+," 6-,-rj"" "/ "", "/ d"6"+ d# 5"6"# d""! ",+ "/ *-*#/,"+ !/,#. R-$")##+"*# "r,)" "d""$ 6"" "/"r 6"*#- 6-""$/" NAPA d"6"+ ,-!)"# 6"d" ,d#*# *-6-r+# *-)-! 6-""$/"" "r,)"% *-*"# d-/" Ud"/(Ud"/ R-6)#, Id-*#" "/ )-r", +-+"/ "r,+#," d" 6*#,+r6#,"% 6"" r-$")##+"*# !-d#, d" **#". Tj" r-$")##+"*# 1. P"*#- !-j"d# *-$"+ 2. D"6"+ !-/-!)"#," 6-/-d"#" -!*# 3. M-!+#="*# "/"r +#d", !-/"/ 6-""$/"" NAPA ,-!)"# 4. M-5#6+"," *#7"+ 6-r#", 6*#+#7 +, !"!6 !-", +""r" 6-""$/"" NAPA @. M-""!," ,-6-r5""" d#r# . M-d#*#6#," ",+ d" 6-r#", *-$"r#($"r# *-5"r" -7-,+#7 d" 6rd,+#7 '"/ d#",," 6-//" NAPA +, !-!)"+ d""! +-r"6# !-r+ 6"d"/" I*"! 1. M-/-+"$# d" !-",## )"$" "r,)" )"/#" d"r# ,$"!"r "/ d#"r"/ d""! #*"!. #," d#"//"r "r"/" +-r*-)+ !"," ""$ "," !-!)-r#," "d<") "/ 6-d#$% )"#, d# d#" )-r6" d"!6", -/"+#7 "/ d# +#!)," +-r+"!" d# ",$#r"+ "+#. 2. M-/-+"$# d" !-"d"r# )"$" ,$"!"r -)#$ )"", d"!6", -/"+#7" d"r# 6"d" 6*#+#7". B"#, d"r# *-/# ,-*-$"+" !"6 d"!6", **#" "/ d#+#!),". S-6-r+# ,-+#d","!"" !"*"r","+ *-,#+"r. 3. M-!)"5" A(Qr" d" )-r<#,#r *-5"r" +-rj"d". M#*"" !-!)"5" A(Qr" *-+#"6 *$"+ *)$ d" !"/$r#)% " )-r<#,#r *-+-"$ *$"+. #," $" ## d# ",," *-5"r" +-r*( !--r*% !"," #" "," !-j"d# )-+-/ )"/# d#r#" *-d#r# d"r# /d""(/d"" *-+"% +-r!"*, d""! !-//"," ,$"!"r 4. B-r+-!" d-/" r"/(r"/ "/ *$-$. B"", ,"** "/ !-j," )"$" *-*-r"/ "/ !-//"," "r,)" ,-r-" 6-/"r$ +-!". O-$ ,"r-" #+% 6##$"$ +-!" ",r") "/ *$-$ *-$#//" ,#+" #,+ !-j"d# r"/ "/ *$-$. @. M-/#*# ",+ d-/" ,-/#"+" 6*#+#7% *-6-r+# ,-!6, )-"j"r% "$r"/" d" *-)"/"#". S-)")% j#," )"", ",+ "/ +-"$ +-r#*# d-/" ,-/#"+" 6*#+#7 !"," ,#+" "," +-r$#d"r d"r# ,-/#"+"(,-/#"+" -/"+#7. K-*#!6" P-//" "r,)" d# Id-*#" *-!",# !-#/,"+. I# d# *-)")," ,"r-" 6*#,/#* r-!"j" !"*#$ ")#. S-$#//" $" ## d# /"," -$ ,!(,! "/ +#d", )-r+"/// j"") +, !-j-r!*," !-r-,". U+, #+ +-r"6# d-+,*#7#,"*# *"/"+ )-r6-r" 6-+#/ d""! 6r*-* 6--)$" 6"d" 6-//" NAPA. +, !-/$#"/"," r"5 NAPA d"r# +)$ 6"*#-
6-""$/"" NAPA. S-"# #+ j/" d#)+$," +-r"6# !-d#, *!"+#, "#+ 6-//"" )"+( )"+" "/ )-r,$"*#"+ +-r$"d"6 ,-"#" 7#*#, )"#, *-)"/"# ",#)"+ +-r"6#. D" +-r"6# 6*#,**#" +, !-!#$," ,-!)"# ,-!"!6" "d"6+"*# d"r# 6"*#- d""! ,-$#d6" *-$"r#($"r#. S-r+" +-r"6# 6*#,r-#/#* "/ j/" *"/"+ 6-+#/ d""! !-5"6"# ,-)-r$"*#" 6--!)$" ,"r-" d"6"+ !-!#$," d" !-!6-r,"+ r"*" 6-r5"" d#r#% $"r"6" d" ,-#!"". S"r" S"r" "/ d"6"+ d#)-r#," *-)-! +-r6-/"r$ "," 6-//"" "r,)" j"/" !-5)"(5)" NAPA. K"r-" "6")#" *d"," !-//"," NAPA !"," *-*-r"/ "," !-r"*",-+"/#$"; ,-+-r/"+/". D" *-" #/# !-!","#" "/#. A6")#" *-*-r"/ *d"$ +-r"jr !-//"," !"," *-)"#," ",," +-r"6# *-5-6"+". K"r-" +-r"6# *"/"+ 6-+#/ d""! 6r*-* 6--!)$". A5,-d/-!-+ P-r+"!"(+"!"% *"" 5"6," +-r#!" ,"*#$ ,-6"d" A"$ ST. K"r-" *"" d#)-r#," ,-*-!6"+" +, !-!)"+ "6r" ,"** ##. S"" j/" !-"!6"#," +-r#!" ,"*#$ ,-6"d" RSKO #))r% ,$**" ,-6"d" "r"*!)-r% +-r#!" ,"*#$ j/" ,-6"d" dr. Hj. R S*#"+# *-", ,rd#"+r ), --,+#7% dr. N"*rdd# Nr% SPK *-", ,rd#"+r ++r )#d"/ ,-6-!#"+" Dr/ A)*-. Pr7. dr. Hj. Q!"r#"$. RS. MS. PKK.AIFM. *-", ++r "/ +-"$ !-/"r"$," d" !-!)-r#," )#!)#/" *-$#//" !"+-r# ## d"6"+ *--*"#. S-r+" )-r+-r#!" ,"*#$ ,-6"d" +-!"(+-!" d"r# ,-!6, dr/ ")*- 1 "+"* *-!" )"+" d" ,-rj"*"!"" D"7+"r P*+"," A#7#"% U% 2008. A6" I+ N"r,+#," d" N"6<". P T B-/"" I!: S-!"r"/. H""r#% D% 200>. P-""$/"" d" K-+-r/"+/" N"6<". B""# P--r)#+" FKUI: ","r+". P"r+d#$"rj% S% 2008. K-"# N"r,)" d" M*$# P-""$/""". Er"//": ","r+" Kr#""% % 2008. Ar+# D-7##*# P-/-r+#" N"r,)" D" G/"; -#* N"r,)" S-)"/"# "+ T-r"r"/. M"*r,$#% Sd#,#. 2012. I*"! d" B"$"" N"r,)". $++6:;;.6",(*d#,#.5!;2012;02;#*"!(d"()"$""("r,)".$+! R"#*% M5$ L,!" F"+"$% SH% 1>>?. Ud"/(Ud" / N"r,+#," d" P*#,+r6#,".
