Inhalants PDF

Inhalants Dr Kaisan Mahadi Inhalants Refers to various substances that typically taken through inhalation. Deliberate or intentional inhalation (via mouth or nose) of fumes, vapors or gases to ‘get high’. Common sources: spray paints, markers, and cleaning fluids. Methods of inhalation...

Inhalants Dr Kaisan Mahadi Inhalants Refers to various substances that typically taken through inhalation. Deliberate or intentional inhalation (via mouth or nose) of fumes, vapors or gases to ‘get high’. Common sources: spray paints, markers, and cleaning fluids. Methods of inhalation Spraying Sniffing/snorting aerosols Huffing Bagging Prevalence In the US, over 2.6 million children aged 12 -17 use an inhalant to get high each year. The first “psychostimulant” among teenagers. Also know as “gateway drug”. Inhalants are the fourth most abused substance after alcohol, tobacco, and marijuana. The fatality linked to inhalants abused is unknown → attributed to many other cases. Why is it common among teenagers? Easy to obtain Cheap Instant effect Misconception of safety Types of inhalants 3 groups of inhalants: ❑ Solvents ❑ Anaesthetics ❑ Nitrites Solvents class of liquid organic chemicals of variable lipopholicity and volatility, small molecular size, and lack of charge. Lipopholicity – ability to dissolve in fats, oil, lipids Volatility – tendency to vaporize Commonly used to dissolve, dilute, or disperse materials that insoluble in water. Adhesives Household glue, rubber cement Aerosols Spray paint, hairspray, air freshener, deodorant, fabric protector Solvents and gases Nail polish remover, paint thinner, type correction fluid and thinner, toxic markers, pure toluene, cigar lighter fluid, gasoline, carburettor cleaner, octane booster Cleaning agents dry cleaning fluid, spot remover, degreaser  Ready absorption across the lung, skin, and GI tract. Metabolised in the liver Brain is a rapidly perfused tissue, high lipid content → quick accumulation of lipophilic solvents. Effects include euphoria, delirium and hallucinations. Addictive and damaging the liver and CNS. Solvent’s inherent toxicity Number of carbon atoms. Whether it is saturated (single) or has double or triple bonds between adjacent carbon atoms. Configuration (i.e., straight chain, branched chain, cyclic) Presence of functional groups. ❑ Subtle differences in chemical structure can be translated into dramatic differences in solvent toxicity Inherent toxicity (continued) High number of carbon atoms → higher lipopholicity & lower volatility Less number of carbon atoms → lower lipopholicity & higher volatility (VOC volatile organic compound) Lipopholicity is the determinant of diffusion rate across lipid bilayer membranes. Partition coefficient of solvents state/vapor determine the absorption in lungs, GIT, and skin.  Solvents Chemicals Source/commercial use Chlorinated Tricholoroethylene Degreasing operation hydrocarbon Dichloromethane Food prep, degreasing agent, agriculture Carbon tetrachloride Cleaning agent, fire extinguisher Chloroform Anaesthetic Aromatic Benzene Petroleum, gasoline hydrocarbon Toluene Paints, lacquers, thinners, glues, cleaning agents Alcohol Ethanol Household, pharma products, beverages Methanol Glycol Ethylene Glycol Anti freeze, hydraulic liquid Fuel Automative gasoline Jet fuels Adverse effects of solvents abuse: Sudden sniffing death syndrome: The highly concentrated chemicals induce irregular heart beat and lead to fatal HF within minutes of a prolonged sniffing. Can also result from a single session of inhalant use by an otherwise healthy person Particularly with the abuse of butane, propane, and chemicals in aerosols.  Central Nervous System Chronic abuse of toluene/naphthalene, damages protective sheath around nerve fibres in the brain and also peripheral nervous system. → clinically similar to multiple sclerosis. Neurotoxicity → damaging certain parts of the brain involved in cognition, movement, vision and hearing. The cognitive abnormalities → severe dementia. Other adverse effects: Asphyxiation – repeated inhalation displaced oxygen availability in the lungs. Suffocation – plastic bag placed over the head Convulsion or seizure – abnormal electrical discharges in the brain Coma – brain is shutting down most vital functions Fatal injury – vehicle accidents while intoxicated Types of inhalants 3 groups of inhalants: ❑ Solvents ❑ Anaesthetics ❑ Nitrites  Nitrites abuse Enhance sexual pleasure by dilating and relaxing blood vessels. Effects: Immediate effects: typically within a few seconds and lasts for 2-5 mins. Causes muscles to relax; increase the blood flow to the heart → increase HR → increase cardiac output. Therefore oxygen rich blood will quickly reach the brain to produce rush.  Nitrous oxide Sometimes referred as “laughing gas”. Immediate effects, usually lasts less than a minute. Repeated use may extend and intensify the experience. Results in temporary loss of motor control and a “dissociative” psychological effect, where sensations and perceptions become disconnected. Effects include a dreamy mental state, and mild audio and visual hallucinations.