35: Vaping Flashcards
how does vaping work?
e liquids that contain nicotine are heated to produce an aerosol, which can then be inhaled
T or F: ecigs do not have vapors
T
what are first gen Ecigs
disposable ecig
what are 2nd gen ecigs
battery pen with cartridge (prefilled or refillable)
what are 3rd gen ecigs
modifiable- allows variable voltage/ watts, tank/ subohm (refillable)
what are 4th gen ecigs
pod mod (prefilled or refillable)
why do people modify their vaping devices
to drip liquids directly onto atomizer to get more aerosol conversion
e liquids are typically a mix of
water,, food grade flavoring, nicotine/ cannabis, propylene glycol, vegetable glycerin
___ and ___ are used as humectants in vapes
PG and VG
T or F: the toxic effects of aerosol flavoring chemicals are well known
F- unknown, effects of nicotine well known
newer modes of ecigs use nicotine ___
salts
what is different about nicotine salts from normal free base nicotine
lower pH than free base nicotine = ↑ exposure = ↑ lvls inhaled more easily with less throat irritation
T or F: ecigs are approved as a quit smoking aid
F- but may assist
which of the following is true
1. ecigs generally contain fewer toxic chemicals than regular smoking
2. e cig aerosols are only inhaled by the smoker, there is less chance of second hand smoke
3. e cigs are approved by HC as a harm reduction alternative to smoking
4. 2nd gen devices are modifiable
1
vapine requires users to do _______ (shorter/ longer and harder/ softer) puffs than cigs
longer, harder
thermal degradation of 1,2, propylene glycol and glycerin produces
acetaldehyde, acrolein, formaldehyde
____ and ____ are found in majority of ecigs as the flavoring agent
diacetyl and 2,3 pentanedione
diacetyl and 2,3 pentanedione are linked to ___________. there is evidence they _________
bronchiolitis obliterans
impair production and function of cilia in human airways
which of the following is not an ingredient found in vape aerosols
1. carbonyl compounds
2. diaetyl and 2,3 pentanedione
3. organic compounds
4. metals
5. all of the above are found in vape aerosols
5
VAPI is
vaping associated pulmonary injury
VAPI sx
acute or subacute chemical pneumonitis, cough, dyspnea, chest pain, N/V/D, and pain
Rapid onset
Pulmonary infiltrates on chest radiography (atypical pneumonia)
some pts require ICU and vent support, some develop ARDs
VAPI predominantly affects
young males and healthy individuals who used an ecig within 90d of onset
describe the pathogenesis of VAPI
largely unknown- associated with products that contain THC and/or vit E acetate used to thicken or dilate the THC in vaping products
may be due to interference with membrane function, heating producing ketenes (Reactive compound)
T or F: what is vit E acetate used for in cannabis vapes
to thicken or dilute THC
what is bronchiolitis obliterans
popcorn lung
inflam of bronchioles = damage = scarring = airway occlusion
what is the major toxic substance associated with developing popcorn lung
acetaldehyde (found in most flavoring agents)
also diacetyl,. ammonia, chlorine, formaldehyde, fumes from metal oxides, HCL, mustard gas or sulfur mustard, nitrogen oxides, sulfur dioxides
what does dumbbbelss stand for in the cholinergic toxidrome
diarrhea, urination, miosis/ muscle weakness, bronchorhea, bronchospasm, bradycardia, emesis, lacrimation, salivation, sweating
nicotine poisoning is ____ absorbed by ______, enters ____ and _______ metabolized
rapidly absorbed by all routes
enters brain quickly
rapidly metabolized
nicotine undergoes _____ excretion
urinary
there is an ____ incidence of nicotine poisoning in children
increased
sx of nicotine poisoning includes
dependence, feeling awake or relaxed, diarrhea ↑ HR/ stroke volume, weight loss, ↑ BP, inhibition of urine production, vomiting, ↑ pain sensitivity, risk of thrombosis, ↑ RR
nicotine dose and time dependent effects are ______
biphasic
GI sx in early nicotine poisoning
N/V, salivation, abd pain
resp sx in early nicotine poisoning
bronchorrhea, hyperpnea
CV sx in early nicotine poisoning
HPTN, tachycardia, pallor
neuro sx in early nicotine poisoning
Agitation, anxiety, dizziness, blurred vision, HA, hyperactivity, confusion, tremors, fasiculations, seizures
GI and resp sx in late nicotine poisoning
diarrhea
hypoventilation, apnea
CV sx in late nicotine poisoning
bradycardia, hypotension, dysrhythmias, shock
neuro sx in late nicotine poisoning
lethargy, weakness, paralysis
key cannabis receptors are
CB1 and CB2
cannabis triggers both _______ and _______
catecholamine release + inhibition of sympathetic reflexes
acute effects of cannabis include
↓ coordination, muscle strength, lethargy, concentration, psychomotor activity
nonclassical effects of cannabis include ________ and are more common with __________
agitation and seizures more common with synthetic or spice blends, incense packaging
AEs from synthetic cannabinoids
sx: blank stare, slow response, normal vitals, lethargy, arousable, normal reflexes, normal pupils, groaning sounds, slow mech movements = zombie like description
why do people do bagging/ huffing/ sniffing/ spraying
Intoxicating effects immediately
Plethora of chemicals readily absorb through lungs + distribute rapidly
Initially stimulating, then less inhibited + less in control
Chemicals prevent/ limit breathing in oxygen
ST effects of huffing/ etc
HA, N/V, loss of balance, dizziness, slurred and slowed speech, mood changes, hallucinations
LT effects of huffing/ etc
cardiotoxicity (from inflam, CHF, sudden cardiac death), respiratory damage, anoxic brain damage, liver and kidney damage, progressive neuro injury (ex- hearing loss, muscle spasms, loss of coordination), loss of concentration, ST memory loss
what is sudden sniffing death syndrome
abrupt CV collapse due to irreg HR (~505 of inhalant related deaths)
1,1 difluoroethane (DFE) is an ____________ used as refrigerant chemical component of canned air
organic HC, colorless, odorless gas
sx of inhaling DFE
inebriation, frostbite, blisters, CNS depression (drowsiness, N, HA, fatigue, weakness)
Asphyxiant (displaces oxygen) + heavier than air + flammable
pathophys of sudden sniffing death syndrome
Cardiac dysrhythmias
Sensitization of myocardium to catecholamines
Blocks K and Ca channels and sodium current = prolongs repolarization or ↑ QT dispersion
Effects often unpredictable and occur in first time users
Startled by being caught = sudden release of catecholamines
how to tx sudden sniffing death sx
CPR, defibrillation, BB (avoid epi)
