Abuse Inhalants (Shelton)

Question 1

What is a heterogeneous grouping of compounds which are defined only by their route of administration?

Answer 1

inhalants

Question 2

What are some use-based categories of inhalants?

Answer 2

1. Volatile solvents
2. Aerosols
3. Volatile anesthetics
4. Nitrites
5. Nitrous oxide
6. Refrigerants

Question 3

What group is most likely to abuse inhalants and why?

Answer 3

Children because they are cheap, easy to get a hold of, and are uncontrolled products

Question 4

What are the most common inhalants abused?

Answer 4

Glue, shoe polish, toluene (paints, lacquers, solvents)

Question 5

Demographically, who does inhalants?

Answer 5

Young rich white kids (both males and females)

Question 6

What are some physical signs of inhalant abuse?

Answer 6

1. Chemical odor on breath
2. Spots or sores in or around the mouth
3. Rhinorrhea
4. Red, irritated eyes
5. Perioral dermatitis

Question 7

What are some general signs of inhalant abuse (some of these are repeats with the “physical signs of inhalant abuse question)?

Answer 7

1. Chemical odor on breath or clothes
2. Paint stains on face, hands, or clothes
3. Hidden empty solvent containers or soaked rags / clothing
4. Lack of coordination
5. Disoriented apperance
6. Slurred speech
7. Inattentiveness

Question 8

What are the five steps of absorption, distribution and elimination of inhalants?

Answer 8

1. Inhalants are breathed in
2. Vapors are absorbed through the lungs
3. Substance gets absorbed into the bloodstream
4. Drug travels to brain and other tissues in the body
5. Primary route of elimination is exhalation

Question 9

What are some acute behavioral effects of inhalants?

Answer 9

1. Depressant-like intoxication
2. Omnipotent feelings
3. Loss of consciousness possible

Question 10

What is the administration of inhalants?

Answer 10

By definition they are inhaled (duh!)

Question 11

What is the absorption of inhalants?

Answer 11

Their high lipid solubility results in rapid absorption

Question 12

What is the distribution of inhalants?

Answer 12

1. Easily cross the BBB and placental barrier

2. Distribution may be selective

Question 13

How are inhalants metabolized and excreted?

Answer 13

1. Metabolized by the liver (the main exception being nitrous oxide)
2. A large percentage are excreted unchanged through exhalation

Question 14

Inhalants have what effect on GABA-A?

Answer 14

Increase transmission of GABA-A

Question 15

What effect do inhalants have on NMDA receptors?

Answer 15

Inhibit transmission on NMDA

Question 16

What are the abuse potential of volatile solvents and aerosols?

Answer 16

1. Rapid intoxication
2. Easily concealed
3. Legal
4. Easy accessibility

Question 17

Which volatile hydrocarbon seems to have a high propensity for abuse?

Answer 17

Toluene

Question 18

What are three of the few “pure” volatile solvents available?

Answer 18

1. Toluene
2. Methyl ethyl ketone
3. Acetone

Question 19

Until 1989, areosols were primarily made up of what?

Answer 19

Chloroflurocarbons (CFCs)

Question 20

Most propellants are now what type of chemicals?

Answer 20

Hydrocarbons (propane, N-butane, isobutane)

Question 21

What are “dusters”?

Answer 21

“Canned air” mostly HFC’s such as difluroethane and trifluorethane

Question 22

What are some inhalational anesthetics?

Answer 22

1. Sevoflurane
2. Isoflurane
3. Desflurane
4. Halothane
5. Ether

Question 23

What is the largest group of inhalational anesthesia abusers?

Answer 23

Human and animal health professionals

Question 24

What are job characteristics of health professionals that may increase the risk of anesthesia abuse?

Answer 24

1. High stress
2. Easy accessibility
3. Exposure / sensitization

Question 25

Is nitrous oxide an analgesic of anesthetic?

Answer 25

Analgesic (is condisered a poor anesthetic)

Question 26

What are some neurological symptoms of chronic nitrous oxide abuse?

Answer 26

1. NUmbness and weakness in limbs 2. Loss of dexterity 3. Sensory loss 4. Loss of balance 5. Cognitive and emotional changes

Question 27

What is methionine important for?

Answer 27

Maintenance of the spinal cord

Question 28

What effect does NO2 have on methionine?

Answer 28

Disrupts the action of methionine synthase, which converts vitamin B12 to methionine

Question 29

Do amyl, butyl, and isobutyl nitrates affect the brain?

Answer 29

NO. Only the periphery

Question 30

What is the chemical difference between a nitrate and a nitrite?

Answer 30

Nitrite is NO2 | Nitrate is NO3

Question 31

What are some acute effects of nitrites?

Answer 31

1. Muscle relaxant effects 2. Vasodilatation 3. Enhance sexual performance and pleasure 4. May be used to treat angina or as an antidote to cyanide poisoning

Question 32

In what ways may inhalants damage the brain?

Answer 32

1. Demyelination 2. Personality changes 3. Memory impairment 4. Loss of coordination 5. Slurred speech 6. Sight disorder

Question 33

How does toluene abuse affect the brain?

Answer 33

Leads to atrophy of the substantial nigra

Question 34

In what ways may inhalants damage the peripheral organs?

Answer 34

1. Reduction in oxygen-carrying capacity of the lungs 2. Damage to mucous membranes or to lung tissue 3. Arrhythmia 4. Liver damage by halogenated compounds such as TCE 5. Disruption of acid-base balance in kidney

Question 35

How may inhalants damage muscles and bones?

Answer 35

1. Muscle weakness and wasting | 2. Damage to bone marrow, including possibility of leukemia

Question 36

What are some causes of death associated with solvent abuse?

Answer 36

1. Sudden sniffing death (especially with toluene) 2. Suffocation 3. Aspiration of vomit 4. Accidental death

Question 37

What are some hematological effects of chronic nitrite abuse?

Answer 37

Hemolytic anemia due to increased formation of methemoglobin (vs hemoglobin)

Question 38

What are some immunological effects of chronic nitrite abuse?

Answer 38

1. Decrease in killer cell activity 2. Interference with T-cell function 3. Decrease in tumoricidal activity of macrophages