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xD3 Pharm Exam 3 > Abuse Inhalants (Shelton) > Flashcards

Abuse Inhalants (Shelton) Flashcards

1
Q

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

A

inhalants

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2
Q

What are some use-based categories of inhalants?

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

What group is most likely to abuse inhalants and why?

A

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

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4
Q

What are the most common inhalants abused?

A

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

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5
Q

Demographically, who does inhalants?

A

Young rich white kids (both males and females)

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6
Q

What are some physical signs of inhalant abuse?

A
  1. Chemical odor on breath
  2. Spots or sores in or around the mouth
  3. Rhinorrhea
  4. Red, irritated eyes
  5. Perioral dermatitis
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7
Q

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

A
  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
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8
Q

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

A
  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
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9
Q

What are some acute behavioral effects of inhalants?

A
  1. Depressant-like intoxication
  2. Omnipotent feelings
  3. Loss of consciousness possible
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10
Q

What is the administration of inhalants?

A

By definition they are inhaled (duh!)

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11
Q

What is the absorption of inhalants?

A

Their high lipid solubility results in rapid absorption

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12
Q

What is the distribution of inhalants?

A
  1. Easily cross the BBB and placental barrier

2. Distribution may be selective

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13
Q

How are inhalants metabolized and excreted?

A
  1. Metabolized by the liver (the main exception being nitrous oxide)
  2. A large percentage are excreted unchanged through exhalation
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14
Q

Inhalants have what effect on GABA-A?

A

Increase transmission of GABA-A

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15
Q

What effect do inhalants have on NMDA receptors?

A

Inhibit transmission on NMDA

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16
Q

What are the abuse potential of volatile solvents and aerosols?

A
  1. Rapid intoxication
  2. Easily concealed
  3. Legal
  4. Easy accessibility
17
Q

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

A

Toluene

18
Q

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

A
  1. Toluene
  2. Methyl ethyl ketone
  3. Acetone
19
Q

Until 1989, areosols were primarily made up of what?

A

Chloroflurocarbons (CFCs)

20
Q

Most propellants are now what type of chemicals?

A

Hydrocarbons (propane, N-butane, isobutane)

21
Q

What are “dusters”?

A

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

22
Q

What are some inhalational anesthetics?

A
  1. Sevoflurane
  2. Isoflurane
  3. Desflurane
  4. Halothane
  5. Ether
23
Q

What is the largest group of inhalational anesthesia abusers?

A

Human and animal health professionals

24
Q

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

A
  1. High stress
  2. Easy accessibility
  3. Exposure / sensitization
25
Q

Is nitrous oxide an analgesic of anesthetic?

A

Analgesic (is condisered a poor anesthetic)

26
Q

What are some neurological symptoms of chronic nitrous oxide abuse?

A
  1. NUmbness and weakness in limbs
  2. Loss of dexterity
  3. Sensory loss
  4. Loss of balance
  5. Cognitive and emotional changes
27
Q

What is methionine important for?

A

Maintenance of the spinal cord

28
Q

What effect does NO2 have on methionine?

A

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

29
Q

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

A

NO. Only the periphery

30
Q

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

A

Nitrite is NO2

Nitrate is NO3

31
Q

What are some acute effects of nitrites?

A
  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
32
Q

In what ways may inhalants damage the brain?

A
  1. Demyelination
  2. Personality changes
  3. Memory impairment
  4. Loss of coordination
  5. Slurred speech
  6. Sight disorder
33
Q

How does toluene abuse affect the brain?

A

Leads to atrophy of the substantial nigra

34
Q

In what ways may inhalants damage the peripheral organs?

A
  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
35
Q

How may inhalants damage muscles and bones?

A
  1. Muscle weakness and wasting

2. Damage to bone marrow, including possibility of leukemia

36
Q

What are some causes of death associated with solvent abuse?

A
  1. Sudden sniffing death (especially with toluene)
  2. Suffocation
  3. Aspiration of vomit
  4. Accidental death
37
Q

What are some hematological effects of chronic nitrite abuse?

A

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

38
Q

What are some immunological effects of chronic nitrite abuse?

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

xD3 Pharm Exam 3 (8 decks)

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