TOXICOLOGY
TREATMENT
■ Supportive therapy
■ Airway management and aspiration precautions
COMPLICATIONS
■ Rhabdomyolysis
Inhalants
Inhaled drugs of abuse are a diverse group of substances (see Table 6.19) that
are inhaled for their euphoric effects. Toxicity is unique to each substance.
HYDROCARBONS
Found in readily available household products, typically in the propellant;
inhaled via three common routes:
■ Sniffing: Directly inhaling from the source
■ Huffing: Inhaling from soaked cloth
■ Bagging: Inhaling from a bag that has been sprayed
Hydrocarbons are rapidly absorbed when volatilized and rapidly distribute to
the CNS because of their high lipid solubility.
MECHANISM/TOXICITY
■ Exact mechanism is not known.
SYMPTOMS/EXAM
■ Short-lived inebriation, euphoria, coma
■ Chronic abuse may result in an organic brain syndrome or peripheral
axonopathy.
■ “Sudden sniffing death”: Sensitization of the heart to catecholamines
results in VT or Vfib when startled.
TREATMENT
■ Supportive care
Hydrodrocarbon’s effect
rapidly resolves when exposed
to fresh air. Prolonged AMS
suggests other etiologies or
hypoxic damage.
TABLE 6.19. Toxicity of Common Inhaled Drugs of Abuse
INHALANT TOXICITY
Hydrocarbons (gasolines, oils) Sudden sniffing death
Peripheral axonopathy
Methylene chloride (paint stripper) Carbon monoxide poisoning
Toluene (glue) Non—anion gap metabolic acidosis (hippuric acid)
Nitrites Methemoglobinemia
Syncope
Nitrous oxide Sedation and coma
Vitamin B 12 deficiency