Inhalant abuse: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
*Generally a clinical diagnosis. | *Generally a clinical diagnosis | ||
*Labs | |||
**Blood gas | |||
**CBC | |||
**Electrolytes | |||
**LFTs, hepatotoxicity | |||
**Serum glucose | |||
**BUN/Cr | |||
**CK, urinalysis | |||
**Toxicological screen | |||
**Serum toluene concentrations do not guide therapy<ref>Toluene. Baselt RC, ed. Disposition of Toxic Drugs and Chemicals in Man. 7th ed. Foster City, CA: Biomedical Publications; 2004. 1120-24.</ref> | |||
==Management== | ==Management== | ||
Revision as of 14:37, 22 June 2016
Background
- First described in the 1950s
- Most common abusant in preteens 11-13yo
- Most abused: gasoline, solvents like toluene, spray paints, lighter fluid, air fresheners, glue, and electronic cleaners (halogenated hydrocarbons)
- Includes: "sniffing", "huffing", "bagging", and "dusting"
Clinical Features
- General: Euphoria, hallucinations
- Neuro: Impaired motor activity, ataxia, depressed mentation, withdrawal potential
- Cardiac: Widened QRS, prolonged QT, syncope, arrhythmias
- Skin: May cause dermal burns
- "Sudden sniffing death" - thought to be occur with sudden catecholamine surge on a "sensitized" myocardium
Differential Diagnosis
Drugs of abuse
- 25C-NBOMe
- Alcohol
- Amphetamines
- Bath salts
- Cocaine
- Ecstasy
- Gamma hydroxybutyrate (GHB)
- Heroin
- Inhalant abuse
- Hydrocarbon toxicity
- Difluoroethane (electronics duster)
- Marijuana
- Kratom
- Phencyclidine (PCP)
- Psilocybin ("magic mushrooms")
- Synthetic cannabinoids
- Chloral hydrate
- Body packing
Diagnosis
- Generally a clinical diagnosis
- Labs
- Blood gas
- CBC
- Electrolytes
- LFTs, hepatotoxicity
- Serum glucose
- BUN/Cr
- CK, urinalysis
- Toxicological screen
- Serum toluene concentrations do not guide therapy[1]
Management
- Supportive care, cardioversion for dysrhythmias
- Careful use of vasopressors as sympathomimetics may increase risk of dysrhythmias
- If founded down with sudden death with history of recent inhalant abuse → give beta-blocker (propanolol, esmolol)
- Thought to counteract myocardial sensitization
Disposition
- Based on patient's clinical status.
See Also
References
- ↑ Toluene. Baselt RC, ed. Disposition of Toxic Drugs and Chemicals in Man. 7th ed. Foster City, CA: Biomedical Publications; 2004. 1120-24.