Inhalant abuse
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.
Management
- Supportive care
- 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.