Butyl nitrite, abuse

Organic solvents inhaled by abusers include gasoline, glue, aerosols, amyl nitrite, butyl nitrite, typewriter correction fluid, lighter fluid, cleaning fluids, paint products, nail polish remover, waxes, and varnishes. Chemicals in these products include nitrous oxide, toluene, benzene, methanol, methylene chloride, acetone, methyl ethyl ketone, methyl butyl ketone, trichloroethylene, and trichloroethane. 

Four types of inhalants are abused (1) anesthetic gases (2) industrial solvents, including a variety of hydrocarbons, such as toluene (3) aerosol propellants, such as various fluorocarbons and (4) organic nitrites, such as amyl or butyl nitrite. The mode of action of the inhalant anesthetics has been discussed in Chapter 25 General Anesthetics. 

Amyl nitrite has been used as a vasodilator drug, a diagnostic agent, and a cyanide treatment adjunct it is an abused inhalant. Butyl nitrite is an abused inhalant. Isobutyl nitrite is an ingredient of various incenses or room odorizers, and it is also used as a jet propellant and in the preparation of fuels. It is an abused inhalant. 

Tenenbein 1992). More important from the perspective of immunomodulation is the abuse of so-called room odorizers or volatile nitrites. These compounds—such as amyl nitrite, butyl nitrite, and isobutyl nitrite (IBN)—produce vasodi-lation of the cerebral vessels, resulting in euphoria (Haverkos and Dougherty 1988) and a reported enhancement in sexual function. Initially used clinically in the treatment of angina pectoris, their use appears to be prevalent in the homosexual community and may be associated with Kaposi s sarcoma (Newell et al. 1984). Use of these compounds has been demonstrated to result in decreased immune function, particularly T-cell-mediated immunity (Dax et al. 1991 Lotzova et al. 1984 Soderberg and Barnett 1991 Ratajczak et al. 1995). The association between inhalants and Kaposi s sarcoma is currently the subject of increased research interest. 

The alkyl nitrites that can be abused by inhalation (cyclohexyl nitrite, isobutyl nitrite, isopentyl nitrite) are a special case in that (1) they are extremely unstable and break down rapidly in vivo to the corresponding alcohols and (2) usually also contain other isomers (butyl nitrite, pentyl nitrite). Any products submitted for analysis will usually contain the corresponding alcohols as well as the nitrites. 

Most abusers are drawn to inhalants for their psychoactive, or mind-altering, effects. Users of nitrites are the exception. The nitrites make up an inhalant subcategory that includes amyl, butyl, and cyclohexyl nitrites. These substances were nicknamed poppers because in the past, they were packaged in ampules. Users cracked the ampules to release the vapors. Nitrites are abused, internationally, because they produce a sexual rush, accompanied by a sense of power and exhilaration. 

Nitrites and nitrates have a number of medicinal uses. Abuse of volatile nitrites (amyl, butyl, and isobutyl nitrites intended for medical use) as recreational drugs (e.g., psychedelics) has been reported. On the street, they may be called rush , poppers , and snappers . 

Organic nitrates (eg, nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate) are widely used as vasodilators for the treatment of ischemic heart disease and heart failure. Organic nitrates such as nitroglycerin are also used in explosives. Bismuth subnitrate, ammonium nitrate, and silver nitrate are used in antidiarrheal dmgs, cold packs, and topical bum medications, respectively. Sodium and potassium nitrate and nitrite are used in preserving cured foods and may also occur in high concentrations in some well water. Butyl, amyl, ethyl, and isobutyl nitrites are often sold as room deodorizers or liquid incense and are sometimes inhaled for abuse purposes. 

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