Nitrite inhalants

No systematic studies of tolerance to the reinforcing effects of inhaled nitrites have been reported. However, anecdotal observations in workers with high exposure to nitrites have suggested that tolerance to the subjective effects of this compound occurs after a few days of exposure (Marsh and Marsh... 

In short, the dark reaction of N02 with water on surfaces is ubiquitous and occurs not only in laboratory systems but also indoors. The combination of this heterogeneous reaction with combustion sources of HONO can produce significant concentrations of HONO indoors. As a result, there is a concern regarding the health impacts of nitrous acid, not only because it is an inhalable nitrite but also because it is likely the airborne acid present in the highest concentrations indoors. 

Only inhale nitrites when yon are in a comfortable sitting or lying position. 

These drugs are used recreationally in dance clubs where patrons sniff them on the dance floor to increase their enjoyment. Combining the beat of the music, rhythm, light shows, and dancing with inhalant use makes the experience more enjoyable for some users. Nitrites were also commonly used in sexual pleasure, particularly by homosexual males during sexual activity to intensify the experience." Unlike other inhalants, nitrite use has decreased considerably since 1979 among high-school students. 

Tran DC, Yeh K, Brazeau DA, and Fung H (2003) Inhalant nitrite exposure alters mouse hepatic angiogenic gene expression. Biochemical and Biophysical Research Communications 310 439-445. 

Hydrogen cyanide (inhaled) or alkali oanides (taken by mouth, rf. p. IQ2) inhale amyl nitrite from freshly opened capsules. Obtain medical attention urgently. 

Care must be exercised in handling n-amyl and the other alkyl nitrites inhalation of the vapour may cause severe headache and heart excitation. The preparation must therefore be conducted in an efficient fume cupboard. 

Sodium nitrite is poisonous and prolonged contact with dry sodium nitrite or its solutions can cause irritation to the skin, eyes, and mucous membranes. The LD q (oral, rat) is 85 mg per kg body weight (11). Inhalation or ingestion of significant quantities of dust or mist may result in acute toxic effects such as nausea, cyanosis, and low blood pressure, which can lead to possible coUapse, coma, and even death. 

Little is known regarding the pharmacokinetic properties of volatile nitrites in humans, particularly isobutyl nitrite and its primary metabolite, isobutyl alcohol. In rodents, after an intravenous infusion of isobutyl nitrite, blood concentrations peaked rapidly and then declined, with a half-life of 1.4 minutes and blood clearance rate of 2.9 L/min/kg (Kielbasa and Fung 2000). Approximately 98% of isobutyl nitrite is metabolized rapidly to isobutyl alcohol, concentrations of which also decline rapidly, with a half-life of 5.3 minutes. Bioavailability of inhaled isobutyl nitrite at a concentration of 300-900 ppm is estimated to be 43%. 

Toluene, volatile nitrites, and anesthetics, like other substances of abuse such as cocaine, nicotine, and heroin, are characterized by rapid absorption, rapid entry into the brain, high bioavailability, a short half-life, and a rapid rate of metabolism and clearance (Gerasimov et al. 2002 Pontieri et al. 1996, 1998). Because these pharmacokinetic parameters are associated with the ability of addictive substances to induce positive reinforcing effects, it appears that the pharmacokinetic features of inhalants contribute to their high abuse liability among susceptible individuals. 

Despite the paucity of systematic studies in humans, the available evidence suggests that, like drugs such as alcohol, sedatives, and stimulants, inhalant drugs (i.e., solvents, general anesthetics, and nitrites) exert reinforcing effects and increase motor activity. Furthermore, with continuous use, these drugs appear to induce both tolerance and symptoms of withdrawal. 

Although, to our knowledge, the effects of inhalation of amyl nitrite or butyl nitrite on glutamatergic neurotransmission have not been studied, NO, the potent compound that mediates the peripheral effects of nitrites in blood vessels, if released in the CNS when nitrites are inhaled, may potentially affect the glutamatergic system. NO has been reported to act directly on the postsynaptic NMDA receptor, where it can increase or decrease NMDA-mediated currents and subsequent calcium influx (Aizenman et al. 1990 Dingledine et al. 1999 Manzoni et al. 1992). 

Haverkos HW, Pinsky PF, Drotman DP, etal Disease manifestation among homosexual men with acquired immunodeficiency syndrome a possible role of nitrites in Kaposi s sarcoma. Sex Transm Dis 12 203-208, 1985 Haverkos HW, Kopstein AN, Wilson H, et al Nitrite inhalants history, epidemiology, and possible links to AIDS. Environ Health Perspect 102 858-861, 1994 Hernandez-Avila CA, Ortega-Soto HA, Jasso A, et al Treatment of inhalant-induced psychotic disorder with carbamazepine versus haloperidol. Psychiatr Serv49 812— 815, 1998... 

Kielbasa W, Fung HL Pharmacokinetics of a model organic nitrite inhalant and its alcohol metabolite in rats. Drug Metab Dispos 28 386-391, 2000... 

Schroeder HG Acute and delayed chloroform poisoning. Br J Anaeseth 37 972—975,1965 Schwartz AM The cause, relief and prevention of headaches arising from contact with dynamite. N Engl J Med 235 541-544, 1946 Schwartz RH, Peary P Abuse of isobutyl nitrite inhalation (rush) by adolescents. Clin Pediatr 25 308-310, 1986... 

Recently nitrosamines have attracted attention because of their marked carcinogenic activity in a wide variety of animal species Q, ). Nitrosamines are likely to be carcinogens in man as well human exposure to these compounds is by ingestion, inhalation, dermal contact and vivo formation from nitrite and amines Nitrite and amines react most rapidly at an acidic pH A variety of factors, however, make nitrosation a potentially important reaction above pH 7 these include the presence of microorganisms, and the possibilities of catalysis by thiocyanate, metals and phenols, and of transnitrosation by other nitroso compounds. 

HEALTH HAZARDS OF NITRITE INHALANTS. Harry W. Haverkos,... 

Because ethyl nitrite is harmful if inhaled continuously, the reaction should be carried out in a hood or out of doors. 

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