Organic nitrites, abuse

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. 

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. 

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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