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Poppers: Difference between revisions
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When nitrite vapors are inhaled in a limited manner (i.e. a few hits during a scene), the risk of significant systemic toxicity is low (though other risks may still exist, see below). <u>At high doses, nitrite compounds are '''highly toxic''' and can cause serious bodily harm or '''death'''.</u> | When nitrite vapors are inhaled in a limited manner (i.e. a few hits during a scene), the risk of significant systemic toxicity is low (though other risks may still exist, see below). <u>At high doses, nitrite compounds are '''highly toxic''' and can cause serious bodily harm or '''death'''.</u> | ||
Systemic toxicity from poppers is caused by a chemical reaction between poppers and hemoglobin (the substance in blood responsible for transporting oxygen from the lungs to the rest of the body). This reaction converts hemoglobin into methemoglobin (which cannot bind to oxygen), causing a condition called '''methemoglobinemia'''. When a considerable fraction of hemoglobin has been converted into methemoglobin (>20%), oxygen delivery to the body becomes significantly impaired, producing symptoms of organ dysfunction. At very high fractions (>40%), organ failure or death can occur. Methylene blue is an effective antidote which can rapidly convert methemoglobin back into hemoglobin, though this should always be administered by medical professionals in a hospital setting. | Systemic toxicity from poppers is caused by a chemical reaction between poppers and hemoglobin (the substance in blood responsible for transporting oxygen from the lungs to the rest of the body). This reaction converts hemoglobin into methemoglobin (which cannot bind to oxygen), causing a condition called '''methemoglobinemia'''.<ref>{{Citation |last=Chen |first=Richard J. |title=Methemoglobinemia |date=2025 |url=http://www.ncbi.nlm.nih.gov/books/NBK537317/ |work=StatPearls |access-date=2026-02-06 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=30726002 |last2=Nappe |first2=Thomas M.}}</ref> When a considerable fraction of hemoglobin has been converted into methemoglobin (>20%), oxygen delivery to the body becomes significantly impaired, producing symptoms of organ dysfunction. At very high fractions (>40%), organ failure or death can occur. Methylene blue is an effective antidote which can rapidly convert methemoglobin back into hemoglobin, though this should always be administered by medical professionals in a hospital setting. | ||
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Dangerous high-dose exposure during recreational use typically occurs in one of two situations: | Dangerous high-dose exposure during recreational use typically occurs in one of two situations: | ||
* Taking many hits repeatedly over a long scene. In this circumstance, signs and symptoms of toxicity will progressively develop, which can provide the opportunity for detection and cessation of use before serious harm develops. <u>Blue coloration of lips, fingers, or toes is the most specific indicator that high levels of methemoglobin have accumulated, in which case poppers use should be immediately stopped in that scene.</u> | * Taking many hits repeatedly over a long scene. In this circumstance, signs and symptoms of toxicity will progressively develop, which can provide the opportunity for detection and cessation of use before serious harm develops. <u>Blue coloration of lips, fingers, or toes is the most specific indicator that high levels of methemoglobin have accumulated, in which case poppers use should be immediately stopped in that scene.</u> | ||
* Ingestion of poppers in liquid form, in which organ failure and/or death can occur '''within minutes'''. Although data is limited, fatal case reports have been published for oral ingestion of amounts as small as 2-3 mL. <u>Thus, the exposure of a nontrivial amount of liquid poppers into any body cavity (oral, nasal, rectal, etc.) should be treated as a medical emergency and emergency medical services should be called '''immediately'''.</u> | * Ingestion of poppers in liquid form, in which organ failure and/or death can occur '''within minutes'''. Although data is limited, fatal case reports have been published for oral ingestion of amounts as small as 2-3 mL.<ref>{{Cite web |title=Toxicological Profile for Nitrate and Nitrite - ATSDR |url=https://www.atsdr.cdc.gov/toxprofiles/tp204-c3.pdf}}</ref> <u>Thus, the exposure of a nontrivial amount of liquid poppers into any body cavity (oral, nasal, rectal, etc.) should be treated as a medical emergency and emergency medical services should be called '''immediately'''.</u> | ||
=== Tissue burns === | === Tissue burns === | ||