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Poppers: Difference between revisions

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In some individuals or in high doses, poppers can cause vomiting, methemoglobinemia, hypoxemia, reduced oxygen level in the blood, and unconsciousness<ref name=":0">{{Cite journal |last=Barry |first=Katherine |last2=McAteer |first2=Kristina E. |date=2023-04-03 |title=Syncope and Methemoglobinemia Preceded by Amyl Nitrite 'Popper' Inhalation |url=https://pubmed.ncbi.nlm.nih.gov/36989098/ |journal=Rhode Island Medical Journal (2013) |volume=106 |issue=3 |pages=49–51 |issn=2327-2228 |pmid=36989098}}</ref> which can persist for an extended time even after popper use is stopped.<ref name=":1">{{Cite journal |last=Olazagasti |first=Coral |last2=Paralkar |first2=Janvi |last3=Vishnevetsky |first3=Michael |last4=Chakravarti |first4=Aloke |last5=Sulica |first5=Roxana |last6=Favila |first6=Kristine |date=2016-10 |title=Poppers Not Only Make You High: A Rare Case of Amyl Nitrate-Induced Hypoxia |url=https://doi.org/10.1016/j.chest.2016.08.1216 |journal=Chest |volume=150 |issue=4 |pages=1108A |doi=10.1016/j.chest.2016.08.1216 |issn=0012-3692}}</ref>
In some individuals or in high doses, poppers can cause vomiting, methemoglobinemia, hypoxemia, reduced oxygen level in the blood, and unconsciousness<ref name=":0">{{Cite journal |last=Barry |first=Katherine |last2=McAteer |first2=Kristina E. |date=2023-04-03 |title=Syncope and Methemoglobinemia Preceded by Amyl Nitrite 'Popper' Inhalation |url=https://pubmed.ncbi.nlm.nih.gov/36989098/ |journal=Rhode Island Medical Journal (2013) |volume=106 |issue=3 |pages=49–51 |issn=2327-2228 |pmid=36989098}}</ref> which can persist for an extended time even after popper use is stopped.<ref name=":1">{{Cite journal |last=Olazagasti |first=Coral |last2=Paralkar |first2=Janvi |last3=Vishnevetsky |first3=Michael |last4=Chakravarti |first4=Aloke |last5=Sulica |first5=Roxana |last6=Favila |first6=Kristine |date=2016-10 |title=Poppers Not Only Make You High: A Rare Case of Amyl Nitrate-Induced Hypoxia |url=https://doi.org/10.1016/j.chest.2016.08.1216 |journal=Chest |volume=150 |issue=4 |pages=1108A |doi=10.1016/j.chest.2016.08.1216 |issn=0012-3692}}</ref>


Poppers containing isopropyl nitrite can cause damage to the fovea and can cause significant visual disturbance<ref name=":2">{{Cite journal |last=Rewbury |first=Rebecca |last2=Hughes |first2=Edward |last3=Purbrick |first3=Robert |last4=Prior |first4=Stephen |last5=Baron |first5=Mark |date=2017-11-01 |title=Poppers: legal highs with questionable contents? A case series of poppers maculopathy |url=https://bjo.bmj.com/content/101/11/1530 |journal=British Journal of Ophthalmology |language=en |volume=101 |issue=11 |pages=1530–1534 |doi=10.1136/bjophthalmol-2016-310023 |issn=0007-1161 |pmid=28396339}}</ref>. There isn't an easy way to verify if a bottle contains isopropyl nitrite without a lab since product labels may be incorrect, misleading, or missing (e.g. unlabeled brown bottle).
Poppers containing isopropyl nitrite can cause damage to the fovea and can cause significant visual disturbance<ref name=":2">{{Cite journal |last=Rewbury |first=Rebecca |last2=Hughes |first2=Edward |last3=Purbrick |first3=Robert |last4=Prior |first4=Stephen |last5=Baron |first5=Mark |date=2017-11-01 |title=Poppers: legal highs with questionable contents? A case series of poppers maculopathy |url=https://bjo.bmj.com/content/101/11/1530 |journal=British Journal of Ophthalmology |language=en |volume=101 |issue=11 |pages=1530–1534 |doi=10.1136/bjophthalmol-2016-310023 |issn=0007-1161 |pmid=28396339}}</ref>. There isn't an easy way to verify if a bottle contains isopropyl nitrite without a lab since product labels may be incorrect, misleading, or missing (e.g. unlabeled brown bottle).


Poppers can cause chemical burns if the liquid becomes exposed to skin or sinuses.
Poppers can cause chemical burns if the liquid becomes exposed to skin or sinuses.


== Risk mitigation ==
== Risk mitigation ==
Cease poppers usage if blood oxygen levels become lowered. Pale or blue skin or lips, or a headache can be used to identify low blood oxygen levels. If you don't recover, then seek medical help.
Cease poppers usage if blood oxygen levels become lowered. Pale or blue skin or lips, or a headache can be used to identify low blood oxygen levels. Seek medical attention if the subject does not recover.


Pulse oximeters should not be used to monitor oxygen level when poppers are used. Oximeters estimate oxygenation by measuring the absorptance of two wavelengths of light, and as poppers generate methemoglobin, it interferes with this absorptance, skewing the results towards a fixed number (in most cases, 85%) regardless of actual oxygenation<ref>{{Cite web |url=https://academic.oup.com/clinchem/article/51/2/434/5629640 |access-date=2024-02-20 |website=academic.oup.com}}</ref>.
Pulse oximeters should not be used to monitor oxygen level when poppers are used. Oximeters estimate oxygenation by measuring the absorptance of two wavelengths of light. Poppers generate methemoglobin which interferes with absorptance measurements, skewing the results towards a fixed number (in most cases, 85%) regardless of actual oxygenation<ref>{{Cite web |url=https://academic.oup.com/clinchem/article/51/2/434/5629640 |access-date=2024-02-20 |website=academic.oup.com}}</ref>.


Avoid poppers which are known to contain isopropyl nitrite. If any vision impairment is observed, stop using the poppers immediately, and consider avoiding that type of poppers again.   
Avoid poppers which are known to contain isopropyl nitrite. If any vision impairment is observed, stop using the poppers immediately, and consider avoiding that type of poppers again.   


Avoid spilling poppers which can expose you to higher concentrations over a period of time than otherwise intended.
Secure containers by closing their lids and placing them on stable surfaces to prevent spills. Spilled poppers which can cause exposure to higher concentrations than otherwise intended.


== Known incidents ==
== Known incidents ==