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Poppers: Difference between revisions
Define methemoglobinemia, add spill prevention, minor fixes
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== Risks == | == Risks == | ||
In some individuals or in high doses, poppers can cause vomiting, methemoglobinemia, hypoxemia | 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> During methemoglobinemia, some oxygen-carrying hemoglobin in the blood is converted to methemoglobin, a form that cannot bind oxygen. | ||
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). | ||
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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. | 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 | Pulse oximeters should not be used to monitor oxygen level when poppers are used. Oximeters estimate oxygenation by measuring the absorbance of two wavelengths of light. Poppers generate methemoglobin which interferes with absorbance 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. | ||
Secure containers by closing their lids and placing them on stable surfaces to prevent spills. Spilled poppers | Secure containers by closing their lids and placing them on stable surfaces to prevent spills. Spilled poppers can cause exposure to higher concentrations than otherwise intended. To avoid spills, transfer a small amount of poppers onto a piece of absorbent cotton or paper in an empty poppers bottle, ensuring that the bottle contains no free liquid. The poppers will evaporate from the absorbent material and can be used as usual. | ||
== Known incidents == | == Known incidents == | ||