HLTH 2040 Quiz #8

Aerosols

- Include spray paints, deodorant and hair sprays, vegetable oil sprays for cooking, and fabric protector sprays. - Often abused not because of the effects produced by their principal ingredients but rather because of the effects of their propellant gases. - Can be dangerous because these devices are capable of generating very high concentrations of the inhaled chemicals.

Volatile Substances

- Includes aerosols, art or office supplies, adhesives, fuels, and industrial or household solvents. - Some abusers inhale vapors directly from their original containers (called sniffing or snorting). - Some abusers inhale volatile solvents from plastic bags (called bagging) or from old rags or bandannas soaked in the solvent fluid and held over the mouth (called huffing).

Anesthetics (e.g., Nitrous Oxide)

- "Laughing gas": frequently used in outpatient procedures - Can also be sold in large balloons or small cylindrical cartridges used as charges for whipped cream dispensers

Potential Consequences

- "Sudden Sniffing Death Syndrome" (SSDS): A condition characterized by serious cardiac arrhythmia occurring during or immediately after inhaling - Brain damage - Damage to heart, kidney, liver, and bone marrow

Government Regulation

- 1964: The Advisory Committee to the U.S. Surgeon General reported that cigarette smoking is related to lung cancer. - 1970: Warnings on cigarette labels.

Current Tobacco Use in the U.S.

- 2014, 66.9 million Americans, 25.2% of the population age 12 or older, reported current use of a tobacco product. - Approximately 31.1 % of males and 19.7% of females age 12 or older were current users of any tobacco product.

Signs of Inhalant Abuse B

- Appear drunk for short periods of time (15 to 60 minutes) but recover quickly - Do not do well in school and are usually unkempt - Sitting with a pen or marker near nose - Constantly smelling clothing sleeves

Nitrites

- Cause vasodilation - Prototype, amyl nitrite, has been used in the past to treat angina - Abuse has decreased dramatically

Tobacco Use Without Smoking

- Chewing tobacco and snuff. - Lead to nicotine addiction and dependence. - Contains 28 cancer-causing agents. - Smokeless tobacco is strongly associated with leukoplakia. - Smokeless tobacco increases the risk of developing cancer of the oral cavity and pancreas. - Smokeless tobacco use during pregnancy increases the risks for preeclampsia, premature birth, and low birth weight.

Cancer

- Cigarette smoking is a major cause of cancers of the lung, bladder, pancreas, cervix, esophagus, stomach, oral cavity, and kidney. - Smoking increases the risk of lung cancer by approximately 25-fold in men and 25.7-fold in women.

Signs of Inhalant Abuse A

- Collect an unusual assortment of chemicals (such as glues, paints, thinners and solvents, nail polish, liquid eraser, and cleaning fluids) in bedrooms or with belongings - Have breath that occasionally smells of solvents - Often have the sniffles similar to a cold but without other symptoms of the ailment

Butane and Propane

- Commonly found in lighter fluid, hair and paint sprays. - SSDS and serious burn injuries (because of flammability) have resulted from abuse.

Electronic Cigarettes

- Electronic cigarettes (e-cigarettes) are devices designed to deliver nicotine or other substances to a user as a vapor. - The FDA has not evaluated e-cigarettes for effectiveness or safety.

Freons

- Freons and other related agents are used in refrigerators, air conditioners, and airbrushes. - Inhalation can cause not only serious liver damage but also SSDS. - Inhalation can cause freeze injuries.

Signs of Inhalant Abuse C

- Hiding rags, clothes, or empty containers of the potentially abused products in closets, boxes, and other places - Possessing chemical-soaked rags, bags, or socks - Abusable household items missing

Legislation

- Inhalants are generally not regulated as are other drugs of abuse. - Some states have adopted laws preventing the use, sale, and/or distribution to minors of various products abused commonly as inhalants.

Tobacco Use: Scope of the Problem

- Leading preventable cause of disease and premature death in U.S. (480,000 deaths annually) - Tobacco is the single largest cause of preventable death

Why Abused?

- Legally obtained - Readily available - Inexpensive - Easy to conceal - Lack of information about potential dangers

Master Settlement Agreement

- Limitations on advertising - Ban on cartoon characters in advertising - Ban on "branded" merchandise - Limitations on sponsoring of sporting events - Disbanding of tobacco trade organizations - Funds designated to support anti-smoking measures and research to reduce youth smoking

History of Tobacco Use

- Mayans: tobacco smoke as "divine incense" - Turkey: poets vs. religious leaders - France: Louis XIII vs. Louis XIV - Nicholas Monardes: infallible cure - Pope Urban VII: excommunication for tobacco users

Methods for Quitting

- Nicotine gum - Nicotine patches - Nicotine spray - Nicotine lozenges - Bupropion - Varenicline

Who Abuses?

- Primarily adolescents, but even small children. - More adolescent males than females. - Chronic inhalant users frequently have a profile similar to that associated with other substance abusers. That is, often they live in unhappy surroundings with severe family or school problems, they have poor self-image, and sniffing gives them an accessible escape.

Nitrous Oxide

- Significant abuse problems of nitrous oxide are infrequent, but there are occasional reports of severe hypoxia or death due to acute overdoses. - Can cause loss of sensation, limb spasms, altered perception and motor coordination, blackouts resulting from blood pressure changes, and reduced cardiac function.

Cardiovascular Disease

- Smoking causes coronary heart disease, a leading cause of death in the United States. - Compared with nonsmokers, smoking increases the risk of coronary heart disease two to four times. - Smoking puts smokers at greater risk for stroke.

Dangers of Inhalants

- Sudden sniffing death syndrome - Damage to brain, liver, kidney, heart - Choking on vomit - Accidents associated with "intoxication" and fires

Considerations

- Synergistic effects - Lipid (fat) composition - Developmentally immature users

Light Cigarettes

- There is no conclusive evidence of reduced health risks associated with low-tar cigarettes. - Filtered cigarettes reduce levels of tar, nicotine, and carbon monoxide at the mouth end of the filter and should be of some limited benefit. - Many smokers lose this benefit because they often smoke more cigarettes per day, increase puff number and volume, or block the filter holes with their fingers or lips.

Types of Inhalants

- Volatile substances - Anesthetics - Nitrites

Tobacco Production

- primary species of tobacco: Nicotiana tabacum. - Flue-cured tobacco is cured with heat transmitted through a flue without exposure to smoke or fumes.

History of Tobacco Use in America

- the early 1800s: Cigars became popular in US. - The introduction of the cigarette-rolling machine spurred cigarette consumption because cigarettes became less expensive.

Gasoline

1. A mixture of volatile chemicals, including toluene, benzene, and triorthocresyl phosphate (TCP) 2. Because of its widespread availability, young people, particularly in rural settings, sometimes abuse gasoline 3. As a mixture of chemicals, its intentional inhalation can be especially dangerous. - Benzene is an organic compound that causes impaired immunologic function, bone marrow injury, increased risk of leukemia, and reproductive system toxicity. - TCP is a fuel additive that causes degeneration of motor neurons.

History

1. 1776, British chemist Joseph Priestley synthesized nitrous oxide, a colorless gas with a slightly sweet odor and no noticeable taste. 2. Priestly and Humphry Davy suggested correctly that the gas might be useful as an anesthetic, and experiments were conducted to test this possibility. 3. 1950s: Abuse of inhalants came to public attention when the news media reported that young people were getting high from sniffing glue.

Benefits of Cessation

1. A return to normalcy of heart rate and blood pressure (which are abnormally high while smoking). 2. A decline of carbon monoxide in the blood within hours. 3. Improved circulation, production of less phlegm, and decreased rate of coughing and sneezing within weeks. 4. Substantial improvements in lung function within several months. 5. Decreased risk for lung and other types of cancer. 6. Decreased risk for coronary heart disease, stroke, and peripheral vascular disease. 7. Decreased respiratory symptoms such as coughing, wheezing, and shortness of breath. 8. Decreased risk of developing chronic obstructive pulmonary disease. 9. Decreased risk for infertility in women. 10. Decreased risk of having a low birth weight baby.

Potential Effects of Inhaling Volatile Substances

1. Can cause irritation of airways causing coughing and sneezing. 2. Low doses: bring a brief feeling of lightheadedness, mild stimulation followed by a loss of control, lack of coordination, and disorientation accompanied by dizziness and possible hallucinations. 3. higher doses: produce relaxation, sleep, or even coma (In some instances) 4. If inhalation is continued, dangerous hypoxia may occur and cause brain damage or death. 5. Other effects include hypertension and damage to the cardiac muscle, peripheral nerves, brain, and kidneys. 6. Chronic abusers of inhalants frequently lose their appetite, are continually tired, and experience nosebleeds.

Toluene

1. Found in some glues, paints, thinners, nail polishes, and typewriter correction fluid 2. A principal ingredient in "Texas shoe shine" 3. Detectable in the arterial blood within 10 seconds of inhalation exposure 4. Highly lipid soluble 5. Can cause brain damage, impaired cognition, and gait disturbances 6. Liver and kidney damage have been reported

Pharmacology of Nicotine

1. It is a colorless, highly volatile liquid alkaloid. 2. Smoked: enters the lungs → absorbed into the bloodstream. 3. Chewed or dipped: absorbed through the mucous lining of the mouth. 4. Amount of tobacco absorbed depends on - Exact composition of tobacco - How densely the tobacco is packed in the cigarette - Whether a filter is used and characteristics of filter - The volume of smoke inhaled - The number of cigarettes smoked

Introduction

1. Volatile substances introduced via the lungs. 2. Most cause intoxicating and/or euphorigenic effects. 3. Many of these substances were never intended to be used by humans as drugs; consequently, they are not often thought of as having abuse potential. 4. Most commonly used drugs by adolescents. 5. Why? A widespread misconception is that inhalant abuse is a harmless phase that occurs commonly during normal childhood and teenage development and as such is not worthy of significant concern.

Effects on Pregnancy

1. approximately 10% of women reported smoking during the last 3 months of pregnancy. (data from 24 states associated with the 2011 Pregnancy Risk Assessment and Monitoring System) 2. Women who smoke during pregnancy are: - ↑ risk of miscarriage. - Smoking during pregnancy: cause a baby to be born prematurely or have low birth weight. - risk factor of sudden infant death syndrome (SIDS). - Babies born to women who smoke are more likely to have certain birth defects, including a cleft palate or lip.

Cigarette Smoking

Cigarette smokers: - tend to die at an earlier age than nonsmokers - have a higher probability of developing certain diseases, including cardiovascular disease, cancer, bronchopulmonary disease, and other illnesses.

Bronchopulmonary Disease

Cigarettes damage the airways and alveoli and cause emphysema and chronic airway obstruction.

Family Smoking Prevention and Tobacco Control Act

Gave FDA authority to regulate the manufacture, distribution, and marketing of tobacco products

Chapter 14

Inhalants

Tobacco Use: A Costly Addiction

More deaths are caused each year by tobacco use than by HIV, illegal drug use, murders, alcohol use, suicides, and motor vehicle injuries combined.

Secondhand Smoke

Secondhand smoke exposure causes an estimated 34,000 heart disease deaths annually in the United States.

Physiological Effects

Stimulates: - central dopamine release - cardiovascular system

Chapter 11

Tobacco

Secondhand smoke include

a mixture of smoke that comes directly from the lighted tip of a cigarette, cigar, or pipe tip and exhaled smoke.

Passive smoking

refers to nonsmokers' inhalation of tobacco smoke.