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Inhalational Anesthetics: Overview01:20

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Secondary amines react with nitrous acid to form N-nitrosamines, as depicted in Figure 1. Nitrous acid, a weak and unstable acid, is formed in situ from an aqueous solution of sodium nitrite and strong acids, such as hydrochloric acid or sulfuric acid, in cold conditions. In the presence of an acid, the nitrous acid gets protonated. The subsequent loss of water results in the formation of the electrophile known as nitrosonium ion.
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Drug Toxicity: Risk factors01:24

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Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
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The enteral drug administration involves three primary routes: oral, sublingual, and buccal. Oral ingestion is the most prevalent, safe, economical, and convenient method for drug administration. However, it has certain drawbacks, including limited absorption due to the drug's low water solubility or poor membrane permeability, possible emesis from GI mucosa irritation, destruction of drugs by digestive enzymes or low gastric pH, and irregular absorption along with food or other drugs.
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Related Experiment Video

Updated: Mar 31, 2026

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Recreational nitrous oxide use: Prevalence and risks.

Jan van Amsterdam1, Ton Nabben2, Wim van den Brink3

  • 1Department of Psychiatry, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.

Regulatory Toxicology and Pharmacology : RTP
|October 27, 2015
PubMed
Summary

Nitrous oxide (N2O), or laughing gas, is a popular recreational drug. While generally safe for moderate use, heavy use can lead to vitamin B12 deficiency and neurological issues.

Keywords:
AnestheticBulbsDependenceLaughing gasMegaloblastomaNitrous oxidePeripheral neuropathyRecreational useWhippits

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Area of Science:

  • Anesthesiology
  • Neuroscience
  • Public Health

Background:

  • Nitrous oxide (N2O), known as laughing gas, is widely used clinically as an anesthetic and for its anxiolytic properties.
  • Recreational N2O use has surged, particularly in nightlife settings, becoming the second most popular recreational drug in the UK.
  • Its legal status, availability, and low cost contribute to its widespread recreational consumption.

Purpose of the Study:

  • To review the clinical and recreational use of nitrous oxide.
  • To assess the associated risks and side effects of N2O.
  • To inform policy and user awareness regarding N2O consumption.

Main Methods:

  • Literature review of clinical and recreational N2O use.
  • Analysis of reported side effects and health consequences.
  • Examination of prevalence data in recreational settings.

Main Results:

  • Recreational N2O use induces rapid euphoric and psychoactive effects, typically short-lived.
  • Common side effects include dizziness, dissociation, and impaired cognition.
  • Heavy or sustained use can lead to vitamin B12 inactivation, causing neurological damage and megaloblastic anemia.
  • Fatalities linked to N2O use are primarily due to asphyxia.

Conclusions:

  • While N2O is relatively safe for moderate recreational use, potential users must be educated about risks.
  • Heavy N2O consumption poses significant risks of vitamin B12 deficiency, leading to neurological and hematological complications.
  • Current legal measures may not be necessary, but enhanced user information is crucial.