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Related Concept Videos

Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

624
While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
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2° Amines to N-Nitrosamines: Reaction with NaNO201:20

2° Amines to N-Nitrosamines: Reaction with NaNO2

5.0K
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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Toxic Reactions: Overview01:26

Toxic Reactions: Overview

1.6K
When toxic substances penetrate the human body, they disseminate to various tissues, undergoing metabolic changes. This process yields reactive metabolites that may covalently bind with specific target molecules, resulting in toxicity.
Toxicity falls into two primary categories: local and systemic.
Local toxicity appears at the exposure site, such as protein denaturation caused by caustic substances.
In contrast, systemic toxicity requires the toxic agent's absorption and distribution,...
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Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

706
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
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Anticholinesterase Agents: Poisoning and Treatment01:26

Anticholinesterase Agents: Poisoning and Treatment

1.3K
Anticholinesterases, also known as cholinesterase inhibitors, work by blocking the breakdown of acetylcholine, leading to its accumulation in the synaptic cleft. This accumulation indirectly enhances both muscarinic and nicotinic actions. These agents are classified as reversible or irreversible based on their mechanism of action.     
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
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Recording Brain Electromagnetic Activity During the Administration of the Gaseous Anesthetic Agents Xenon and Nitrous Oxide in Healthy Volunteers
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Nitrous oxide-induced toxic leukoencephalopathy.

Ramey Assaf1, Philips George Michael2, Nigel Langford3

  • 1Anaesthesia, Leicester Royal Infirmary, Leicester, UK ramey.assaf@doctors.org.uk.

BMJ Case Reports
|December 11, 2020
PubMed
Summary
This summary is machine-generated.

Recreational nitrous oxide inhalation can cause toxic leukoencephalopathy (TL), a serious brain condition. This case highlights a young adult’s full neurological recovery after TL diagnosis from nitrous oxide abuse.

Keywords:
drug interactionsdrug misuse (including addiction)drugs misuse (including addiction)poisoningunwanted effects/adverse reactions

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Area of Science:

  • Neuroscience
  • Toxicology
  • Neuropathology

Background:

  • Toxic leukoencephalopathy (TL) is a neurological condition affecting the brain's white matter.
  • It can result from exposure to various toxins, including recreational drugs.
  • Nitrous oxide is a commonly abused substance, particularly among young individuals.

Observation:

  • A young, healthy male presented with an altered mental state.
  • Investigations revealed significant recreational nitrous oxide inhalation.
  • Brain imaging confirmed the diagnosis of toxic leukoencephalopathy.

Findings:

  • The patient was diagnosed with toxic leukoencephalopathy secondary to nitrous oxide abuse.
  • Following extensive medical care and a prolonged hospital stay, he experienced a complete neurological recovery.

Implications:

  • This case underscores the neurotoxic potential of recreational nitrous oxide.
  • It highlights the importance of considering substance abuse in cases of unexplained neurological decline.
  • Early diagnosis and management may lead to favorable neurological outcomes in toxic leukoencephalopathy.