Inhalant and Respiratory Stimulant

• INHALANTS

  volatile substances that produce chemical vapors that can be inhaled to induce a psychoactive, or mind-altering, effect.
• CATEGORIES OF INHALANTS

  VOLATILE

  AEROSOL

  GASES

  NITRITES
• VOLATILE

  -liquids that vaporize at room temperature
• AEROSOL

  -sprays that contain propellants and solvents
• Volatile

  EXAMPLES : paint thinners and removers, dry-cleaning fluids, degreasers, gasoline, glues, correction fluids, and felt-tip markers
• Aerosol

  -EXAMPLES:

  spray paints,

  deodorant and hair sprays,

  vegetable oil sprays for cooking,

  and fabric protector sprays.
• GASES

  -common in medical anesthetics and household products
• Gases

  -EXAMPLES:

  Medical anesthetics

  -ether,

  chloroform,

  halothane,

  and nitrous oxide (laughing gas)

  Household products

  -butane lighters,

  propane tanks,

  and refrigerants
• NITRITES

  -act primarily to dilate blood vessels and relax the muscles.
• NITRITES

  -a special class of inhalants
• NITRITES

  -used primarily as sexual enhancers
• NITRITES

  EXAMPLES:

  cyclohexyl nitrite,

  isoamyl (amyl) nitrite,

  and isobutyl (butyl) nitrite
• Amyl nitrite

  is used in certain diagnostic procedures and was prescribed in the past to treat some patients for heart pain.
• COMMON INHALANTS

  OXYGEN

  CARBON DIOXIDE

  NITROGEN

  NITROUS OXIDE

  ETHER

  CHLOROFORM

  HALOTHANE
• weakens hypoxia

  -induced mitochondrial depolarization that generates reactive oxygen species and/or apoptosis
• Studies investigating hyperbaric oxygen therapy have shown that oxygen supplementation can induce neural stem cell proliferation in neonatal rats thus promoting neurological regeneration after injuries.
• CD34+, CD45-dim leukocytes

  are also potential targets for hyperbaric oxygen therapy benefit as their mobilization was increased in vitro which could facilitate the acceleration of recovery at peripheral sites.
• OXYGEN (O₂)

  INDICATIONS:

  various types of anoxia

  hypoxia or dyspnea

  trauma

  poisonings

  drug overdoses
• CARBON DIOXIDE (CO₂)

  USES:

  an insufflation gas

  for cryotherapy

  respiratory stimulant before and after anesthesia

  for expansion of blood vessels if required

  to stimulate breathing after a period of non-breathing
• an insufflation gas

  ▪ for minimal invasive surgery like laparoscopy, endoscopy, and arthroscopy

  ▪ to enlarge and stabilize body cavities to provide better visibility of the surgical area
• for expansion of blood vessels if required :

  ▪ to increase carbon dioxide level after rapid breathing
• NITROGEN (N₂)

  • LIQUID NITROGEN

  Mainly used as a cryogenic agent for treatment of various benign and malignant skin lesions.
• NITROUS OXIDE (NO₂)

  USES:

  Analgesics (Non-Narcotic)

  Anesthetics (Inhalation,Gases or volatile liquids)
• NITROUS OXIDE (NO₂)

  Analgesics (Non-Narcotic)

  ▪ A subclass of analgesic agents that typically do not bind to OPIOID RECEPTORS and are not addictive.
• NITROUS OXIDE (NO₂)

  Anesthetics (Inhalation,Gases or volatile liquids)

  ▪ Gases or volatile liquids that vary in the rate at which they induce anesthesia; potency; the degree of circulation, respiratory, or neuromuscular depression they produce; and analgesic effects. Inhalation anesthetics have advantages over intravenous agents in that the depth of anesthesia can be changed rapidly by altering the inhaled concentration. Because of their rapid elimination, any postoperative respiratory depression is of relatively short duration.
• ETHER (R-O-R’)

  • USES:

  Anesthetics (Inhalation,Gases or volatile liquids)

  Solvent
• ETHER (R-O-R’)

  Anesthetics (Inhalation,Gases or volatile liquids)

  ▪ Lower ethers are used as general anesthetics. Since they produce intense local cooling when sprayed on the skin, ethers are also used as local anesthetics for minor surgical operations. o
• ETHER (R-O-R’)

  Solvents

  ▪ Liquids that dissolve other substances (solutes), generally solids, without any change in chemical composition, as, water containing sugar.

  ▪ Can be both in the laboratory and in industry
• CHLOROFORM (CHCl₃)

  • USES

  an industrial solvent

  an anesthetic

  an important laboratory agent.

  for the preparation of important compounds like chloropicrin, and chloritone
• HALOTHANE (C₂HBrClF₃)

  -also called as Fluothane
• HALOTHANE (C₂HBrClF₃)

  USES

  general inhalation anesthetic for induction and maintenance of general anesthesia

  reduces the blood pressure o frequently decreases the pulse rate and depresses respiration.

  induces muscle relaxation

  reduces pains sensitivity

  ▪ by decreasing the extent of gap junction mediated cell-cell coupling and altering the activity of the channels that underlie the action potential
• reduces pains sensitivity

  ▪ by decreasing the extent of gap junction mediated cell-cell coupling and altering the activity of the channels that underlie the action potential
• RESPIRATORY STIMULANTS

  medications used to stimulate respiration post anesthesia or to treat respiratory conditions
• Diseases that treats with Respiratory Stimulant

  Chronic Obstructive Pulmonary Disease (COPD)

  Respiratory failure/depression

  Neonatal Apnea
• FDA-approved INDICATIONS:

  Chronic obstructive pulmonary disease associated with hypercapnia (high carbon dioxide level in the blood).

  Respiratory depression post-anesthesia.

  Drug-induced central nervous system depression

  Fatigue and drowsiness

  Respiratory failure

  Neonatal apnea (cessation of breathing in newborn)
• MECHANISM OF ACTION (MOA)

  1.Stimulating the brain’s respiratory center in the medulla oblongata, located at the base of the brain.

  2.The medulla senses a rise in carbon dioxide and drop in oxygen levels in the blood and stimulates respiration.
• SIDE EFFECTS

  muscle tremors

  agitation

  anxiety

  irritability

  insomnia
• CONTRAINDICATIONS

  
  

  Arteriosclerosis

  cardiovascular disease

  hypertension

  Pregnancy and breastfeeding

  History of seizures

  Hepatic or renal disease

  Theophylline
• CONTRAINDICATIONSDRUG

  INTERACTIONS WITH:

  beta blockers

  phenytoin

  beta adrenergic agonists

  antidepressants

  cimetidine

  ciprofloxacin

  tobacco smoke

  marijuana
• COMMON RESPIRATORY STIMULANTS

  Phosphodiesterase enzyme inhibitors

  Doxapram