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"documento" => "article" "crossmark" => 1 "subdocumento" => "rev" "cita" => "Med Clin. 2023;161:533-42" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Review</span>" "titulo" => "Rheumatoid arthritis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "533" "paginaFinal" => "542" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Artritis reumatoide" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3438 "Ancho" => 2925 "Tamanyo" => 567385 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0085" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Treatment algorithm for rheumatoid arthritis according to the Spanish Society of Rheumatology.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">DMARDs: disease-modifying antirheumatic drugs; csDMARD: conventional synthetic DMARD; tsDMARD: targeted synthetic DMARD; MTX: methotrexate.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Federico Díaz-González, María V. 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"apellidos" => "Hernández-Hernández" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775323004645" "doi" => "10.1016/j.medcli.2023.07.014" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775323004645?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623004692?idApp=UINPBA00004N" "url" => "/23870206/0000016100000012/v2_202401260944/S2387020623004692/v2_202401260944/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Special article</span>" "titulo" => "The new trend of some inhalant use: Risks and warnings of false harmlessness" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "543" "paginaFinal" => "546" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Jose Cárdenas-Quesada, Clara Pérez-Mañá, Esther Papaseit, Magí Farré" "autores" => array:4 [ 0 => array:3 [ "nombre" => "Jose" "apellidos" => "Cárdenas-Quesada" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Clara" "apellidos" => "Pérez-Mañá" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Esther" "apellidos" => "Papaseit" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:4 [ "nombre" => "Magí" "apellidos" => "Farré" "email" => array:1 [ 0 => "mfarre.germanstrias@gencat.cat" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Farmacología, de Terapéutica y de Toxicología, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Farmacología Clínica, Hospital Universitari Germans Trias i Pujol y Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La nueva moda de consumo de algunos inhalantes: riesgos y alerta por la falsa inocuidad" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 194 "Ancho" => 500 "Tamanyo" => 5981 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0095" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Chemical structure of ethyl chloride.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A few years ago, we published a review in <span class="elsevierStyleSmallCaps">MEDICINA CLÍNICA</span> on the use of some medicines in recreational settings that ended up becoming drugs of abuse.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> These included ketamine, dextromethorphan, nitrous oxide (inhaled use) and gamma hydroxybutyrate (GHB). Since then, the abuse of inhalants has been increasing, and some countries such as the Netherlands and Australia have banned the possession and use of nitrous oxide. In this new manuscript we report 2 medicines that are currently used as drugs of abuse, namely alkyl nitrites, mainly amyl nitrite and ethyl chloride. In addition, 2 inhalants for home or industrial use, such as glues and "lighter gases", are included, which are also misused. In all cases, these are substances that are administered by inhalation and are reputed to be safe after use. It should be noted that they are readily available and their consumption seems to be increasing. This article reports their chemical properties, patterns and epidemiology of use, pharmacological effects and toxicity in humans.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Alkyl nitrites: <span class="elsevierStyleItalic">poppers</span></span><p id="par0010" class="elsevierStylePara elsevierViewall">Alkyl nitrites (amyl nitrite, as well as butyl and isobutyl nitrite among others) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), are part of the volatile nitrites, aliphatic esters of nitrous acid.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> They are commonly known as <span class="elsevierStyleItalic">poppers,</span> nitrogenous compounds that are available in small bottles or ampoules of 10–30<span class="elsevierStyleHsp" style=""></span>ml and contain the substance in yellowish liquid form. They are highly volatile products which rapidly convert to gaseous form at room temperature and are consumed by inhaling the fumes from the bottle. They are highly flammable substances and contact with fire should be avoided.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Since its discovery in the 19th century, it has been known to be used to increase sexual arousal, facilitate penile erection and relax anal muscles. From 1867, amyl nitrite was used to treat angina pectoris, although it was discarded due to dosage difficulties. It can also be used as an antidote in cyanide poisoning due to the formation of methaemoglobin which, when combined with cyanide, reverses the toxicity,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> although it is of little clinical use due to the hypoxia it produces by blocking the transport of oxygen through haemoglobin.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Organic nitrites are partially metabolised in the liver to nitric oxide (NO), a potent cerebral and peripheral vasodilator.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The vascular pharmacological effects consist of the induction of vascular smooth muscle relaxation, with an indirect effect on the heart resulting in tachycardia and decreased blood pressure. In addition, side effects such as flushing of the face and neck, nausea and vomiting may occur. The drop in blood pressure is maximal at 30<span class="elsevierStyleHsp" style=""></span>s, with a decrease of 30<span class="elsevierStyleHsp" style=""></span>mmHg in systolic pressure, returning to normal at 2<span class="elsevierStyleHsp" style=""></span>min.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Poppers</span> produce a stimulant and vasodilatory effect within seconds of inhalation, with increased sex drive, euphoria and a feeling of physical lightness, although these effects disappear around 2<span class="elsevierStyleHsp" style=""></span>min<span class="elsevierStyleHsp" style=""></span>post-exposure.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> For a long time, its use was directly associated with sex between men who have sex with men (MSM), regardless of the context in which it took place, with inhalations being taken during sex just prior to orgasm. Since the 1990s, the use of alkyl nitrites has become popular in <span class="elsevierStyleItalic">"chemsex"</span> situations (also known as "party and play" or "PnP"), contexts in which certain recreational drugs are consumed at sexual parties to facilitate or enhance sexual encounters.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Prevalence data in these cases have increased dramatically relative to the general population. In Australia, a study in MSM found that 24.3% used <span class="elsevierStyleItalic">poppers</span> weekly or more frequently,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> while another study, again in Australia, showed the percentage rising to 38% in young people (again in MSM).<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In Europe, a study conducted in Paris among MSM showed that 46.7% of respondents reported having used <span class="elsevierStyleItalic">poppers</span> in the last 3 months. This pattern of use is significantly associated with the diagnosis of sexually transmitted diseases (STDs), especially chlamydia and syphilis infections, risky sexual behaviour, and use of alcohol and other recreational drugs during sex.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">In Spain, a study conducted in Madrid and Barcelona on sexualised drug use (SDU) among MSM attending 4 HIV/STD diagnostic services in these cities revealed that the most commonly used substance as a first drug for sex was <span class="elsevierStyleItalic">poppers</span>, with the highest percentage at 53.6%, followed by <span class="elsevierStyleItalic">cannabis</span> and sildenafil. The prevalence of lifetime use increased to 61.9%.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In addition to the already well-known use in "<span class="elsevierStyleItalic">chemsex</span>", nowadays its use is extended to any kind of young public beyond the exclusive sexual context to which it was originally related. In these new uses, the rapid sensation of euphoria and well-being, and short duration, are sought after. Their widespread use stems from a misconception of the harmlessness of this substance due to the duration of the effect or the accessibility of this type of product. Although the 2022 Report of the Spanish Observatory on Drugs and Addictions estimates the lifetime prevalence of inhalant use among 14–18-year-olds at 1.8%,<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> the presence of these products at youth parties is a fact reflected in many surveys, with the prevalence increasing in <span class="elsevierStyleItalic">"clubbing</span>" communities.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">In fact, studies based on electronic dance music (EDM) party-goers in New York have shown that the prevalence of past-year poppers use was 14.5% in 2018.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> Extrapolating to the general population, the <span class="elsevierStyleItalic">Global Drug Survey</span> (GDS), which collects anonymous use data from thousands of users, found that in 2021, 5.8% of respondents had used <span class="elsevierStyleItalic">poppers</span> in the past year, while 15.8% had used poppers at some point in their lives.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">These substances are not without risks, one of the most common of which is methaemoglobinaemia.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> Methaemoglobin concentrations of up to 94% have been reached in some extreme cases, leading to hypoventilation, hypotension, bradycardia and cardiac arrest.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">It should also be noted that it is a potent vasodilator and therefore has potential drug interactions. Thus, the consumption of any of these nitrites with phosphodiesterase type V inhibitor drugs for erectile dysfunction (including sildenafil or tadalafil, among others) or therapeutic nitrates leads to a potentiation of the vasodilator effect, with a significant reduction in blood pressure causing dizziness, loss of consciousness, and in extreme cases, cardiac ischaemia or cardiovascular accident, even resulting in death.<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17,18</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Finally, the visual impairment caused by <span class="elsevierStyleItalic">poppers,</span> namely maculopathy, which leads to a progressive loss of central vision, should be mentioned. One case reported blurred vision in both eyes for 7 days after having used <span class="elsevierStyleItalic">poppers</span> regularly (at least 2–3 times a month) for the previous 7 years. The potential cause of retinal damage is thought to be the high concentration of nitric oxide, which at high doses causes apoptosis in the photoreceptors or also vasodilatation, with increased intraocular pressure and secondary retinal damage.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Although the risks are well known and the fact that these products are banned in Spain, they are easy to obtain on websites, at a very affordable price. For this reason, the false idea that these products are harmless should once again be highlighted, and although there is hardly any data on addictive disorders with these volatile inhalants, despite the possibility of tolerance, the short duration of the pharmacological effect increases the possibility of repeated use. It is also important to draw the attention of young people who do not use other substances to the fact that their use can turn them into "gateway drugs".</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Chloroethyl</span><p id="par0070" class="elsevierStylePara elsevierViewall">Chloroethane or ethyl chloride, also commonly known as chloroethyl, is a chlorinated hydrocarbon (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) in spray form, which is applied directly to the skin of the area to be anaesthetised. It was originally intended as a general anaesthetic, but as it did not have an adequate safety profile due to cardiac toxicity and risk of death, it was limited to use as a topical anaesthetic, a use that is still present, being marketed as a medical device.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Ethyl chloride evaporates rapidly once it leaves the spray and is directed to the skin, contact causes a reduction in skin temperature of up to -20<span class="elsevierStyleHsp" style=""></span>°C, and by this cryo-anaesthesia reduces pain. After approximately 10<span class="elsevierStyleHsp" style=""></span>s of contact it can cause a topical anaesthesia of up to 30<span class="elsevierStyleHsp" style=""></span>s. It is also a flammable compound that requires caution with fire.<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20,21</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">During the 1980s it had already been described as a recreational drug at a national level, being considered as the first substance that expanded in Spain within the consumption of inhalants.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> It is a substance that is easy to acquire and is used in a similar way to the aforementioned nitrites or <span class="elsevierStyleItalic">poppers</span> with similar pharmacological effects.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> It is usually administered by inhalation after spraying it onto a garment or fabric, causing short-lived euphoric and excitatory states similar to those described for <span class="elsevierStyleItalic">poppers</span>, although the disinhibition or lack of coordination may continue for longer, even hours.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">These effects occur through generalised central nervous system depression, including loss of consciousness, respiratory depression, arterial hypotension and nausea.<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">22,23</span></a> There are also risks of interactions with other sedative substances.</p><p id="par0090" class="elsevierStylePara elsevierViewall">In one of the few published cases of fatal chloroethyl inhalation poisoning, 11 canisters of chloroethyl spray were found in a patient with a history of inhalant abuse. Death was caused by cardiovascular depression, which occurs in parallel with respiratory depression. Fentanyl and citalopram were also found in this poisoning, again highlighting the potential synergistic depressant effects with joint consumption.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Due to the easy accessibility of the product, its use is widespread among young people, as it does not require a medical prescription and there is no control over its purchase. Even in places where its availability has been limited, accessibility on websites is widespread, so that the supposed control is not an obstacle. Furthermore, there is very little data on the use epidemiology of this substance in the scientific literature or surveys. In the latter, it is only found within the group of inhalants (which includes <span class="elsevierStyleItalic">poppers</span> and solvents, among others) in the reports of the Spanish Observatory on Drugs and Addictions.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> In the USA, for several years its use was reported separately, although it is currently grouped with other inhalants in a similar way to Spain.</p><p id="par0100" class="elsevierStylePara elsevierViewall">In Brazil, even more commonly and with a marked cultural tendency, the well-known <span class="elsevierStyleItalic">lança-perfume</span> is consumed during carnival, and is one of the most consumed substances by young people. It is composed of ether, chloroform and chloroethyl, producing effects very similar to those mentioned above, but with a longer duration.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">One event that brought chloroethyl back into the spotlight was the fatal poisoning of a public figure who died of respiratory arrest secondary to chloroethyl inhalation. The absence of any other substance in the toxicological examination demonstrates the danger of chloroethyl alone.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">At the same time, there are many references to the re-emergence of chloroethyl in Spain as a recreational drug, such as in the case of <span class="elsevierStyleItalic">"Clore Parties".</span> These are parties for young people where there is a high presence of chloroethyl, as well as other substances.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> It is worth noting the consumption of alcohol at this type of party, which, due to its vasodilator and central nervous system depressant effects, can produce synergistic effects with the co-administration of chloroethyl.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Other non-medical inhalants</span><p id="par0115" class="elsevierStylePara elsevierViewall">In addition to the aforementioned drugs, there has been a long-standing use of some volatile substances or inhalants marketed for home and/or industrial use, which are consumed to obtain disinhibition and euphoria. These include industrial solvents (toluene or petrol among others), gases (butane or propane), anaesthetics (nitrous oxide) and nitrites (discussed above). They constitute a global public health problem. The most commonly used substances are glues due to their greater availability and accessibility. The misuse of glues as inhalant drugs is and has been a widespread practice mainly from the 1980s to the present day and has been described in various settings, mainly in schools.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">Contact, craft or modelling glues contain volatile substances, such as toluene, also present in adhesives, paints or paint thinners or cyanoacrylate (in quick-drying adhesives), which can be inhaled and cause adverse effects on the central nervous system and other organs, mainly at the cardiac level. Among these volatile substances is toluene, a liquid hydrocarbon derived from benzene, which causes, when its vapours are inhaled, pharmacological effects typical of other CNS depressants. Toluene can cause hypokalaemia, nephrotoxicity and cardiac arrhythmias.<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">27,28</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">There is now a reported increase in the prevalence of consumption of new products such as "lighter gas" as it is colloquially known, referring to gases used to charge cigarette lighters. They are generally composed of different gaseous hydrocarbons such as butane or propane which have flammable and explosive properties and when inhaled can cause severe burns.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> Butane, an aliphatic hydrocarbon, the main component of "lighter gas" is a particularly volatile compound, which facilitates its CNS diffusion, causing pharmacological effects similar to those described above, such as a feeling of euphoria, disinhibition or distortion of reality, as well as dizziness, headache and light-headedness. The greatest risk from consumption of this gas is hypoxia, and possible sudden death resulting from heart failure. In fact, a minor was recently reported to have died from exposure to "lighter gas" which, in conjunction with <span class="elsevierStyleItalic">cannabis</span> use, led to cardiorespiratory arrest and death.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">In the case of poisoning, volatile inhalants have no specific antidote, except in the case of methaemoglobinaemia due to abuse of laughing gas or nitrous oxide (methylene blue). Treatment is symptomatic with ventilatory support and cardiac monitoring.</p><p id="par0135" class="elsevierStylePara elsevierViewall">While it is true that, for decades, all volatile substances have been considered less risky by the population, due to the theoretical absence of possible addiction development, the high variability of products and the lack of social risk perception makes them to be considered as a gateway drug that could lead to experimentation with other even more toxic substances. All this should raise the alarm for increased restrictions and more research into their use. The potential risks must now be taken into account, including interactions with the most common substances, cases of serious or fatal poisoning and all the behaviours with which they have been associated, particularly risky sexual practices. Healthcare professionals must be aware of these new uses of known substances in order to take them into account in their routine practice, both at the level of history-taking and in terms of their non-detection in hospital laboratories, at least in the emergency department.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Ethical considerations</span><p id="par0140" class="elsevierStylePara elsevierViewall">Not necessary as it is a narrative review and does not include personal data.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Funding</span><p id="par0145" class="elsevierStylePara elsevierViewall">The authors declare that there is no external funding.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conflict of interest</span><p id="par0150" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest in relation to this article.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:7 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Alkyl nitrites: poppers" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Chloroethyl" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Other non-medical inhalants" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Ethical considerations" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Funding" ] 5 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflict of interest" ] 6 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2023-05-16" "fechaAceptado" => "2023-07-03" "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 232 "Ancho" => 1500 "Tamanyo" => 16492 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0090" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chemical structure of the main nitrites found in poppers: amyl nitrite, butyl nitrite and isobutyl nitrite, from left to right, respectively.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 194 "Ancho" => 500 "Tamanyo" => 5981 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0095" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Chemical structure of ethyl chloride.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Club drugs: los viejos fármacos son las nuevas drogas de la fiesta [Club drugs: old medicines as new party drugs]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Abanades" 1 => "A.M. Peiró" 2 => "M. Farré" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0025-7753(04)74499-1" "Revista" => array:6 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2004" "volumen" => "123" "paginaInicial" => "305" "paginaFinal" => "311" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15373979" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Methaemoglobinaemia associated with the use of cocaine and volatile nitrites as recreational drugs: a review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L. Hunter" 1 => "L. Gordge" 2 => "P.I. Dargan" 3 => "D.M. Wood" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2125.2011.03950.x" "Revista" => array:6 [ "tituloSerie" => "Br J Clin Pharmacol" "fecha" => "2011" "volumen" => "72" "paginaInicial" => "18" "paginaFinal" => "26" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21352269" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Energy Control. Poppers. [Accessed 26 June 2023]. Available from: <a target="_blank" href="https://energycontrol.org/sustancias/poppers/">https://energycontrol.org/sustancias/poppers/</a>." ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Drug Scope. Nitrites. [Accessed 26 June 2023]. Available from: <a target="_blank" href="https://web.archive.org/web/20070405132026/http://www.drugscope.org.uk/druginfo/drugsearch/ds_results.asp?file=%5cwip%5c11%5c1%5c1%5cnitrites.html">https://web.archive.org/web/20070405132026/http://www.drugscope.org.uk/druginfo/drugsearch/ds_results.asp?file=%5cwip%5c11%5c1%5c1%5cnitrites.html</a>." ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Psychosexual aspects of the volatile nitrites" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "T.P. Lowry" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/02791072.1982.10471914" "Revista" => array:6 [ "tituloSerie" => "J Psychoactive Drugs" "fecha" => "1982" "volumen" => "14" "paginaInicial" => "77" "paginaFinal" => "79" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6126533" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Delegación del Gobierno Para El Plan Nacional Sobre Drogas. Poppers. [Accessed 26 June 2023]. Available from: <a target="_blank" href="https://pnsd.sanidad.gob.es/ciudadanos/dosieresinformacion/pdf/20221229_Dosier_Popper.pdf">https://pnsd.sanidad.gob.es/ciudadanos/dosieresinformacion/pdf/20221229_Dosier_Popper.pdf</a>." ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "When "Chems" Meet Sex: A Rising Phenomenon Called "ChemSex" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. Giorgetti" 1 => "A. Tagliabracci" 2 => "F. Schifano" 3 => "S. Zaami" 4 => "E. Marinelli" 5 => "F.P. Busardò" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2174/1570159X15666161117151148" "Revista" => array:6 [ "tituloSerie" => "Curr Neuropharmacol" "fecha" => "2017" "volumen" => "15" "paginaInicial" => "762" "paginaFinal" => "770" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27855594" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence, frequency, and motivations for alkyl nitrite use among gay, bisexual and other men who have sex with men in Australia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.J. Vaccher" 1 => "M.A. Hammoud" 2 => "A. Bourne" 3 => "T. Lea" 4 => "B.G. Haire" 5 => "M. Holt" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Int J Drug Policy" "fecha" => "2020" "volumen" => "76" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Harmless? A hierarchical analysis of poppers use correlates among young gay and bisexual men" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D. Demant" 1 => "O. Oviedo-Trespalacios" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/dar.12958" "Revista" => array:6 [ "tituloSerie" => "Drug Alcohol Rev" "fecha" => "2019" "volumen" => "38" "paginaInicial" => "465" "paginaFinal" => "472" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31209963" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of poppers and HIV risk behaviours among men who have sex with men in Paris, France: an observational study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H.R. Hambrick" 1 => "S.H. Park" 2 => "J.J. Palamar" 3 => "A. Estreet" 4 => "J.A. Schneider" 5 => "D.T. Duncan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1071/SH17217" "Revista" => array:6 [ "tituloSerie" => "Sex Health" "fecha" => "2018" "volumen" => "15" "paginaInicial" => "370" "paginaFinal" => "373" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29852927" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sexualized drug use among men who have sex with men in Madrid and Barcelona: the gateway to new drug use?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.M. Guerras" 1 => "J. Hoyos" 2 => "M. Donat" 3 => "L. de la Fuente" 4 => "D. Palma Díaz" 5 => "O. Ayerdi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Front Public Health" "fecha" => "2022" "volumen" => "10" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Observatorio Español de las Drogas y las Adicciones. Informe 2022. Alcohol, tabaco y drogas ilegales en España. [Accessed 26 June 2023]. Available from: <a target="_blank" href="https://pnsd.sanidad.gob.es/profesionales/sistemasInformacion/informesEstadisticas/pdf/2022OEDA-INFORME.pdf">https://pnsd.sanidad.gob.es/profesionales/sistemasInformacion/informesEstadisticas/pdf/2022OEDA-INFORME.pdf</a>." ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adverse drug-related effects among electronic dance music party attendees" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.J. Palamar" 1 => "P. Acosta" 2 => "A. Le" 3 => "C.M. Cleland" 4 => "L.S. Nelson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.drugpo.2019.07.005" "Revista" => array:6 [ "tituloSerie" => "Int J Drug Policy" "fecha" => "2019" "volumen" => "73" "paginaInicial" => "81" "paginaFinal" => "87" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31349134" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Global Drug Survey. GDS 2021 Global Report. [Accessed 26 June 2023]. Available from: <a target="_blank" href="https://www.globaldrugsurvey.com/wp-content/uploads/2021/12/Report2021_global.pdf">https://www.globaldrugsurvey.com/wp-content/uploads/2021/12/Report2021_global.pdf</a>." ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => ""Popper" induced methemoglobinemia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "F. Elgendy" 1 => "G.D. Rio-Pertuz" 2 => "D. Nguyen" 3 => "D. Payne" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/08998280.2022.2030188" "Revista" => array:6 [ "tituloSerie" => "Proc (Bayl Univ Med Cent)" "fecha" => "2022" "volumen" => "35" "paginaInicial" => "385" "paginaFinal" => "386" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35518804" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Extreme methaemoglobinaemia secondary to recreational use of amyl nitrite" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.J. Edwards" 1 => "J. Ujma" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/emj.12.2.138" "Revista" => array:6 [ "tituloSerie" => "J Accid Emerg Med" "fecha" => "1995" "volumen" => "12" "paginaInicial" => "138" "paginaFinal" => "142" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7582412" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recreational use of sildenafil by HIV-positive and -negative homosexual/bisexual males" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F. Romanelli" 1 => "K.M. Smith" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1345/aph.1D571" "Revista" => array:6 [ "tituloSerie" => "Ann Pharmacother" "fecha" => "2004" "volumen" => "38" "paginaInicial" => "1024" "paginaFinal" => "1030" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15113986" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "FDA. Highlights of prescribing information: VIAGRA® (sildenafil citrate) [Accessed 26 June 2023]. Available from: <a target="_blank" href="https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/20895s039s042lbl.pdf">https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/20895s039s042lbl.pdf</a>." ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case of maculopathy from rush poppers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.T. Guo" 1 => "L.B. Jiang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.18240/ijo.2022.04.25" "Revista" => array:6 [ "tituloSerie" => "Int J Ophthalmol" "fecha" => "2022" "volumen" => "15" "paginaInicial" => "674" "paginaFinal" => "676" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35450173" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Energy Control. Cloretilo. [Accessed 26 June 2023]. Available from: <a target="_blank" href="https://energycontrol.org/sustancias/cloretilo/">https://energycontrol.org/sustancias/cloretilo/</a>." ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Poison Control. What is ethyl chloride spray? [Accessed 26 June 2023]. Available from: <a target="_blank" href="https://www.poison.org/articles/what-is-ethyl-chloride-spray">https://www.poison.org/articles/what-is-ethyl-chloride-spray</a>." ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Vice. Cloretilo, el poper de los adoslescentes de los 2000. [Accessed 26 June 2023]. Available from: <a target="_blank" href="https://www.vice.com/es/article/9kepgv/cloretilo-droga-farmacia-congela-cerebro">https://www.vice.com/es/article/9kepgv/cloretilo-droga-farmacia-congela-cerebro</a>." ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Death related to ethyl chloride inhalation abuse: a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "I.Z. Hong" 1 => "R. Ponampalam" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5847/wjem.j.1920-8642.2022.083" "Revista" => array:6 [ "tituloSerie" => "World J Emerg Med" "fecha" => "2022" "volumen" => "13" "paginaInicial" => "422" "paginaFinal" => "424" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36119769" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Hospital Santa Mônica. Lança-perfume: um dossiê completo sobre a droga. [Accessed 26 June 2023]. Available from: <a target="_blank" href="https://hospitalSantamonica.com.br/lanca-perfume-um-dossie-completo-sobre-a-droga/">https://hospitalSantamonica.com.br/lanca-perfume-um-dossie-completo-sobre-a-droga/</a>." ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "The Guardian. Darius Campbell Danesh died of inhalation of chloroethane. [Accessed 26 June 2023]. Available from: <a target="_blank" href="https://www.theguardian.com/music/2022/sep/10/darius-danesh-died-of-accidental-inhalation-of-chloroethane">https://www.theguardian.com/music/2022/sep/10/darius-danesh-died-of-accidental-inhalation-of-chloroethane</a>." ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "NIUS. Cloretilo, el anestésico de moda que crea adicción en los jóvenes que lo inhalan. [Accessed 26 June 2023]. Available from: <a target="_blank" href="https://www.niusdiario.es/sociedad/sucesos/20230228/cloretilo-anestesico-moda-adiccion-jovenes-inhalan_18_08849492.html">https://www.niusdiario.es/sociedad/sucesos/20230228/cloretilo-anestesico-moda-adiccion-jovenes-inhalan_18_08849492.html</a>." ] ] ] 26 => array:3 [ "identificador" => "bib0135" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "El PAÍS. El. peligro de los inhalantes. [Accessed 26 June 2023]. Available from: <a target="_blank" href="https://elpais.com/diario/1981/03/04/madrid/352556658_850215.html?event=go%26event_log=go%26prod=REGCRART%26o=cerrado">https://elpais.com/diario/1981/03/04/madrid/352556658_850215.html?event=go&event_log=go∏=REGCRART&o=cerrado</a>." ] ] ] 27 => array:3 [ "identificador" => "bib0140" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effects of the inhalant toluene on cognitive function and behavioral flexibility: a review of recent findings" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.J. Woodward" 1 => "K.M. Braunscheidel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Addict Neurosci" "fecha" => "2023" "volumen" => "5" ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0145" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A two-decade review of butane toxicity as a substance of abuse" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Vahabzadeh" 1 => "B. Mégarbane" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/bcpt.13760" "Revista" => array:6 [ "tituloSerie" => "Basic Clin Pharmacol Toxicol" "fecha" => "2022" "volumen" => "131" "paginaInicial" => "155" "paginaFinal" => "164" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35661589" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0150" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Diario de Sevilla. Inhalar’ gas mechero’ y otras peligrosas modas entre la juventud. [Accessed 26 June 2023]. Available from: <a target="_blank" href="https://www.diariodesevilla.es/salud/investigacion-tecnologia/mortales-riesgos-inhalar-gas-mechero-nueva-moda-jovenes_0_1726327449.html">https://www.diariodesevilla.es/salud/investigacion-tecnologia/mortales-riesgos-inhalar-gas-mechero-nueva-moda-jovenes_0_1726327449.html</a>." ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000016100000012/v2_202401260944/S2387020623004680/v2_202401260944/en/main.assets" "Apartado" => array:4 [ "identificador" => "44145" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Special article" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000016100000012/v2_202401260944/S2387020623004680/v2_202401260944/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623004680?idApp=UINPBA00004N" ]
Journal Information
Vol. 161. Issue 12.
Pages 543-546 (December 2023)
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Vol. 161. Issue 12.
Pages 543-546 (December 2023)
Special article
The new trend of some inhalant use: Risks and warnings of false harmlessness
La nueva moda de consumo de algunos inhalantes: riesgos y alerta por la falsa inocuidad
Jose Cárdenas-Quesadaa, Clara Pérez-Mañáa,b, Esther Papaseita,b, Magí Farréa,b,
Corresponding author
a Departamento de Farmacología, de Terapéutica y de Toxicología, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain
b Servicio de Farmacología Clínica, Hospital Universitari Germans Trias i Pujol y Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Barcelona, Spain
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