PDF(Pubmed)
Abstract：
Although inhalant abuse is common, it is one of the most neglected and overlooked forms of substance abuse. Inhalants refer to a wide variety of substances including volatile solvents, aerosols, gases, and nitrites. The mechanism of action of inhalants has not been fully defined. Several molecular targets contribute to the pharmacology, including ion-channel proteins that control neuronal excitability. These agents interact with various receptors and can cause changes in cell-membrane fluidity and nerve-membrane ion channels. Three main pharmacologic categories of inhalants, namely, volatile solvents and anesthetic gases, nitrous oxide, and volatile alkyl nitrites, have distinct pharmacologies, mechanisms of action, and toxicities. Inhalants are linked to multisystem damage affecting the pulmonary, cardiac, dermatologic, renal, hematologic, gastrointestinal, hepatic, and neurologic systems. Chronic inhalant abuse can also cause psychiatric, cognitive, behavioral, and anatomical deficits in humans, leading to reduced productivity and quality of life. Inhalant abuse during pregnancy is associated with fetal abnormalities. Clinical assessment for inhalant abuse should be done systematically. After decontamination and stabilization of the patient, further history and physical examination is necessary to establish an appropriate diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Laboratory testing for inhalant abuse is very limited, and imaging studies may be helpful in certain situations. The treatment of inhalant use disorder is similar to that of other substance abuse disorders and includes supportive care, pharmacotherapy, and behavioral therapy. Preventive measures are essential.
摘要：
虽然滥用吸入剂很常见，它是最被忽视和被忽视的药物滥用形式之一。吸入剂是指各种各样的物质，包括挥发性溶剂，气溶胶,气体,和亚硝酸盐。吸入剂的作用机制尚未完全确定。几个分子靶标有助于药理学，包括控制神经元兴奋性的离子通道蛋白。这些试剂与各种受体相互作用，并可引起细胞膜流动性和神经膜离子通道的变化。吸入剂的三种主要药理学类别，即,挥发性溶剂和麻醉气体，一氧化二氮,和挥发性亚硝酸烷基酯，有不同的药理学，行动机制,和毒性。吸入剂与影响肺部的多系统损伤有关，心脏,皮肤病学,肾,血液学，胃肠,肝，和神经系统。长期滥用吸入剂也会导致精神病，认知，行为，和人类的解剖学缺陷，导致生产力和生活质量下降。怀孕期间吸入性滥用与胎儿异常有关。应系统地进行吸入剂滥用的临床评估。在对患者进行净化和稳定后，进一步的病史和体格检查是必要的，以建立一个适当的诊断基于精神疾病诊断和统计手册，第五版。吸入剂滥用的实验室测试非常有限，成像研究在某些情况下可能会有所帮助。吸入剂使用障碍的治疗与其他药物滥用障碍的治疗相似，包括支持性护理，药物治疗,和行为疗法。预防措施至关重要。
