5-Minute Emergency Consult
Toluene Poisoning
Toluene Poisoning is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
Description
- Prototypical volatile hydrocarbon
- Clear, colorless liquid with sweet odor
Etiology
Etiology
- Abused for its euphoric effect
- Occupational exposures
- Used as organic solvent found in:
- Oil paints and stains
- Paint thinners
- Glues, inks, dyes, correction fluid
- Coolants
- Petroleum products
- Aerosolized household products
- Degreasers
- Production and use of gasoline is the largest source of exposure
Pathophysiology
Pathophysiology
- Mechanism:
- Rapidly absorbed by inhalation
- Readily crosses blood–brain barrier, reaching high concentrations in brain
- Inhibits NMDA receptors, increase GABA and glycine receptor function
- Induces oxygen radicals in the brain, particularly the hippocampus (learning and memory)
- May sensitize myocardium to arrhythmogenic effect of catecholamines
- Inhibits myocardial voltage-gated sodium channels and inward rectifying potassium channels
- Alveolar excretion and liver metabolism
- Methods of intoxication:
- Sniffing: Simple inhalation of substance directly from container
- Huffing: Vapors inhaled through cloth saturated with substance
- Bagging: Vapors inhaled from bag containing substance
- Toxic range:
- 100 ppm: Impairment of psychomotor and perceptual performance
- 500–800 ppm: Headache, drowsiness, nausea, weakness, and confusion, potential lethal ranges
- >800 ppm: Convulsions, ataxia, staggering gait
- 10,000–30,000 ppm: Anesthesia within 1 min
Pediatric Considerations
- Prevalent in adolescent age group:
- Inexpensive “high” with readily available sources
- Many psychosocial problems
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
Description
- Prototypical volatile hydrocarbon
- Clear, colorless liquid with sweet odor
Etiology
Etiology
- Abused for its euphoric effect
- Occupational exposures
- Used as organic solvent found in:
- Oil paints and stains
- Paint thinners
- Glues, inks, dyes, correction fluid
- Coolants
- Petroleum products
- Aerosolized household products
- Degreasers
- Production and use of gasoline is the largest source of exposure
Pathophysiology
Pathophysiology
- Mechanism:
- Rapidly absorbed by inhalation
- Readily crosses blood–brain barrier, reaching high concentrations in brain
- Inhibits NMDA receptors, increase GABA and glycine receptor function
- Induces oxygen radicals in the brain, particularly the hippocampus (learning and memory)
- May sensitize myocardium to arrhythmogenic effect of catecholamines
- Inhibits myocardial voltage-gated sodium channels and inward rectifying potassium channels
- Alveolar excretion and liver metabolism
- Methods of intoxication:
- Sniffing: Simple inhalation of substance directly from container
- Huffing: Vapors inhaled through cloth saturated with substance
- Bagging: Vapors inhaled from bag containing substance
- Toxic range:
- 100 ppm: Impairment of psychomotor and perceptual performance
- 500–800 ppm: Headache, drowsiness, nausea, weakness, and confusion, potential lethal ranges
- >800 ppm: Convulsions, ataxia, staggering gait
- 10,000–30,000 ppm: Anesthesia within 1 min
Pediatric Considerations
- Prevalent in adolescent age group:
- Inexpensive “high” with readily available sources
- Many psychosocial problems
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Citation
Schaider, Jeffrey J., et al., editors. "Toluene Poisoning." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307645/all/Toluene_Poisoning.
Toluene Poisoning. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307645/all/Toluene_Poisoning. Accessed April 1, 2023.
Toluene Poisoning. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307645/all/Toluene_Poisoning
Toluene Poisoning [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2023 April 01]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307645/all/Toluene_Poisoning.
* Article titles in AMA citation format should be in sentence-case
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T1 - Toluene Poisoning
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ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307645/all/Toluene_Poisoning
PB - Lippincott Williams & Wilkins
ET - 5
DB - Emergency Central
DP - Unbound Medicine
ER -
