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Toluene Poisoning

Toluene Poisoning is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Prototypical volatile hydrocarbon
  • Clear, colorless liquid with sweet odor

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 largest source of exposure

Pediatric Considerations
  • Prevalent in adolescent age group:
    • Inexpensive “high” with readily available sources
    • Many psychosocial problems
  • May develop chronic neurologic dysfunction
  • Mechanism:
    • Rapidly absorbed by inhalation
    • Readily crosses blood–brain barrier, reaching high concentrations in brain
    • May sensitize myocardium to dysrhythmogenic 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

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Citation

Rosen, Peter, 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: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307645/all/Toluene_Poisoning. Accessed April 24, 2019.
Toluene Poisoning. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307645/all/Toluene_Poisoning
Toluene Poisoning [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 24]. 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
TY - ELEC T1 - Toluene Poisoning ID - 307645 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, 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 -