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The Drug-Induced Respiratory Disease Website

Philippe Camus, M.D.

Dijon, France

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Inhalants (volatile substances)

5

XIV.a Methemoglobinemia

3
Last update : 12/02/2013
 
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Identify causative drugs
Diagnosing DIRD
1
Drug and radiation history
2
Drug singularity - Correct identification of the drug
3
Consistent timing of exposure v. onset of symptoms
4
Clinical, imaging, BAL, pathological pattern consistent with the specific drug
5
Careful exlusion of another cause
6
Remission of symptoms with removal of drug
7
Recurrence with rechallenge (rarely advisable)
8
Causality assessment
More detailed checklist
See also under
Abused drugs/substances (illicit-, street drugs - IV/inhaled)
5
Amyl-nitrite, butyl-nitrite, isobutyl-nitrite ('Poppers')
4
Barotrauma
5
Chemicals
5
Cocaine
5
Cocaine, levamisole-tainted
5
Crack cocaine
5
Glue sniffing
3
Hydrocarbons (oil or oils). Inhaled-Aspirated
5
Hydrocarbons (petrochemicals: petroleum, petrolatum, paraffin, vaseline, naphta, jet fuel (kerosene), Diesel, gasoil), ointments, salad oil, variegated oils, butter). Aspirated
5
Inhaled anesthetic agents
3
Nitric oxide (NO)
4
Nitrous oxide (N2O)
1

Publications

Isobutyl-nitrite-induced methemoglobinemia; treatment with an exchange blood transfusion during hyperbaric oxygenation.
Acta anaesthesiologica Scandinavica 2003 Nov;47;1300-1 2003 Nov
Fatal methemoglobinemia due to inhalation of isobutyl nitrite.
Journal of toxicology. Clinical toxicology 1994;32;179-84 1994

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