Severe Cardiomyopathy after Huffing Dust-Off<i>™</i>

Cates, Alexis L.; Cook, Matthew D.

doi:10.1155/2016/9204790

Cited by 8 publications

(9 citation statements)

References 2 publications

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“…The Florida State Medical Examiners Commission found that there were 49 statewide deaths caused by inhalants in 2018 of which 83% involved halogenated inhalants, especially DFE [ 24 ]. Reported acute health effects of DFE inhalation in nonfatal cases include auditory and visual hallucinations and delusions [ 25 ], mania with psychosis [ 26 ], disorientation, poor judgement and disinhibition, tremors, ataxia [ 23 ], generalized tonic clonic seizure activity [ 27 ], dyspnea on exertion [ 23 ], pulmonary irritation and cough [ 28 ], frostbite burns of skin [ 20 , 29 ], cutaneous burn injury by hydrofluoric acid from thermal degradation of DFE [ 30 ], cutaneous flame burns from fire ignition of DFE [ 30 ], angioedema [ 31 ], palpitations and irregular pulse, chest pain, pneumopericardium [ 29 ], cardiomyopathy [ 32 , 33 ], toxic myocarditis [ 23 ], nausea and vomiting, acute liver injury and fulminant hepatitis [ 23 , 33 , 34 ], rhabdomyolysis and acute renal failure [ 22 , 33 , 34 ]. Some reported long-term health effects include skeletal fluorosis [ 35 ] and possibly chronic kidney disease [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

1,1-Difluoroethane Detection Time in Blood after Inhalation Abuse Estimated by Monte Carlo PBPK Modeling

Huet

Johanson

2020

Pharmaceutics

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(1) Background: Inhalant abuse and misuse are still widespread problems. 1,1-Difluoroethane abuse is reported to be potentially fatal and to cause acute and chronic adverse health effects. Lab testing for difluoroethane is seldom done, partly because the maximum detection time (MDT) is unknown. We sought to reliably estimate the MDT of difluoroethane in blood after inhalation abuse; (2) Methods: MDT were estimated for the adult male American population using a physiologically based pharmacokinetic (PBPK) model and abuse patterns detailed by two individuals. Based on sensitivity analyses, variability in huffing pattern and body mass index was introduced in the model by Monte Carlo simulation; (3) Results: With a detection limit of 0.14 mg/L, the median MDT was estimated to be 10.5 h (5th–95th percentile 7.8–12.8 h) after the 2-h abuse scenario and 13.5 h (10.5–15.8 h) after the 6-h scenario. The ranges reflect variability in body mass index and hence amount of body fat; (4) Conclusions: Our simulations suggest that the MDT of difluoroethane in blood after abuse ranges from 7.8 to 15.8 h. Although shorter compared to many other drugs, these MDT are sufficient to allow for testing several hours after suspected intoxication in a patient.

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Section: Introductionmentioning

confidence: 99%

1,1-Difluoroethane Detection Time in Blood after Inhalation Abuse Estimated by Monte Carlo PBPK Modeling

Huet

Johanson

2020

Pharmaceutics

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“…In another case, a 34-year-old man was found down in a parking lot after huffing 15 cans of Dust-Off [2]. The patient experienced a torsades de pointes arrhythmia, and echocardiogram revealed left and right ventricular dysfunction with an ejection fraction of 25%; he had an elevated troponin that peaked at 20 ng/mL.…”

Section: Discussionmentioning

confidence: 99%

“…Inhalant abuse, also known as huffing, is common among teenagers and adolescents, but can occur in any age group; according to the National Institute on Drug Abuse, nearly 21.7 million Americans aged 12 years and older have used inhalants at least once in their lives [1]. Huffing can cause symptoms such as respiratory distress, hypoxia, nausea, vomiting, central nervous system depression, and myocardial sensitization [2].…”

Section: Introductionmentioning

confidence: 99%

Air Duster Inhalant Abuse Causing Non-ST Elevation Myocardial Infarction

Cao

Ray

Klebanov

2020

Cureus

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Inhalant abuse, also known as huffing, is common among teenagers and adolescents in the United States and worldwide. Inhaled aerosols are dangerous due to both the presence of volatile hydrocarbons causing direct organ damage and the risk of the compressed air causing physical trauma (e.g. expansion, barotrauma) or skin trauma from chemical or temperature burn. Here, we present the case of a 35-year-old man who was inhaling multiple canisters of Dust-Off (Falcon Safety Products Inc., Branchburg, NJ) keyboard air duster daily for approximately one month. He presented with intermittent burning chest pains, and was found to have elevated troponin (peak 17 ng/mL, normal range 0-0.5 ng/mL) without ST-segment elevations, concerning for non-ST elevation myocardial infarction (NSTEMI) as well as elevated aminotransferases and elevated serum creatinine. He was treated conservatively with supportive measures, with successful resolution of his laboratory abnormalities as well as his chest pain. Clinicians should be aware of the possible medical complications of inhalant abuse, and the expected clinical course. In this case, we aim to demonstrate the acute onset and selfresolution of significant cardiomyocyte damage in a young male patient abusing duster.

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“…On inhalation, it causes acute onset of euphoric effects and rapidly enters the bloodstream [ 1 ]; therefore, it has become increasingly popular as a recreational drug. Adverse effects from difluoroethane inhalation vary based on acuity and dose, including nausea, vomiting, altered mental status, seizure, acute kidney injury [ 2 ], hypocalcemia, skeletal fluorosis [ 3 ], and cardiac arrhythmias [ 4 , 5 ]. Here, we present the case of a 51-year-old male who presented with adverse effects including severe hypocalcemia and multiple rib fractures following a fall, with a recent history of tibial fracture.…”

Section: Introductionmentioning

confidence: 99%

Acute Refractory Hypocalcemia in a 51-Year-Old Male With a History of 1,1-Difluoroethane Inhalation

Gleaves

Nanney

Syed

et al. 2021

Cureus

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Hypocalcemia is a common electrolyte derangement that is most associated with parathryoid hormone or vitamin D abnormalities. Less common causes that most providers are aware of include hyperphosphatemia, acute pancreatitis, chronic kidney disease, and sepsis. However, certain populations are at risk for less common, but no less dangerous, causes. One such cause is 1,1-difluoroethane, an organofluorine that is used as a propellant in aerosol sprays and is commonly abused. 1,1-Difluoroethane has been noted to cause severe hypocalcemia by accumulation of the metabolite fluorocitrate in tissues. Here, we present the case of a 51-year-old male with severe hypocalcemia and multiple rib fractures following a fall, with recent history of tibial fracture. The patient had a medical history of osteoporosis with numerous fractures and chronic steroid use. He admitted to using keyboard cleaner as an inhalant for the previous month, which was found to contain 1,1-difluoroethane. Previous case reports on 1,1-difluoroethane inhalation have not reported a patient with preexisting osteoporosis or refractory hypocalcemia.

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Severe Cardiomyopathy after Huffing Dust-Off™

Cited by 8 publications

References 2 publications

1,1-Difluoroethane Detection Time in Blood after Inhalation Abuse Estimated by Monte Carlo PBPK Modeling

1,1-Difluoroethane Detection Time in Blood after Inhalation Abuse Estimated by Monte Carlo PBPK Modeling

Air Duster Inhalant Abuse Causing Non-ST Elevation Myocardial Infarction

Acute Refractory Hypocalcemia in a 51-Year-Old Male With a History of 1,1-Difluoroethane Inhalation

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