emDOCs ToxCard - March 03, 2023 - By Anthony James; Kathryn T Kopec
Reviewed by: James Dazhe Cao; Alex Koyfman; Brit Long
Clinical Pearls:
- Nitrites are commonly used for recreational purposes and are easily accessible in “commercial products”
- Asking patients about their use of nitrites in a non-judgmental manner can aid in diagnosing associated adverse effects and complications
- Complications of nitrites tend to be more severe with routes of exposure other than inhalation such as ingestion or aspiration
- Methemoglobinemia is a less common but potentially life-threatening complication of nitrite exposure
- Treatment is supportive care and methylene blue administration
- Harm reduction conversations should include avoiding concurrent use of alcohol and PDE inhibitors if a patient plans to continue using alkyl nitrites recreationally