In organic chemistry , alkyl nitrites are a group of organic compounds based upon the molecular structure R−O−N=O , where R represents an alkyl group . Formally they are alkyl esters of nitrous acid . They are distinct from nitro compounds ( R−NO 2 ).
60-544: Poppers (or popper ) is a slang term referring to recreational drugs belonging to the alkyl nitrite family of chemical compounds . When fumes from these substances are inhaled , they act as potent vasodilators , producing mild euphoria, warmth, and dizziness. Most effects have a rapid onset and are short-acting. Its recreational use is believed to be potentially dangerous for people with heart problems , anaemia , or glaucoma . Reported adverse effects include fainting , retinal toxicity, and vision loss. As poppers include
120-452: A neoclassical compound built from the combining forms tachy- + -cardia , which are from the Greek ταχύς tachys , "quick, rapid" and καρδία, kardia , "heart". As a matter both of usage choices in the medical literature and of idiom in natural language , the words tachycardia and tachyarrhythmia are usually used interchangeably, or loosely enough that precise differentiation
180-440: A broad range of chemical types , their legality differs across different jurisdictions. They are often packaged under the guise of room deodorizer, leather polish, nail polish remover, or videotape head cleaner to evade anti-drug laws . The term poppers stems from the "popping" sound of glass vials containing the substance when crushed to release vapour for inhalation. Amyl nitrite , a chemical analogue of alkyl nitrite ,
240-624: A cause of maculopathy (eye damage), as reported in France and the United Kingdom. Some studies have concluded that there may be increased risk for at least temporary retinal damage with habitual popper use in certain users; in a letter to the New England Journal of Medicine , an ophthalmologist described four cases in which recreational users of isopropyl nitrite poppers suffered temporary changes in vision. In November 2014, it
300-582: A class of chemicals called alkyl nitrites. To the extent that poppers products contain alkyl nitrites, the following applies. The following table summarizes alkyl nitrite chemical and physical properties, including chemical structure: The French chemist Antoine Jérôme Balard synthesized amyl nitrite in 1844. Sir Thomas Lauder Brunton , a Scottish physician born in the year of amyl nitrite's first synthesis, documented its clinical use to treat angina pectoris in 1867 when patients experiencing chest pains would experience complete relief after inhalation. Brunton
360-731: A drop in blood pressure and an immediate (compensatory) increase in heart rate (reflex tachycardia). Vasodilation may cause giddiness, dizziness, headache, nausea, vomiting and flushing, and may produce a sensation of heat and excitement. Maximum vasodilatory effect is usually reached within 30 seconds, with (secondary) physiological effects lasting for 5 to 10 minutes. Inhaling nitrites, produces several psychological effects such as euphoria, increased sensual awareness, lowered inhibitions or increased confidence, and potential for impaired judgement and disorientation. Alkyl nitrites interact with other vasodilators , such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis), to cause
420-432: A fast-acting, short-lived and non-specific relaxation of smooth muscles (along with the sphincter muscles of the anus and the vagina ). Blood vessels are surrounded by smooth musculature, which directly influences blood pressure by increasing or decreasing its inward pressure on the blood vessels. With relaxation of the smooth muscles, the 'inward' pressure on the blood vessels decreases and they dilate , resulting in
480-467: A long QT interval. Both of these rhythms normally last for only a few seconds to minutes ( paroxysmal tachycardia ) , but if VT persists it is extremely dangerous, often leading to ventricular fibrillation . This is a type of tachycardia that originates from above the ventricles, such as the atria. It is sometimes known as paroxysmal atrial tachycardia (PAT). Several types of supraventricular tachycardia are known to exist. Atrial fibrillation
540-404: A narrow complex tachycardia, intravenous adenosine may be attempted. In all others, immediate cardioversion is recommended. If the problem is a simple acceleration of the heart rate that worries the patient, but the heart and the general patient's health remain stable enough, it is possible to correct it by a simple deceleration using some physical maneuvers called vagal maneuvers . But, if
600-483: A normal human resting heart rate is based on age. Cutoff values for tachycardia in different age groups are fairly well standardized; typical cutoffs are listed below: Heart rate is considered in the context of the prevailing clinical picture. When the heart beats excessively or rapidly, the heart pumps less efficiently and provides less blood flow to the rest of the body, including the heart itself. The increased heart rate also leads to increased work and oxygen demand by
660-399: A psychoactive substance or a legal high , "appear to fall within the scope of The Intoxicating Substances (Supply) Act 1985 ". The Psychoactive Substances Act 2016 , scheduled to be enacted 1 April 2016, was initially claimed to impose a blanket ban on the production, import and distribution of all poppers. On 20 January 2016 a motion to exempt poppers (alkyl nitrites) from this legislation
SECTION 10
#1732779906244720-442: A serious decrease in blood pressure , which can cause strokes, and low blood pressure leading to people fainting. Side effects of popper abuse include tachycardia , headaches , migraines , dizziness and fainting . The Merck Manual of Diagnosis and Therapy reports insignificant hazard associated with inhalation of alkyl nitrites, and British governmental guidance on the relative harmfulness of alkyl nitrites places them among
780-549: A third of gay men having used poppers at least once. Poppers were partial inspiration for songs such as Troye Sivan 's Rush . Poppers are legal in Australia, and from 2020, poppers can also be purchased as a schedule 3 substance from pharmacies, or a schedule 4 substance with a prescription. In June 2018, the Therapeutic Goods Administration (TGA) motioned to reschedule alkyl nitrites to be in
840-537: Is amyl nitrite (3-methylbutyl nitrite). Alkyl nitrites were initially, and largely still are, used as medications and chemical reagents , a practice which began in the late 19th century. In their use as medicine, they are often inhaled for relief of angina and other heart-related symptoms of disease. However, when referred to as " poppers ", alkyl nitrites represent recreational drugs . Organic nitrites are prepared from alcohols and sodium nitrite in sulfuric acid solution . They decompose slowly on standing,
900-438: Is "possibly carcinogenic to humans". The group primarily looked at 2 studies on animals, one on rats and one on mice. Both of these involved the administration of doses of isobutyl nitrite at seemingly low doses (0, 37.5, 75, or 150 ppm) 6 hours a day, 5 days a week, for a total of 103 weeks. This is different from the relatively brief exposure to isobutyl nitrite that inhaling poppers recreationally usually provides. Nonetheless, in
960-622: Is called reflex tachycardia. This can happen in response to a decrease in blood volume (through dehydration or bleeding ), or an unexpected change in blood flow . The most common cause of the latter is orthostatic hypotension (also called postural hypotension ). Fever , hyperventilation , diarrhea and severe infections can also cause tachycardia, primarily due to increase in metabolic demands. Upon exertion, sinus tachycardia can also be seen in some inborn errors of metabolism that result in metabolic myopathies , such as McArdle's disease (GSD-V) . Metabolic myopathies interfere with
1020-436: Is no such term as "healthy/physiologic supraventricular tachycardia". The same themes are also true of AVRT and AVNRT . Thus this pair is an example of when a particular prescription (which may have been tenable 50 or 100 years earlier) can no longer be invariably enforced without violating idiom. But the power to differentiate in an idiomatic way is not lost, regardless, because when the specification of physiologic tachycardia
1080-437: Is not explicit. Some careful writers have tried to maintain a logical differentiation between them, which is reflected in major medical dictionaries and major general dictionaries. The distinction is that tachycardia be reserved for the rapid heart rate itself, regardless of cause, physiologic or pathologic (that is, from healthy response to exercise or from cardiac arrhythmia ), and that tachyarrhythmia be reserved for
1140-456: Is not generally needed. Ventricular tachycardia (VT or V-tach) is a potentially life-threatening cardiac arrhythmia that originates in the ventricles. It is usually a regular, wide complex tachycardia with a rate between 120 and 250 beats per minute. A medically significant subvariant of ventricular tachycardia is called torsades de pointes (literally meaning "twisting of the points", due to its appearance on an EKG), which tends to result from
1200-749: Is one of the most common cardiac arrhythmias. In general, it is an irregular, narrow complex rhythm. However, it may show wide QRS complexes on the ECG if a bundle branch block is present. At high rates, the QRS complex may also become wide due to the Ashman phenomenon . It may be difficult to determine the rhythm's regularity when the rate exceeds 150 beats per minute. Depending on the patient's health and other variables such as medications taken for rate control, atrial fibrillation may cause heart rates that span from 50 to 250 beats per minute (or even higher if an accessory pathway
1260-424: Is packaged under a variety of trade names in small bottles. In the late 1970s Time magazine and The Wall Street Journal reported that popper use among gay men began as a way to enhance sexual pleasure, but "quickly spread to avant-garde heterosexuals ". A series of interviews conducted in the late 1970s revealed a wide spectrum of users. Poppers were well established in the gay community, with more than
SECTION 20
#17327799062441320-643: Is present). However, new-onset atrial fibrillation tends to present with rates between 100 and 150 beats per minute. AV nodal reentrant tachycardia (AVNRT) is the most common reentrant tachycardia. It is a regular narrow complex tachycardia that usually responds well to the Valsalva maneuver or the drug adenosine . However, unstable patients sometimes require synchronized cardioversion . Definitive care may include catheter ablation . AV reentrant tachycardia (AVRT) requires an accessory pathway for its maintenance. AVRT may involve orthodromic conduction (where
1380-473: Is thought to be 220 bpm minus age. Inappropriate sinus tachycardia (IST) is a diagnosis of exclusion , a rare but benign type of cardiac arrhythmia that may be caused by a structural abnormality in the sinus node . It can occur in seemingly healthy individuals with no history of cardiovascular disease. Other causes may include autonomic nervous system deficits , autoimmune response, or drug interactions. Although symptoms might be distressing, treatment
1440-794: The AIDS crisis, widespread use of poppers among AIDS patients led to the later disproved hypothesis that poppers contributed to the development of Kaposi's sarcoma , a rare form of cancer that occurs in AIDS patients. Modest, short-term reductions in immune function were observed in animal studies, but not replicated in human studies. Amyl nitrites were part of some kits used to treat cyanide poisoning , containing amyl nitrite, sodium nitrite , and sodium thiosulfate . The nitrites were administered to produce methemoglobin and induce vasodilation . Amyl nitrites were discontinued in 2012 in standard cyanide kits. Cyanide kits now use hydroxocobalamin . Poppers contain
1500-401: The throat and anus . Such physiological effects, along with others (such as mild euphoria), have resulted in poppers being used as recreational drugs , sometimes during sexual intercourse (known colloquially as chemsex), as the effects can heighten arousal and help facilitate acts such as anal intercourse . It has been reported that poppers were a part of the club culture which began during
1560-504: The EU; isobutyl nitrite is prohibited. In France , the sale of products containing butyl nitrite has been prohibited since 1990 on grounds of danger to consumers. In 2007, the government extended this prohibition to all alkyl nitrites that were not authorized for sale as drugs . After litigation by sex shop owners, this extension was quashed by the Council of State on the grounds that
1620-633: The FDA put in the prescription requirement again in 1969. Butyl nitrites were outlawed in 1988 by the Anti-Drug Abuse Act of 1988 . This prompted distributors to sell other alkyl nitrites not yet banned, like isopropyl nitrite . In 1990, isopropyl nitrites and other nitrites not yet banned were outlawed by the Crime Control Act of 1990 . Both of these laws include an exception for commercial purpose , defined as any use other than for
1680-530: The United Kingdom associated with isopropyl nitrite (substitute for isobutyl nitrite which was banned in 2007). A working group in 2019 from the International Agency for Research on Cancer determined there to be "sufficient evidence" to suggest carcinogenic properties of isobutyl nitrite on experimental animals, and because they could not find any sufficient studies regarding its carcinogenic effects on humans, they determined that isobutyl nitrite
1740-433: The aforementioned activities and time frames. Those with GSD-V also experience " second wind ", after approximately 6–10 minutes of light-moderate aerobic activity, such as walking without an incline, where the heart rate drops and symptoms of exercise intolerance improve. An increase in sympathetic nervous system stimulation causes the heart rate to increase, both by the direct action of sympathetic nerve fibers on
1800-445: The cause of the tachycardia is chronic (permanent), it would return after some time, unless that cause is corrected. Besides, the patient should avoid receiving external effects that cause or increase tachycardia. The same measures than in unstable tachycardia can also be taken, with medications and the type of cardioversion that is appropriate for the patient's tachycardia. The word tachycardia came to English from Neo-Latin as
1860-437: The decomposition products being oxides of nitrogen , water , the alcohol, and polymerization products of the aldehyde . They are also prone to undergo homolytic cleavage to form alkyl radicals, the nitrite C–O bond being very weak (on the order of 40–50 kcal ⋅ mol ). Alkyl nitrites are generally weak nitrosating agents , but nitrosate amines in the presence of a nucleophile catalyst. An isolated but classic example of
Poppers - Misplaced Pages Continue
1920-536: The drug laws of the corresponding countries. Occasionally, poppers were seized from sex shops, when sold there illegally. Poppers are sold in nightclubs , bars , sex shops, drug paraphernalia head shops , over the Internet and in markets. It is illegal under Medicines Act 1968 to sell them advertised for human consumption. The Advisory Council on the Misuse of Drugs noted in 2011 that poppers, rather than being
1980-422: The early 1970s in the gay male community in bars , discothèques and bathhouses . It was packaged and sold pharmaceutically in fragile glass ampoules wrapped in cloth sleeves which, when crushed or "popped" in the fingers, released the amyl nitrite for inhalation, hence the colloquialism poppers . The term extended to the drug in any form as well as to other drugs with similar effects, e.g. butyl nitrite which
2040-450: The emergency treatment of AVRT, because they may paradoxically increase conduction across the accessory pathway. Junctional tachycardia is an automatic tachycardia originating in the AV junction. It tends to be a regular, narrow complex tachycardia and may be a sign of digitalis toxicity. The management of tachycardia depends on its type (wide complex versus narrow complex), whether or not
2100-494: The existing medical literature ignores it even when the words stand alone but also because the terms for specific types of arrhythmia (standard collocations of adjectives and noun) are deeply established idiomatically with the tachycardia version as the more commonly used version. Thus SVT is called supraventricular tachycardia more than twice as often as it is called supraventricular tachyarrhythmia; moreover, those two terms are always completely synonymous—in natural language there
2160-501: The government had failed to justify such a blanket prohibition: according to the court, the risks cited, concerning rare accidents often following abnormal usage, rather justified compulsory warnings on the packaging. The possession in Germany , Austria and Switzerland is not subject to any regulations regarding anesthetic drugs and is therefore legal; however, the purchase, sale or trade of amyl nitrite without permission violates
2220-659: The heart and by causing the endocrine system to release hormones such as epinephrine (adrenaline) , which have a similar effect. Increased sympathetic stimulation is usually due to physical or psychological stress. This is the basis for the so-called fight-or-flight response , but such stimulation can also be induced by stimulants such as ephedrine , amphetamines or cocaine . Certain endocrine disorders such as pheochromocytoma can also cause epinephrine release and can result in tachycardia independent of nervous system stimulation. Hyperthyroidism can also cause tachycardia. The upper limit of normal rate for sinus tachycardia
2280-587: The heart). Tachycardia can lead to fainting . When the rate of blood flow becomes too rapid, or fast blood flow passes on damaged endothelium , it increases the friction within vessels resulting in turbulence and other disturbances. According to the Virchow's triad , this is one of the three conditions (along with hypercoagulability and endothelial injury/dysfunction ) that can lead to thrombosis (i.e., blood clots within vessels). Some causes of tachycardia include: Drug related: The upper threshold of
2340-517: The heart, which can lead to rate related ischemia . An electrocardiogram (ECG) is used to classify the type of tachycardia. They may be classified into narrow and wide complex based on the QRS complex . Equal or less than 0.1s for narrow complex. Presented in order of most to least common, they are: Tachycardias may be classified as either narrow complex tachycardias (supraventricular tachycardias) or wide complex tachycardias. Narrow and wide refer to
2400-473: The impulse travels down the AV node to the ventricles and back up to the atria through the accessory pathway) or antidromic conduction (which the impulse travels down the accessory pathway and back up to the atria through the AV node). Orthodromic conduction usually results in a narrow complex tachycardia, and antidromic conduction usually results in a wide complex tachycardia that often mimics ventricular tachycardia . Most antiarrhythmics are contraindicated in
2460-402: The late 1890s by Brunton and despite being found to have generally the same effects as amyl nitrites, they were never used as a clinical alternative to amyl nitrates. Brunton also found that propyl nitrites had the same effects as well. Although amyl nitrite is known for its practical therapeutic applications, the first documented case of recreational use was in 1964. The poppers "craze" began in
Poppers - Misplaced Pages Continue
2520-453: The less harmful of recreational drugs. If in contact with the skin, Butyl Nitrite poppers can cause chemical burns and contact dermatitis of the skin around the mouth and nose. Swallowing poppers (rather than inhaling the vapour) may cause cyanosis , methemoglobinemia , unconsciousness, coma, and complications leading to death. Accidental aspiration of amyl or butyl nitrites may cause lipoid pneumonia . Isopropyl nitrite poppers may be
2580-442: The mid-1970s disco scene, and surged in popularity during the rave scene of the 1980s and 1990s. Poppers come in liquid form, but this liquid is not directly consumed. When the bottle is opened, the vapors are inhaled, rather than the liquid. This is typically done through the nasal cavities, commonly directly from the bottle (avoiding touching the bottle to the skin) or with the help of small inhalers. Inhaling nitrites produces
2640-413: The muscle's ability to create energy. This energy shortage in muscle cells causes an inappropriate rapid heart rate in response to exercise. The heart tries to compensate for the energy shortage by increasing heart rate to maximize delivery of oxygen and other blood borne fuels to the muscle cells. "In McArdle's, our heart rate tends to increase in what is called an 'inappropriate' response. That is, after
2700-668: The past decade with very little evidence of harm and has been in use by a high proportion of gay men over a long period. A final decision was pushed back from 29 November 2018 to late January or early February 2019 for further consultation with the public. As of March 2019, two public meetings have taken place in Sydney and Melbourne with The Kirby Institute and the Australian Research Centre in Sex, Health and Society (ARCSHS). Along with 70 written public proposals, there
2760-468: The pathologic form (that is, an arrhythmia of the rapid rate type). This is why five of the previously referenced dictionaries do not enter cross-references indicating synonymy between their entries for the two words (as they do elsewhere whenever synonymy is meant), and it is why one of them explicitly specifies that the two words not be confused. But the prescription will probably never be successfully imposed on general usage , not only because much of
2820-437: The person is stable or unstable, and whether the instability is due to the tachycardia. Unstable means that either important organ functions are affected or cardiac arrest is about to occur. Stable means that there is a tachycardia, but it does not seem an immediate threat for the patient's health, but only a symptom of an unknown disease, or a reaction that is not very dangerous in that moment. In those that are unstable with
2880-450: The production of consumer products containing volatile alkyl nitrites meant for inhaling or otherwise introducing volatile alkyl nitrites into the human body for euphoric or physical effects. Alkyl nitrite The first few members of the series are volatile liquids; methyl nitrite and ethyl nitrite are gaseous at room temperature and pressure. The compounds have a distinctive fruity odor. Another frequently encountered nitrite
2940-589: The same category as heroin and cocaine ( Schedule 9 ). This was met by criticism from the LGBTQI community for being discriminatory and further evidence was demanded and further consultation sought. In October 2018, the Australian Federation of AIDS Organisations (AFAO) pointed out the lack of quality evidence provided by the TGA to justify the rescheduling and that use of amyl nitrites has been stable over
3000-555: The scope of the Psychoactive Substances Act 2016. Amyl nitrite was originally marketed as a prescription drug in 1937. It remained so until 1960, when the Food and Drug Administration removed the prescription requirement due to its safety record. This requirement was reinstated in 1969, after observing an increase in recreational use . There was a huge increase in the number of brands for butyl nitrites after
3060-437: The start of exercise it increases much more quickly than would be expected in someone unaffected by McArdle's." As skeletal muscle relies predominantly on glycogenolysis for the first few minutes as it transitions from rest to activity, as well as throughout high-intensity aerobic activity and all anaerobic activity, individuals with GSD-V experience during exercise: sinus tachycardia, tachypnea , muscle fatigue and pain, during
SECTION 50
#17327799062443120-466: The studies there was shown to be no increase in death rates for the animals exposed to isobutyl nitrite, but there was shown to be an increase in tumors in the lungs of the males and females of both species in the groups exposed, as well as in the thyroids of the male mice exposed. Isobutyl Nitrite is no longer sold as 'Poppers' having been banned in the EU since 2007 and banned in the USA since 1990. Early in
3180-560: The use of alkyl nitrites can be found in Woodward and Doering's quinine total synthesis : for which they proposed this reaction mechanism : Tachycardia Tachycardia , also called tachyarrhythmia , is a heart rate that exceeds the normal resting rate . In general, a resting heart rate over 100 beats per minute is accepted as tachycardia in adults. Heart rates above the resting rate may be normal (such as with exercise ) or abnormal (such as with electrical problems within
3240-480: The width of the QRS complex on the ECG . Narrow complex tachycardias tend to originate in the atria, while wide complex tachycardias tend to originate in the ventricles. Tachycardias can be further classified as either regular or irregular. The body has several feedback mechanisms to maintain adequate blood flow and blood pressure . If blood pressure decreases, the heart beats faster in an attempt to raise it. This
3300-559: Was defeated. This was opposed by Conservative MP Ben Howlett . Howlett's fellow Conservative MP Crispin Blunt declared that he has used and currently uses poppers. Manufacturers expressed concern over loss of business and potential unemployment. In March 2016, the Advisory Council on the Misuse of Drugs stated that, because alkyl nitrites do not directly stimulate or depress the central nervous system , poppers do not fall within
3360-416: Was done by crushing them between the fingers, followed by a popping sound. This administration process seems to be the origin of the slang term "poppers". It was then administered via direct inhalation of the vapors or inhalation through silk that covered the capsule. Brunton found that amyl nitrites had effects of dilating blood vessels and flushing of the face. Isobutyl nitrites were also documented around
3420-493: Was inspired by earlier work with the same agent, performed by Arthur Gamgee and Benjamin Ward Richardson . Brunton reasoned that the angina sufferer's pain and discomfort could be reduced by administering amyl nitrite—to dilate the coronary arteries of patients, thus improving blood flow to the heart muscle. Amyl nitrites were originally enclosed in a glass mesh called "pearls". The usual administration of these pearls
3480-649: Was observed maculopathy is a rare complication of isopropyl nitrite abuse. A full recovery of visual acuity in longterm abuse could be demonstrated after drug abstinence. Studies have shown that poppers users who have HIV and/or use Sildenafil in combination with poppers are at an increased risk of developing poppers‐associated maculopathy. Foveal (center-of-gaze) damage has also been described, in six habitual users of isopropyl nitrite poppers. Furthermore, in June 2014, optometrists and ophthalmologists reported having noticed an increase in vision loss in chronic popper users in
3540-479: Was originally prescribed in the late 1800s for the medical management of angina . Many analogues exist, such as isoamyl nitrite, isopentyl nitrite , isopropyl nitrite , and isobutyl nitrite . These substances are subject to different regulations; for example, isobutyl nitrite is banned in the European Union . Poppers act as muscle relaxants , causing the relaxation of involuntary smooth muscles such as
3600-440: Was significant opposition to alkyl nitrites rescheduling. Banning alkyl nitrites was not considered acceptable as their use was said to help reduce harms such as anal injury and blood-borne disease transmission during anal sex. In June 2019, Australia decided not to ban poppers. Since 2013, Health Canada has banned all distribution and sales of poppers. Since 2007, reformulated poppers containing isopropyl nitrite are sold in
#243756