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Methanol poisoning

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HYDROCARBONS AND VOLATILE
SUBSTANCES

• Hydrocarbons are a diverse group of organic compounds
consisting primarily of carbon and hydrogen atoms arranged in
various aliphatic and aromatic configurations.
• Products containing hydrocarbons are found in many
household and occupational settings:
fuels, lighter fluids, lamp oil, paints, paint removers,
pesticides, medications, cleaning and polishing agents, spot
removers, degreasers, lubricants and solvents.
• Hydrocarbon and volatile substance exposure may cause lifethreatening toxicity and, in some cases, sudden death.

• Most hydrocarbons are produced from
petroleum distillation:
»aliphatic (open-chain) mixtures of
hydrocarbons
& Short-chain& Intermediate-chain
»The wood distillates
»Aromatic hydrocarbons (containing a
benzene ring)
»halogenated hydrocarbons
3

Epidemiology
• Exposures to hydrocarbons and volatiles most commonly
occur in one of two settings:
- Ingestion
- Inhalation.
• 3.5 to 10 percent of young people have experimented with
volatile substance inhalation to produce inebriation
• The most commonly implicated volatiles were:
butane (39 percent),
aerosols (26 percent),
cleaners (16 percent),
glue (10 percent).

Clinical features
• The toxic potential of hydrocarbons depends on:
– physical characteristics(volatility, viscosity, and
surface tension)
– chemical characteristics(aliphatic, aromatic, or
halogenated), presence of toxic additives
(pesticides or heavy metals),
– route of exposure,
– concentration
– dose.

5

Clinical features
• Viscosity: the resistance to flow, and surface
tension, ( a major role in determining the
aspiration potential.)
• Substances with viscosities less than 60 SUS (e.g.,
gasoline, kerosene, mineral seal oil, turpentine, and
aromatic and halogenated hydrocarbons) are at

greater risk for than are those ingesting
substances with viscosities greater than 100 SUS
(e.g., diesel oil, grease, mineral oil, paraffin wax, and
petroleum jelly)
6

• Low surface tension also increases the risk of aspiration.
• Volatility :denotes the ability of a substance to vaporize.
• A compound with high volatility evaporates easily and usually has
low viscosity and low surface tension.
• Inhalation of volatile agents, )such as aromatic hydrocarbons,
halogenated hydrocarbons, or gasoline(, results in systemic
absorption and the potential for significant toxicity.
• Dermal exposure to hydrocarbons: causes local toxicity, and
occasionally leads to systemic absorption.
• Intravenous administration of hydrocarbons :may cause
pulmonary toxicity by their first-pass exposure through the lungs
(first capillary bed encountered).
7

• Characteristic presentations usually affect one or more of the
following systems:
• Pulmonary,
• Neurologic :
- central
- peripheral
• Gastrointestinal
• Cardiac
• Hepatic
• Renal
• Hematologic
• Dermal.

8

1. Pulmonary Toxicity
• Pulmonary complications, especially aspiration, are the most
frequent adverse effects of hydrocarbon exposure.
• Aliphatic hydrocarbons have a limited GI absorption; toxicity
usually results from aspiration of the low-viscosity compounds
or inhalation (with resulting systemic absorption) of
compounds with high volatility.
• Ingestion of aromatic or halogenated hydrocarbons may also
result in aspiration, GI absorption is greater.
• That results in the development of lipoid pneumonia. Deaths
from hydrocarbon lipoid pneumonia have been reported.

9

• The risk and degree of aspiration is not dependent on volume
ingested. ( 0.2 mL instilled intratracheally has caused
pneumonitis.)
• Pulmonary toxicity does not result from GI absorption but occurs
from direct aspiration of the hydrocarbon into the pulmonary
tree.
• There is no evidence that hydrocarbons reflux from the stomach
into the airway.
• Spontaneous vomiting, however, does increase the risk of
aspiration.
• Pulmonary toxicity manifested as: acute bilateral pneumonitis (
from the inhalation of an aerosolized aliphatic hydrocarbon such
as gasoline)
10

• Hydrocarbon aspiration causes :
Direct toxic injury to the pulmonary parenchyma
Altered surfactant function.
Increased vascular permeability and edema.
Clinical bronchospasm
Ventilation/perfusion mismatch.
Pneumatoceles
Pneumothoraces
...


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