Southern medical journal
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Southern medical journal · Apr 1983
Comparative StudyAcidosis and other metabolic abnormalities associated with paint sniffing.
Acidosis (arterial pH 6.88 to 7.38) and many other metabolic abnormalities were found in eight patients observed during 16 hospitalizations for paint sniffing. In four episodes, a high anion gap was found, perhaps secondary to an accumulation of metabolites of toluene. The anion gap was normal during 12 episodes, of which seven were associated with a urine pH greater than 5.5 indicating renal tubular acidosis (RTA). ⋯ In two patients the urine pH, titratable acid, and ammonium excretion were determined before and after bicarbonate therapy. These results suggested distal but not proximal RTA. Our observations indicate that multiple metabolic abnormalities may result from solvent abuse and suggest guidelines for therapy.
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Allergic rhinitis unresponsive to conservative therapy with antihistamines, decongestants, and environmental control may require the use of corticosteroids for symptomatic relief, even while hyposensitization is being carried out. Such therapy may be given orally, intramuscularly, as a nasal aerosol, or by intraturbinal injection. This discussion deals with the characteristics and appropriate use of each modality.