The reaction of urea, nitric acid and sulfuric acid according to the present invention proceeds as follows. 2 (NH 2 ) 2 CO + 2 HNO 3 + H 2 SO 4 -> 2 N 2 O + 2 CO 2 + (NH 4 ) 2 SO 4 + 2 H 2 O In the practice of the present invention, the nitric acid can [erowid.org]

We present a case of a patient who received nitrous oxide on two occasions within a period of 8 weeks and who subsequently developed a diffuse myelopathy, characterized by upper extremity paresis, lower extremity paraplegia and neurogenic bladder. [ncbi.nlm.nih.gov]

• Unconsciousness

  While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely. [psychonautwiki.org]

  But that's not to say that its ability to render the mind unconscious wasn't tried before that. It was. [eic.rsc.org]

  Abstract Anesthesia arguably provides one of the only systematic ways to study the neural correlates of global consciousness/unconsciousness. [ncbi.nlm.nih.gov]

  […] heart attack and died, potentially unrelated. 2015-03-02, Aaron Dunford, 22, Brighton UK - cronic user, B12 deficiency, presumed asphyxia. 2014-02-06, Jordan Guise, 21, France - unknown cause of death. 2013-05-17, Ali Mirza, 19, Claremont CA USA - found unconscious [justsayn2o.com]

  Because the gas reduces anxiety and coordination before causing unconsciousness, it may be impossible to escape from such a situation even if you realise your mistake. [drugscience.org.uk]

• Inflammation

  CONCLUSION: The transmucosal N 2 O exchange rate for the middle ear is increased during inflammation caused by nasal histamine exposure. [ncbi.nlm.nih.gov]

  […] of inflammable air from dilute metal–acid solutions [ 18, Part 1, pp. 43–45, Part II, pp. 104–105]. [doi.org]

  […] air; and inflammable air, by agitation in water, ceases to be inflammable, and becomes respirable. [erowid.org]

  Humphrey Davy (1778-1829), one of the pioneers of N2O experimentation, described the effects of N2O on himself following self-administration for a toothache and gum infection as follows: “On the day when the inflammation was the most troublesome, I breathed [dentalfearcentral.org]

• Fatigue

  Commonly reported effects in laboring women include: detachment, dizziness, euphoria, fatigue, hallucinations, hazy memory of events, headache, nightmares, pleasure, relaxation, sedation, and a sense of warmth. [mamanatural.com]

  Acute exposure: The signs and symptoms of acute exposure to nitrous oxide include dizziness, difficult breathing, headache, nausea, fatigue, and irritability. [web.archive.org]

  […] symptoms such as headache, blurred vision, vertigo, ataxia, tinnitus, nausea, anorexia, and weakness are not uncommon" with low concentrations of gasoline fumes; and that chronic exposure to gasoline fumes may produce "muscular weakness, listlessness, fatigue [druglibrary.org]

  The detonation, the mechanical pounding, actually mechanically erodes or fatigues material out of the piston. [contactmagazine.com]

• Epilepsy

  Abstract The link between various air pollutants and hospitalization for epilepsy has come under scrutiny. [ncbi.nlm.nih.gov]

  It’s also safe to use if you suffer from epilepsy, liver disease, heart disease, diabetes, or cerebrovascular disease. [dentalfearcentral.org]

  Such hypoxaemia should be well tolerated by a fit person but could give rise to seizures, arrhythmias, or even respiratory or cardiac arrest in patients with epilepsy, cardiac disease, or other co-morbidities, especially if combined with other centrally [academic.oup.com]

• Intravenous Drugs

  Other sedation techniques have a fixed duration of action (because the effects of pills or intravenous drugs last for a specific time span), whereas gas can be given for the exact time span it’s needed for. [dentalfearcentral.org]

• Dyspnea

  Incompatibilities & Reactivities Aluminum, boron, hydrazine, lithium hydride, phosphine, sodium Exposure Routes inhalation, skin and/or eye contact (liquid) Symptoms dyspnea (breathing difficulty); drowsiness, headache; asphyxia; reproductive effects; [cdc.gov]

  Most often the patient will note chest or upper body discomfort and dyspnea as the predominant presenting symptoms accompanied by diaphoresis, nausea, vomiting, and dizziness. 17 – 19 Isolated diaphoresis, nausea, vomiting, or dizziness are unusual predominant [doi.org]

• Nasal Congestion

  Dental contraindications Dental nitrous oxide may be contraindicated in patients with severe nasal congestion, those who breathe through their mouths, or those unable to wear a nasal mask. [emedicine.medscape.com]

• Nausea

  Omission of nitrous oxide reduced the odds of postoperative nausea and vomiting by 37%, a reduction in risk of 28%. [doi.org]

  Both these agents are known risk factors for postoperative nausea and vomiting (PONV). However, remifentanil and N2O have not been directly compared in a published study. [ncbi.nlm.nih.gov]

• Gagging

  Abstract The purpose of this study was to compare the effectiveness of various concentrations of N 2 O/O 2 on obtunding a hypersensitive gag reflex. [ncbi.nlm.nih.gov]

  Inhalation sedation is very effective in minimizing gagging. It works rapidly as it reaches the brain within 20 seconds. In as little as 2-3 minutes its relaxation and pain killing properties develop. [mmbdentistry.com]

  Sedation dentistry may also be appropriate for people who: have a low pain threshold can't sit still in the dentist's chair have very sensitive teeth have a bad gag reflex need a large amount of dental work completed Sometimes, children are given sedation [webmd.com]

  […] adult dental patients include anxiety, low pain tolerance, underlying psychiatric disorders, and mental retardation. [1, 4] Nitrous oxide may also be useful for prolonged or more involved dental procedures as well as in patients with hyperresponsive gag [emedicine.medscape.com]

• Abdominal Pain

  A 27-year-old woman was treated in the emergency department for complaints of abdominal pain and inability to urinate for about 12 hours. [ncbi.nlm.nih.gov]

  To the victim's own astonishment, the wound was unaccompanied by pain. [druglibrary.org]

• Toothache

  Would you rather endure the agony of a toothache than step foot in a dentist's office? You're not alone. A lot of people are so phobic about going to the dentist that they prefer not to have any treatment. [webmd.com]

  Humphrey Davy (1778-1829), one of the pioneers of N2O experimentation, described the effects of N2O on himself following self-administration for a toothache and gum infection as follows: “On the day when the inflammation was the most troublesome, I breathed [dentalfearcentral.org]

  Hoffmann recommended his Anodyne for pains due to kidney stones, gallstones, intestinal cramps, earache, toothache, and painful menstruation. Ether labeled as Anodyne, Dr. Nagle notes, is "still available over the counter in some countries. [druglibrary.org]

• Heart Disease

  There is a condition called Methyltetrafolate Reductase Disorder that often occurs in families with high numbers of people with heart disease or Alzheimer's Disease. [side-effects-site.com]

  It’s also safe to use if you suffer from epilepsy, liver disease, heart disease, diabetes, or cerebrovascular disease. [dentalfearcentral.org]

  Prehospital delay in patients with acute coronary heart disease: concordance between patient interviews and medical records. Am Heart J. 135 (pt 1):293–299, 1998. Medline Google Scholar 112. [doi.org]

• Alopecia

  For example, pernicious anemia may occur together with autoimmune thyroid disease, type 1A diabetes mellitus, alopecia, vitiligo, and chronic atrophic gastritis in type III polyglandular autoimmune (PGA) syndrome—one of a rare group of disorders also [emedicine.com]

• Euphoria

  Nitrous Oxide (N2O) is a simple gas that, when inhaled, causes rapid analgesia (pain relief), euphoria, mild sedation, and sometimes psychedelic dissociation. It is widely available and its effects are short lasting. [wiki.tripsit.me]

  It is commonly called laughing gas since it produces euphoria and mirth when inhaled in small amounts. It is also used in making certain canned pressurized foods, e.g., instant whipped cream. [infoplease.com]

  At higher concentrations, nitrous acts as a dissociative drug which causes a sense of euphoria and both visual and auditory hallucinations. [justsayn2o.com]

  However, drug liking and euphoria, two face-valid measures of abuse liability, were unrelated to choice. [ncbi.nlm.nih.gov]

• Visual Hallucination

  At higher concentrations, nitrous acts as a dissociative drug which causes a sense of euphoria and both visual and auditory hallucinations. [justsayn2o.com]

  On very high doses (many repeated inhalations), users often report an “otherworldly” mental state, and may experience visual hallucinations. Be careful! Always remain seated. The greatest risk of using nitrous is injury from falling down. [dancesafe.org]

• Confusion

  After a second surgical intervention, the patient became confused. Four months after onset, the patient had paraplegia, severe weakness of the upper limbs, cutaneous anesthesia sparing the head, and confusion. [ncbi.nlm.nih.gov]

  Whether other drugs are taken around the same time The following effects may be felt almost immediately and can last for a few minutes: 2,4,5 Euphoria Numbness of the body Sedation Giddiness Uncontrolled laughter Uncoordinated movements Blurred vision Confusion [adf.org.au]

  They tend to induce a state known as dissociative anesthesia, marked by catalepsy, amnesia, and analgesia, while side effects can include hallucinations, nightmares, and confusion. [ebi.ac.uk]

  This mental confusion occurs as a result of the nitrous oxide causing Vitamin B12 Malabsorption by depleting the Vitamin B12 stores in the body. [side-effects-site.com]

• Tingling

  A 24-year-old man presented to the Emergency Department complaining of numbness and tingling of his hands and feet, as well as worsening clumsiness and gait disturbances after escalating use of nitrous oxide in the prior 2 weeks. [ncbi.nlm.nih.gov]

• Headache

  Total 1-5 minutes After-effects 15-30 minutes Effects Postive Anxiolytic Euphoria Giggling and laughing Neuroprotection Dream-like state Neutral Analgesia Sound distortion Minor to strong hallucinations & visualizations Negative Neurotoxicity Nausea Headaches [wiki.tripsit.me]

  Incompatibilities & Reactivities Aluminum, boron, hydrazine, lithium hydride, phosphine, sodium Exposure Routes inhalation, skin and/or eye contact (liquid) Symptoms dyspnea (breathing difficulty); drowsiness, headache; asphyxia; reproductive effects; [cdc.gov]

  Headache Saunders et al 16 found no occurrences of headache in a group of 47 patients treated with 50% nitrous oxide or placebo. [doi.org]

  Headaches - Although uncommon, a certain subset of people report headaches during the offset of nitrous oxide. [psychonautwiki.org]

  Short-term side effects can include headaches, dizziness and unconsciousness, while long-term, excessive use has been associated with anaemia, incontinence, depleted bone marrow and numbness in fingers and toes. [theweek.co.uk]

• Ataxia

  A patient who abused nitrous oxide chronically developed ataxia, paresthesia, and urinary retention while self-medicating with cyanocobalamin. [ncbi.nlm.nih.gov]

• Peripheral Neuropathy

  Vitamin B (12) deficiency can lead to progressive demyelination and axonal lesions on the peripheral nerves and cervicothoracic spinal cord causing a peripheral neuropathy. [ncbi.nlm.nih.gov]

Thus, pernicious anemia must be differentiated from other disorders that interfere with the absorption and metabolism of vitamin B-12 (see DDx and Workup ). [emedicine.com]

[…] diagnosis of ACS is important and will help to guide immediate therapy, the estimation of risk for major adverse cardiac events in the immediate, short-term, and long-term time frames helps the physician determine the urgency in completing the diagnostic workup [doi.org]

• Macrocytosis

  Significant investigation results included a low serum vitamin B12 concentration, mild macrocytosis and raised serum homocysteine concentration. [ncbi.nlm.nih.gov]

  In erythroid precursors, macrocytosis and ineffective erythropoiesis occur. Severe neurological impairment, usually subacute combined system degeneration, occurs in cobalamin deficiency. [emedicine.com]

We present a case of acquired ataxia and myelopathy due to nitrous oxide abuse and discuss diagnosis, pathophysiology, and response to treatment. [ncbi.nlm.nih.gov]

In general, the prevalence of pernicious anemia is probably underestimated, due to the complexity of the diagnosis. [6] Prognosis The disease is called pernicious anemia because it was fatal prior to the discovery that it was a nutritional disorder. [emedicine.com]

Cardiac troponins are useful in diagnosis, risk stratification, and determination of prognosis. [doi.org]

Cervical MRI demonstrated an isolated dorsal column signal that was suggestive of a nontraumatic etiology. The patient's symptoms resolved entirely over the course of 48 hours. Nitrous oxide abuse is increasing in prevalence. [ncbi.nlm.nih.gov]

Children who develop cobalamin deficiency usually have a hereditary disorder, and the etiology of their cobalamin deficiency is different from the etiology observed in classic pernicious anemia. [emedicine.com]

PPCI after ROSC in subjects with arrest of presumed ischemic cardiac etiology may be reasonable, even in the absence of a clearly defined STEMI (Class IIb, LOE B). [doi.org]

Victoria, Australia. 4 Department of Anaesthesia and Perioperative Medicine, The Alfred Hospital, Melbourne, Victoria, Australia. 5 Department of Anaesthesia and Perioperative Medicine, Monash University, Melbourne, Victoria, Australia. 6 Department of Epidemiology [ncbi.nlm.nih.gov]

Epidemiology The adult form of pernicious anemia is most prevalent among individuals of either Celtic (ie, English, Irish, Scottish) or Scandinavian origin. In these groups, 10-20 cases per 100,000 people occur per year. [emedicine.com]

Dargan, The epidemiology and patterns of acute and chronic toxicity associated with recreational ketamine use, Emerging Health Threats Journal, 4, 1, (7107), (2011). [doi.org]

Since environmental exposures were not measured during these epidemiologic studies, no dose-effect relationship could be established. [cdc.gov]

Epidemiological studies, primarily of operating room personnel, have shown increased risks of spontaneous abortion, premature delivery, and involuntary infertility among these occupationally exposed populations [ACGIH 1991; Hathaway et al. 1991]. * Signs [web.archive.org]

We present a case of acquired ataxia and myelopathy due to nitrous oxide abuse and discuss diagnosis, pathophysiology, and response to treatment. [ncbi.nlm.nih.gov]

Pathophysiology Classic pernicious anemia is caused by the failure of gastric parietal cells to produce sufficient IF (a gastric protein secreted by parietal cells) to permit the absorption of adequate quantities of dietary vitamin B-12. [emedicine.com]

This clinically important risk of major harm reduces the usefulness of omitting N2O to prevent postoperative emesis. [ncbi.nlm.nih.gov]

The gas is prepared commercially by the thermal decomposition of ammonium nitrate, NH 4 NO 3, at about 240°C to produce nitrous oxide and water; the reaction must be carefully controlled to prevent explosive decomposition of the nitrous oxide. [infoplease.com]