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 be desirably [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]

  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]

• 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]

• Hunting

  Google Scholar Crossref Medline ISI McCambridge, J, Winstock, A, Hunt, N. ( 2007 ) 5-year trends in use of hallucinogens and other adjunct drugs among UK dance drug users. Eur Addict Res 13: 57 – 64. [dx.doi.org]

  King SB, Smith SC, Hirshfeld JW, Jacobs AK, Morrison DA, Williams DO, Feldman TE, Kern MJ, O'Neill WW, Schaff HV, Whitlow PL, Adams CD, Anderson JL, Buller CE, Creager MA, Ettinger SM, Halperin JL, Hunt SA, Krumholz HM, Kushner FG, Lytle BW, Nishimura [doi.org]

• Coronary Atherosclerosis

  Homocysteine has been linked to endothelial dysfunction and coronary atherosclerosis and this case report highlights one of the dangers of recreational abuse of nitrous oxide. [ncbi.nlm.nih.gov]

• Pharyngitis

  An MRI confirmed the absence of pharyngeal haematoma and the absence of thrombosis of the basilar artery. [ncbi.nlm.nih.gov]

• 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]

• 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]

  pain, and weight loss" along with "neurological effects such as confusion, ataxia, tremor, paresthesias [itching], neuritis, and paralysis of peripheral and cranial nerves." 28 If Dr. [druglibrary.org]

• Thrombosis

  An MRI confirmed the absence of pharyngeal haematoma and the absence of thrombosis of the basilar artery. [ncbi.nlm.nih.gov]

  Fondaparinux was associated with increased risk of catheter thrombosis in PCI. 324 Bivalirudin No benefit in combined outcome was observed when bivalirudin was administered in hospital compared to UFH in patients with non-ST-segment elevation ACS, however [doi.org]

• Lip Numbness

  After profound lip numbness, endodontic treatment was performed. Success was defined as the ability to perform endodontic access and instrumentation with no pain or mild pain. [ncbi.nlm.nih.gov]

• Hyperhidrosis

  The use of nitrous oxide/oxygen mixture resulted in a significant reduction in pain when used for photodynamic therapy, botulinum toxin therapy for hyperhidrosis of both the palms and axilla, aesthetic procedures involving various laser procedures, and [ncbi.nlm.nih.gov]

• Flexion Contracture

  Physical examination was notable for pathologically brisk reflexes in all extremities, generalized flexion contracture of the fingers, decreased sensation in a stocking and glove distribution, and a weakly positive Babinski sign. [ncbi.nlm.nih.gov]

• Neck Swelling

  A 17-year-old girl presented to the A&E department with significant neck swelling with associated chest, neck and throat pain. [ncbi.nlm.nih.gov]

• Euphoria

  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]

  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]

  The gas is inhaled, typically by discharging nitrous gas cartridges (bulbs or whippets) into another object, such as a balloon, or directly into the mouth. 3 Inhaling nitrous oxide produces a rapid rush of euphoria and feeling of floating or excitement [adf.org.au]

• Visual Hallucination

  When inhaled, nitrous produces a variety of physical effects including: Disorientation (both spatial and time-based) Fixated vision Throbbing or pulsating auditory hallucinations Similarly pulsating visual hallucinations Increased pain threshold Deep [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]

  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]

  Not only is this a bit unpleasant but there is a risk of inhaling your own vomit if you are a bit confused or temporarily unconscious. [justsayn2o.com]

• Headache

  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]

  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]

  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

  A case is reported of prolonged and intensive nitrous oxide abuse that resulted in the development of a peripheral neuropathy. [ncbi.nlm.nih.gov]

• Foot Drop

  Later reevaluation revealed a steppage gait and foot drop. Electrodiagnostic studies (ie, electromyography and nerve conduction studies) revealed a severe peripheral polyneuropathy. [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]

• Liver Biopsy

  Patient-administered nitrous oxide/oxygen provides safe and effective analgesia for percutaneous liver biopsy: A randomized placebo-controlled trial. Am J Gastroentol 2001 ; 96 : 1553 –7. Saunders BP, Elsby B, Boswell AM, et al. [doi.org]

All treatment groups (A, B, C) will receive standard pain treatment (oral immediate-release morphine) plus a pre-prepared nitrous oxide/oxygen mixture, and the control group (D) will receive the standard pain treatment plus oxygen. [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]

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]

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]

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]