Instituto Nacional de Psiquiatría (México)
XXIV Reunión Anual de Investigación
6 de octubre del 2009
Investigación básica en inhalables y su repercusión en la salud mental
Presenta: Dra. Silvia Cruz
3. Inhalables Compuestos volátiles a temperatura ambiente. Sus vapores se inhalan para obtener un estado alterado de conciencia y prácticamente no se usan por otra vía de administración. Disolventes, gases, nitritos
8. Estados Unidos Death of Cal State Bakersfield student caused by abuse of inhalant Friends suspected she might be abusing inhalants to get a temporary high. The Kern County Coroner's office tells 29 Eyewitness News Erin Ruge died from "asphyxiation due to inhalation of a gaseous substance."The 21-year-old Ruge was found dead inside her apartment on the 82 hundred block of Kroll Way on March 27Th. In this particular case, the coroner's office says Ruge was using a product called Clean Safe Dust Remover that shoots a blast of compressed air to clear dust from computer keyboards.Health officials say the abuse of inhalants is widespread across the United States, but it may be under reported because law enforcement and health care providers are often unfamiliar with signs of abuse. Muere una estudiante por abuso de inhalables
9. Estados Unidos, Junio 2006 06/12/2006 Rapid City Police Investigate Motorcycle Fatality Rapid City police say a 19-year-old man who crashed into a motorcyclist at an intersection was high on marijuana and an inhalant.Michael Reger was jailed on several charges, including vehicular homicide, which can bring up to 15 years in prison.Killed was 54-year-old motorcyclist Robert Cox. Cox was stopped at an intersection when he was rear-ended by Reger.Police say Reger tried to flee the scene, but was blocked by another motorist. Motociclista involucrado en accidente estaba bajo los efecto de mariguana e inhalables
10. El abuso de inhalables fue un factor en la muerte de una joven de 18 años.
11. Hollywood, Mayo 2006 Steve-O Admits To Pumping Paris Full Of Happy Gas Before Crash Its funny, Steve-O laughed during his appearance on Thursday s episode of JIMMY KIMMEL LIVE. About a half hour before Paris Hilton had that car crash, I may have given her some mind altering substances. He stated that prior to the accident he met Hilton and Niarchos at a night club and provided them with Nitrous filled balloons. I probably shouldn t say that, the daredevil continued. Whoops! Nitrous. Laughing gas. Whippits. No matter how you refer to the dizzyingly sweet inhalant, it's an intoxicating high, though preferably not when at the wheel of a $170,000 automobile, as it tends to turn the very solid world around you into one gigantic bouncy castle. Paris Hilton había inhalado óxido nitroso en globos antes del accidente automovilístico.
12. Ndola, Zambia, 2007 Drug use is regularly reported as a source of violent flare-ups between street children by SCA partner The Rainbow Project. In Zambia, as in many other countries, street children sniff glue and petrol to stave off hunger and keep warm at night. A distilled mixture of petrol and glue, called “bostic” is a high-value commodity for street children. A Rainbow Project street worker tells of a fight between street youth: Los niños inhalan pegamento y gasolina para no sentir hambre y frio.
13. Islas Caimanes, Junio de 2006 Chief Executive Officer of the National Drug Council (NDC) Cathy Chesnut said parents, teachers and caregivers need to carefully look for signs that children may be consuming drugs and alcohol.The NDC’s CEO said students who snort chalkboard cleaner mask their action by concealing the inhalant in empty bags of potatoes chips. She said that teachers have reported seeing children with empty potato chip bags but they never suspected what was happening.“They see the fluffy whip can around the schoolyard and at home but they believe that the student use them to play-fight. We had to show them how they use it to get high,” Ms Chesnut added. Los jóvenes inhalan líquido limpiador de pizarrones y ocultan el producto en bolsas vacías de papas.
17. Datos Epidemiológicos México 2 % de la población general 27 % de los niños que viven y/o trabajan en la calle Su consumo va en aumento en población escolar Medina-Mora y Berenzon
18. Uso de drogas en estudiantes en México Mariguana Inhalables Cocaína Porcentaje AÑO De la Serna et al, 1001; Castro, 1992; Median-Mora et al., 1991, 1993; Villatoro et al, 1997, 2000, 2003
27. Necesidad de tratamiento Número de pacientes que buscaron tratamiento por abuso de inhalables: 3,168 (5.2%). Hombres: 91.8 %; Mujeres: 8.2 %. 81.5% inhalaban diariamente. Edad de inicio: 10-19 años. 63.7% reportaron a los inhalables como droga de inicio. SISVEA, Perfil de inhalables 2006
52. ¿Mecanismo de acción? “El mecanismo de acción de los disolventes es aún un misterio” Dinwiddie, 1994. Meyer y Overton Perturbación membranal inespecífica
55. Registros en ovocitos Expresión de receptores DNA Inyección de ovocitos Xenopus laevis Registro de corrientes iónicas
56. Disolventes: inhiben NMDA Corrientes catiónicas expresadas en ovocitos Benceno Tolueno NMDA + glicina Cruz et al., 1998, 2000
57. Disolventes: potencian GABAA Al igual que otros inhibidores del SNC, son moduladores positivos de GABAA picrotoxina alcohol Benzodiacepinas barbitúricos Stahl, SM. Essential Psychopharmacology, 2000
61. Disolventes y arritmias El tolueno produce bloqueo de los canales de sodio cardiacos. ¿Relación con muerte súbita por inhalación? Cruz et al., 2004; Gauthereau et al., 2005
62. The abused inhalant toluene increases dopamine release in the nucleus accumbens by directly stimulating ventral tegmental area neurons. Riegel AC, Zapata A, Shippenberg TS, French ED. The abused inhalant toluene increases dopamine release in the nucleus accumbens by directly stimulating ventral tegmental area neurons. Riegel AC, Zapata A, Shippenberg TS, French ED. (1999) Brain-Imaging Study Offers Clues to Inhalant Abuse http://www.bnl.gov/bnlweb/pubaf/pr/2002/bnlpr041502.htm
64. Áreas de investigaciónExposición prenatal a inhalablesMecanismos de acción de otros inhalablesEfectos de mezclas ComorbilidadPrevención Tratamiento
69. Gases Riesgos asociados a la inhalación Muerte súbita Congelamiento de tejido (boca, labios, mejillas, vías aéreas superiores) Explosión (son inflamables y más densos que el aire)
70. Mecanismo de acción La mayoría de los inhalables estudiados son moduladores positivos GABAA
71. ¿Qué es el “aire comprimido”? Sustancia activa: 1,1-difluoroetano. Sinónimos: F152a, R152a, fluoruro de etileno. Produce euforia rápida y transitoria. Riesgos: muerte súbita y congelamiento de boca y vías aéreas.
73. Prevención Leyendas precautorias. Manejo tipo sustancias tóxicas. Sustitución de productos. National Prevention Coalition
74. Tratamiento YSAC, Canada Enfoque holístico -Terapia individual - De grupo - Familiar - Tradicional indígena - Educación artística - Escuela - Recreación - Alimentación - Servicios de salud The Whiskyjack Treatment Centre