Other effects include diaphoresis, chest pain, and persistent dry cough, all of which may result in weight loss, anorexia and may also lead to right-side heart enlargement and heart disease in advanced cases. Prolonged exposure to relatively low levels of nitrogen (II) oxide may cause persistent headaches and nausea. Like chlorine gas poisoning, symptoms usually resolve themselves upon removal from further nitrogen dioxide exposure, unless there had been an episode of severe acute poisoning. Treatment and management vary with symptoms. Patients are often observed for hypoxemia for a minimum of 12 hours if there are no initial symptoms and if the patient is hypoxemic, oxygen may be administered but high-dose steroids are recommended for patients with pulmonary manifestations. Patients may also be hospitalized for 12 to 24 hours or longer for observation if the gaseous exchange is impaired. In a case where gaseous exchange is impaired, mechanical ventilation and intubation may be necessary and if bronchiolitis obliterans develop within 2 to 6 weeks of nitrogen dioxide exposure, corticosteroid therapy or anticholinergic medications may be required for 6 to 12 months to lower the body overreaction to nitrogen dioxide gas. Cause
Occupational exposures constitute the highest risk of toxicity and it is often high for farmers especially those that deal with food grains. It is equally high for firefighters and military personnel, especially those officers that deal in explosives. The risk is also high for arc welders, traffic officers, aerospace staffs and miners as well as those people whose occupations are connected with the nitric acid.
Delsym is an American brand of cough medicine owned by Reckitt, and manufactured at Unither Manufacturing in Rochester, NY. It is different from most brands of cough medicine in that the active ingredient is "time released". The time release feature allows the drug to suppress the cough reflex for a longer period of time. The active ingredient per teaspoon (5 mL) is dextromethorphan polistirex, equivalent to dextromethorphan HBr 30 mg. Method of action
The active ingredient, dextromethorphan (metabolized to dextrorphan), is surrounded by an edible plastic called polistirex. When the Delsym arrives in the stomach, an initial amount of dextromethorphan is immediately released into the bloodstream while the rest is surrounded by a plastic that is slowly dissolved by stomach acid. After the polistirex is dissolved sufficiently, more dextromethorphan is released. Recreational use
Intentionally consuming more than the recommended dosage of Delsym may result in euphoria, lack of coordination, hallucinations, apathy, feelings of dissociation, and disorientation. This is due to dextromethorphan as well as its pharmacologically-active metabolite dextrorphan, both dissociative drugs that work as NMDA receptor antagonists the same way nitrous oxide (N2O), ketamine, and phencyclidine (PCP) do. Because of the abuse potential, many pharmacies and large retail chains have begun taking precautions such as restricting sales to those under age 18 and limiting the number of sales of dextromethorphan-containing products per customer. References
External links
Official website