University of Maryland School of Medicine logo
Emergency Medicine
All Departments
UMSOM Assistant
UMEM Educational Pearls
  • Home
  • Departments
  • Emergency Medicine
  • CME
  • UMEM Educational Pearls
  • CME
  • Courses and Conferences
  • Free Open Access Medical Education
  • UMEM Educational Pearls

Search

Title: Can too much whipped cream be bad for your health? Nitrous oxide toxicity

Category: Toxicology

Keywords: nitrous oxide, neurotoxicity (PubMed Search)

Posted: 9/5/2019 by Hong Kim, MD

 

Numerous different household products can potentially be misused/abused. One such product is whipped cream charger/propellant that contains nitrous oxide.

Acute toxicity produce dose dependent response

  • Euphoria 
  • Anxiolysis
  • Sedation
  • Unconsciousness
  • Asphyxiation

Chronic toxicity causes myeloneuropathy (demyelination of the dorsal and lateral columns of the spinal cord) due to vitamin B12 deficiency

  • Extremity paresthesias
  • Ataxia
  • Peripheral sensory neuropathy (loss of vibration sense and proprioception)
  • Weakness 
  • Hematologic effects: leukopenia, thrombocytopenia, megaloblastic anemia

Management

  • Cessation of nitrous oxide use
  • Vitamin B12 (cyanocobalamin) repletion (IM)

References

J Med Toxicol. 2019 Aug 6. doi: 10.1007/s13181-019-00726-x. [Epub ahead of print]
Nitrous oxide toxicity: case files of the carolinas medical center medical toxicology fellowship.
Shah K1, Murphy C2.

University of Maryland School of Medicine logo
  • Departments
  • Programs
  • Research Centers
  • Institutes
  • Graduate Education
  • CIBR Cores
  • Offices of the Dean
    • University of Maryland, Baltimore
    • University of Maryland Medical Center
    • Medical Alumni Association of the University of Maryland
    • Health Sciences and Human Services Library
University of Maryland School of Medicine
655 W. Baltimore Street
Baltimore, MD 21201
Contact Us

© University of Maryland School of Medicine

    • Webmaster
    • Web Accessibility
    • Site Index
    • UMB Hotline
    • Employment
    • Map