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Replied to the WMA Statement on Electronic Cigarettes and Other Electronic Nicotine Delivery SystemsA nice article. In my opinion, our Group should move forward to globally spread the message that "any form of Nicotine is addictive and harmful to hu
227 days ago
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Posted a new discussion, WMA Statement on Electronic Cigarettes and Other Electronic Nicotine Delivery SystemsAdopted by the 63rd WMA General Assembly, Bangkok, Thailand, October 2012 INTRODUCTION Electronic cigarettes (e-cigarettes) are products designed ...
229 days ago
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Posted a new discussion, A new study with potential benefits for e-cigarette. I looks nice to have an international study to look at this effect. What do you think?Drug Alcohol Rev. 2012 Sep 20. doi: 10.1111/j.1465-3362.2012.00512.x. [Epub ahead of print] Patterns of electronic cigarette use and user beliefs abo ...
239 days ago
Every day, thousands adolescents light up their first cigarette across the world .
From the American Cancer Society:
• Eighty-nine percent of people who ever try a cigarette try by age 18. Almost no one starts the smoking habit during adulthood.
• Seventy percent of adolescent smokers say they would never have started if they could choose again. That's because the nicotine in cigarettes is addictive. The risk of becoming addicted to nicotine is between one in two and one in three.
• Tobacco is responsible for nearly one in every five deaths in the United States. It is the largest cause of preventable death.
More than 400,000 people die every year from smoking-related diseases. That's more than from alcohol, crack, heroin, murder, suicide, car accidents, and AIDS combined!
What can we do?
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A nice article. In my opinion, our Group should move forward to globally spread the message that "any form of Nicotine is addictive and harmful to humanity" - including the E-Cigarettes.
It might be questioned if Propylene Glycol is safe as a main substance in e-cigarettes. Today I would like to discuss about it.
Propylene glycol is a solvent of some medications such as Benzodiazepines. Wilson and his colleagues in Boston showed that propylene glycol toxicity is a potentially life-threatening iatrogenic complication. Although, they did not evaluate inhaler complications of e-cigarettes, the systemic effects of propylene glycol probably is the similar. Please find more detail here.
Chest. 2005 Sep;128(3):1674-81.
Propylene glycol toxicity: a severe iatrogenic illness in ICU patients receiving IV benzodiazepines: a case series and prospective, observational pilot study.
Wilson KC, Reardon C, Theodore AC, Farber HW.
Source
The Pulmonary Center, R-304, Boston University School of Medicine, 715 Albany St, Boston, MA 02118, USA. kwilson@lung.bumc.bu.edu
Abstract
STUDY OBJECTIVES:
Benzodiazepines are commonly administered to medical ICU (MICU) patients. Propylene glycol (1,2-propanediol) is the solvent used to deliver lorazepam and diazepam IV. Although propylene glycol toxicity is increasingly recognized and reported, its incidence is unknown. Herein, we describe five MICU patients who acquired severe propylene glycol toxicity due to IV lorazepam or diazepam administration. Additionally, we evaluate the incidence of propylene glycol toxicity in MICU patients receiving IV lorazepam or diazepam.
DESIGN:
Case series and prospective, observational study.
SETTING:
Eighteen-bed MICU in a 550-bed urban academic hospital.
PATIENTS AND METHODS:
MICU patients administered IV benzodiazepines during a 3-month period were enrolled. Patients were categorized according to the IV benzodiazepine that they received. Laboratory data and highlights of their clinical course were recorded daily. The incidence of propylene glycol toxicity was determined and the groups compared.
RESULTS:
Forty-four patients were enrolled. Twenty-one patients received a benzodiazepine delivered in propylene glycol (lorazepam or diazepam), and 23 patients received a benzodiazepine delivered in an alternative solvent (midazolam). We found that four patients (19%) who received IV lorazepam or diazepam had metabolic evidence of propylene glycol toxicity. None of the patients had clinical deterioration. Neither metabolic abnormality nor clinical deterioration suggestive of propylene glycol toxicity were identified in subjects receiving IV midazolam.
CONCLUSION:
Propylene glycol toxicity is a potentially life-threatening iatrogenic complication that is common and preventable. It should be considered whenever a patient has an unexplained anion gap, unexplained metabolic acidosis, hyperosmolality, and/or clinical deterioration. Close monitoring of all patients receiving IV lorazepam or diazepam for early evidence of propylene glycol toxicity is warranted.
