Products
Nitrous oxide (chemical name: dinitrogen monoxide) is commercially available as an inhalation gas as a monopreparation and as a fixed combination with oxygen. It has been used medicinally since 1844.
Structure and properties
Nitrous oxide (N2O, Mr = 44.01 g/mol) exists as a colorless gas with a sweetish odor, obtained from ammonium nitrate by thermal decomposition. It is oxidizing and heavier than air.
Effects
Nitrous oxide (ATC N01AX13) has analgesic (analgesic), central depressant (sedative), antianxiety (anxiolytic), weak anesthetic, weak amnesic, and very weak muscle relaxant properties. It has a rapid onset of action and a short duration of action in the range of minutes. It enters the bloodstream pulmonarily and is also eliminated unchanged through the lungs. The effects are attributed in part to NMDA antagonism.
Indications
- As an analgesic and sedative, for short-term prevention and treatment of pain, for example in dentistry and obstetrics.
- As an anesthetic (combination therapy with other anesthetics).
Dosage
According to the professional information. The gas is administered by inhalation mixed with oxygen.
Abuse
Nitrous oxide can be abused as a euphoric, dissociative, and depressant intoxicant. For example, it is contained as a propellant gas in cream capsules (Rahm capsules) and is usually inhaled with the aid of a balloon. Because of the possible undesirable side effects, it is strongly discouraged, especially chronic use.
Contraindications
Full precautions can be found in the drug label.
Interactions
Drug-drug interactions have been described with the following agents:
- Other anesthetics, opioids
- Central depressant drugs
- Alcohol
- Naloxone
- Methotrexate
Adverse effects
The most common possible adverse effects include dizziness, lightheadedness, fatigue, euphoria, nausea, vomiting, flatulence, and a feeling of pressure in the middle ear. Nitrous oxide inactivates vitamin B12 and may cause symptoms of vitamin B12 deficiency with regular use.
