Nitrites and nitrates are readily accessible and are often sold without full disclosure of their hazards if misused.
Several salts available, but amyl and isobutyl are the more common. "Poppers" are named for the sound made by a thin-walled glass ampoule being crushed.
Intake: inhalation or ingestion. Ingestion may result in a higher dose and so greater toxicity.
Effects:
(1) peripheral vasodilation
(2) euphoria
(3) sexual enhancement
(4) aphrodisiac
(5) relaxation of anal sphincter
The drug may be mixed with other drugs, especially stimulants.
Red flags:
(1) cyanosis without obvious lung disease
(2) hypoxemia unresponsive to supplemental oxygen
(3) chocolate colored blood
(4) dark brown urine
If methemoglobinemia from nitrate/nitrite abuse is diagnosed, then be sure to:
(1) check for sexually transmitted infections
(2) drugs of abuse
