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Nausea | |
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A 1681 painting depicting a person vomiting | |
Specialty | Gastroenterology |
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Nausea is an unpleasant, diffuse sensation of unease and discomfort, often perceived as an urge to vomit.[1] While not painful, it can be a debilitating symptom if prolonged, and has been described as placing discomfort on the chest, upper abdomen, or back of the throat.[2]
Nausea is a non-specific symptom, which means that it has many possible causes. Some common causes of nausea are gastroenteritis and other gastrointestinal disorders, food poisoning, motion sickness, dizziness, migraine, fainting and low blood sugar. Nausea is a side effect of many medications including chemotherapy, or morning sickness in early pregnancy. Nausea may also be caused by anxiety, disgust and depression.[1][3][4][5]
Medications taken to prevent and treat nausea are called antiemetics. The most commonly prescribed antiemetics in the US are promethazine, metoclopramide and the newer, extremely effective ondansetron. The word nausea is from Latinnausea, from Greekναυσία – nausia,[6] 'ναυτία' – nautia, motion sickness, 'feeling sick or queasy'.[7]
- 1Causes
- 1.8Comprehensive list
- 2Diagnostic approach
- 4Treatment
Causes[edit]
Gastrointestinal infections (37%) and food poisoning are the two most common causes of acute nausea and vomiting.[1] Side effects from medications (3%) and pregnancy are also relatively frequent.[1] There are many causes of chronic nausea.[1] Nausea and vomiting remain undiagnosed in 10% of the cases. Aside from morning sickness, there are no gender differences in complaints of nausea. After childhood, doctor consultations decrease steadily with age. Only a fraction of one percent of doctor visits by those over 65 are due to nausea.[8]
Gastrointestinal[edit]
Gastrointestinal infection is one of the most common causes of acute nausea and vomiting.[1] Chronic nausea may be the presentation of many gastrointestinal disorders, occasionally as the major symptom, such as gastroesophageal reflux disease, functional dyspepsia, gastroparesis, peptic ulcer, celiac disease, non-celiac gluten sensitivity, Crohn's disease, hepatitis, upper gastrointestinal malignancy, and pancreatic cancer.[1][9] Uncomplicated Helicobacter pylori infection does not cause chronic nausea.[1]
Food poisoning[edit]
Food poisoning usually causes an abrupt onset of nausea and vomiting one to six hours after ingestion of contaminated food and lasts for one to two days.[10] It is due to toxins produced by bacteria in food.[10]
Medications[edit]
Many medications can potentially cause nausea.[10] Some of the most frequently associated include cytotoxic chemotherapy regimens for cancer and other diseases, and general anaesthetic agents. An old cure for migraine, ergotamine, is well known to cause devastating nausea in some patients; a person using it for the first time will be prescribed an antiemetic for relief if needed.
Pregnancy[edit]
Nausea or 'morning sickness' is common during early pregnancy but may occasionally continue into the second and third trimesters. In the first trimester nearly 80% of women have some degree of nausea.[11] Pregnancy should therefore be considered as a possible cause of nausea in any women of child bearing age.[10] While usually it is mild and self-limiting, severe cases known as hyperemesis gravidarum may require treatment.[12]
Disequilibrium[edit]
A number of conditions involving balance such as motion sickness and vertigo can lead to nausea and vomiting.
Psychiatric[edit]
Nausea may be caused by depression, anxiety disorders and eating disorders.[13]
Potentially serious[edit]
While most causes of nausea are not serious, some serious conditions are associated with nausea. These include: pancreatitis, small bowel obstruction, appendicitis, cholecystitis, hepatitis, Addisonian crisis, diabetic ketoacidosis, increased intracranial pressure, Spontaneous Intracranial Hypotension, brain tumors, meningitis, heart attack,[14]carbon monoxide poisoning and many others.[1]
Comprehensive list[edit]
Inside the abdomen[edit]
Obstructing disorders
Enteric infections
Inflammatory diseases
Sensorimotor dysfunction
- Chronic idiopathic nausea
- Functional vomiting
Other
- Abdominal irradiation[15]
Outside the abdomen[edit]
Cardiopulmonary
- Myocardial infarction (heart attack)
Inner-ear diseases
Intracerebral disorders
Psychiatric illnesses
- Anorexia and bulimia nervosa
Other
- Post-operative vomiting[15]
Medications and metabolic disorders[edit]
Drugs
Endocrine/metabolic disease
- Thyroid and parathyroid disease
Toxins
Diagnostic approach[edit]
Patient history[edit]
Taking a thorough patient history may reveal important clues to the cause of nausea and vomiting. If the patient's symptoms have an acute onset, then drugs, toxins, and infections are likely. In contrast, a long-standing history of nausea will point towards a chronic illness as the culprit. The timing of nausea and vomiting after eating food is an important factor to pay attention to. Symptoms that occur within an hour of eating may indicate an obstruction proximal to the small intestine, such as gastroparesis or pyloric stenosis. An obstruction further down in the intestine or colon will cause delayed vomiting. An infectious cause of nausea and vomiting such as gastroenteritis may present several hours to days after the food was ingested.[15] The contents of the emesis is a valuable clue towards determining the cause. Bits of fecal matter in the emesis indicate obstruction in the distal intestine or the colon. Emesis that is of a bilious nature (greenish in color) localizes the obstruction to a point past the stomach. Emesis of undigested food points to an obstruction prior to the gastric outlet, such as achalasia or Zenker's diverticulum. If patient experiences reduced abdominal pain after vomiting, then obstruction is a likely etiology. However, vomiting does not relieve the pain brought on by pancreatitis or cholecystitis.[15]
Physical exam[edit]
It is important to watch out for signs of dehydration, such as orthostatic hypotension and loss of skin turgor. Auscultation of the abdomen can produce several clues to the cause of nausea and vomiting. A high-pitched tinkling sound indicates possible bowel obstruction, while a splashing 'succussion' sound is more indicative of gastric outlet obstruction. Eliciting pain on the abdominal exam when pressing on the patient may indicate an inflammatory process. Signs such as papilledema, visual field losses, or focal neurological deficits are red flag signs for elevated intracranial pressure.[15]
Diagnostic testing[edit]
When a history and physical exam are not enough to determine the cause of nausea and vomiting, certain diagnostic tests may prove useful. A chemistry panel would be useful for electrolyte and metabolic abnormalities.[16] Liver function tests and lipase would identify pancreaticobiliary diseases.[16] Abdominal X-rays showing air-fluid levels indicate bowel obstruction, while an X-ray showing air-filled bowel loops are more indicative of ileus. More advanced imaging and procedures may be necessary, such as a CT scan, upper endoscopy, colonoscopy, barium enema, or MRI. Abnormal GI motility can be assessed using specific tests like gastric scintigraphy, wireless motility capsules, and small-intestinal manometry.[15]
Pathophysiology[edit]
Research on nausea and vomiting has relied on using animal models to mimic the anatomy and neuropharmacologic features of the human body.[17] The physiologic mechanism of nausea is a complex process that has yet to be fully elucidated. There are four general pathways that are activated by specific triggers in the human body that go on to create the sensation of nausea and vomiting.[18]
- Central nervous system (CNS): Stimuli can affect areas of the CNS including the cerebral cortex and the limbic system. These areas are activated by elevated intracranial pressure, irritation of the meninges (i.e. blood or infection), and extreme emotional triggers such as anxiety.
- Chemoreceptor trigger zone (CTZ): The CTZ is located in the area postrema in the floor of the fourth ventricle within the brain. This area is outside the blood brain barrier, and is therefore readily exposed to substances circulating through the blood and cerebral spinal fluid. Common triggers of the CTZ include metabolic abnormalities, toxins, and medications. Activation of the CTZ is mediated by dopamine (D2) receptors, serotonin (5HT3) receptors, and neurokinin receptors (NK1).
- Vestibular system: This system is activated by disturbances to the vestibular apparatus in the inner ear. These include movements that cause motion sickness and dizziness. This pathway is triggered via histamine (H1) receptors and acetylcholine (ACh) receptors.
- Peripheral Pathways: These pathways are triggered via chemoreceptors and mechanoreceptors in the gastrointestinal tract, as well as other organs such as the heart and kidneys. Common activators of these pathways include toxins present in the gastrointestinal lumen and distension of the gastrointestinal lumen from blockage or dysmotility of the bowels. Signals from these pathways travel via multiple neural tracts including the vagus, glossopharyngeal, splanchnic, and sympathetic nerves.
Signals from any of these pathways then travel to the brainstem, activating several structures including the nucleus of the solitary tract, the dorsal motor nucleus of the vagus, and central pattern generator.[19] These structures go on to signal various downstream effects of nausea and vomiting. The body's motor muscle responses involve halting the muscles of the gastrointestinal tract, and in fact causing reversed propulsion of gastric contents towards the mouth while increasing abdominal muscle contraction. Autonomic effects involve increased salivation and the sensation of feeling faint that often occurs with nausea and vomiting.
Treatment[edit]
If dehydration is present due to loss of fluids from severe vomiting, rehydration with oral electrolyte solutions is preferred.[1] If this is not effective or possible, intravenous rehydration may be required.[1] Medical care is recommended if: a person cannot keep any liquids down, has symptoms more than 2 days, is weak, has a fever, has stomach pain, vomits more than two times in a day or does not urinate for more than 8 hours.[20]
Medications[edit]
Many pharmacologic medications are available for the treatment of nausea. There is no medication that is clearly superior to other medications for all cases of nausea.[21] The choice of antiemetic medication may be based on the situation during which the person experiences nausea. For people with motion sickness and vertigo, antihistamines and anticholinergics such as meclizine and scopolamine are particularly effective.[22] Nausea and vomiting associated with migraine headaches respond best to dopamine antagonists such as metoclopramide, prochlorperazine, and chlorpromazine.[22] In cases of gastroenteritis, serotonin antagonists such as ondansetron were found to suppress nausea and vomiting, as well as reduce the need for IV fluid resuscitation.[22] The combination of pyridoxine and doxylamine is the first line treatment for pregnancy-related nausea and vomiting.[22]Dimenhydrinate is an inexpensive and effective over the counter medication for preventing postoperative nausea and vomiting.[23] Other factors to consider when choosing an antiemetic medication include the person's preference, side-effect profile, and cost.
Alternative medicine[edit]
In certain people, cannabinoids may be effective in reducing chemotherapy associated nausea and vomiting.[24][25] Several studies have demonstrated the therapeutic effects of cannabinoids for nausea and vomiting in the advanced stages of illnesses such as cancer and AIDS.[26][27]
In hospital settings topical anti-nausea gels are not indicated because of lack of research backing their efficacy.[28] Topical gels containing lorazepam, diphenhydramine, and haloperidol are sometimes used for nausea but are not equivalent to more established therapies.[28]
Ginger has also been shown to be potentially effective in treating several types of nausea.[29][30]
Prognosis[edit]
The outlook depends on the cause. Most people recover within few hours or a day. While short-term nausea and vomiting are generally harmless, they may sometimes indicate a more serious condition. When associated with prolonged vomiting, it may lead to dehydration or dangerous electrolyte imbalances or both. Repeated intentional vomiting, characteristic of bulimia, can cause stomach acid to wear away at the enamel in teeth.[31]
Epidemiology[edit]
Nausea and or vomiting is the main complaint in 1.6% of visits to family physicians in Australia.[8] However, only 25% of people with nausea visit their family physician.[1] In Australia, nausea, as opposed to vomiting, occurs most frequently in persons aged 15–24 years, and is less common in other age groups.[8]
See also[edit]
References[edit]
- ^ abcdefghijklMetz A, Hebbard G (September 2007). 'Nausea and vomiting in adults--a diagnostic approach'(PDF). Aust Fam Physician (Review). 36 (9): 688–92. PMID17885699.
- ^'Nausea'.
- ^'Stress symptoms: How stress affects your body and behavior'. Mayo Clinic.
- ^Diagnostic Criteria: Clinical Guidelines for the Management of Anxiety. PubMed. National Collaborating Centre for Primary Care (UK).
- ^'Disease Information for Stress/Emotional/Physical: Clinical Manifestations'. Archived from the original on 2013-04-18.
- ^ναυσία, Henry George Liddell, Robert Scott,.A Greek-English Lexicon, on Perseus
- ^ναυτία, Henry George Liddell, Robert Scott, A Greek-English Lexicon, on Perseus
- ^ abcHelena Britt; Fahridin, S (September 2007). 'Presentations of nausea and vomiting'(PDF). Aust Fam Physician. 36 (9): 673–784. PMID17885697.
- ^Volta U, Caio G, Karunaratne TB, Alaedini A, De Giorgio R (2017). 'Non-coeliac gluten/wheat sensitivity: advances in knowledge and relevant questions'. Expert Rev Gastroenterol Hepatol (Review). 11 (1): 9–18. doi:10.1080/17474124.2017.1260003. PMID27852116.
A lower proportion of NCG/WS patients (from 30% to 50%) complain of upper gastrointestinal tract manifestations, e.g. vomiting, nausea, gastroesophageal reflux disease, aerophagia and aphthous stomatitis. (NCG/WS: Non-coeliac gluten/wheat sensitivity)
- ^ abcdScorza K, Williams A, Phillips JD, Shaw J (July 2007). 'Evaluation of nausea and vomiting'. Am Fam Physician. 76 (1): 76–84. PMID17668843.
- ^Koch KL, Frissora CL (March 2003). 'Nausea and vomiting during pregnancy'. Gastroenterol. Clin. North Am. 32 (1): 201–34, vi. doi:10.1016/S0889-8553(02)00070-5. PMID12635417.
- ^Sheehan P (September 2007). 'Hyperemesis gravidarum--assessment and management'. Aust Fam Physician. 36 (9): 698–701. PMID17885701.
- ^Singh P, Yoon SS, Kuo B (2016). 'Nausea: a review of pathophysiology and therapeutics'. Therap Adv Gastroenterol (Review). 9 (1): 98–112 (Table 1). doi:10.1177/1756283X15618131. PMC4699282. PMID26770271.
- ^O'Connor RE, Brady W, Brooks SC, Diercks D, Egan J, Ghaemmaghami C, Menon V, O'Neil BJ, Travers AH, Yannopoulos D (2010). 'Part 10: acute coronary syndromes: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care'. Circulation. 122 (suppl 3): S787–817. doi:10.1161/circulationaha.110.971028. PMID20956226.
- ^ abcdefHasler WL. Nausea, Vomiting, and Indigestion. In: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds. 'Harrison's Principles of Internal Medicine, 19e. New York, NY: McGraw-Hill; 2015.
- ^ abPorter, Ryan (American College of Gastroenterology). 'Nausea and Vomiting'(PDF). Med.unc.edu. Retrieved 24 January 2018.Check date values in:
|date=
(help) - ^Horn, Andrews (2006). 'Signals for nausea and emesis: implications for models of upper gastrointestinal disease'. Autonomic Neuroscience. 125 (1–2): 100–115. doi:10.1016/j.autneu.2006.01.008. PMC2658708. PMID16556512. Retrieved 2015-01-11.
- ^Lien, C (2012). Principles and Practice of Hospital Medicine. New York, NY: McGraw HIll. pp. Chapter 217: Domains of Care: Physical Aspects of Care.
- ^Bashashati, Mohammad; McCallum, Richard W. (2014-01-05). 'Neurochemical mechanisms and pharmacologic strategies in managing nausea and vomiting related to cyclic vomiting syndrome and other gastrointestinal disorders'. European Journal of Pharmacology. 722: 79–94. doi:10.1016/j.ejphar.2013.09.075. ISSN1879-0712. PMID24161560.
- ^'When you have nausea and vomiting: MedlinePlus Medical Encyclopedia'. Nlm.nih.gov. Retrieved 2014-03-20.
- ^Furyk, Jeremy S; Meek, Robert A; Egerton-Warburton, Diana (2015-09-28). 'Drugs for the treatment of nausea and vomiting in adults in the emergency department setting'. Reviews. 9 (9): CD010106. doi:10.1002/14651858.cd010106.pub2. ISSN1465-1858. PMID26411330.
- ^ abcdFlake, ZA (March 1, 2015). 'Practical selection of antiemetics in the ambulatory setting'. American Family Physician. 91 (5): 293–6. PMID25822385. Retrieved 10 November 2015.
- ^Kranke P, Morin AM, Roewer N, Eberhart LH (March 2002). 'Dimenhydrinate for prophylaxis of postoperative nausea and vomiting: a meta-analysis of randomized controlled trials'. Acta Anaesthesiol Scand. 46 (3): 238–44. doi:10.1034/j.1399-6576.2002.t01-1-460303.x. PMID11939912.
- ^Tramèr MR, Carroll D, Campbell FA, Reynolds DJ, Moore RA, McQuay HJ (July 2001). 'Cannabinoids for control of chemotherapy induced nausea and vomiting: quantitative systematic review'. BMJ. 323 (7303): 16–21. doi:10.1136/bmj.323.7303.16. PMC34325. PMID11440936.
- ^Drug Policy Alliance (2001). 'Medicinal Uses of Marijuana: Nausea, Emesis and Appetite Stimulation'. Archived from the original on 2007-08-05. Retrieved 2007-08-02.
- ^World health Organization, Cannabis - epidemiology. http://www.who.int/substance_abuse/facts/cannabis/en/
- ^Whiting, P. F.; Wolff, R. F.; Deshpande, S; Di Nisio, M; Duffy, S; Hernandez, A. V.; Keurentjes, J. C.; Lang, S; Misso, K; Ryder, S; Schmidlkofer, S; Westwood, M; Kleijnen, J (2015-06-23). 'Cannabinoids for medical use: A systematic review and meta-analysis'. JAMA. 313 (24): 2456–2473. doi:10.1001/jama.2015.6358. ISSN0098-7484. PMID26103030.
- ^ abAmerican Academy of Hospice and Palliative Medicine, 'Five Things Physicians and Patients Should Question', Choosing Wisely: an initiative of the ABIM Foundation, American Academy of Hospice and Palliative Medicine, retrieved August 1, 2013, which cites
- Smith, T. J.; Ritter, J. K.; Poklis, J. L.; Fletcher, D.; Coyne, P. J.; Dodson, P.; Parker, G. (2012). 'ABH Gel is Not Absorbed from the Skin of Normal Volunteers'. Journal of Pain and Symptom Management. 43 (5): 961–966. doi:10.1016/j.jpainsymman.2011.05.017. PMID22560361.
- Weschules, D. J. (2005). 'Tolerability of the Compound ABHR in Hospice Patients'. Journal of Palliative Medicine. 8 (6): 1135–1143. doi:10.1089/jpm.2005.8.1135. PMID16351526.
- ^Marx, WM; Teleni L; McCarthy AL; Vitetta L; McKavanagh D; Thomson D; Isenring E. (2013). 'Ginger (Zingiber officinale) and chemotherapy-induced nausea and vomiting: a systematic literature review'. Nutr Rev. 71 (4): 245–54. doi:10.1111/nure.12016. PMID23550785.
- ^Ernst, E.; Pittler, M.H. (1 March 2000). 'Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials'(PDF). British Journal of Anaesthesia. 84 (3): 367–371. doi:10.1093/oxfordjournals.bja.a013442. PMID10793599. Retrieved 6 September 2006.
- ^'Bulimia Nervosa-Topic Overview'. WebMD. Archived from the original on 25 July 2012. Retrieved 26 July 2012.
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External links[edit]
Classification |
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External resources |
Look up nausea in Wiktionary, the free dictionary. |
Retrieved from 'https://en.wikipedia.org/w/index.php?title=Nausea&oldid=897871132'
Names | |
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Preferred IUPAC name | |
Other names Glycerin Glycerine Propanetriol 1,2,3-Trihydroxypropane 1,2,3-Propanetriol | |
Identifiers | |
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ChEBI | |
ChEMBL |
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ChemSpider | |
DrugBank |
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ECHA InfoCard | 100.000.263 |
E number | E422 (thickeners, ..) |
KEGG | |
PubChemCID | |
UNII |
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Properties | |
C3H8O3 | |
Molar mass | 92.094 g·mol−1 |
Appearance | colorless liquid hygroscopic |
Odor | odorless |
Density | 1.261 g/cm3 |
Melting point | 17.8 °C (64.0 °F; 290.9 K) |
Boiling point | 290 °C (554 °F; 563 K)[4] |
miscible[1] | |
log P | -2.32[2] |
Vapor pressure | 0.003 mmHg (50°C)[1] |
-57.06·10−6 cm3/mol | |
Refractive index (nD) | 1.4746 |
Viscosity | 1.412 Pa·s[3] |
Pharmacology | |
A06AG04 (WHO) A06AX01 (WHO), QA16QA03 (WHO) | |
Hazards | |
Safety data sheet | See: data page JT Baker |
NFPA 704 | |
Flash point | 160 °C (320 °F; 433 K) (closed cup) 176 °C (349 °F; 449 K) (open cup) |
US health exposure limits (NIOSH): | |
TWA 15 mg/m3 (total) TWA 5 mg/m3 (resp)[1] | |
REL (Recommended) | None established[1] |
N.D.[1] | |
Supplementary data page | |
Refractive index (n), Dielectric constant (εr), etc. | |
Phase behaviour solid–liquid–gas | |
UV, IR, NMR, MS | |
Except where otherwise noted, data are given for materials in their standard state (at 25 °C [77 °F], 100 kPa). | |
verify (what is ?) | |
Infobox references |
Glycerol (/ˈɡlɪsərɒl/;[5] also called glycerine or glycerin; see spelling differences) is a simple polyol compound. It is a colorless, odorless, viscous liquid that is sweet-tasting and non-toxic. The glycerol backbone is found in many lipids which are known as glycerides. It is widely used in the food industry as a sweetener and humectant in pharmaceutical formulations. Glycerol has three hydroxyl groups that are responsible for its solubility in water and its hygroscopic nature.[6]
- 2Production
- 3Applications
- 3.8Niche uses
Structure[edit]
Although achiral, glycerol is prochiral with respect to reactions of one of the two primary alcohols. Thus, in substituted derivatives, the stereospecific numbering labels the molecule with a 'sn-' prefix before the stem name of the molecule.[7][8][9]
Production[edit]
Glycerol is generally obtained from plant and animal sources where it occurs in triglycerides, esters of glycerol with long-chain carboxylic acids. The hydrolysis, saponification, or transesterification of these triglycerides produces glycerol as well as the fatty acid derivative:
3 ×
Triglycerides can be saponified with sodium hydroxide to give glycerol and fatty sodium salt or soap.
Typical plant sources include soybeans or palm. Animal-derived tallow is another source. Approximately 950,000 tons per year are produced in the United States and Europe; 350,000 tons of glycerol were produced per year in the United States alone from 2000 to 2004.[10] The EU directive 2003/30/EC set a requirement that 5.75% of petroleum fuels are to be replaced with biofuel sources across all member states by 2010. It was projected in 2006 that by the year 2020, production would be six times more than demand, creating an excess of glycerol.[6]
Glycerol from triglycerides is produced on a large scale, but the crude product is of variable quality, with a low selling price of as low as 2-5 U.S. cents per kilogram in 2011.[11] It can be purified, but the process is expensive. Some glycerol is burned for energy, but its heat value is low.[12]
Crude glycerol from the hydrolysis of triglycerides can be purified by treatment with activated carbon to remove organic impurities, alkali to remove unreacted glycerol esters, and ion exchange to remove salts. High purity glycerol (> 99.5%) is obtained by multi-step distillation; vacuum is necessary due to the high boiling point of glycerol (290 °C).[6]
Synthetic glycerol[edit]
Although usually not cost-effective, glycerol can be produced by various routes from propylene. The epichlorohydrin process is the most important; it involves the chlorination of propylene to give allyl chloride, which is oxidized with hypochlorite to dichlorohydrins, which reacts with a strong base to give epichlorohydrin. This epichlorohydrin is then hydrolyzed to give glycerol. Chlorine-free processes from propylene include the synthesis of glycerol from acrolein and propylene oxide.[6]
Because of the large-scale production of biodiesel from fats, where glycerol is a waste product, the market for glycerol is depressed. Thus, synthetic processes are not economical. Owing to oversupply, efforts are being made to convert glycerol to synthetic precursors, such as acrolein and epichlorohydrin.[13] (See the Chemical intermediate section of this article.
Applications[edit]
Food industry[edit]
In food and beverages, glycerol serves as a humectant, solvent, and sweetener, and may help preserve foods. It is also used as filler in commercially prepared low-fat foods (e.g., cookies), and as a thickening agent in liqueurs. Glycerol and water are used to preserve certain types of plant leaves.[14] As a sugar substitute, it has approximately 27 kilocalories per teaspoon (sugar has 20) and is 60% as sweet as sucrose. It does not feed the bacteria that form plaques and cause dental cavities.[citation needed] As a food additive, glycerol is labeled as E number E422. It is added to icing (frosting) to prevent it from setting too hard.
As used in foods, glycerol is categorized by the Academy of Nutrition and Dietetics as a carbohydrate. The U.S. Food and Drug Administration (FDA) carbohydrate designation includes all caloric macronutrients excluding protein and fat. Glycerol has a caloric density similar to table sugar, but a lower glycemic index and different metabolic pathway within the body, so some dietary advocates[who?] accept glycerol as a sweetener compatible with low-carbohydrate diets.
It is also recommended as an additive when using polyol sweeteners such as erythritol and xylitol which have a cooling effect, due to its heating effect in the mouth, if the cooling effect is not wanted.[15]
Medical, pharmaceutical and personal care applications[edit]
A bottle of glycerin purchased at a pharmacy
Personal lubricants commonly contain glycerol
Glycerol is an ingredient in products such as hair gel
Glycerol suppositories used as laxatives
Glycerol is used in medical, pharmaceutical and personal care preparations, often as a means of improving smoothness, providing lubrication, and as a humectant. Ichthyosis and xerosis have been relieved by the topical use glycerin.[16][17] It is found in allergen immunotherapies, cough syrups, elixirs and expectorants, toothpaste, mouthwashes, skin care products, shaving cream, hair care products, soaps, and water-based personal lubricants. In solid dosage forms like tablets, glycerol is used as a tablet holding agent. For human consumption, glycerol is classified by the U.S. FDA among the sugar alcohols as a caloric macronutrient. Glycerol is also used in blood banking to preserve red blood cells prior to freezing.
Glycerol is a component of glycerin soap. Essential oils are added for fragrance. This kind of soap is used by people with sensitive, easily irritated skin because it prevents skin dryness with its moisturizing properties. It draws moisture up through skin layers and slows or prevents excessive drying and evaporation.[citation needed]
Taken rectally, glycerol functions as a laxative by irritating the anal mucosa and inducing a hyperosmotic effect,[18] expanding the colon by drawing water into it to induce peristalsis resulting in evacuation.[19] It may be administered undiluted either as a suppository or as a small-volume (2–10 ml) enema. Alternatively, it may be administered in a dilute solution, e.g., 5%, as a high volume enema.[20]
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Taken orally (often mixed with fruit juice to reduce its sweet taste), glycerol can cause a rapid, temporary decrease in the internal pressure of the eye. This can be useful for the initial emergency treatment of severely elevated eye pressure.[21]
Glycerol has also been incorporated as a component of bio-ink formulations in the field of bioprinting.[22] The glycerol content acts to add viscosity to the bio-ink without adding large protein, carbohydrate, or glycoprotein molecules.
Botanical extracts[edit]
Star wars rebels season 3 download. When utilized in 'tincture' method extractions, specifically as a 10% solution, glycerol prevents tannins from precipitating in ethanol extracts of plants (tinctures). It is also used as an 'alcohol-free' alternative to ethanol as a solvent in preparing herbal extractions. It is less extractive when utilized in a standard tincture methodology. Alcohol-based tinctures can also have the alcohol removed and replaced with glycerol for its preserving properties. Such products are not 'alcohol-free' in a scientific sense, as glycerol contains three hydroxyl groups. Fluid extract manufacturers often extract herbs in hot water before adding glycerol to make glycerites.[23][24]
When used as a primary 'true' alcohol-free botanical extraction solvent in non-tincture based methodologies, glycerol has been shown to possess a high degree of extractive versatility for botanicals including removal of numerous constituents and complex compounds, with an extractive power that can rival that of alcohol and water–alcohol solutions.[citation needed] That glycerol possesses such high extractive power assumes it is utilized with dynamic methodologies as opposed to standard passive 'tincturing' methodologies that are better suited to alcohol. Glycerol possesses the intrinsic property of not denaturing or rendering a botanical's constituents inert (as alcohols – i.e. ethyl (grain) alcohol, methyl (wood) alcohol, etc., do). Glycerol is a stable preserving agent for botanical extracts that, when utilized in proper concentrations in an extraction solvent base, does not allow inverting or reduction-oxidation of a finished extract's constituents, even over several years.[citation needed] Both glycerol and ethanol are viable preserving agents. Glycerol is bacteriostatic in its action, and ethanol is bactericidal in its action.[25][26][27]
Electronic cigarette liquid[edit]
Glycerin is often used in electronic cigarettes to create the vapor
Glycerin, along with propylene glycol, is a common component of e-liquid, a solution used with electronic vaporizers (electronic cigarettes). This glycerol is heated with an atomizer (a heating coil often made of Kanthal wire), producing the aerosol that delivers nicotine to the user.[28]
Antifreeze[edit]
Like ethylene glycol and propylene glycol, glycerol is a non-ionic kosmotrope that forms strong hydrogen bonds with water molecules, competing with water-water hydrogen bonds. This interaction disrupts the formation of ice. The minimum freezing point temperature is about −36 °F (−38 °C) corresponding to 70% glycerol in water.
Glycerol was historically used as an anti-freeze for automotive applications before being replaced by ethylene glycol, which has a lower freezing point. While the minimum freezing point of a glycerol-water mixture is higher than an ethylene glycol-water mixture, glycerol is not toxic and is being re-examined for use in automotive applications.[29][30]
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In the laboratory, glycerol is a common component of solvents for enzymaticreagents stored at temperatures below 0 °C due to the depression of the freezing temperature. It is also used as a cryoprotectant where the glycerol is dissolved in water to reduce damage by ice crystals to laboratory organisms that are stored in frozen solutions, such as bacteria, nematodes, and mammalian embryos.
Chemical intermediate[edit]
Glycerol is used to produce nitroglycerin, which is an essential ingredient of various explosives such as dynamite, gelignite, and propellants like cordite. Reliance on soap-making to supply co-product glycerol made it difficult to increase production to meet wartime demand. Hence, synthetic glycerol processes were national defense priorities in the days leading up to World War II. Nitroglycerin, also known as glyceryl trinitrate (GTN) is commonly used to relieve angina pectoris, taken in the form of sub-lingual tablets, or as an aerosol spray.
An oxidation of glycerol affords mesoxalic acid.[31]
Vibration damping[edit]
Glycerol is used as fill for pressure gauges to damp vibration. External vibrations, from compressors, engines, pumps, etc., produce harmonic vibrations within Bourdon gauges that can cause the needle to move excessively, giving inaccurate readings. The excessive swinging of the needle can also damage internal gears or other components, causing premature wear. Glycerol, when poured into a gauge to replace the air space, reduces the harmonic vibrations that are transmitted to the needle, increasing the lifetime and reliability of the gauge.[32]
Niche uses[edit]
Film industry[edit]
How to get windows 8 iso download. Glycerol is used by the film industry when filming scenes involving water to stop areas from drying out too quickly.[33]
Glycerine is used—combined with water (around in a 1:99 proportion)—to create a smooth smoky environment. The solution is vaporized and pushed into the room with a ventilator.
Ultrasonic couplant[edit]
Glycerol can be sometimes used as replacement for water in ultrasonic testing, as it has favourably higher acoustic impedance (2.42MRayl vs 1.483MRayl for water) while being relatively safe, non-toxic, non-corrosive and relatively low cost.[34]
Bubble Mixture[edit]
Glycerol is added to bubble mixture for blowing soap bubbles. It creates longer-lasting bubbles by thickening the mixture.[citation needed]
Internal combustion fuel[edit]
Glycerol is also used to power diesel generators supplying electricity for the FIAFormula E series of electric race cars.[35]
Research on uses[edit]
Research has been conducted to try to make value-added products from glycerol obtained from biodiesel production.[36] Examples (aside from combustion of waster glycerol):
- Hydrogengas production[37]
- Glycerine acetate is a potential fuel additive.[38]
- Conversion to propylene glycol[39]
- Conversion to acrolein[40][41]
- Conversion to ethanol[42]
- Conversion to epichlorohydrin,[43] a raw material for epoxy resins
Metabolism[edit]
Glycerol is a precursor for synthesis of triacylglycerols and of phospholipids in the liver and adipose tissue. When the body uses stored fat as a source of energy, glycerol and fatty acids are released into the bloodstream. Circulating glycerol does not glycate proteins as do glucose or fructose, and does not lead to the formation of advanced glycation endproducts (AGEs). In some[which?] organisms, the glycerol component can enter the glycolysis pathway directly and, thus, provide energy for cellular metabolism (or, potentially, be converted to glucose through gluconeogenesis).
Before glycerol can enter the pathway of glycolysis or gluconeogenesis (depending on physiological conditions), it must be converted to their intermediate glyceraldehyde 3-phosphate in the following steps:
ADP
NADH
NADH
The enzyme glycerol kinase is present mainly in the liver and kidneys, but also in other body tissues, including muscle and brain.[44][45][46] In adipose tissue, glycerol 3-phosphate is obtained from dihydroxyacetone phosphate (DHAP) with the enzyme glycerol-3-phosphate dehydrogenase.
Glycerol has very low toxicity when ingested; its LD50 oral dose for rats is 12600 mg/kg and 8700 mg/kg for mice.
Historical cases of contamination with diethylene glycol[edit]
On 4 May 2007, the US Food and Drug Administration advised all US makers of medicines to test all batches of glycerol for the toxic diethylene glycol.[47] This followed an occurrence of hundreds of fatal poisonings in Panama resulting from a falsified import customs declaration by Panamanian import/export firm Aduanas Javier de Gracia Express, S. A. The cheaper diethylene glycol was relabeled as the more expensive glycerol.[48][49]
Etymology[edit]
The origin of the gly- and glu- prefixes for glycols and sugars is from Greek γλυκύς glukus which means sweet.[50]
Isomers[edit]
- 1,1,1-Propanetriol
- 1,1,2-Propanetriol
- 1,1,3-Propanetriol
- 1,2,2-Propanetriol
See also[edit]
- Saponification/Soapmaking
References[edit]
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External links[edit]
Retrieved from 'https://en.wikipedia.org/w/index.php?title=Glycerol&oldid=897120059'