Nicotine toxicity
- 1. Important Facts About Nicotine toxicity Reiam Ameer Higher Diploma Student Dept. :Pharmacology And Toxicology College Of Pharmacy Baghdad University
- 2. • Nicotine is a colorless alkaloid chemical obtained from the leaves of the tobacco plant, and it is the main constituent of tobacco smoke. (1) • Nicotiana tabacum, the type of nicotine found in tobacco plants, comes from the nightshade family(2) • Tobacco is a plant grown for its leaves, which are dried and fermented before being put in tobacco products. Tobacco contains nicotine, an ingredient that can lead to addiction, which is why so many people who use tobacco find it difficult to quit. There are also many other potentially harmful chemicals found in tobacco or created by burning it. (1)
- 3. Where is nicotine found? smoking cigarettes chewing tobacco water pipe electronic cigarette(vaping) pipe tobacco nicotine lozenges nicotine gum tobacco plants nicotine patches some insecticides
- 5. Pharmacologic effects When humans, mammals, and most other types of animals are exposed to nicotine, it increases their heart rate, heart muscle oxygen consumption rate, and heart stroke volume.so Nicotine has a range of effects on the body.(2) Depending on the dose of nicotine taken and the individual’s nervous system arousal, nicotine can also act as sedative.(3)(2) When a body is exposed to nicotine stimulating the adrenal glands, which results in the release of adrenaline(epinephrine) ,This surge of adrenaline stimulates the body(CNS). There is an immediate release of glucose, as well as an increase in heart rate, breathing activity, and blood pressure. Dopamine is neurotransmitter that is activated when nicotine reaches the brain. Dopamine causes feelings of euphoria and is thought to play a significant role in addiction.(2)(3)
- 6. • Concentration and memory • These are Studies have shown that nicotine appears to improve memory and concentration. It is thought that this is due to an increase in acetylcholine and norepinephrine. Norepinephrine also increases the sensation of wakefulness, or arousal.(2) • Reduced anxiety • Nicotine results in increased levels of beta-endorphin, which reduces anxiety. (2)
- 7. Side effects • Nicotine causes a wide range of side effects in most organs and systems. • The circulation of the blood can be affected in the following ways: (2) an increased clotting tendency, leading to a risk of harmful blood clots atherosclerosis, in which plaque forms on the artery wall enlargement of the aorta Side effects in the brain include: dizziness and light-headedness irregular and disturbed sleep bad dreams and nightmares possible blood restriction
- 8. • In the gastrointestinal system, nicotine can have the following effects: nausea and vomiting dry mouth, or xerostomia indigestion peptic ulcers diarrhea Heartburn • The heart can experience the following after taking in nicotine: changes in heart rate and rhythm an increase in blood pressure constrictions and diseases of the coronary artery an increased risk of stroke
- 9. if a woman smokes while pregnant, the following risks are likely in the development of the child: obesity high blood pressure type 2 diabetes respiratory difficulties infertility problems with brain development behavioral issues Other effects include: spasms in the lungs pneumonia tremors and pain in the muscles increase levels of insulin and insulin resistance, contributing to the risk of diabetes joint pain
- 10. nicotine poisoning: • Nicotine is poisonous and, though uncommon, results from overdose nicotine in the body. An overdose occurs when the person uses too much of a drug and has a toxic reaction that results in serious, harmful symptoms or death. • Vaping and liquid nicotine are the most common forms to cause nicotine poisoning in adults. • Eating cigarettes or consuming liquid nicotine is the most common method of poisoning in children.(3)
- 11. Symptoms of nicotine poisoning • Nicotine poisoning tends to occur in 2 stages. • symptoms of the toxic effects of nicotine following ingestion, inhalation, or skin contact.(3) • Within the first 15 to 60 minutes following exposure, symptoms are related to the stimulatory effects of nicotine and include: • excess saliva in the mouth • feeling nauseous • stomach ache • vomiting • loss of appetite • dehydration • eye irritation •headache •dizziness •tremors •anxiety and restlessness •confusion •sweating •cough •rapid breathing •increased heart rate •elevated blood pressure
- 12. Following this stage, the body begins to wind down. Nicotine’s depressor effects appear within a few hours. These include: (3) • low blood pressure • slow heart rate • shallow breathing • diarrhea • fatigue • weakness • pale skin • In extreme cases, symptoms include: • seizures • coma • breathing difficulties • respiratory failure • Serious or fatal nicotine overdoses can occur but are rare.
- 13. Nicotine is highly addictive • People who regularly consume nicotine and then suddenly stop experience withdrawal symptoms, which may include: (2) • cravings • a sense of emptiness • anxiety • depression • moodiness • irritability • difficulty focusing or paying attention
- 15. Treatment • The treatment of nicotine dependency is known as smoking cessation therapy. It aims to reduce the urges to consume nicotine as well as the associated risks and health problems. • Medications (2) • Drug treatment options for nicotine dependency include: • Nicotine replacement therapy (NRT): • This is available in skin patches, nasal sprays, inhalers, chewing gum and lozenges.(FDA APPROVED) • Non _nicotine medications: The FDA have approved two non-nicotine-containing drugs to help smokers quit. These are : Bupropion: • This was used in the first instance as anti-depressant medication. • acts on chemicals in the brain that play a role in nicotine craving and reduces cravings and symptoms of nicotine withdrawal. Bupropion is taken in tablet form for 12 weeks, but if you have successfully quit smoking in that time, you can use it for a further 3 to 6 months to reduce the risk of smoking relapse. Varenicline, sold as Chantix: • interferes with the nicotine receptors in the brain, which results in reducing the pleasure that you get from tobacco use, and decreases nicotine withdrawal symptoms. Varenicline is used for 12 weeks, but again, if you have successfully kicked the habit, then you can use the drug for another 12 weeks to reduce smoking relapse risk. • It can cause mostly mild nausea in around 30 percent of people who pursue this course of treatment, but varenicline is normally well tolerated. It has also demonstrated a stronger effect on nicotine dependency than bupropion.
- 17. • Combining medication – such as NRT, bupropion, and varenicline – with behavioural support has been demonstrated to increase the chances of long-term smoking cessation by up to 25 percent. • Treatments that are used when these first-line treatments are not successful, as they are more likely to cause severe side effects, include: • Clonidine: an anti-hypertensive drug that has also shown to reduce symptoms of nicotine withdrawal but can also cause low blood pressure, dry mouth, constipation, and a slow heartbeat • Nortryptyline: a tricyclic antidepressant whose effects can replace those of nicotine but has many of the major side effects of antidepressants and has not been given a full safety profile • behavioral support : Behavioral support can range from written information and advice to group therapy or individual counseling in person, by phone, or online. Self-help materials likely increase quit rates compared with no support at all, but overall, individual counseling is the most effective behavioral support method.
- 18. alternative therapies: • Some alternative methods to help you to stop smoking might include: • filters • smoking deterrents • electronic cigarettes (e-cigarettes) • tobacco strips and sticks • nicotine drinks, straws, and lip balms • hypnosis • acupuncture • magnet therapy • cold laser therapy • herbs and supplements • yoga, mindfulness, and meditation
- 19. • Treatment for nicotine poisoning is usually carried out at a hospital. The treatments administered will depend on the amount of nicotine ingested and the symptoms experienced. • Activated charcoal may be used to bind with the nicotine in the stomach and take it out of the body. • If the person is experiencing breathing difficulties, a ventilator will be used to deliver oxygen. • Other supportive treatments, including medications, are used to manage seizures, low blood pressure, and abnormal heart rates.
- 20. Prevention The most effective way to prevent nicotine poisoning is to stop using cigarettes and other nicotine-containing products. Other preventative measures include: protecting the skin, especially when using liquids containing nicotine safely storing nicotine products away from children and pets correctly disposing of nicotine products – including cigarette butts and empty nicotine cartridges. (3)
- 21. References : 1. National institute on drug abuse 2020 (drug facts) 2. Medically reviewed by Deborah Weatherspoon, Ph.D., R.N., CRNA on January 11, 2018 — Written by Adam Felman 3. Medically reviewed by Suzanne Falck, MD on October 6, 2017 — Written by Jayne Leonard