presentation

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