Despite the general negative impression on nicotine, it also has significant functions in reversing its primary effect. Individuals should ensure safe application to avoid complications.
Nicotine is an alkaloid that belongs in the Solanaceae or nightshade plant family present in tobacco, coca, green pepper, tomato, potato and eggplant. It serves as an antiherbivore chemical with relative effects as an insecticide due to its unique specificity to insects. Low concentrations of the substance have a stimulating effect that is also responsible for its addictive properties. Although nicotine is known more widely for its consequential actions, it also shows to have therapeutic value in treating nicotine dependence related to smoking.
The use of nicotine in controlled levels in the form of dermal patches, gums, nasal sprays and lozenges helps long term smokers overcome dependence on the substance. The risks related to concurrent use of tar and other harmful ingredients contained in cigarettes and cigars are also eliminated. Nicotine can increase the flow of the neurotransmitter dopamine that can enhance mood causing the dependence. Nicotine replacements aim to mimic the delivery methods to reduce withdrawal methods.
Nicotine can cause various side effects ranging from mild to severe. Examples are dizziness, hiccups, belching, stomach upset, nausea, mouth or throat soreness, dry mouth, watery mouth or salivation, watery eyes, headache, constipation, white patches or sores inside the mouth or on the lips, taste changes, sneezing, coughing, runny or stuffy nose, abdominal pain, mental confusion, tachycardia, muscle pain, pruritus, insomnia, diarrhea, vomiting, cold sweat, dizziness, itching, burning on the patch area, chest pain, seizure, irregular heartbeat, vision changes, hearing changes, confusion and death. Nicotine overdose can also occur as evidenced by confusion, cardiovascular and respiratory collapse and diarrhea.
Contraindications include patients with known hypersensitivity to nicotine or other components present in alternative forms, smoking patients after myocardial infarction, patients with life-threatening arrhythmias, severe angina pectoris or chest pain, pregnant women, nursing mothers and those with gum disease. Doctors should be fully informed about all underlying conditions and drugs that the person is currently taking to avoid adverse interactions. Special precautions should be given to those with high blood pressure, history of heart disease, overactive thyroid, diabetes, liver or kidney disease, vasospastic disease, stomach ulcer, asthma, pulmonary disease and pheochromocytoma or adrenal gland tumor.
Nicotine presents its primary effects through autonomic ganglia stimulation. Small doses of the alkaloid result to stimulation of all autonomic ganglia while larger doses result to a transmission block after initial stimulation. Depending on the dose, biphasic actions will result as well as stimulation of the central nervous system via nicotine-specific receptors. Nicotine also stimulates the release of dopamine which is responsible for mood so overall, the person will experience slight mood escalation.
237 smokers aging 22 to 26 years old were included in a trial wherein they were given a nicotine transdermal patch for 5 months. Nicotine nasal sprays were given for 1 year to 118 patients while the rest received a placebo spray. Results showed that those on actual nicotine nasal sprays had sustained smoking abstinence compared to the placebo group. A combination of a patch and spray is also shown to be more effective for long term abstinence.
Nicotine in any form is available in pharmacies, online drugstores and a number of supermarkets. These can be bought at very cheap prices with sprays being the most expensive in the group. Cigarettes have 10 to 25 mg of nicotine which is considered to be more than the controlled therapeutic limit.
Nicotine gums should be slowly chewed for 30 minutes. Lozenges should not be swallowed or chewed but allowed to dissolve slowly under the tongue. Patches have instructions that should be followed carefully to avoid side effects. For sprays, 1 to 2 sprays per hour is indicated but not more than 10 sprays. Take note that overdose can have fatal results.
Nicotine has the following structural formula:
• Molecular formula of nicotine is C10H14N2
• Chemical IUPAC Name is 3-(1-methylpyrrolidin-2-yl)pyridine
• Molecular weight is 162.232 g/mol
• Nicotine available : 2mg gum, 4mg gum, 5mg patch, 15mg patch
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