nicotin replacement therapy

Introduction smoking

Smoke contents- 4000 chemicals

- 400 toxic - 43 known cancer

causing

Contents of cigarette smoke

Acetone            Cyanide Aluminum          DDT/Dieldrin Ammonia           Ethenol Arsenic              Formaldehyde Benzene            Hydrogen cyanide Butane               Lead Cadmium             Methanol Carbon monoxide Nicotine Carbon dioxide     Tar Chloroform          Vinyl Chloride 

Nicotine withdrawal Symptoms

• Tension

• Drowsiness

• Lack of concentration

• Irritability

Nicotine addiction Nicotine increases several neurotransmitters like dopamine These neurotransmitters cause the euphoria & relaxation to brain

Types of NRT

Nicotine Medications - Nicotine patches

- Nicotine gum

- Nicotine lozenge

- Nicotine oral inhalers

- Nicotine nasal spray

By nicotine agonists

- acetyl choline - choline - epibatidine

- lobeline - varenicline

By nicotine antagonists

- Bupropion -

mecamylamine - 18-methoxy coronaridie

Non-Nicotine Medications

Nicotine medicationNicotine medication

Nicotine patchesNicotine patches

Use: -Apply to clean skin area (upper trunk/ arms)-24 or 16 hour dosing

Dosing:

14-21mg/patch

Length of Treatment: -Up to 12 weeks

side effects

Drowsiness, hallucination Skin irritation Allergic reaction

Nicotine gum Use: Chew and park Slow, buccal

absorption Dosing: 2-4mg/dayLength of Treatment 8-10 weeks

Side effects

High amount nicotine produce irritation

Prolonged usage may cause ediction

Nicotine Lozenge

These are nicotine sublingual tablets

Nicotine is absorbed through lining of mouth

Nicotine Nasal spray/inhaler

This are aerosols contain nicotine

They are absorbed through lining of the nose and through lungs

They show quick onset of action

Side effect

Nose and throat irritation

Varenicline Partial agonist Action at 42 nicotine receptor Blocks nicotine from binding to

receptor Releases lower amounts of

dopamine

Non –nicotine medication

Dose

Treatment with Varenicline begins one week before the quit date.

0.5-1mg every day

Adverse effects Nausea Head ache Difficulty to sleep Vomiting Constipation

Bupropion

It is an α3β4 nicotinic antagonist Bupropion is a dopamine and

norepinephrine reuptake inhibitor

Start 7-10 days prior to quit dateDose150-300mg every dayContinue 7-12 weeks or longer

17

Dose

Adverse effects hypertension

Insomnia

Dryness of mouth

Seizures

CONCLUSION NRT is being provided to assist tobacco

users to become tobacco free.

NRT is not a treatment in itself, but is intended to complement the other assessments and treatments provided.

Pharmacotherapy works and is relatively safe and more effective.

Thank youThank you