Article Contents ::
Details About Generic Salt :: Nicotine
Main Medicine Class:: Nervous System Sub Medicine Class :: Drugs for Substance Abuse
| 1K. DRUGS FOR SUBSTANCE ABUSE in 1. NERVOUS SYSTEM |
| NICOTINE |
| CHOLINERGIC | SMOKING DETERRENT |
| PK: A: Slow (Transdermal) M: Hepatic E: Urine |
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Indications & Dose: SMOKING CESSATION PO Adult Gum (2mg & 4mg): Who smoke <20 cigarettes/day starts with 2mg strength gum chewed slowly over about 30min, when the urge to smoke occurs. Those who smoke >20cigarettes/day should receive 4mg strength, max 15 pieces/day | PO Adult Lozenges (1 or 2 mg): Initial dose 1 lozenge q1-2h, increased to max daily dose of 30 of 1-mg lozenges or 15 of 2-mg lozenges | SL Adult 1 or 2 tablets qh, max 40 tablets/day (1 tablet 2mg) | TD Adult Patients smoking >10 cigarettes/day: 21mg/day 6 wk, then14mg/day 2 wk, followed by 7mg/day 2 wk, patients smoking <10 cigarettes/day: 14 mg/day 6 wk, followed by 7mg/day 2 wk, apply a new patch for q24h | NSL Adult Spray (500µg): Initially one spray is given into each nostril 1-2 sprays/h, max 80 sprays/day for first 8 wk, then decrease the dose gradually | Inh Adult Cartridge (10mg): 6-16 cartridges/day up to 12 wk, then reduce the dose gradually by inhaler mouthpiece |
| Contra: Hypersensitivity, patients who are smoking during the post MI period, arrhythmias/severe angina pectoris, active temporomandibular joint disease, in nonsmokers
Precautions: CVD, hyperthyroidism, patients with oropharyngeal inflammation, history of esophagitis/PUD, pheochromocytoma, severe renal dysfunction, hepatic dysfunction, patients with bronchospastic disease, patients with certain skin diseases, in chronic nasal disorders, discontinue therapy if signs of nicotine toxicity occur ADR: Others: Headache, mouth/throat irritation, dyspepsia, cough, rhinitis, acne, dysmenorrhea, flatulence, gum problems, diarrhea, hiccup, nausea, taste disturbance, tooth disorder, back pain, arthralgia, jaw/neck pain, withdrawal symptoms, allergy, amnesia, bronchospasm, sputum increased, xerostomia, vision abnormalities, concentration impaired, depression, constipation, flatulence, gingival bleeding DDI: Serious Vasopressin causes marked hypotension & bradycardia, Alcohol effects enhanced by drug as a patch, β-blockers enhances drug effects, Cannabis increases addictive potential of both drugs, Tranylcypromine inhibits drug (oral) metabolism, Antidiabetics insulin resistance may increased by drug, Ranitidine/Cimetidine reduces drug clearance in non-smokers Monitor: HR & BP periodically during therapy |