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

•   Tension
•   Drowsiness
•   Lack of concentration
•   Irritability
Types of NRT

   Nicotine Medications
    - Nicotine patches
    - Nicotine gum
    - Nicotine lozenge
    - Nicotine oral inhalers
    - Nicotine nasal spray
Non-Nicotine Medications
   By nicotine agonists  By nicotine antagonists
    - acetyl choline       - Bupropion
          - choline             - mecamylamine
                   -           - 18-methoxy
    epibatidine            coronaridie
     - lobeline
          - varenicline
Nicotine medication
             Nicotine 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/day
Length 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
Non –nicotine medication
     Varenicline
 Partial agonist
 Action at α4β2 nicotine receptor

 Blocks nicotine from binding to
  receptor
 Releases lower amounts of
  dopamine
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
       Dose
      Start 7-10 days prior to quit date
      Dose150-300mg every day
      Continue 7-12 weeks or longer

17
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 you

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Nicotin replacement therapy

  • 1.
  • 2. Introduction smoking  Smoke contents - 4000 chemicals - 400 toxic - 43 known cancer causing
  • 3. 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
  • 4.
  • 5. Nicotine addiction  Nicotine increases several neurotransmitters like dopamine  These neurotransmitters cause the euphoria & relaxation to brain Nicotine withdrawal Symptoms • Tension • Drowsiness • Lack of concentration • Irritability
  • 6. Types of NRT  Nicotine Medications - Nicotine patches - Nicotine gum - Nicotine lozenge - Nicotine oral inhalers - Nicotine nasal spray
  • 7. Non-Nicotine Medications  By nicotine agonists  By nicotine antagonists - acetyl choline - Bupropion - choline - mecamylamine - - 18-methoxy epibatidine coronaridie - lobeline - varenicline
  • 8. Nicotine medication Nicotine 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
  • 9. side effects  Drowsiness, hallucination  Skin irritation  Allergic reaction
  • 10. Nicotine gum  Use: Chew and park Slow, buccal absorption  Dosing: 2-4mg/day Length of Treatment 8-10 weeks
  • 11. Side effects  High amount nicotine produce irritation  Prolonged usage may cause ediction
  • 12. Nicotine Lozenge  These are nicotine sublingual tablets  Nicotine is absorbed through lining of mouth
  • 13. 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
  • 14. Side effect Nose and throat irritation
  • 15. Non –nicotine medication Varenicline  Partial agonist  Action at α4β2 nicotine receptor  Blocks nicotine from binding to receptor  Releases lower amounts of dopamine
  • 16. 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
  • 17. Bupropion  It is an α3β4 nicotinic antagonist  Bupropion is a dopamine and norepinephrine reuptake inhibitor Dose  Start 7-10 days prior to quit date  Dose150-300mg every day  Continue 7-12 weeks or longer 17
  • 18. Adverse effects  hypertension  Insomnia  Dryness of mouth  Seizures
  • 19. 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.