SHEHANA TAWASIL MUSAHARI

NICOTINE

DESCRIPTION OF THE POISON

Nicotine is a naturally occurring toxic chemical found in tobacco plants and is a highly
addictive CNS stimulant
Cigarettes others tobacco plants and tobacco smoke contain nicotine.
Was once used in the US as an insecticides and fumigants; However, it is no longer
produced since nicotine affects the nervous system and the heart and induces a state of
euphoria in the brain of the smoker, thus causing addiction.

SIGNS AND SYMPTOMS

EARLY PHASE Stimulation/ excitation ( increase HR, BP, Level of alertness)

Others- nausea, vomiting, increase salivation.
Late phase- inhibition / depression ( bradycardia, hypotension, loss of normal muscle
tone): Others: abnormal heart rate rhythms, diarrhea, shallow breathing, lethargy

MECHANISM OF TOXICITY
1. Inhalation of tobacco smoke
2. Inhaled smoke is carried to the pulmonary veins and enter the systemic circulation and
quickly goes to the brain.
3. Binds to nicotinic cholinergic receptor
4. Opening of channels and allows conductance of multiple cations including sodium,
calcium, and potassium.
5. Depolarization, which activates voltage-gated calcium channels and allows more calcium
to enter the axon terminal. Calcium stimulates the release of dopamine into the synapse.
Dopamine binding to its receptor is responsible the euphoric and addictive properties of
nicotine.
6. Calcium also triggers the release of epinephrine into the bloodstream, which causes
vasoconstriction, increased blood pressure, increased heart rate, and increase blood
sugar.
ANTIDOTES

Mecamylanine is a specific antagonist of nicotine actions; however since it is only

available in tablets, therefore it is not suitable for a patient who is vomiting, convulsive or
hypotensive.
Atropine sulphate ( Adult 0.4-2 mg; child 0.01 mg/kg )
Phentolamine 1-5 mg i.m or i.v to control signs of sympathetic hyperactivity, such as
hypertension.