Knowledge of Nicotine in Medical Practice

Overview

Acute cardiac attacks in smokers are provoked by three main mechanisms:
1. enhanced liability to form thrombi, most probably due to elevated levels of circulatingepinephrine. Although in animal experiments epinephrine secretion was influenced by largenicotine doses, amounts used for nicotine replacement therapy do not produce this effect;2. reduced oxygen saturation of blood due to carbonmonoxide. This mechanism is not involvedin nicotine replacement therapy;3. haemodynamic effects of nicotine.The nicotine release from polacrilex chewing gums or transdermal patches is different fromthat during smoking. During nicotine replacement therapy there is no increased prostacyclinesynthesis stimulating endothelial activity. In subjects using permanently smokeless tobaccoelevated prostascycline levels were not observed.Transdermally absorbed nicotine stimulates to a much smaller extent the activation of sympaticnerves than nicotine from cigarettes.

Key words:
smoking - nicotine - polacrilex chewing gums - transdermal patches - treatment.