Nicotine poisoning
Nicotine poisoning is acute and chronic. The most common cause of poisoning is tobacco smoking or prolonged stay in rooms filled with tobacco smoke.
Nicotine is a plant alkaloid with a powerful psychotropic effect. Synthesized by plants of the Solanaceae family; forming in the roots, it accumulates in the stems and leaves. The pure substance is a clear oily, pungent-bitter liquid, readily soluble in both water and fats.
Source: depositphotos.com
Nicotine is a powerful neurotropic poison. In terms of toxicity, it is comparable to hydrocyanic acid: the amount of a substance contained in one cigar, when ingested, can lead to death. This does not happen, because in the process of smoking, the bulk of the nicotine contained in tobacco burns out. The inhaled volume varies greatly depending on:
- varieties of tobacco;
- the presence of a filter;
- smoking habits.
When smoking, nicotine penetrates the blood-brain barrier for 8 seconds and reaches the brain, triggering a chain of biochemical reactions: it provokes an increase in the concentration of the neurotransmitter dopamine, thereby artificially stimulating the pleasure center. 20-30 minutes after stopping smoking, the concentration of dopamine in the structures of the brain is significantly reduced.
Nicotine belongs to the so-called ganglionic poisons, since it is the autonomic ganglia (nerve nodes) that are the point of application of the toxic effect of nicotine. In small concentrations, the substance stimulates their activity; in large doses, after a short period of stimulation, ganglion blockade occurs, which is manifested by a characteristic clinic of poisoning.
Nicotine can enter the systemic circulation not only through inhalation of air with tobacco smoke, but also through intact skin and mucous membranes. Nicotine crosses the placental barrier from mother to child during pregnancy, and is determined in large quantities in breast milk.
Toxic concentration in blood - 5 ml / l, lethal dose - 10-22 mg / l (depending on the individual properties of the organism).
How does nicotine poisoning happen?
Nicotine poisoning is acute and chronic. Acute poisoning most often occurs in the following cases:
- smoking a large number of cigarettes (cigars, cigarettes, pipes) in a limited time;
- smoking on an empty stomach with reduced nicotine tolerance;
- the use of tobacco by children during the game;
- work with nicotine-containing insecticides without personal protective equipment (gloves, respirator);
- abuse of nicotine-containing chewing gums, patches;
- the use of infusion of tobacco for medicinal purposes or for the purpose of committing suicide.
Chronic nicotine intoxication is widespread among smokers and their families who regularly come into contact with tobacco smoke. In addition to smokers, workers in industries producing tobacco products are often susceptible to chronic nicotine poisoning.
Poisoning symptoms
Acute nicotine intoxication is the final stage of the effect of nicotine on the receptors of the central and peripheral nervous system, in which two phases are distinguished: excitation and inhibition.
The main mechanism of poisoning is a violation of the conduction of a nerve impulse from the central nervous system to the periphery.
In the first phase of acute poisoning, neuropsychiatric excitement and hyperactivation of the cardiovascular system (increased heart rate, short-term increase in blood pressure (blood pressure)) are noted, which in the second phase are replaced by a decrease in blood pressure up to collapse and depression of mental activity.
In addition to the listed symptoms, in case of nicotine poisoning, the following are noted:
- sore throat;
- dry mouth or increased salivation;
- nausea, vomiting;
- pain in the abdomen;
- intense headache, dizziness;
- blue discoloration of the skin;
- cold, pouring sweat;
- dilated or narrowed pupils;
- palpitations;
- dyspnea;
- tremor of the limbs;
- anxiety, in severe cases - depression of consciousness;
- tonic and clonic seizures.
In case of mild nicotine poisoning, the main symptoms are nausea and vomiting, the poisoning stops on its own, and an intense headache persists for up to a day.
With severe intoxication, development is possible:
- delirious syndrome (disorientation with auditory and visual hallucinations, secondary delusions, senestopathies);
- loss of consciousness;
- coma;
- death from paralysis of the respiratory and vasomotor centers.
Chronic intoxication is characterized by similar symptoms, but forming for a long time, over several weeks or months. Also in this case are noted:
- aggravation of the course of chronic inflammatory processes;
- violation of reproductive function;
- various somatoform disorders (when, with many complaints, there is no diagnostic confirmation);
- dystrophic changes in organs and tissues.
Source: depositphotos.com
First aid for nicotine poisoning
In acute nicotine poisoning, first aid should be started as early as possible:
- Provide air access (unbutton tight clothing, open windows, doors).
- Give a comfortable position to the body, if the victim is unconscious, make sure that aspiration does not occur with vomit or sunken tongue.
- If the victim is conscious, wash the stomach, for which it is necessary to drink 1–1.5 liters of warm water or a weak solution of potassium permanganate, and then induce an emetic urge by pressing on the root of the tongue.
- Take any enterosorbent (activated carbon, Enterosgel, Polysorb, Polyphepan, Lactofiltrum).
- Take a saline laxative (magnesium sulfate).
- Provide an increased drinking regime to detoxify and prevent dehydration.
- With strong neuropsychic arousal, take a mild sedative (tincture of valerian, motherwort, lily of the valley);
- With symptoms of clinical death (lack of pupil response to light, cessation of breathing and cardiac activity, lack of consciousness), perform basic cardiopulmonary resuscitation.
If nicotine gets on your skin, rinse thoroughly with running or acidified water.
When is medical attention required?
An ambulance team must be called if:
- against the background of the provision of emergency care, the victim's condition worsens or does not improve;
- a pregnant woman, a child, an elderly person was injured;
- the state of the victim is inhibited, he is not available to contact or contact is limited;
- neurological symptoms appeared (impaired coordination, speech, vision, seizures);
- developed delirium;
- the victim fell into unconsciousness.
Treatment of nicotine poisoning is carried out in stationary conditions. Symptomatic and detoxification therapy is carried out. Efforts are also directed at preventing respiratory muscle paralysis, maintaining cardiac activity and liver function (nicotine is metabolized in the liver).
Possible consequences
Possible complications of acute and chronic nicotine intoxication are:
- allergic reactions;
- renal failure;
- reactive inflammation of the pancreas;
- inflammation of the organs of the hepatobiliary zone;
- damage to the peripheral nervous system;
- visual disturbances.
Prevention
To prevent nicotine intoxication, you must:
- comply with safety regulations when working in the tobacco industry;
- use personal protective equipment (gloves, respirator) when using nicotine-containing insecticides;
- in case of self-treatment with nicotine-based infusions, adequately assess the possible consequences;
- refrain from smoking in confined spaces with no adequate ventilation;
- refrain from smoking in the presence of children and pregnant women.
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Olesya Smolnyakova Therapy, clinical pharmacology and pharmacotherapy About the author
Education: higher, 2004 (GOU VPO "Kursk State Medical University"), specialty "General Medicine", qualification "Doctor". 2008-2012 - Postgraduate student of the Department of Clinical Pharmacology, KSMU, Candidate of Medical Sciences (2013, specialty "Pharmacology, Clinical Pharmacology"). 2014-2015 - professional retraining, specialty "Management in education", FSBEI HPE "KSU".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
