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Cholinergic Antagonists
Published in Sahab Uddin, Rashid Mamunur, Advances in Neuropharmacology, 2020
Vishal S. Gulecha, Manoj S. Mahajan, Aman Upaganlawar, Abdulla Sherikar, Chandrashekhar Upasani
Nicotine poisoning, especially in children, may result from an unintended intake of nicotine-containing insecticide sprays or chewing tobacco products. Severe lethal dose of nicotine in adults is about 60 mg of the base and tobacco smoke contains about 6–11 mg (1–2%) of nicotine. It appears that the absorption of nicotine from tobacco is delayed during tobacco chewing due to slow gastric emptying leading to vomiting and removal of tobacco from GIT. The symptoms of acute and severe nicotine poisoning appear quickly. It is characterized by nausea, increased salivary secretions, abdominal ache, vomiting, diarrhea, cold sweat, headache, vertigo, dizziness, impaired hearing, balance and vision, mental confusion, and weakness. These symptoms can be overcome by vomiting, gastric lavage, or by the administration of adsorbents like activated charcoal slurry through a tube in the left side of stomach and maintenance of respiration (Brunton et al. 2011).
Catalog of Herbs
Published in James A. Duke, Handbook of Medicinal Herbs, 2018
Toxicity — The FDA classes this an unsafe herb, because of the alkaloids hydroxytyramine, isosparteine, and sparteine.62 Ths plant is narcotic, stupefying sheep who eat it. The tops are cathartic and emetic.29 Toxicity symptoms suggest nicotine poisoning: circulatory collapse with tachycardia, paralysis of the ileus, nausea, diarrhea, vertigo, and headache.33 Even Herbal Highs51 says what is true of any beverage, food, medicine, or herb: “too much of it is definitely injurious”.
Nicotine addiction, electronic nicotine delivery systems and Shisha smoking
Published in G. Hussein Rassool, Alcohol and Drug Misuse, 2017
In contrast with some of the above findings, the Report from Public Health England (2015) on an update on evidence on e-cigarettes indicates that e-cigarettes pose no risk of nicotine poisoning to users when used as intended. The Report stated that “while vaping may not be 100% safe, most of the chemicals causing smoking-related disease are absent and the chemicals which are present pose limited danger. It has been previously estimated that e-cigarettes … are around 95% safer than smoking” (p. 12). In relation to second-hand exposure or passive smoking environmental pollution, the evidence suggests that e-cigarettes release negligible amounts of nicotine into the environment, and no health risks to bystanders have been identified. Furthermore, there is good-quality evidence that e-cigarettes offer the potential of providing a low-cost, effective intervention and can be effective in helping people quit smoking.
Toxicological assessment of electronic cigarette vaping: an emerging threat to force health, readiness and resilience in the U.S. Army
Published in Drug and Chemical Toxicology, 2022
Marc A. Williams, Gunda Reddy, Michael J. Quinn, Amy Millikan Bell
As of May 2016, the European Union (EU) Tobacco Product Directive limits nicotine in e-cig refills to 200 mg per 10 ml; however, 1–10 mg/kg of nicotine could be lethal for a child (Neuberger 2015). In addition, in the adult population, an oral dose of 50–60 mg/kg is equivalent to a 70 kg man or woman being exposed to approximately 30–40 mg/m3 nicotine for 30 mins. Therefore, it was suggested that e-cig refill bottles be handled in the same manner as other dangerous (restricted use) drugs. Poison information centers, which have observed an increase in reported intoxications by e-cig refills, also warn against skin absorption. In the field of pediatrics, accidental nicotine poisoning is well described, with low concentrations of nicotine provoking adverse effects and admission to pediatric emergency departments (Mowry et al.2013, Forrester 2015, Gill et al.2015). The emergent concern has prompted the Surgeon General’s office to warn of the growing evidence, which is now considered sufficient to caution women of reproductive age, pregnant women and adolescents against nicotine-containing product use, including smokeless tobacco, dissolvables and ENDS as safer alternatives to smoking combustible tobacco cigarettes (DHHS 2014).
Poisoning exposure cases involving e-cigarettes and e-liquid in the United States, 2010–2018
Published in Clinical Toxicology, 2020
Baoguang Wang, Sherry Liu, Alexander Persoskie
After several years of increase since 2010, the overall number of e-cigarette exposure cases began to decrease in 2015–2016 and continued to decrease in 2017, as did the number of e-cigarette exposure cases among young children. The decrease in e-cigarette exposure cases in recent years has been reported previously [13,14], and the decrease among young children was considered to be partially attributable to laws requiring child-resistant packaging for liquid nicotine containers and greater public awareness of risks associated with e-cigarettes [14]. The downward trend we observed coincided with two major activities. First, between December 2014 and July 2016, 18 US states enacted laws requiring child-resistant packaging for liquid nicotine containers [14,20]. Second, in January 2016, the Child Nicotine Poisoning Prevention Act of 2015 was signed into law and became effective six months later [21]. This federal law requires child-resistant packaging for liquid nicotine containers that are sold or distributed in the US. The spontaneous reporting of poisoning exposures involving e-cigarettes could have also been influenced by several other factors, such as awareness level and media coverage of e-cigarette-related poisoning and injuries.
Is it time to be concerned about the effects of e-cigarettes on cardiovascular health?
Published in Expert Review of Cardiovascular Therapy, 2018
Giuseppe Lippi, Fabian Sanchis-Gomar
Polosa et al. recently published the results of a small, 3.5-year prospective observational study consisting of 9 daily ENDSs users (mean age 30 ± 6 years) and 12 matched controls who had never smoked [3]. At the end of the follow-up period, pathological findings in the lung and heart rate, blood pressure, and respiratory symptoms were found to be similar between the two cohorts. Hua and Talbot carried out an Internet search for identifying case reports describing health problems associated with ENDSs use [4]. Overall, 27 cases could be detected with this search, which could be classified in 3 categories of unfavorable health effects (i.e., systemic effects, mechanical injury, and nicotine poisoning). More specifically, respiratory symptoms were the most frequent and could be identified in six subjects, followed by gastrointestinal (n = 3), cardiovascular (n = 2), neurological (n = 1), and immune (n = 1) complications. Importantly, as many as 12 cases of nicotine poisoning could be identified, resulting from accidental, misuse/abuse, or suicidal/intentional ingestion. Finally, two cases could be found of people injured by ENDSs battery explosion.