L7: Nicotine Flashcards
How does a cigarette have a highly perfected drug delivery system?
The lungs have an enormous surface area designed for gas exchange as well as the absorption of chemicals that you breathe in. This causes rapid absorption of nicotine and the chemicals into the blood. The blood then goes from the lungs back to the heart and the heart pumps the oxygenated blood to the rest of the body and nicotine gets into the brain right away (7 seconds).
Why is smoking cigarettes so addictive?
The nicotine gets to the brain very quickly (7 sec) which causes a very rapid effect to the nicotine. The faster the drug gets to the brain the more addicting it is.
What does the cigarette filter not successfully filter?
Chemicals, many of which are carcinogens.
Enzyme inhibitors.
Ciliotoxins, impair the ability of the lung to get rid of all of the particles and pollutants inhaled.
What is the mucociliary system? What happens to the mucociliary system when you smoke?
- The cilia in the lungs are always beating and propelling particles and mucus out of the lungs. How the lungs clean themselves.
- When you smoke, your cilia get paralyzed and damaged which compromises the mucociliary clearance rate.
What happens when you smoke and are exposed to asbestos at the same time?
Your chance of getting lung cancer is 50 to 90 times more than normal. On its own, smoking is 10x more and asbestos is 5x more.
What medical problems does smoking cause?
- Cancer
- Coronary heart disease
- Strokes
- Peripheral vascular disease: decreased blood flow to legs = hard to walk
- Lung diseases
- Increased risk of diabetes, pneumonia, tuberculosis, and influenza
What does nicotine do to veins and blood flow? Explain the effect.
Vasoconstriction. Constricts blood flow to all of the fine vessels in the periphery. Causes major wrinkles and cataracts.
What is second hand smoke and what is it composed of?
Second hand smoke is what the person exhales and mainly what is coming off the burning end of the cigarette. It has a different chemical composition than what the smoker is inhaling because when a smoker inhales, more oxygen moves through the cigarrette which increases the temperature and changes the chemical composition.
What can happen to children as a result of second hand smoke?
Sudden infant death, brain cancer, other cancers, asthma, infections.
What are the different ways to administer nicotine? What is it soluble in?
Chewing tobacco, swallowing pills, sublingual, transdermal patches. Nicotine is lipid soluble.
What kind of base is nicotine? And in what environment will it be more soluble?
Weak base. Most soluble form at a high pH.
What are the consequences of smoking bypassing the first pass effect?
- Absorption through the lungs is as fast as IV injection.
- Chemicals in cigarettes aren’t partially metabolized by the liver before going to the systemic circulation so there is a larger quantity of chemicals in the blood to affect the body.
What allows nicotine to diffuse into the capillaries so easily?
Thin walls between the alveoli and capillaries maximizes gas exchange.
Why doesn’t lowering nicotine cigarettes make the cigarette safer?
The smoker will adjust the drug delivery in order to get the required level of nicotine they are addicted to; the smoker will control their bioavailability of nicotine. When given lower level nicotine cigarette, they take more puffs and hold it in their lungs for longer. If given higher nicotine cigarettes, they will take less puffs so the nicotine level wont be much higher than usual.
Why is swallowing nicotine very dangerous? For children?
Because it is absorbed from the intestine. If children eat it they will die if they don’t vomit quickly enough.
Why shouldn’t pregnant woman and breastfeeding women smoke?
- Nicotine will reach the fetus
2. Nicotine is present in breast milk (lipid soluble)
Why can nicotine cross the blood brain barrier?
It is lipid soluble
What will save a child from nicotine?
The fact that nicotine stimulates the “chemoreceptor trigger zone” (CTZ) which does not contain a blood brain barrier. This is important because it will be quickly affected by nicotine and will send a signal to the vomiting center.
Why don’t smokers throw up every time they smoke?
The CTZ becomes desensitized to nicotine after chronic use.
What mainly metabolizes nicotine?
The CYP450 system in the liver. The predominant CYP enzyme for nicotine is CYP2A6.
What does CYP2A6 metabolize nicotine into?
The less active metabolite, cotinine.
Describe the plasma concentration of nicotine in a smoker throughout the day.
- In the morning they are in the “abstinence zone” before having their first cig.
- The first few cigarettes of the day bring the smoker to their normal nicotine levels.
- When they sleep, their nicotine levels decrease.