[OT] Historical facts about Nicotine.

[alsih2o]

another nice little bit about nicotine being "one of the most lethal poisons known" as well as a bit at the end on a suicide by nicote ingestion sorry if this is overkill, but darn it feels good right now


Nicotine Poisoning

Nicotine is one of the most lethal poisons known. At present, virtually all toxicities involving nicotine are being reported from cigarettes. More than 90% of toxic exposures from cigarettes in the United States are reported in children less than 5 years of age. A recent report from Germany states that most of the cases are within the 7 month to 2 year old age range. In Nigeria, a herbal drug containing nicotine increases morbidity and mortality in this paediatric group. Ingestion of 1 cigarette (or 3 but ts) or drinking saliva expectorated by tobacco chewer (which is often collected in a can) should be considered potentially toxic for children. In adults, suicidal ingestion of nicotine-containing pesticides, and occasionally after cutaneous exposure to ni cotine, such as tobacco harvesters can cause poisoning. Green tobacco sickness (GTS) is an illness resulting from dermal exposure to dissolved nicotine from wet tobacco leaves. GTS is characterised by nausea, vomitting, weakness, dizziness and sometimes f luctuations in blood pressure or heart rate. Nicorette intoxication is uncommon.

More than 95% of the reported cigarette toxicity is either asymptomatic (70%) or mild (25%). Most of the recently reported serious toxic states from nicotine have been from accidental exposure to animal control agents by their handlers.

No specific histological changes occur after nicotine poisoning. The mouth, pharynx, oesophagus and stomach may show evidence of the caustic effect following the ingestion of nicotine.

Symptoms

Respiratory stimulation and gastrointestinal hyperactivity are two main symptoms of nicotine poisoning.

Acute poisoning can result from skin contamination or inhalation of tobacco smoke, depending on the doses.


Small doses: Respiratory stimulation, nausea and vomitting, dizziness, headache, diarrhoea, tachycardia, elevation of blood pressure, sweating and salivation. Patient will gradually recover, after a period of weakness.
Large doses: Burning sensation of the mouth, throat, stomach, followed immediately by the above symptoms. Patient may progress to prostration, convulsions, bradycardia, arrhythmia and finall y coma. Death may occur within 5 min to 4 hours.
Among others, tobacco smoking increases the incidence of coronary heart disease and respiratory tract cancer. The chart below esimates the number of smoking-related deaths in the United States in 1990.

Pharmacokinetics

Peak serum levels: Peak serum levels are attained 30 minutes after chewing nicotine gum, compared to 5 to 10 minutes after smoking cigarettes. For example, mean steady-state levels of 11.8ng/ml are achieved after 2 mg of gum. Protein binding is 20% . Nicotine has an apparent volume of distribution in adults of about 1 L/kg. Smokers appear to have a decreased volume of distribution compared to non-smokers. Between 80-90% of the absorbed compound is detoxified in the liver, while 10-20% is excreted un changed by the kidneys. The principle metabolites are cotinine and nicotine-1'-N-oxide. The elimination half-lives of nicotine is approximately 0.8 hour in smokers and 1.3 hours in non-smokers.

Treatment
Acute Poisoning

Emergency Procedure
In case of contamination, wash skin by flooding with water and scrubbing vigorously with soap.
Emesis - patient may already be vomitting. Emesis is not advisable because it may be dangerous. If possible, give activated charcoal orally to adsorb any remaining nicotine. Administer charcoal slurry, aqueous or mixed with saline cathartic or sorbitol. The FDA suggests 240 ml of diluent/30 g of charcoal. Usual charcoal dose is 30 to 100 g in adults and 15-30 g in children (1-2 g/kg in infants).
Administer one dose of a cathartic, mixed with charcoal or given separately.
Gastric lavage - may be indicated if performed soon after ingestion, or in patients who are comatose or at risk of convulsing. Protect airway by placement in Trendelenburg and left lateral decubitus position or by cuffed endotracheal intuba tion. Use tap water containing activated charcoal, if available.
After control of any seizures present, perform gastric lavage. Volume of lavage return should approximate fluid given.
Initiate artificial respiration using oxygen, is available.


Specific Drugs and Antidotes
Mecamylamine 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 vomitting, convulsive or hypotensive.
either give atropine sulphate, (adult 0.4-2 mg; child 0.01 mg/kg, not to exceed 0.4 mg per dose) i.m. or i.v. and repeat every 3-8 min. until signs of parasympathetic toxicity are controlled. Repeat atropine frequently to maintain control o f symptoms. As much as 12 mg of atropine has been given safely in the first 2 hours in adult. Ensure proper oxygenation to avoid arrythmias associated with hypoxia. Interruption of atropine therapy may be rapidly followed by fatal pulmonary oedema or resp iratory failure.
or give phentolamine 1-5 mg i.m. or i.v. to control signs of sympathetic hyperactivity, such as hypertension.


General Measures
Control convulsions: Administer diazepam i.v. bolus (adult, 5-10 mg initially which may be repeated every 15 minutes PRN up to 30 mg; child, 0.25-0.4 mg/kg dose up to 10 mg/dose) or lorazepam i.v. bolus (adult, 4-8 mg; child, 0.05-0.1 mg/kg).
Do not administer antacids since nicotine is better absorbed in an alkaline media.
Monitor ECG and vital signs carefully.
Chronic Poisoning

Remove from further exposure to dust or smoke.
Prognosis

Survival for more than 4 hours is usually followed by complete recovery.

CASE REPORT:
Suicidal poisoning due to nicotine
An Autopsy Case of Fatal Nicotine Poisoning Takayasu, T. et al. Nippon Hoigaku Zasshi, 46: 327-32 (1992)
A fatal case of nicotine poisoning is reported in which a 44-year-old female committed suicide in a short time by taking orally the eluate from tobacco. External examination showed no abnormal findings except for markedly dark red-purple postmortem lividi ty, and internal examination demonstrated no pathological changes but the signs of sudden death. Through the toxicological investigation by GC and GC-MS, however, nicotine was detected in the solution which she had taken orally and in the blood, urine and the contents of the stomach and small intestine. The nicotine concentrations of the blood, urine and contents of stomach and small intestine were 6.3 micrograms/ml, 1.5 micrograms/ml, 30 micrograms/ml and 71 micrograms/g respectively, and enough to be le thal.

 

[Buttercup]

About two years ago, an infant in my locale consumed an ashtray full of cigarette butts. She died from nicotine poisoning. Her mother claimed that she never realized an 18 month old would get into an ashtray sitting on a coffee table. I believe she was charged with child endangerment.

 

[Mistwell]

Man, I am soooooo tired of fools thinking the McDonald's Coffee case is the end-all-be-all of frivolous lawsuits.

Here are the real facts:

!) The victim, who also underwent debridement treatments, sought to settle her claim for $20,000, but McDonalds refused.

2) During discovery, McDonalds produced documents showing more than 700 claims by people burned by its coffee between 1982 and 1992. Some claims involved third-degree burns substantially similar to the Victims

3) McDonalds also said during discovery that, based on a consultants advice, it held its coffee at between 180 and 190 degrees fahrenheit to maintain optimum taste. He admitted that he had not evaluated the safety ramifications at this temperature. Other establishments sell coffee at substantially lower temperatures, and coffee served at home is generally 135 to 140 degrees.

4) Further, McDonalds' quality assurance manager testified that the company actively enforces a requirement that coffee be held in the pot at 185 degrees, plus or minus five degrees. He also testified that a burn hazard exists with any food substance served at 140 degrees or above, and that McDonalds coffee, at the temperature at which it was poured into styrofoam cups, was not fit for consumption because it would burn the mouth and throat. The quality assurance manager admitted that burns would occur, but testified that McDonalds had no intention of reducing the "holding temperature" of its coffee.

5) Plaintiffs' expert, a scholar in thermodynamics applied to human skin burns, testified that liquids, at 180 degrees, will cause a full thickness burn to human skin in two to seven seconds. Other testimony showed that as the temperature decreases toward 155 degrees, the extent of the burn relative to that temperature decreases exponentially. Thus, if the Victim's spill had involved coffee at 155 degrees, the liquid would have cooled and given her time to avoid a serious burn.

6) McDonalds asserted that customers buy coffee on their way to work or home, intending to consume it there. However, the companys own research showed that customers intend to consume the coffee immediately while driving.

7) McDonalds also argued that consumers know coffee is hot and that its customers want it that way. The company admitted its customers were unaware that they could suffer third degree burns from the coffee...

8) The jury awarded Liebeck $200,000 in compensatory damages. This amount was reduced to $160,000 because the jury found Liebeck 20 percent at fault in the spill. The jury also awarded Liebeck $2.7 million in punitive damages, which equals about two days of McDonalds' coffee sales. (Note: It was never, ever, ever $8 Million dollars).

9) Post-verdict investigation found that the temperature of coffee at the local Albuquerque McDonalds had dropped to 158 degrees fahrenheit.

10) The trial court subsequently reduced the punitive award to $480,000 -- or three times compensatory damages -- even though the judge called McDonalds' conduct reckless, callous and willful. (Again, nowehere near $8 Million Dollars!)

11) No one will ever know the final ending to this case. The parties eventually entered into a secret settlement which has never been revealed to the public.

 

[Eosin the Red]

Nicotine is toxic - but it is not nearly as toxic as popular myth makes it out to be. There are way too many urban legends about it. The first post on this thread is horse hookey.

If you want to see a good incapaciting agent Nicotine is your friend but generally it has to be ingested - I treated a woman who ingested 2 pieces of nicorette once. It took several hours for the vomiting to stop, even with medications.

Personally, I think organophosphates (nicotinic + muscarinic with strong CNS effects) are the most troublesome here in the us. The last few years have seen the rise of Phosphine (not Phosgine, a byproduct of combustion) as one of the most lethal substance worldwide (esp India). Either one of these two far, far, far outstips the dangers of nicotine poisoning. Let me add it once more for effect - far outstrip. There are poisons/toxins that are worse than these but these are the most common ones that cause us problems.

 

[LostSoul]

Let smokers smoke, drinkers drink, and gamers play. Just don't do it at the casino table while I'm gambling.

Hey, I'm smoking and drinking right now!

If only I had some dice.... wait a second...

 

[mmadsen]

From Anticholinesterase Poisons:

A well-known alkaloid that blocks receptor sites in a manner similar to that of curare and atropine is nicotine. This powerful poison causes stimulation and then depression of the central nervous system. The probable lethal dose for a 70-kg person is less than 0.3 g.

 

[jgbrowning]

Guess I should probably stop smoking perhaps.

Nah- might as well continue, that way in about 20 more years or so, I can turn around say I didn't know it was bad for me, sue RJ Reynolds or someone and win like $28 million dollars.

better learn sign language then.. hard to talk without a throat.

joe b.

 

[Eosin the Red]

From Anticholinesterase Poisons:

Wrong... those are the estimated levels for nicotine sulfate [nicotine with an added salt - this chemically engineered substance was classified as supertoxic by the EPA in 85] not for nicotine. To get ahold of this substance you would need to give a genetic sample and have to TOP MAN 9 perk.

They experimented with it as an insectiside @ 1.2% but all of the cattle sprayed with it died within 1 hour (1997).

Survival with plain jane nicotine has been reported with doses of up to 4 g, but has not been well studied since 1936. It is very likely that we have seen larger ingestions survive.

It is also important to note route, rectal administration bypasses the 'first pass' throught the liver and can result in a much more serious case.

Other Supertoxics:
Dimethylmercury: Baselt (2000) estimated the average lethal dose of organic mercury compounds, in general, as 100 milligrams.
Dioxins: One review article by Reggiani (1978) reports a minimum lethal dose of 1 mcg/kg (Schardein, 2000).

Some sources consider Parathion (a type of OP) Supertoxic others Very toxic.

In all cases Nicotine is moderatly toxic, but Nicotine Sulfate is ST.

The discussion about organophospates is for farm grade stuff not the weaponized varieties that we experimented with.

Finally - It is fairly bad form to quote a website. I have one and can put whatever I want on the site - then quote it right back here. Although, I do use one website fairly reqularly in my job - the vaults of Erowyd. Need to know who is making what in their garage this is the place to go.

 

[Piratecat]

better learn sign language then.. hard to talk without a throat.

"Courteous and polite in person, it is easy to forget that the "loveable rogue" -- as one fan described him -- is a criminal with a long record for violent assaults, kidnapping, firearms offenses and conspiracy.

"But Barger shrugs off any questions about his past and says he has only one regret in a life filled with battles, jail, drugs and divorce.

"If I had to do it all again, I probably wouldn't smoke," he said with a short laugh, speaking through a hole in his windpipe after his larynx was removed during cancer surgery 20 years ago."

Hell's Angel Founder Lives Life in Biker Heaven

 

[JacktheRabbit]

Have anything to back that up or are you being a rude for no reason at all?

Nicotine is toxic - but it is not nearly as toxic as popular myth makes it out to be. There are way too many urban legends about it. The first post on this thread is horse hookey.