Nicotine patches

Like mAChRs, nAChRs have been implicated in the etiology of ALheimef s disease and related dementias as well as in gastrointestinal and cardiovascular disorders. Nicotine has high abuse potential and is the primary component in reinforcing smoking behaviors. Nicotine patches have been... 

Jorenby DE, Leischow SJ, Nides MA, et al A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation. N Eng J Med 340 685— 691, 1999... 

Transdermal nicotine (i.e., the nicotine patch) is also available over the counter for smoking cessation. This form of nicotine dehvery may be espe-... 

In general, for smokers with cardiac disease, the benefits of nicotine replacement therapy outweigh the potential risks. In a safety and efficacy study that included veterans with cardiac disease, smoking concurrently with the nicotine patch was not associated with an increase in adverse events (Joseph et al. 1996). Although bupropion SR is generally well tolerated by smokers, it has not been adequately studied in persons with cardiac disease, and definitive conclusions regarding its safety in this patient population cannot currently be made (Society for Research on Nicotine and Tobacco 2003). 

Fiore MC, Smith SS, Jorenby DE, et al The effectiveness of the nicotine patch for smoking cessation. JAMA 271 1940-1947, 1994 Fiore MC, Bailey WC, Cohen SJ, et al Smoking Cessation. Clinical Practice Guideline No 18 (ACHPRPublNo 96-0692). Rockville, MD, U.S. Department of Health and Human Services, 1996... 

Killen JD, Fortmann SP, Schatzberg AF, etal Nicotine patch and paroxetine for smoking cessation. J Consult Clin Psychol 68 883—889, 2000 Kornitzer M, Boutsen M, Dramaix M, et al Combined use of nicotine patch and gum in smoking cessation aplacebo-controlled clinical trial. Prev Med24 41 7,1995... 

Oncken CA, Hatsukami DK, Lupo VR, et al Effects of short-term use of nicotine gum in pregnant smokers. Clin Pharmacol Ther 59 654-61, 1996 Pomerleau OF, Pomerleau CS Neuroregulators and the reinforcement of smoking towards a biobehavioral explanation. Neurosci Biobehav Rev 8 503—513, 1984 Prochazka AV, Weaver MJ, Keller RT, et al A randomized trial of nortriptyline for smoking cessation. Arch Intern Med 158 2035-2039, 1998 Puska P, Korhonen HJ, Vartiainen E, et al Combined use of nicotine patch and gum compared with gum alone in smoking cessation a clinical trial in North Karelia. Tob Control 4 231-235, 1995... 

False. Nicotine is a highly addictive drug and the smoking habit can be very difficult to stop. Many people have to resort to medication, such as nicotine patches or gum, to help them stop. The best plan is never to start. 

Nicotine patch Transdermal Nicotine gum Buccal Nicotine lozenge Buccal Nicotine nasal spray Intranasal 7-22 mg/day (started at 21 mg per day x 2 weeks then 14 mg per day x 2 weeks then 7 mg/day) 20-40 mg/day 2 or 4 mg/piece one piece every 2 hours up to 10 times/day 20-40 mg/day 2-4 mg/lozenge one lozenge every 2 hours, up to 10 times/day 16-32 mg/day 1-2 mg/spray, one in each nostril up to 16 times/day... 

However, nicotine also has been shown to stimulate the hypothalamic-pituitary-adrenal axis in rodents, leading to elevated plasma levels of adrenocorticotropic hormone and corticosterone (Andersson et al. 1983 Cam et al. 1979), which are known to exert a wake-promoting effect. However, studies in humans have shown that only intense smoking is able to activate the hypothalamic-pituitary-adrenal axis (Gilbert et al. 1992 Kirschbaum et al. 1992). Nicotine patches, in addition to their use in nicotine suppression and craving, have been used to explore the relationship between sleep and nicotine in human... 

Staner L., Luthringer R., Dupon D., Aubin H. J., Lagrue G. (2006). Sleep effects of a 24-h versus a 16-h nicotine patch a polysomnographic study during smoking cessation. Sleep Med. 7, 147-54. 

Krishnan-Sarin, S., Meandzija, B., O Malley, S. Naltrexone and nicotine patch smoking cessation a preliminary study. Nicotine Tob. Res. 5 851, 2003. 

Stapleton JA, Russell MAH, Feyerabend C, Wiseman SM, Gustavsson G, Sawe U and Wiseman D (1995). Dose effects and predictors of outcome in a randomised trial of transdermal nicotine patches in general practice. Addiction, 90, 31 42. 

Buproprion SR4 First-line Titrate up to 150 mg orally twice daily 3-6 months Patients receiving both bupropion and a nicotine patch should be monitored tor hypertension. At... 

Bupropion is another alternative pharmacological approach to tobacco abstinence. It is an antidepressant drug that blocks reuptake of norepinephrine and dopamine, and also blocks nicotinic receptors in the low to intermediate micromolar range (Fryer and Lukas 1999). Thus, the effects of bupropion on nicotine addiction may be through dual effects on dopaminergic and nicotinic systems. Further, it has been an effective treatment in controlled studies, both alone and in combination with the nicotine patch. Bupropion alone or in combination with a nicotine patch was more effective than placebo or the nicotine patch alone. 

Wilson AL, Langley LK, Monley J, Bauer T, Rottunda S, McFalls E, Kovera C, McCarten JR. (1995). Nicotine patches in Alzheimer s disease pilot study on learning, memory, and safety. Pharmacol Blochem Behav. 51(2-3) 509-14. 

Fant RV, Henningfleld JE, Shiffman S, Strahs KR, Reitberg DP (2000) A pharmacokinetic crossover study to compare the absorption characteristics of three transdermal nicotine patches. Pharmacol Biochem Behav 67(3) 479 82... 

Lawrence and colleagues (2002) explored the neural substrates of nicotine effects on sustained attention using the rapid visual information processing (RVIP) task. Smokers (n = 15) received either placebo or 21-mg transdermal nicotine patch prior to testing. Matched nonsmokers (n = 14) were tested under similar conditions, but did not receive a nicotine patch. Relative to the placebo condition, the smokers in the nicotine condition demonstrated improved task performance and increased neural activity in the parietal and occipital cortices, the thalamus and caudate, and decreased activity in left frontal, anterior and posterior cingulate, insula, and left parahippocampal regions (see Fig. 3). As noted by the authors, previous studies... 

Fig. 3 Activation difference between the rapid visual information processing (RVIP) and control tasks in smokers after administration of placebo and nicotine patches. The graphs show the percent change in activation (from baseline) during performance of each task in smokers in the two drug conditions. After receiving nicotine, smokers demonstrated better task performance and more task-related activity in the parietal (A and B) and occipital (C and D) cortices compared to the parallel measures after they received placebo (Kumari et al. 2003)...

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