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DRUGS & BEHAVIOR > TOBACCO/VAPING: NICOTINE > Flashcards

TOBACCO/VAPING: NICOTINE Flashcards

1
Q

nicotine history

A
  • comes from nicotania tabacum plant
  • Spanish monopolized tobacco market
  • addictive properties 17th century
  • isolated from tobacco leaves in 1828
  • extremely toxic similar to cyanide
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2
Q

tobacco medical properties

A
  • applied externally for pain (internal & external)
  • treat diseases of ears, eyes, mouth, and nose
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3
Q

air curing

tobacco processing

A
  • hung and allowed to dry 4-8 weeks
  • cigar & burley tobaccos
  • low sugar, light-sweet flavor, high nicotine
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4
Q

fire curing

A
  • hung to dry near burning hardwood for 3-10 days
  • pipe & chewing tobacco, snuff
  • low sugar, smoky, high nicotine
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5
Q

flue curing

tobacco processing

A
  • strung onto tobacco sticks & hung in flue
  • exposed to low heat without any smoke for about a week
  • high sugar, medium-high nicotine
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6
Q

sun curing

tobacco processing

A
  • dries leaves uncovered in the sun
  • oriental tobacco
  • low sugar, low nicotine
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7
Q

report on smoking and health

A
  • surgeon general’s warning added 1964
  • detailed cigarettes as a cause of cancer, heart disease, effects to pregnancy
  • this warning helped decrease cigarette use
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8
Q

why study smoking?

A
  1. social and clinical significance (global issue)
  2. ubiquitous (no target demographic; everyone)
  3. addictiveness (most addictive) → most common drug in adolescents
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9
Q

biological reason why smoking starts at a young age

A
  • adolescent brain is more sensitive to rewarding/reinforcing effects of nicotine
  • feelings of euphoria more intense at younger age
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10
Q

biopsychological reason smoking starts at a young age

A
  • personality characteristics (hostility & aggression) have increased stimulation by nicotine
  • nicotine both stimulant & relaxant → either depletes hostility or increases it
  • having these personality characteristics create predisposition to continued use
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11
Q

psychological reason smoking starts at a young age

A
  • novelty seekers are more receptive to tobacco ads that advertise fun
  • sensation seeking → more likely to be influenced fun, cool status in ads
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12
Q

social reason smoking starts at a young age

A
  • trying to fit in
  • parent/family acceptance of nicotine use
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13
Q

PK of nicotine

A
  • small molecule, both lipid & water soluble
  • 7-20 seconds to reach brain when smoked
  • amount absorbed into bloodstream depends on: type of tobacco, smoked vs. chewed, using filter
  • receptors saturated quickly → decreasing effects after first puff
  • short lived psychoactive effects → repeatedly dose themselves
  • receptors occupied so subsequent puffs with decreasing effects
  • if all receptors accessible, 1 puff saturates a lot of receptors
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14
Q

inhalation

A
  • absorbed with lungs
  • nicotine reaches brain in 10sec
  • absorbed into bloodstream with oxygen through lungs
  • ~20% cigarette nicotine absorbed to blood
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15
Q

smokeless tobacco

A
  • peak plasma level ~15min
  • slowest method
  • usually under tongue
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16
Q

nicotine gum

A
  • peak plasma level ~30min
  • used as treatment
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17
Q

transdermal

A
  • patch
  • peak plasma levels in ~5-12hrs
  • used as treatment
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18
Q

nicotine inhaler

A
  • nasal absorption within 1min
  • used as treatment
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19
Q

nicotine and liver

A
  • metabolized & eliminated in ~2hrs
  • converted to cotanine (lipophilic)
  • detectable for weeks
20
Q

monoamine oxidase inhibitors (MAOIs)

A
  • found in tobacco
  • inhibits enzyme for monoamines
  • monoamine (dopamine) not metabolized → continued activation of reward pathway
21
Q

nicotine PD

A
  • nicotine = agonist of nicotinic acetylcholine receptors (nAChR)
  • nAChR found on DA neurons in VTA
  • depolarizes neurons (more -)
  • both PNS & CNS
  • primary peripheral = NEUROMSUCULAR JUNCTION
  • results in increased dopamine in NAC
  • tobacco also MAOIs (inhibit enzyme) → even more dopamine
  • neuro-effector & chemosensitive sites & stimulate receptors
22
Q

nicotine binding preference

A
  • higher affinity for brain vs. peripheral nACh receptors
  • subunits of receptor
23
Q

acute pharmacological nicotine effects

AS GENERAL CNS STIMULANT

A
  • increases behavioral activity
  • may produce tremors
  • stimulates vomiting center in brain (quickly develop tolerance)
  • release of anti-diuretic hormone → constricts blood vessels & increased BP
  • reduces muscle tone
  • enhances alertness, learning, & memory
24
Q

physiological effects

A
  • increases HR, BP, and contraction of heart
  • initiates dilation of arteries because increased oxygen demand with nicotine
25
Q

nicotine toxicity

A
  • fatal dose in adults = 60mg
  • rapid symptom onset
  • nausea, salivating, abdominal pain, vomiting, diarrhea, cold sweat, headache, dizziness, disturbed vision/hearing, mental confusion
  • falling BP & labored breathing
26
Q

nicotine tolerance

A
  • tolerance created throughout day with more intense effect first time in day
  • builds throughout day
  • crashes once asleep before waking up
  • nausea & dizziness absent with repeated intake
27
Q

nicotine withdrawal

A
  • craving is primary symptom
  • leads to relapse
  • depressed mood & anxiety
  • insomnia
  • irritability, frustration, anger, impatient
  • difficulty concentrating
  • decreased HR
  • increased appetite & weight gain
28
Q

nicotine use disorder

A
  • one of the hardest additions to break
  • molecule involvement causes receptor dysregulation
  • NAC/VTA role in DA release
  • glutamatergic/cholinergic synaptic transmission
  • GABAergic effects
  • environmental stimuli drive learned behavior
  • behavioral tolerance not reversible
29
Q

titration hypothesis of nicotine dependence

A
  • person creates constant level of nicotine to avoid withdrawal, maintains nicotine levels
  • need smoke breaks often because of metabolism
30
Q

nicotine positive reinforcement

A
  • behavioral/learning stage
  • 10 puffs/cig at 1 pack/day means user positively reinforces behavior 200 times daily
  • new smoker most likely will increase use from reinforcement & RITUALS → strengthens psychological dependence
31
Q

nicotine negative reinforcement

A
  • occurs during dependence
  • smoking to remove unpleasant effects of acute withdrawal
32
Q

tar

A
  • multiple ingredients
  • dark, sticky combo of 100s of poisons & cancer-causing chemicals
  • levels vary
  • heavy smokers will smoke “light” cigs but need to smoke more to achieve nicotine level → still smoking MORE
33
Q

carbon monoxide

A
  • forms when tobacco burned
  • poisonous emission from cars
  • replaces oxygen in red blood cells, COHb
34
Q

smoking & cancer

A
  • not from nicotine; from SMOKE
  • increased cervical risk in women
  • other admin. not inhaled still increase risk of oral cancer when chewed
  • smoke contains potent mutagen (BaP) & metabolized into BPDE
  • BPDE damages gene that supresses tumors in lungs
  • hot spots on lungs
35
Q

smoking & cancer

A
  • not from nicotine; from SMOKE
  • increased cervical risk in women
  • other admin. not inhaled still increase risk of oral cancer when chewed
  • smoke contains potent mutagen (BaP) & metabolized into BPDE
  • BPDE damages gene that supresses tumors in lungs
  • hot spots on lungs
36
Q

smoking & COPD

A
  • coronary obstructive
  • 80-90% smokers
  • several lung diseases
  • emphysema → alveoli rupture
37
Q

smoking & cardiovascular disease

A
  • smokers’ hearts need to work harder
  • lack of oxygen in lungs = heart works harder to pump
  • blood vessels narrow & harden (antherosclerosis)
  • clotting (thrombosis)
38
Q

cardiovascular lung disease

A
  • caused by CO & nicotine (PNS effects)
  • heart attack, artery hardening, high BP
  • kills > lung cancer
39
Q

second hand smoke

A

high rates of cancer & cardiovascular disease from exposure of smoke/nicotine

40
Q

electronic nicotine delivery systems (ENDS)

A
  • thought to be healthier alternative because less carcinogens BUT
  • contains toxic chemicals (propylene glycol, flavorants)
  • metal coil can flake off metal particles damaging lungs
  • varied nicotine levels
  • increased use in adolescents
41
Q

intrinsic motivation

smoker treatment

A
  • internal drive to want to quit
  • fear of getting sick (cancer, COPD, etc)
  • still difficult to quit
42
Q

extrinsic motivation

smoker treatment

A
  • external drive
  • being force to quit/nagged
  • difficult to quit regardless
43
Q

treatment options

A

*

44
Q

physicians’ 4 As

A
  • brief interventional tactic
  • ask, advise, assist, arrange
45
Q

nicotine replacement

treatment

A
  • patches, gum, nasal spray, lozenges
  • efficacy vs. effectiveness
  • reduces negative reinforcing symtpoms (crash with withdrawal)
46
Q

medications

treatment

A
  • used to alleviate withdrawal symptoms
  • Wellbutrin to inhibit dopamine reuptake
  • some nicotine agonist - reduces craving
  • can combine with CBT to decrease tobacco reward
47
Q

nicotine vaccine

A
  • creates antibodies & blocks nicotine from crossing BBB
  • makes smoking less pleasurable
  • FDA fast tracked 2006

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