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Pronunciation

NIK-o-teen

Classifications

Therapeutic Classification: smoking deterrents

Indications

REMS


Action

  • Provides a source of nicotine during controlled withdrawal from cigarette smoking.
Therapeutic effects:
  • Lessened sequelae of nicotine withdrawal (irritability, insomnia, somnolence, headache, and increased appetite).

Pharmacokinetics

Absorption: Gum, lozenge: Slowly absorbed from buccal mucosa during chewing/sucking. Nasal spray: 53% absorbed from nasal mucosa. Transdermal: 70% of nicotine released from the system is absorbed through the skin.

Distribution: Enter breast milk.

Metabolism/Excretion: Mostly metabolized by the liver. Small amounts are metabolized by kidneys and lungs; 10–20% excreted unchanged by kidneys.

Half-Life: 1–2 hr.

Time/Action Profile

(plasma concentrations)

ROUTEONSETPEAKDURATION
Gumrapid15–30 minunknown
Lozengeunknownunknownunknown
Nasal sprayrapid4–15 minunknown
Transdermalrapid2–4 hrunknown





Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: tachycardia, chest pain, hypertension

Derm:

transdermal

burning at patch site, erythema, pruritus, cutaneous hypersensitivity, rash, sweating

EENT: sinusitis,

gum

pharyngitis,

nasal spray

nasopharyngeal irritation, sneezing, watering eyes, change in smell, earache, epistaxis, eye irritation, hoarseness

Endo: dysmenorrhea

GI: abdominal pain, abnormal taste, constipation, diarrhea, dry mouth, dyspepsia, hiccups, nausea, vomiting,

gum

belching, appetite, salivation, oral injury, sore mouth

MS: arthralgia, back pain, myalgia,

gum

jaw muscle ache

Neuro: paresthesia, headache, insomnia, abnormal dreams, dizziness, drowsiness, impaired concentration, nervousness, seizures, weakness

Resp:

Nasal spray

cough, dyspnea

Interactions

Drug-drug:

Route/Dosage

Availability

(Generic available)

Assessment

Toxicity and Overdose:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

nicotine chewing gum: Nicorette,

nicotine lozenge: Nicorette,

nicotine nasal spray: Nicotrol NS,

nicotine transdermal patch: Habitrol, Nicoderm CQ