Nicotine Replacement Therapies

Summary

Nicotine replacement therapies are medications that deliver nicotine to help with smoking cessation. They work as agonists at nicotinic acetylcholine receptors.

Clinically, nicotine replacement aids are used for smoking cessation and to treat smoking withdrawal symptoms. Long-acting forms like patches and short-acting forms like lozenges or gum can be combined for optimal results.

Side effects of these drugs include CNS stimulation, headaches, and oral irritation.

Key Points

• Nicotine Replacement Therapies
  • Mechanism
    • Nicotinic ACh receptor Agonist
      • Mimics the effects of nicotine from tobacco
      • Binds to nicotinic acetylcholine receptors in the brain
      • Provides controlled doses of nicotine
  • Clinical Use
    • May help smoking cessation
      • Increases quit rates compared to placebo
      • Most effective when combined with behavioral support
    • Relieves withdrawal symptoms from smoking
      • Reduces cravings
      • Alleviates irritability, anxiety, and difficulty concentrating
    • Long acting patch + short-acting (lozenge) can be combined
      • Patch provides steady nicotine levels
      • Lozenge offers quick relief for sudden cravings
      • May be more effective for heavy smokers
  • Side Effects
    • Causes headache
      • Usually mild and transient
    • Causes oral irritation
      • More common with gum and lozenge forms
      • Can be minimized by proper use technique
    • Causes CNS stimulation
      • May lead to insomnia or vivid dreams
      • Generally less severe than with smoking