Nicotine poisoning can occur in children and adults. Symptoms of nicotine toxicity from tobacco products usually begin within 15 minutes of exposure, depending on the route of administration. If you develop only minor symptoms, recovery is relatively quick. There is no specific antidote for nicotine toxicity, so treatment can be complicated and is focused on treating the symptoms that occur individually with medications.
Created by Mai Takematsu, MD. These answers are provided by volunteer medical toxicologists for the purpose of public education, and do not necessarily represent the policies or positions of the American College of Medical Toxicology.
What happens if my child accidentally eats nicotine? What happens if I take too much nicotine? What treatments are available for nicotine poisoning? What is nicotine and what forms of nicotine are available? Top of Page What happens if my child accidentally eats nicotine?
Top of Page What happens if I take too much nicotine? Top of Page What treatments are available for nicotine poisoning? Also, you might think that these types of products are safer than cigarette smoke and then consume more of them.
According to the Archives of Toxicology , 30 to 60 milligrams of nicotine is considered lethal in adults. In theory, then, consuming a few e-cigarettes could be fatal. Using more than one nicotine-containing product can also increase your risk. Poisoning can happen when using cigarettes, e-cigarettes, or a a smoking cessation product at the same time.
When you think of nicotine poisoning, you might think of toxicity from inhaling smoke and vapors. However, exposure can also occur from skin contact and ingestion. Third-hand vapors from e-cigarettes can stick to clothing, carpet, and other fabrics. This can cause poisoning in people who then touch these materials.
Children are the most vulnerable. People who work with nicotine-based products, such as in tobacco plants and harvesting fields, are also possibly at risk. Treatment for nicotine poisoning depends on the severity and amount of exposure. It generally requires treatment at the hospital. A doctor may provide activated charcoal.
When ingested, the charcoal binds with the nicotine and exits the body without further absorption in the blood. The hospital can also provide antidotes to help reverse the effects of the poisonous substance. This prevents the possibility of choking on vomit. You should never encourage a loved one to force themselves to vomit after a poison exposure. Nicotine poisoning should be treated like any other type of poisoning.
Call the poison control center at Severe cases warrant an emergency room visit. Call to request an ambulance. Nicotine is light sensitive photosensitive and will gradually turn brown on exposure to air or light. Onset of physical effects is dependent on route of exposure.
Early phase findings occur within 15 minutes to 1 hour. Vomiting is the most common symptom of nicotine poisoning. Late phase findings occur within 30 minutes to 4 hours. The duration of symptoms is about 1 to 2 hours following mild exposure, and up to 18 to 24 hours following severe exposure.
Death may occur within 1 hour after severe exposure. More severe exposures cause muscle fasciculations involuntary twitching , seizures, and abnormal heart rhythms; these effects are followed by multi-system organ depression including slow heart rate bradycardia , low blood pressure hypotension , and paralysis of the muscles that control breathing. Death may occur, and is typically due to paralysis of the muscles that control breathing, a build-up of fluid in the airways bronchorrhea , and failure of the heart and blood vessels cardiovascular collapse.
Pure nicotine in the eye may cause severe pain and inflammation of the conjuctiva. Severe exposure may cause opacification of the cornea. INGESTION EXPOSURE : Early phase: nausea, vomiting emesis , abdominal pain, and increased salivation; fluid build-up in the airways bronchorrhea ; rapid, heavy breathing hyperpnea ; high blood pressure hypertension , rapid heart rate tachycardia , and generalized narrowing of the blood vessels vasoconstriction with pale skin; and headache, dizziness, confusion, agitation, restlessness, loss of balance and difficulty walking, and visual and hearing auditory distortions.
Late phase: diarrhea particularly at larger doses ; shallow breathing hypoventilation , no breathing apnea , low blood pressure hypotension , slow heart rate bradycardia , abnormal heart rhythms dysrhythmias , and shock critically low blood pressure ; and loss of normal reflexes hyporeflexia , loss of normal muscle tone hypotonia , lethargy, weakness, paralysis, and coma long-term loss of consciousness.
Possible burning sensation in the mouth, throat, and stomach. Absorption of nicotine by ingestion is not complete because acid in the stomach prevents nicotine from being very well absorbed.
Occupational handling of tobacco leaves may result in green tobacco sickness caused by dermal absorption of nicotine. Absorption through the skin and particularly through the mucous membranes may result in whole-body systemic toxicity.
See Ingestion Exposure. Care should be taken during decontamination, because absorbed agent can be released from clothing and skin as a gas. Your Incident Commander will provide you with decontaminants specific for the agent released or the agent believed to have been released. The warm zone should include two decontamination corridors.
One decontamination corridor is used to enter the warm zone and the other for exiting the warm zone into the cold zone. The decontamination zone for exiting should be upwind and uphill from the zone used to enter. Decontamination area workers should wear appropriate PPE. See the PPE section of this card for detailed information. A solution of detergent and water which should have a pH value of at least 8 but should not exceed a pH value of Soft brushes should be available to remove contamination from the PPE.
Labeled, durable 6-mil polyethylene bags should be available for disposal of contaminated PPE. Always move in a downward motion from head to toe. Make sure to get into all areas, especially folds in the clothing. Wash and rinse using cold or warm water until the contaminant is thoroughly removed.
Place all PPE in labeled durable 6-mil polyethylene bags. Remove all clothing at least down to their undergarments and place the clothing in a labeled durable 6-mil polyethylene bag. First Aid. Repeat as necessary. Immediately wash eyes with large amounts of tepid water for at least 15 minutes. Seek medical attention immediately. Do not induce vomiting emesis. Do not administer antacids; alkaline conditions improve the absorption of nicotine.
Monitor heart function and evaluate for low blood pressure hypotension , abnormal heart rhythms dysrhythmias , and reduced respiratory function respiratory depression. Evaluate for low blood sugar hypoglycemia , electrolyte disturbances, and low oxygen levels hypoxia. If evidence of shock or low blood pressure hypotension is observed, begin intravenous IV fluid administration. If fluid administration fails to reverse hypotension, dopamine and norepinephrine may be used.
If seizures occur, treat them with benzodiazepines. Maintain adequate hydration and urine output. Evaluate respiratory function and pulse. If shortness of breath occurs or breathing is difficult dyspnea , administer oxygen. Assist ventilation as required. Always use a barrier or bag-valve-mask device. If breathing has ceased apnea , provide artificial respiration. See the Ingestion section for first aid recommendations.
If signs of systemic exposure develop, see the Ingestion section for first aid recommendations. Long-Term Implications.
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