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Becam J, Martin E, Pouradier G, Doudka N, Solas C, Guilhaumou R, Fabresse N. Transdermal Nicotine Poisoning: A Rare Case Report of Occupational Exposure. TOXICS 2023; 11:toxics11050464. [PMID: 37235278 DOI: 10.3390/toxics11050464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023]
Abstract
We report a case of accidental nicotine intoxication following transdermal exposure in a 22-year-old man with no medical history, who worked in a company manufacturing e-liquids for electronic cigarettes. He accidentally spilled 300 mL of pure nicotine solution (>99%) on his right leg without wearing protective clothing or a mask. Less than a minute later, he experienced dizziness, nausea, and headaches, followed by painful burning sensations in the affected area. He immediately removed his pants and washed his leg thoroughly with water. He presented to the emergency department two hours later, where he exhibited a respiratory rate of 25 cpm, a heart rate of 70 bpm, headaches, abdominal pain, pallor, and vomiting. He recovered without specific treatment five hours post-intoxication. Plasma levels of nicotine, cotinine, and hydroxycotinine were measured five hours after exposure using liquid chromatography-mass spectrometry. The concentrations found were 447 ng/mL for nicotine, 1254 ng/mL for cotinine, and 197 ng/mL for hydroxycotinine. Nicotine is an alkaloid that can be highly toxic, with doses of 30-60 mg being potentially fatal. Transdermal intoxication is rare, with very few cases reported in the literature. This case highlights the risk of acute intoxication through cutaneous exposure to nicotine-containing liquid products and the need for protective clothing when handling such products in a professional context.
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Affiliation(s)
- Jenny Becam
- Laboratory of Pharmacokinetics and Toxicology, La Timone University Hospital, 264 Rue Saint Pierre, CEDEX 5, 13385 Marseille, France
| | - Edouard Martin
- Intensive Care Unit, Laveran Military Teaching Hospital, 34 Boulevard Laveran, 13384 Marseille, France
| | - Gildas Pouradier
- Intensive Care Unit, Laveran Military Teaching Hospital, 34 Boulevard Laveran, 13384 Marseille, France
| | - Natalia Doudka
- Department of Clinical Pharmacology and Pharmacovigilance, La Timone University Hospital, 264 Rue Saint Pierre, CEDEX 5, 13385 Marseille, France
| | - Caroline Solas
- Laboratory of Pharmacokinetics and Toxicology, La Timone University Hospital, 264 Rue Saint Pierre, CEDEX 5, 13385 Marseille, France
| | - Romain Guilhaumou
- Department of Clinical Pharmacology and Pharmacovigilance, La Timone University Hospital, 264 Rue Saint Pierre, CEDEX 5, 13385 Marseille, France
- Institut de Neurosciences des Systèmes, Aix Marseille University, INSERM UMR 1106, 13385 Marseille, France
| | - Nicolas Fabresse
- Laboratory of Pharmacokinetics and Toxicology, La Timone University Hospital, 264 Rue Saint Pierre, CEDEX 5, 13385 Marseille, France
- Economic and Social Sciences of Health and Medical Information Processing, Aix Marseille University, INSERM UMR 1252, IRD, SESSTIM, 13385 Marseille, France
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Ratsch A, Bogossian F, Burmeister EA, Ryu B, Steadman KJ. Higher blood nicotine concentrations following smokeless tobacco (pituri) and cigarette use linked to adverse pregnancy outcomes for Central Australian Aboriginal pregnancies. BMC Public Health 2022; 22:2157. [DOI: 10.1186/s12889-022-14609-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022] Open
Abstract
Abstract
Background
In central Australia, Aboriginal women use wild tobacco plants, Nicotiana spp. (locally known as pituri) as a chewed smokeless tobacco, with this use continuing throughout pregnancy and lactation. Our aim was to describe the biological concentrations of nicotine and metabolites in samples from mothers and neonates and examine the relationships between maternal self-reported tobacco use and maternal and neonatal outcomes.
Methods
Central Australian Aboriginal mothers (and their neonates) who planned to birth at the Alice Springs Hospital (Northern Territory, Australia) provided biological samples: maternal blood, arterial and venous cord blood, amniotic fluid, maternal and neonatal urine, and breast milk. These were analysed for concentrations of nicotine and five metabolites.
Results
A sample of 73 women were enrolled who self-reported: no-tobacco use (n = 31), tobacco chewing (n = 19), or smoking (n = 23). Not all biological samples were obtained from all mothers and neonates. In those where samples were available, higher total concentrations of nicotine and metabolites were found in the maternal plasma, urine, breast milk, cord bloods and Day 1 neonatal urine of chewers compared with smokers and no-tobacco users. Tobacco-exposed mothers (chewers and smokers) with elevated blood glucose had higher nicotine and metabolite concentrations than tobacco-exposed mothers without elevated glucose, and this was associated with increased neonatal birthweight. Neonates exposed to higher maternal nicotine levels were more likely to be admitted to Special Care Nursery. By Day 3, urinary concentrations in tobacco-exposed neonates had reduced from Day 1, although these remained higher than concentrations from neonates in the no-tobacco group.
Conclusions
This research provides the first evidence that maternal pituri chewing results in high nicotine concentrations in a wide range of maternal and neonatal biological samples and that exposure may be associated with adverse maternal and neonatal outcomes. Screening for the use of all tobacco and nicotine products during pregnancy rather than focusing solely on smoking would provide a more comprehensive assessment and contribute to a more accurate determination of tobacco and nicotine exposure. This knowledge will better inform maternal and foetal care, direct attention to targeted cessation strategies and ultimately improve long-term clinical outcomes, not only in this vulnerable population, but also for the wider population.
Note to readers
In this research, the central Australian Aboriginal women chose the term ‘Aboriginal’ to refer to themselves, and ‘Indigenous’ to refer to the broader group of Australian First Peoples. That choice has been maintained in the reporting of the research findings.
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Cross-species evidence that nicotine widens the attentional window. Psychopharmacology (Berl) 2021; 238:3559-3568. [PMID: 34618202 PMCID: PMC8629923 DOI: 10.1007/s00213-021-05972-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 08/23/2021] [Indexed: 10/20/2022]
Abstract
RATIONALE The ability to spread attention over items or locations is as important for everyday functioning as the ability to focus narrowly. Little is known about neuronal processes involved in broad monitoring, but indirect evidence suggests a role of nicotinic acetylcholine receptors (nAChRs). OBJECTIVE The present study tested whether the prototypical nAChR agonist nicotine enhances the ability of humans and rodents to maintain a broad attentional window. METHODS Fifty-three never-smokers wearing a nicotine (7 mg/24 h) or placebo patch performed an attention task requiring detection of stimuli presented randomly in one of four peripheral locations, with a central cue predicting the target location or indicating the need to spread attention over all locations. Nineteen rats performed the 5-choice serial reaction time task requiring detection of stimuli presented randomly in a horizontal array of five locations. Performance after nicotine (0.1 and 0.2 mg/kg) or vehicle administration was analyzed as a function of target location eccentricity. RESULTS In human subjects, nicotine caused greater reaction time reduction when all locations were monitored than when a single location was cued. In rats, nicotine attenuated the decline in stimulus detections and the increase in omission errors with greater target location eccentricity. CONCLUSIONS The findings represent cross-species evidence that nAChR agonism facilitates the ability to spread attention broadly. This suggests that nAChR hypofunction may be central to broad monitoring deficits as seen, for example, in schizophrenia. The homology of findings between the rodent and the human paradigm contributes to validating a translational strategy for treatment development.
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Shin SH, Yu M, Hammell DC, Ghosh P, Raney SG, Hassan HE, Stinchcomb AL. Evaluation of in vitro/in vivo correlations for three fentanyl transdermal delivery systems using in vitro skin permeation testing and human pharmacokinetic studies under the influence of transient heat application. J Control Release 2021; 342:134-147. [PMID: 34838928 DOI: 10.1016/j.jconrel.2021.11.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 11/26/2022]
Abstract
The value of developing an in vitro/in vivo correlation (IVIVC) is substantial in biopharmaceutical drug development because once the model is developed and validated, an in vitro method may be used to efficiently assess and predict drug product performance in vivo. In this study, three bioequivalent, matrix-type, fentanyl transdermal delivery systems (TDS) were evaluated in vitro using an in vitro permeation test (IVPT) and dermatomed human skin, and in vivo in human pharmacokinetic (PK) studies under harmonized study designs to evaluate IVIVC. The study designs included 1 h of transient heat application (42 ± 2 °C) at either 11 h or 18 h after TDS application to concurrently investigate the influence of heat on drug bioavailability from TDS and the feasibility of IVPT to predict the effects of heat on TDS in vivo. Level A (point-to-point) and Level C (single point) IVIVCs were evaluated by using PK-based mathematical equations and building IVIVC models between in vitro fraction of drug permeation and in vivo fraction of drug absorption. The study results showed that the three differently formulated fentanyl TDS have comparable (p > 0.05) heat effects both in vitro and in vivo. In addition, the predicted steady-state concentration (Css) from in vitro flux data and the observed Css in vivo showed no significant differences (p > 0.05). However, the effects of heat on enhancement of fentanyl bioavailability observed in vivo were found to be greater compared to those observed in vitro for all three drug products, resulting in a weak prediction of the impact of heat on bioavailability from the in vitro data. The results from the current work suggest that while IVPT can be a useful tool to evaluate the performance of fentanyl TDS in vivo with a relatively good predictability at a normal temperature condition and to compare the effect of heat on drug delivery from differently formulated TDS, additional testing measures would enhance the ability to predict the heat effects in vivo with a lower prediction error.
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Affiliation(s)
- Soo Hyeon Shin
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, MD 21201, United States of America
| | - Mingming Yu
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, MD 21201, United States of America
| | - Dana C Hammell
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, MD 21201, United States of America
| | - Priyanka Ghosh
- Division of Therapeutic Performance, Office of Research and Standards, Office of Generic Drugs, U.S. Food and Drug Administration, Silver Spring, MD 20993, United States of America
| | - Sam G Raney
- Division of Therapeutic Performance, Office of Research and Standards, Office of Generic Drugs, U.S. Food and Drug Administration, Silver Spring, MD 20993, United States of America
| | - Hazem E Hassan
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, MD 21201, United States of America; Department of Pharmaceutics, Industrial Pharmacy Faculty of Pharmacy, Helwan University, Cairo, Egypt
| | - Audra L Stinchcomb
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, MD 21201, United States of America.
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Kovar L, Selzer D, Britz H, Benowitz N, St Helen G, Kohl Y, Bals R, Lehr T. Comprehensive Parent-Metabolite PBPK/PD Modeling Insights into Nicotine Replacement Therapy Strategies. Clin Pharmacokinet 2021; 59:1119-1134. [PMID: 32166575 PMCID: PMC7467963 DOI: 10.1007/s40262-020-00880-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background Nicotine, the pharmacologically active substance in both tobacco and many electronic cigarette (e-cigarette) liquids, is responsible for the addiction that sustains cigarette smoking. With 8 million deaths worldwide annually, smoking remains one of the major causes of disability and premature death. However, nicotine also plays an important role in smoking cessation strategies. Objectives The aim of this study was to develop a comprehensive, whole-body, physiologically based pharmacokinetic/pharmacodynamic (PBPK/PD) model of nicotine and its major metabolite cotinine, covering various routes of nicotine administration, and to simulate nicotine brain tissue concentrations after the use of combustible cigarettes, e-cigarettes, nicotine gums, and nicotine patches. Methods A parent–metabolite, PBPK/PD model of nicotine for a non-smoking and a smoking population was developed using 91 plasma and brain tissue concentration–time profiles and 11 heart rate profiles. Among others, cytochrome P450 (CYP) 2A6 and 2B6 enzymes were implemented, including kinetics for CYP2A6 poor metabolizers. Results The model is able to precisely describe and predict both nicotine plasma and brain tissue concentrations, cotinine plasma concentrations, and heart rate profiles. 100% of the predicted area under the concentration–time curve (AUC) and maximum concentration (Cmax) values meet the twofold acceptance criterion with overall geometric mean fold errors of 1.12 and 1.15, respectively. The administration of combustible cigarettes, e-cigarettes, nicotine patches, and nicotine gums was successfully implemented in the model and used to identify differences in steady-state nicotine brain tissue concentration patterns. Conclusions Our PBPK/PD model may be helpful in further investigations of nicotine dependence and smoking cessation strategies. As the model represents the first nicotine PBPK/PD model predicting nicotine concentration and heart rate profiles after the use of e-cigarettes, it could also contribute to a better understanding of the recent increase in youth e-cigarette use. Electronic supplementary material The online version of this article (10.1007/s40262-020-00880-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lukas Kovar
- Clinical Pharmacy, Saarland University, Campus C2 2, 66123, Saarbrücken, Germany
| | - Dominik Selzer
- Clinical Pharmacy, Saarland University, Campus C2 2, 66123, Saarbrücken, Germany
| | - Hannah Britz
- Clinical Pharmacy, Saarland University, Campus C2 2, 66123, Saarbrücken, Germany
| | - Neal Benowitz
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Gideon St Helen
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Yvonne Kohl
- Fraunhofer Institute for Biomedical Engineering IBMT, Sulzbach, Germany
| | - Robert Bals
- Department of Internal Medicine V, Saarland University, Homburg, Germany
| | - Thorsten Lehr
- Clinical Pharmacy, Saarland University, Campus C2 2, 66123, Saarbrücken, Germany.
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Somayaji MR, Das D, Garimella HT, German CL, Przekwas AJ, Simon L. An Integrated Biophysical Model for Predicting the Clinical Pharmacokinetics of Transdermally Delivered Compounds. Eur J Pharm Sci 2021; 167:105924. [PMID: 34289340 DOI: 10.1016/j.ejps.2021.105924] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 06/01/2021] [Accepted: 06/30/2021] [Indexed: 11/19/2022]
Abstract
The delivery of therapeutic drugs through the skin is a promising alternative to oral or parenteral delivery routes because dermal drug delivery systems (D3S) offer unique advantages such as controlled drug release over sustained periods and a significant reduction in first-pass effects, thus reducing the required dosing frequency and level of patient noncompliance. Furthermore, D3S find applications in multiple therapeutic areas, including drug repurposing. This article presents an integrated biophysical model of dermal absorption for simulating the permeation and absorption of compounds delivered transdermally. The biophysical model is physiologically/biologically inspired and combines a holistic model of healthy skin with whole-body physiology-based pharmacokinetics through dermis microcirculation. The model also includes the effects of chemical penetration enhancers and hair follicles on transdermal transport. The model-predicted permeation and pharmacokinetics of select compounds were validated using in vivo data reported in the literature. We conjecture that the integrated model can be used to gather insights into the permeation and systemic absorption of transdermal formulations (including cosmetic products) released from novel depots and optimize delivery systems. Furthermore, the model can be adapted to diseased skin with parametrization and structural adjustments specific to skin diseases.
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Affiliation(s)
- Mahadevabharath R Somayaji
- Manager, Computational Medicine and Biology, CFD Research Corporation, Huntsville, AL 35806, United States.
| | - Debarun Das
- Manager, Computational Medicine and Biology, CFD Research Corporation, Huntsville, AL 35806, United States
| | - Harsha Teja Garimella
- Manager, Computational Medicine and Biology, CFD Research Corporation, Huntsville, AL 35806, United States
| | - Carrie L German
- Manager, Computational Medicine and Biology, CFD Research Corporation, Huntsville, AL 35806, United States
| | - Andrzej J Przekwas
- Manager, Computational Medicine and Biology, CFD Research Corporation, Huntsville, AL 35806, United States
| | - Laurent Simon
- Otto H. York Department of Chemical and Materials Engineering, New Jersey Institute of Technology, Newark, NJ 07102, United States
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Kitamura A, Takagaki T, Nemoto D, Tomita Y, Nishibe H, Kakuyama H. Pharmacokinetic Evaluation of Blonanserin Transdermal Patch: Population Analysis and Simulation of Plasma Concentration and Dopamine D 2 Receptor Occupancy in Clinical Settings. J Clin Pharmacol 2021; 61:1069-1080. [PMID: 33599975 DOI: 10.1002/jcph.1835] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 02/10/2021] [Indexed: 11/10/2022]
Abstract
Blonanserin is an atypical antipsychotic drug with high affinity and selective antagonism for dopamine D2 and D3 and serotonin 5-HT2A receptors. Blonanserin transdermal patch is the first transdermal formulation developed for the treatment of schizophrenia. The purpose of this population pharmacokinetic (PPK) analysis was to evaluate the characteristics of blonanserin pharmacokinetics after transdermal patch application, to estimate the daily fluctuation in blonanserin plasma concentration, and to evaluate the impact of patch application noncompliance to support usage in clinical settings. A total of 3747 plasma blonanserin concentrations from 9 clinical studies (93 healthy volunteers and 348 patients with schizophrenia) were used in the PPK analysis. The plasma concentration was predicted using the final PPK model, and dopamine D2 receptor occupancy was estimated on the basis of the results of a separately reported positron emission tomography study. A 2-compartment, parallel zero-order absorption with a lag time and first-order elimination model was developed to describe the pharmacokinetics of blonanserin, including the change in absorption rate during patch application. The maximum/minimum ratio of plasma concentration was estimated as 1.10 at steady state, indicating minimal fluctuation. In the case of failure to remove the previous patch or a missing application, the increase or decrease in plasma concentration and dopamine D2 receptor occupancy was <20%. These results indicated that the plasma blonanserin concentration and dopamine D2 receptor occupancy were stable after blonanserin transdermal patch application, which may lead to improved tolerability during the treatment of patients with schizophrenia.
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Affiliation(s)
- Atsushi Kitamura
- Clinical Research, Drug Development Division, Sumitomo Dainippon Pharma Co., Ltd., Konohana-ku, Osaka, Japan
| | - Takeshi Takagaki
- Clinical Research, Drug Development Division, Sumitomo Dainippon Pharma Co., Ltd., Konohana-ku, Osaka, Japan
| | - Daisuke Nemoto
- Clinical Research, Drug Development Division, Sumitomo Dainippon Pharma Co., Ltd., Konohana-ku, Osaka, Japan
| | - Yoshiko Tomita
- Clinical Research, Drug Development Division, Sumitomo Dainippon Pharma Co., Ltd., Konohana-ku, Osaka, Japan
| | - Hironori Nishibe
- Clinical Research, Drug Development Division, Sumitomo Dainippon Pharma Co., Ltd., Chuo-ku, Tokyo, Japan
| | - Hiroyoshi Kakuyama
- Clinical Research, Drug Development Division, Sumitomo Dainippon Pharma Co., Ltd., Chuo-ku, Tokyo, Japan
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Hahn B, Harvey AN, Concheiro-Guisan M, Huestis MA, Ross TJ, Stein EA. Nicotinic receptor modulation of the default mode network. Psychopharmacology (Berl) 2021; 238:589-597. [PMID: 33216167 DOI: 10.1007/s00213-020-05711-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 11/10/2020] [Indexed: 12/29/2022]
Abstract
RATIONALE Previous neuroimaging studies of cognition involving nicotinic acetylcholine receptor (nAChR) agonist administration have repeatedly found enhanced task-induced deactivation of regions of the default mode network (DMN), a group of brain systems that is more active at rest and mediates task-independent thought processes. This effect may be related to pro-cognitive nAChR agonist effects OBJECTIVES: The present study sought to test whether nAChR modulation of the DMN is bi-directional, i.e., whether a nAChR antagonist would reduce task-induced deactivation. METHODS Eighteen healthy non-smokers underwent functional magnetic resonance imaging while performing a letter N-back task. Scans were performed after nicotine administration (7 mg/24 h, transdermally), after administration of the nAChR antagonist mecamylamine (7.5 mg, p.o.), and after double placebo, in counterbalanced sequence. Blood-oxygen-level-dependent (BOLD) signal was analyzed within ventromedial prefrontal cortex (vmPFC) and posterior cingulate cortex (PCC) regions of interest-central hubs of the DMN in which consistent nAChR agonist-induced changes had previously been identified. RESULTS Nicotine enhanced hit rate in both the 0-back and 2-back condition, while mecamylamine slowed reaction time in the 2-back condition. Mecamylamine reduced task-induced deactivation of vmPFC and PCC. Nicotine had no significant effects on the BOLD signal. CONCLUSIONS The finding that nAChR tone reduction by mecamylamine weakened task-induced DMN deactivation indicates that a constant tone of nAChR activation helps regulate DMN activity in healthy individuals. This suggests that low nAChR tone may play a causal role in DMN dysregulation seen in conditions such as mild cognitive impairment or Alzheimer's disease.
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Affiliation(s)
- Britta Hahn
- University of Maryland School of Medicine, Maryland Psychiatric Research Center, P.O. Box 21247, Baltimore, MD, 21228, USA.
| | - Alexander N Harvey
- University of Maryland School of Medicine, Maryland Psychiatric Research Center, P.O. Box 21247, Baltimore, MD, 21228, USA
| | - Marta Concheiro-Guisan
- Neuroimaging Research Branch, National Institute on Drug Abuse Intramural Research Program, 251 Bayview Blvd, Suite 200, Baltimore, MD, 21224, USA
| | - Marilyn A Huestis
- Neuroimaging Research Branch, National Institute on Drug Abuse Intramural Research Program, 251 Bayview Blvd, Suite 200, Baltimore, MD, 21224, USA
| | - Thomas J Ross
- Neuroimaging Research Branch, National Institute on Drug Abuse Intramural Research Program, 251 Bayview Blvd, Suite 200, Baltimore, MD, 21224, USA
| | - Elliot A Stein
- Neuroimaging Research Branch, National Institute on Drug Abuse Intramural Research Program, 251 Bayview Blvd, Suite 200, Baltimore, MD, 21224, USA
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Olsson Gisleskog PO, Perez Ruixo JJ, Westin Å, Hansson AC, Soons PA. Nicotine Population Pharmacokinetics in Healthy Smokers After Intravenous, Oral, Buccal and Transdermal Administration. Clin Pharmacokinet 2020; 60:541-561. [PMID: 33354734 PMCID: PMC8016787 DOI: 10.1007/s40262-020-00960-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2020] [Indexed: 11/24/2022]
Abstract
Background In 4 decades, numerous nicotine replacement therapy products have been developed. Population pharmacokinetic models can support exposure–response modeling and inform nicotine replacement therapy product development, but only limited model-based cross-study population pharmacokinetic analyses for nicotine replacement therapy products have been published. Objectives The aim of this retrospective analysis was to assess the population pharmacokinetics of nicotine across intravenous, oral, transdermal and oromucosal (mouth spray, chewing gum, lozenge and inhaler) routes and formulations in healthy smoking subjects. Methods Data on 930 unique subjects (46,016 observations) from 29 single- and repeated-dose studies with multiple formulations across intravenous, oral, transdermal and oromucosal routes of administration were included. Data from intravenous and extravascular routes of administration were modelled separately for run efficiency reasons. For developing extravascular models, clearance and disposition parameters and their inter-individual variabilities were fixed to the estimates for intravenously delivered nicotine. Detectable pre-dose nicotine concentrations were modelled as a hypothetical nicotine bolus into the central compartment at the start of wash-out. Modelling repeated-dose oral and buccal administrations required a time-dependent increase in clearance or decrease in bioavailability to describe the data adequately. Results Disposition of intravenous nicotine was best described by a three-compartment model with initial and terminal half-lives of 7 min and 4.5 h, respectively, and the absorption of single oral doses was best described with a first-order absorption rate constant of 1.55 h−1. The data of buccal formulations were modelled with parallel oromucosal absorption and gastrointestinal absorption of a part of the dose that is swallowed. For transdermal nicotine, parallel zero- and first-order release from the patch and a transit-compartment absorption model best described the data. Key pharmacokinetic parameters were reliably estimated, with typical values for clearance (67 L/h for a 70-kg subject), volume of distribution (4.3 L/kg), oral bioavailability (40%) and transdermal bioavailability (76%) within expected ranges. The estimated fraction of the dose swallowed for buccal formulations ranged from 55% (gum) to 69% (lozenge). Conclusions Robust population pharmacokinetic models were developed for five nicotine replacement therapy product types and for intravenous and oral nicotine. These population pharmacokinetic models are used in exposure–response analyses and simulation-based nicotine replacement therapy product design. Electronic supplementary material The online version of this article (10.1007/s40262-020-00960-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | - Åke Westin
- McNeil AB, Global Medical Affairs and Clinical Research, Helsingborg, Sweden
| | | | - Paul A Soons
- Janssen Pharmaceutica NV, Alliance Management, Turnhoutseweg 30, 2340, Beerse, Belgium.
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Kawasaki Y, Li YS, Ootsuyama Y, Nagata K, Yamato H, Kawai K. Effects of smoking cessation on biological monitoring markers in urine. Genes Environ 2020; 42:26. [PMID: 32944094 PMCID: PMC7488543 DOI: 10.1186/s41021-020-00165-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/01/2020] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Urinary nicotine and cotinine levels are often measured as biomarkers for tobacco smoke exposure. However, these biomarkers are not appropriate to evaluate the effects of quitting smoking for several days, because of their short half-lives. In this study, we focused on the changes in the urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) levels of 55 patients in a smoking cessation program, because of the long half-life. At the same time, urinary 7-methylguanine (m7Gua) and 8-hydroxy-2'-deoxyguanosine (8-OHdG), as DNA damage markers of cigarette smoking, were also measured. RESULTS In the subjects who completed the quit-smoking program (18 subjects out of 55), the urinary nicotine and cotinine levels decreased to 1.7 and 0.2% at 8 weeks after the first visit to the clinic. By contrast, the NNAL levels decreased to 12.3% at 8 weeks after quitting smoking. During the same period, the urinary m7Gua levels significantly decreased, from 27.32 μg/mg creatinine to 14.17 μg/mg creatinine by the elimination of subjects who showed increased levels of NNAL during the smoking cessation program. The 8-OHdG levels were also reduced within the same period, but were not significantly different. From the all data analysis, the urinary levels of cotinine and NNAL positively correlated with the level of m7Gua. CONCLUSIONS NNAL may be an appropriate exposure marker for evaluating the smoking status of patients in a smoking cessation program. The urinary cotinine and NNAL levels positively correlated with the m7Gua levels.
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Affiliation(s)
- Yuya Kawasaki
- Department of Environmental Oncology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555 Japan
| | - Yun-Shan Li
- Department of Environmental Oncology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555 Japan
| | - Yuko Ootsuyama
- Department of Environmental Oncology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555 Japan
| | - Kazuhiko Nagata
- Nagata Medical Clinic, 4-3-1 Takasu Higashi, Wakamatsu-ku, Kitakyushu, Fukuoka, 808-0144 Japan
| | - Hiroshi Yamato
- Department of Health Development, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555 Japan
| | - Kazuaki Kawai
- Department of Environmental Oncology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555 Japan
- Center for Stress-related Disease Control and Prevention, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555 Japan
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Hahn B, Olmstead CK, Yuille MB, Chiappelli JJ, Wells AK. Attention-enhancing effects of propranolol and synergistic effects with nicotine. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2020; 20:658-668. [PMID: 32405757 PMCID: PMC7272290 DOI: 10.3758/s13415-020-00794-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Nicotine increases the output of every major neurotransmitter. In previous studies designed to identify the secondary neurotransmitter systems mediating nicotine's attention-enhancing effects in a rat model, the β-adrenoceptor antagonist propranolol blocked these effects. The present study was designed to test whether this mechanism held true in humans, thus guiding development of novel nicotinic agonists for cognitive enhancement. Twenty-six nonsmokers completed a nicotine (7 mg/24 h transdermally) x propranolol (40 mg p.o., body weight-adjusted) interaction study. Over four test days, each participant received double-placebo, nicotine only, propranolol only, and nicotine plus propranolol in randomized sequence before cognitive testing. No drug effects were seen in a visuospatial attention task. In the Rapid Visual Information Processing Task, performed in two 15-min blocks, neither drug alone significantly affected hit rate, but both drugs combined acted synergistically to alleviate its decrement over time in the first block and displayed additive beneficial effects in the second. In a change detection task, propranolol enhanced accuracy and reduced reaction time independent of nicotine presence. Propranolol also enhanced subjective self-reports of vigor. Overall, the findings were contrary to those hypothesized. Propranolol displayed beneficial effects on cognition, especially on sustaining performance over time. β-adrenoceptor activation by nicotine-induced noradrenaline release appeared to limit performance-enhancing effects of nicotine, because they were unmasked by β-adrenoceptor antagonism. The results suggest that cognitive effects of changes in β-adrenoceptor tone are context-dependent; contrary to rodent paradigms, human cognitive paradigms require no physical orienting in space but prolonged periods of remaining stationary while sustaining predictable processing demands.
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Affiliation(s)
- Britta Hahn
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, P.O. Box 21247, Baltimore, MD, 21228, USA.
| | - Cory K Olmstead
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, P.O. Box 21247, Baltimore, MD, 21228, USA
| | - Marie B Yuille
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, P.O. Box 21247, Baltimore, MD, 21228, USA
| | - Joshua J Chiappelli
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, P.O. Box 21247, Baltimore, MD, 21228, USA
| | - Ashleigh K Wells
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, P.O. Box 21247, Baltimore, MD, 21228, USA
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12
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Nicotine patch for cannabis withdrawal symptom relief: a randomized controlled trial. Psychopharmacology (Berl) 2020; 237:1507-1519. [PMID: 32034447 DOI: 10.1007/s00213-020-05476-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 01/30/2020] [Indexed: 10/24/2022]
Abstract
RATIONALE Given that tetrahydrocannabinol (THC) and nicotine have similar effects on negative affect (NA), we hypothesized that a 7-mg nicotine patch (NP) would reduce NA-related cannabis (CAN) withdrawal symptoms in cannabis-dependent (CD) individuals who were not nicotine dependent. OBJECTIVE We sought to determine whether NP reduces NA across 15 days of CAN abstinence in two groups: non-tobacco smokers (NTS) and light tobacco smokers (LTS). METHODS CD participants (N = 127; aged 18-35) who used CAN at least 5 times/week for the past 12 + months were randomized to (1) NP or (2) a placebo patch (PP) and received $300 for sustained biochemically verified CAN abstinence. Of those randomly assigned, 52 of 63 NP, and 56 of 64 PP maintained biochemically verified CAN abstinence and 51 NP and 50 PP participants complied with all aspects of the study. Affect and other withdrawal symptoms were measured every 48 h across 15 days of CAN abstinence. RESULTS After controlling for age, tobacco use, baseline THC concentration, and baseline measurements of the dependent variable, NP reduced NA symptoms across the 15-day treatment relative to PP. Differences in NA and CAN withdrawal symptoms were not moderated by tobacco user status. CONCLUSIONS The findings provide the first evidence that NP may be able to attenuate NA-related withdrawal symptoms in individuals with cannabis use disorder who are not heavy users of tobacco or nicotine. CLINICAL TRIALS REGISTRY NCT01400243 http://www.clinicaltrials.gov.
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Malovichko MV, Zeller I, Krivokhizhina TV, Xie Z, Lorkiewicz P, Agarwal A, Wickramasinghe N, Sithu SD, Shah J, O'Toole T, Rai SN, Bhatnagar A, Conklin DJ, Srivastava S. Systemic Toxicity of Smokeless Tobacco Products in Mice. Nicotine Tob Res 2020; 21:101-110. [PMID: 30085294 DOI: 10.1093/ntr/ntx230] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 10/02/2017] [Indexed: 02/05/2023]
Abstract
Introduction Smokeless tobacco products such as snuff and snus are used worldwide. However, little is known about the systemic and cardiovascular toxicity of smokeless tobacco exposure. Methods Biomarkers of endothelial activation and injury, immune functions, platelet activation and insulin resistance were measured in 8-week old male C57BL/6 mice exposed to commercial snuff, CRP-2 reference snuff, commercial snus, CRP-1 reference snus, and nicotine in drinking water (100 µg/mL) for 4, 12, and 24 weeks. Results Twenty-four weeks of exposure to smokeless tobacco products or nicotine significantly decreased the levels of circulating Flk+/Sca+ endothelial progenitor cells. Twelve and 24 weeks of exposure to all the smokeless tobacco products and nicotine significantly decreased the levels of circulating CD19+ B cells, CD4+ T cells, CD8+ T cells, and CD11b+ monocytes, whereas 4 weeks of exposure to Camel snus and Copenhagen snuff significantly depleted the levels of peripheral blood CD19+ B cells and CD11b+ monocytes. Twenty-four weeks of exposure to smokeless tobacco products or nicotine significantly decreased plasma IFNγ levels. However, plasma TNFα levels were significantly increased in mice exposed to Copenhagen snuff or nicotine for 24 weeks. This was accompanied by a five to sevenfold increase in the hepatic expression of TNFα. Neither smokeless products nor nicotine affected plasma lipoproteins, platelet activation, or systemic insulin sensitivity. Conclusions Chronic exposure to snuff and snus suppresses circulating levels of EPCs, endothelial microparticles and immune cells, but increases plasma TNF-α levels. These effects of smokeless tobacco products are attributable, at least in part, to nicotine. Implications Exposure to smokeless tobacco products results in the depletion of endothelial progenitor cells, which may impair the endothelium repair. Suppression of the circulating levels of immune cells upon exposure to smokeless tobacco products may increase the susceptibility to secondary infection. Increased formation of proinflammatory cytokines such as TNFα by nicotine or Copenhagen snuff may lead to vascular inflammation and thereby exacerbate atherogenesis.
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Affiliation(s)
- Marina V Malovichko
- American Heart Association-Tobacco Regulation and Addiction Center, Institute of Molecular Cardiology, and Diabetes and Obesity Center, University of Louisville, Louisville, KY
| | - Iris Zeller
- American Heart Association-Tobacco Regulation and Addiction Center, Institute of Molecular Cardiology, and Diabetes and Obesity Center, University of Louisville, Louisville, KY
| | - Tatiana V Krivokhizhina
- American Heart Association-Tobacco Regulation and Addiction Center, Institute of Molecular Cardiology, and Diabetes and Obesity Center, University of Louisville, Louisville, KY
| | - Zhengzhi Xie
- American Heart Association-Tobacco Regulation and Addiction Center, Institute of Molecular Cardiology, and Diabetes and Obesity Center, University of Louisville, Louisville, KY
| | - Pawel Lorkiewicz
- American Heart Association-Tobacco Regulation and Addiction Center, Institute of Molecular Cardiology, and Diabetes and Obesity Center, University of Louisville, Louisville, KY
| | - Abhinav Agarwal
- American Heart Association-Tobacco Regulation and Addiction Center, Institute of Molecular Cardiology, and Diabetes and Obesity Center, University of Louisville, Louisville, KY
| | - Nalinie Wickramasinghe
- American Heart Association-Tobacco Regulation and Addiction Center, Institute of Molecular Cardiology, and Diabetes and Obesity Center, University of Louisville, Louisville, KY
| | - Srinivas D Sithu
- American Heart Association-Tobacco Regulation and Addiction Center, Institute of Molecular Cardiology, and Diabetes and Obesity Center, University of Louisville, Louisville, KY
| | - Jasmit Shah
- American Heart Association-Tobacco Regulation and Addiction Center, Institute of Molecular Cardiology, and Diabetes and Obesity Center, University of Louisville, Louisville, KY
| | - Timothy O'Toole
- American Heart Association-Tobacco Regulation and Addiction Center, Institute of Molecular Cardiology, and Diabetes and Obesity Center, University of Louisville, Louisville, KY
| | - Shesh N Rai
- American Heart Association-Tobacco Regulation and Addiction Center, Institute of Molecular Cardiology, and Diabetes and Obesity Center, University of Louisville, Louisville, KY
| | - Aruni Bhatnagar
- American Heart Association-Tobacco Regulation and Addiction Center, Institute of Molecular Cardiology, and Diabetes and Obesity Center, University of Louisville, Louisville, KY
| | - Daniel J Conklin
- American Heart Association-Tobacco Regulation and Addiction Center, Institute of Molecular Cardiology, and Diabetes and Obesity Center, University of Louisville, Louisville, KY
| | - Sanjay Srivastava
- American Heart Association-Tobacco Regulation and Addiction Center, Institute of Molecular Cardiology, and Diabetes and Obesity Center, University of Louisville, Louisville, KY
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14
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Evidence for positive allosteric modulation of cognitive-enhancing effects of nicotine in healthy human subjects. Psychopharmacology (Berl) 2020; 237:219-230. [PMID: 31686175 PMCID: PMC6952331 DOI: 10.1007/s00213-019-05363-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 09/11/2019] [Indexed: 11/16/2022]
Abstract
RATIONALE Cognitive benefits of nicotinic acetylcholine receptor (nAChR) agonists are well established but have generally been of small magnitude and uncertain clinical significance. A way of raising the effect size may be to facilitate agonist-induced responses by co-administering a nAChR positive allosteric modulator (PAM). OBJECTIVE The aim was to test whether galantamine, a PAM at several nAChR subtypes, can potentiate the cognitive-enhancing effects of nicotine. METHODS Twenty-six adult never-smokers were treated, in a double-blind counterbalanced sequence, with nicotine (7 mg/24 h, transdermally) and galantamine (4 mg, p.o.) combined, nicotine alone, galantamine alone, and double placebo. A low dose of galantamine was chosen to minimize acetylcholinesterase inhibition, which was verified in blood assays. In each condition, participants were tested with three cognitive tasks. RESULTS Nicotine significantly improved reaction time (RT) and signal detection in a visuospatial attention task and the Rapid Visual Information Processing Task. Galantamine did not modulate these effects. A trend toward RT reduction by galantamine correlated with acetylcholinesterase inhibition. In a change detection task, there were no effects of nicotine or galantamine alone on accuracy or RT. However, both drugs combined acted synergistically to reduce RT. This effect was not associated with acetylcholinesterase inhibition. CONCLUSIONS A pattern consistent with allosteric potentiation of nicotine effects by galantamine was observed on one of six performance measures. This may reflect specific nAChR subtype involvement, or additional pharmacological actions of galantamine may have overshadowed similar interactions on other measures. The finding suggests that allosteric potentiation of nAChR agonist-induced cognitive benefits is possible in principle.
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Marchand M, Brossard P, Merdjan H, Lama N, Weitkunat R, Lüdicke F. Nicotine Population Pharmacokinetics in Healthy Adult Smokers: A Retrospective Analysis. Eur J Drug Metab Pharmacokinet 2018; 42:943-954. [PMID: 28283988 PMCID: PMC5681983 DOI: 10.1007/s13318-017-0405-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background and Objective Characterizing nicotine pharmacokinetics is challenging in the presence of background exposure. We performed a combined retrospective population pharmacokinetic analysis of 8 trials, including exposure to Tobacco Heating System and cigarettes (both inhaled), nicotine nasal spray and oral nicotine gum. Method Data from 4 single product use trials were used to develop a population pharmacokinetic model with Phoenix® NLME™ and to derive exposure parameters. Data from 4 separate ad libitum use studies were used for external validation. A total of 702 healthy adult smokers (54% males; 21–66 years of age; smoking ≥10 cigarettes/day; from US, Europe and Japan) were eligible for participation. Results Two-compartment linear disposition combined with zero-order absorption model was adequate to describe nicotine pharmacokinetics, and a mono-exponentially decreasing background component was utilized to account for nicotine carry-over effects. Apparent nicotine clearance was typically 0.407 L/min in males and 26% higher in females (68% inter-individual variability). Bioavailability was product-specific, decreased with increasing nicotine ISO yield, and increased with increasing body weight. Absorption duration was apparently prolonged with nicotine gum. The typical initial and terminal half-lives were 1.35 and 17 h, respectively. The presence of menthol did not impact the determinants of the area under the curve. The model adequately described the external validation data. Conclusions The population model was able to describe in different populations the nicotine pharmacokinetics after single product use and after 4 days of ad libitum use of Tobacco Heating System, cigarettes, and of different nicotine replacement therapies with various routes of administration. Electronic supplementary material The online version of this article (doi:10.1007/s13318-017-0405-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Patrick Brossard
- PMI R&D (Part of Philip Morris International Group of Companies), Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | | | - Nicola Lama
- PMI R&D (Part of Philip Morris International Group of Companies), Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
| | - Rolf Weitkunat
- PMI R&D (Part of Philip Morris International Group of Companies), Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland.
| | - Frank Lüdicke
- PMI R&D (Part of Philip Morris International Group of Companies), Philip Morris Products S.A., Quai Jeanrenaud 5, 2000, Neuchâtel, Switzerland
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16
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Shin SH, Thomas S, Raney SG, Ghosh P, Hammell DC, El-Kamary SS, Chen WH, Billington MM, Hassan HE, Stinchcomb AL. In vitro-in vivo correlations for nicotine transdermal delivery systems evaluated by both in vitro skin permeation (IVPT) and in vivo serum pharmacokinetics under the influence of transient heat application. J Control Release 2017; 270:76-88. [PMID: 29175139 DOI: 10.1016/j.jconrel.2017.11.034] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/18/2017] [Accepted: 11/20/2017] [Indexed: 10/18/2022]
Abstract
The in vitro permeation test (IVPT) has been widely used to characterize the bioavailability (BA) of compounds applied on the skin. In this study, we performed IVPT studies using excised human skin (in vitro) and harmonized in vivo human serum pharmacokinetic (PK) studies to evaluate the potential in vitro-in vivo correlation (IVIVC) of nicotine BA from two, matrix-type, nicotine transdermal delivery systems (TDS). The study designs used for both in vitro and in vivo studies included 1h of transient heat (42±2°C) application during early or late time periods post-dosing. The goal was to evaluate whether any IVIVC observed would be evident even under conditions of heat exposure, in order to investigate further whether IVPT may have the potential to serve as a possible surrogate method to evaluate the in vivo effects of heat on the bioavailability of a drug delivered from a TDS. The study results have demonstrated that the BA of nicotine characterized by the IVPT studies correlated with and was predictive of the in vivo BA of nicotine from the respective TDS, evaluated under the matched study designs and conditions. The comparisons of single parameters such as steady-state concentration, heat-induced increase in partial AUCs and post-treatment residual content of nicotine in TDS from the in vitro and in vivo data sets showed no significant differences (p≥0.05). In addition, a good point-to-point IVIVC (Level A correlation) for the entire study duration was achieved by predicting in vivo concentrations of nicotine using two approaches: Approach I requiring only an in vitro data set and Approach II involving deconvolution and convolution steps. The results of our work suggest that a well designed IVPT study with adequate controls can be a useful tool to evaluate the relative effects of heat on the BA of nicotine from TDS with different formulations.
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Affiliation(s)
- Soo Hyeon Shin
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, MD 21201, United States
| | - Sherin Thomas
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, MD 21201, United States
| | - Sam G Raney
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, United States Food and Drug Administration, Silver Spring, MD 20993, United States
| | - Priyanka Ghosh
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, United States Food and Drug Administration, Silver Spring, MD 20993, United States
| | - Dana C Hammell
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, MD 21201, United States
| | - Samer S El-Kamary
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, United States
| | - Wilbur H Chen
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD 21201, United States
| | - M Melissa Billington
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD 21201, United States
| | - Hazem E Hassan
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, MD 21201, United States; Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Helwan University, Cairo, Egypt.
| | - Audra L Stinchcomb
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, MD 21201, United States.
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17
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Linakis MW, Rower JE, Roberts JK, Miller EI, Wilkins DG, Sherwin CMT. Population pharmacokinetic model of transdermal nicotine delivered from a matrix-type patch. Br J Clin Pharmacol 2017; 83:2709-2717. [PMID: 28771779 DOI: 10.1111/bcp.13393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 07/18/2017] [Accepted: 07/24/2017] [Indexed: 12/30/2022] Open
Abstract
AIMS Nicotine addiction is an issue faced by millions of individuals worldwide. As a result, nicotine replacement therapies, such as transdermal nicotine patches, have become widely distributed and used. While the pharmacokinetics of transdermal nicotine have been extensively described using noncompartmental methods, there are few data available describing the between-subject variability in transdermal nicotine pharmacokinetics. The aim of this investigation was to use population pharmacokinetic techniques to describe this variability, particularly as it pertains to the absorption of nicotine from the transdermal patch. METHODS A population pharmacokinetic parent-metabolite model was developed using plasma concentrations from 25 participants treated with transdermal nicotine. Covariates tested in this model included: body weight, body mass index, body surface area (calculated using the Mosteller equation) and sex. RESULTS Nicotine pharmacokinetics were best described with a one-compartment model with absorption based on a Weibull distribution and first-order elimination and a single compartment for the major metabolite, cotinine. Body weight was a significant covariate on apparent volume of distribution of nicotine (exponential scaling factor 1.42). After the inclusion of body weight in the model, no other covariates were significant. CONCLUSIONS This is the first population pharmacokinetic model to describe the absorption and disposition of transdermal nicotine and its metabolism to cotinine and the pharmacokinetic variability between individuals who were administered the patch.
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Affiliation(s)
- Matthew W Linakis
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA.,Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah College of Pharmacy, Salt Lake City, Utah, USA
| | - Joseph E Rower
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Jessica K Roberts
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Eleanor I Miller
- Department of Pharmacology and Toxicology, Center for Human Toxicology, University of Utah, Salt Lake City, Utah, USA
| | - Diana G Wilkins
- Department of Pharmacology and Toxicology, Center for Human Toxicology, University of Utah, Salt Lake City, Utah, USA.,Division of Medical Laboratory Sciences, Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Catherine M T Sherwin
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA.,Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah College of Pharmacy, Salt Lake City, Utah, USA
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18
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Ruela ALM, Perissinato AG, Lino MEDS, Mudrik PS, Pereira GR. Evaluation of skin absorption of drugs from topical and transdermal formulations. BRAZ J PHARM SCI 2016. [DOI: 10.1590/s1984-82502016000300018] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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19
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Abdallah IA, Hammell DC, Stinchcomb AL, Hassan HE. A fully validated LC–MS/MS method for simultaneous determination of nicotine and its metabolite cotinine in human serum and its application to a pharmacokinetic study after using nicotine transdermal delivery systems with standard heat application in adult smokers. J Chromatogr B Analyt Technol Biomed Life Sci 2016; 1020:67-77. [DOI: 10.1016/j.jchromb.2016.03.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 03/15/2016] [Accepted: 03/17/2016] [Indexed: 10/22/2022]
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20
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Lee SH, Kim SH, Noh YH, Choi BM, Noh GJ, Park WD, Kim EJ, Cho IH, Bae CS. Pharmacokinetics of Memantine after a Single and Multiple Dose of Oral and Patch Administration in Rats. Basic Clin Pharmacol Toxicol 2015; 118:122-7. [PMID: 26310825 DOI: 10.1111/bcpt.12479] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 08/13/2015] [Indexed: 11/29/2022]
Abstract
Memantine is a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist used to treat Alzheimer's disease. We investigated memantine pharmacokinetics after oral, IV and patch administration in rats, and compared memantine pharmacokinetics after multiple- or single-dose oral and transdermal administration. Venous blood was collected at preset intervals in single- and multiple-dose studies. Non-compartmental pharmacokinetics was analysed for all formulations. The oral, IV and patch memantine doses were 10 mg/kg, 2 mg/kg and 8.21 ± 0.89 mg/kg, respectively. The maximum plasma concentration was lower and the half-life longer after patch administration than oral and IV administration. Memantine bioavailability was 41 and 63% for oral and patch administration, respectively. Steady state was achieved around 24 hr for oral and patch administration. The mean AUC increased after oral or patch administration from single to multiple dose. The memantine patch formulation displayed a longer duration of action and lower peak plasma concentration. However, drug exposure was similar to the oral formulation at each dose. Additionally, the memantine patch formulation displayed a smaller interindividual variability and lower accumulation than the oral formulation.
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Affiliation(s)
- Soo-Han Lee
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - Seung-Hyun Kim
- Department of Veterinary Surgery, College of Veterinary Medicine, Chonnam National University, Gwangju, Korea
| | - Yook-Hwan Noh
- Department of Bioengineering and Therapeutic Sciences, School of Pharmacy, University of California San Francisco, San Francisco, CA, USA
| | - Byung-Moon Choi
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gyu-Jeong Noh
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Clinical Pharmacology and Therapeutics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo-Dae Park
- Department of Veterinary Nurse and Pet Science, Seojeong College, Yangju, Korea
| | - Eun-Jung Kim
- Pharmaceutical Research Center, Handok Incorporation, Seoul, Korea
| | - Ik-Hyun Cho
- Department of Convergence Medical Science, Kyunghee University, Seoul, Korea
| | - Chun-Sik Bae
- Department of Veterinary Surgery, College of Veterinary Medicine, Chonnam National University, Gwangju, Korea
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Gajewska M, Worth A, Urani C, Briesen H, Schramm KW. The acute effects of daily nicotine intake on heart rate--a toxicokinetic and toxicodynamic modelling study. Regul Toxicol Pharmacol 2014; 70:312-24. [PMID: 25066669 DOI: 10.1016/j.yrtph.2014.07.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 07/16/2014] [Accepted: 07/17/2014] [Indexed: 11/29/2022]
Abstract
Joint physiologically-based toxicokinetic and toxicodynamic (PBTK/TD) modelling was applied to simulate concentration-time profiles of nicotine, a well-known stimulant, in the human body following single and repeated dosing. Both kinetic and dynamic models were first calibrated by using in vivo literature data for the Caucasian population. The models were then used to estimate the blood and liver concentrations of nicotine in terms of the Area Under Curve (AUC) and the peak concentration (Cmax) for selected exposure scenarios based on inhalation (cigarette smoking), oral intake (nicotine lozenges) and dermal absorption (nicotine patches). The model simulations indicated that whereas frequent cigarette smoking gives rise to high AUC and Cmax in blood, the use of nicotine-rich dermal patches leads to high AUC and Cmax in the liver. Venous blood concentrations were used to estimate one of the most common acute effects, mean heart rate, both at rest and during exercise. These estimations showed that cigarette smoking causes a high peak heart rate, whereas dermal absorption causes a high mean heart rate over 48h. This study illustrates the potential of using PBTK/TD modelling in the safety assessment of nicotine-containing products.
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Affiliation(s)
- M Gajewska
- Systems Toxicology Unit and EURL ECVAM, Institute for Health and Consumer Protection, European Commission, Joint Research Centre, 21027 Ispra, VA, Italy; University of Milano Bicocca, Dep. of Earth and Environmental Sciences, Piazza della Scienza 1, Milano, Italy; TUM, Wissenschaftszentrum Weihenstephan für Ernährung und Landnutzung, Department für Biowissenschaften, Weihenstephaner Steig 23, 85350 Freising, Germany.
| | - A Worth
- Systems Toxicology Unit and EURL ECVAM, Institute for Health and Consumer Protection, European Commission, Joint Research Centre, 21027 Ispra, VA, Italy
| | - C Urani
- University of Milano Bicocca, Dep. of Earth and Environmental Sciences, Piazza della Scienza 1, Milano, Italy
| | - H Briesen
- TUM, Wissenschaftszentrum Weihenstephan für Ernährung und Landnutzung, Lehrstuhl für Systemverfahrenstechnik, Weihenstephaner Steig 23, 85350 Freising, Germany
| | - K-W Schramm
- TUM, Wissenschaftszentrum Weihenstephan für Ernährung und Landnutzung, Department für Biowissenschaften, Weihenstephaner Steig 23, 85350 Freising, Germany; Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Molecular EXposomics (MEX), Ingolstädter Landstr.1, D-85764 Neuherberg, Germany
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22
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Concentration dependency in nicotine skin penetration flux from aqueous solutions reflects vehicle induced changes in nicotine stratum corneum retention. Pharm Res 2014; 31:1501-11. [PMID: 24452807 DOI: 10.1007/s11095-013-1256-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 12/05/2013] [Indexed: 10/25/2022]
Abstract
PURPOSE This study sought to understand the mechanism by which the steady state flux of nicotine across the human skin from aqueous solutions is markedly decreased at higher nicotine concentrations. METHODS Nicotine's steady state flux through human epidermis and its amount in the stratum corneum for a range of aqueous nicotine solutions was determined using Franz diffusion cells, with the nicotine analysed by high performance liquid chromatography (HPLC). Nicotine's thermodynamic activity in the various solutions was estimated from its partial vapour pressure and stratum corneum hydration was determined using a corneometer. The amount of nicotine retained in the stratum corneum was estimated from the nicotine amount found in individual stratum corneum tape strips and a D-Squame determined weight for each strip. RESULTS The observed steady state flux of nicotine across human epidermis was found to show a parabolic dependence on nicotine concentration, with the flux proportional to its thermodynamic activity up to a concentration of 48% w/w. The nicotine retention in the stratum corneum showed a similar dependency on concentration whereas the diffusivity of nicotine in the stratum corneum appeared to be concentration independent. This retention, in turn, could be estimated from the extent of stratum corneum hydration and the nicotine concentration in the applied solution and volume of water in the skin. CONCLUSIONS Nonlinear dependency of nicotine skin flux on its concentration results from a dehydration induced decrease in its stratum corneum retention at higher concentration and not dehydration induced changes nicotine diffusivity in the stratum corneum.
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Miura N, Yuki D, Minami N, Kakehi A, Onozawa M. Pharmacokinetic analysis of nicotine when using non-combustion inhaler type of tobacco product in Japanese adult male smokers. Regul Toxicol Pharmacol 2013; 67:198-205. [DOI: 10.1016/j.yrtph.2013.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 07/12/2013] [Accepted: 07/15/2013] [Indexed: 10/26/2022]
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Udo T, Harrison ELR, Shi J, Tetrault J, McKee SA. A preliminary study on the effect of combined nicotine replacement therapy on alcohol responses and alcohol self-administration. Am J Addict 2013; 22:590-7. [PMID: 24131167 DOI: 10.1111/j.1521-0391.2013.12014.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 08/01/2012] [Accepted: 10/23/2012] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Limiting alcohol consumption may help prevent alcohol-mediated smoking relapse in heavy drinking smokers. This pilot study examined whether combining a nicotine patch with nicotine nasal spray has stronger attenuating effects on alcohol response and consumption than a nicotine patch alone. METHODS Twenty-two non-alcohol dependent heavy drinking smokers completed the double-blind cross-over, placebo-controlled study (21 mg nicotine patch + nicotine or placebo nasal spray). Six hours after 21 mg nicotine patch application, subjective and physiological responses to a priming drink (0.3 g/kg) were assessed, followed by two 1-hr alcohol self-administration periods, with possible consumption of up to 4 drinks per period (each 0.15 g/kg). Nasal spray (1 mg [active] or 0 mg [placebo] per dose) was administered 10 min prior to the priming dose and each self-administration period. RESULTS Active nasal spray did not increase serum nicotine levels, compared with placebo administration. The number of drinks consumed did not differ by the nasal spray conditions. However, positive subjective responses to the priming drink were lower in the active nasal spray condition than the placebo nasal spray condition. During the self-administration period, urge to drink was also lower in the active spray condition than the placebo condition. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE Augmenting the nicotine patch with nicotine nasal spray attenuated positive subjective alcohol response and craving and suggests that future studies should investigate whether these findings translate to a clinical setting.
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Affiliation(s)
- Tomoko Udo
- Yale University School of Medicine, New Haven, Connecticut
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Hahn B, Harvey AN, Concheiro-Guisan M, Huestis MA, Holcomb HH, Gold JM. A test of the cognitive self-medication hypothesis of tobacco smoking in schizophrenia. Biol Psychiatry 2013; 74:436-43. [PMID: 23660272 PMCID: PMC3755590 DOI: 10.1016/j.biopsych.2013.03.017] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Revised: 02/22/2013] [Accepted: 03/15/2013] [Indexed: 12/15/2022]
Abstract
BACKGROUND Heavier tobacco smoking among people with schizophrenia (SCZ) has been suggested to reflect self-medication of cognitive deficits. The idea that cognitive-enhancing effects of nicotine are a primary motivator of tobacco consumption in SCZ and that abstinence would deprive SCZ of such beneficial effects might explain hesitation among providers to pursue smoking cessation in SCZ. This study tested predictions of the cognitive self-medication hypothesis. METHODS In three counterbalanced sessions, 17 SCZ and 17 healthy control subjects (HCS), all smokers, were tested under ad libitum smoking or 3.5 hours after abstaining and receiving a nicotine (14 mg/24 hours) or placebo patch. RESULTS Attention task performance was improved by transdermal nicotine relative to placebo, with intermediate performance by ad libitum smoking. These effects were of similar size in SCZ and HCS and did not reflect remediation of functions disproportionately impaired in SCZ. Although more SCZ reported that the need to concentrate influenced their smoking, this was not reflected by the actual behavior of these patients. Self-reported ability to concentrate changed with nicotine status in HCS but not SCZ, suggesting insensitivity of SCZ to nicotine-derived performance benefits. Nicotine plasma concentrations after ad libitum smoking were not associated with performance benefits but instead with the propensity to experience nicotine withdrawal upon abstinence. This association was seen selectively in SCZ, suggesting a possible reason for heavier smoking. CONCLUSIONS These findings suggest that subjective or objective attentional benefits are unlikely the primary driving force of tobacco consumption in SCZ and should not discourage providers from supporting quit attempts.
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Affiliation(s)
- Britta Hahn
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD 21228, USA.
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Czarnetzki C, Schiffer E, Lysakowski C, Haller G, Bertrand D, Tramèr MR. Transcutaneous nicotine does not prevent postoperative nausea and vomiting: a randomized controlled trial. Br J Clin Pharmacol 2011; 71:383-90. [PMID: 21284697 DOI: 10.1111/j.1365-2125.2010.03844.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
AIMS There is empirical evidence that smokers are less likely to suffer from postoperative nausea and vomiting (PONV). We sought to investigate whether transcutaneus nicotine prevents PONV. METHODS Non-smokers receiving general anaesthesia for surgery were randomly allocated to Nicotinell Patch 10cm(2) (TTS 10), containing 17.5mg of nicotine (average delivery rate, 7mg 24h(-1) ) or matching placebo patch. Patches were applied 1h before surgery and were left in situ until 24h after surgery (or until the first PONV symptoms occurred). RESULTS We randomized 90 patients (45 nicotine, 45 placebo). In the post-anaesthetic care unit, the incidence of nausea was 22.2% with nicotine and 24.4% with placebo (P= 0.80), and the incidence of vomiting was 20.0% with nicotine and 17.8% with placebo (P= 0.78). Cumulative 24h incidence of nausea was 42.2% with nicotine and 40.0% with placebo (P= 0.83), and of vomiting was 31.1% with nicotine and 28.9% with placebo (P= 0.81). PONV episodes tended to occur earlier in the nicotine group. Postoperative headache occurred in 17.8% of patients treated with nicotine and in 15.6% with placebo (P= 0.49). More patients receiving nicotine reported a low quality of sleep during the first postoperative night (26.7% vs. 6.8% with placebo; P= 0.01). CONCLUSIONS Non-smokers receiving a prophylactic nicotine patch had a similar incidence of PONV during the first 24h and tended to develop PONV symptoms earlier compared with controls. They had a significantly increased risk of insomnia during the first postoperative night.
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Affiliation(s)
- Christoph Czarnetzki
- Division of Anaesthesiology Clinical Trial Unit, University Hospitals of Geneva, Geneva, Switzerland Department of Neurosciences Medical Faculty, University of Geneva, Geneva, Switzerland.
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Froeliger B, Gilbert DG, McClernon FJ. Effects of nicotine on novelty detection and memory recognition performance: double-blind, placebo-controlled studies of smokers and nonsmokers. Psychopharmacology (Berl) 2009; 205:625-33. [PMID: 19488741 DOI: 10.1007/s00213-009-1571-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Accepted: 05/08/2009] [Indexed: 10/20/2022]
Abstract
RATIONALE Dependent smokers exhibit deficits in attentional and memory processes when smoking abstinent as compared to when satiated. While nicotine replacement therapy improves attention during abstinence, it is unclear whether this is due to the alleviation of withdrawal-related deficits or inherent beneficial effects of nicotine. OBJECTIVES The primary aim of these studies was to test whether nicotine exerts a beneficial effect on novelty detection and whether such effects occur in nonsmokers as well as habitual smokers. MATERIALS AND METHODS In two parallel, double-blind, placebo-controlled studies, 24 smokers (study 1) and 24 nonsmokers (study 2) were tested in two counterbalanced sessions: once while wearing a nicotine patch (smokers = 14 mg; nonsmokers = 7 mg) and once while wearing a placebo patch. On each day, participants performed three content-specific oddball tasks (perceptual, semantic, and emotional) that required them to press a button whenever they saw a novel target (20% of stimuli) embedded in a stream of common nontarget stimuli (80% of stimuli). Recognition memory for targets was subsequently tested. Reports of mood, smoking withdrawal, patch side effects, and blind success were collected in each session. RESULTS Among smokers, compared to placebo, nicotine decreased target reaction time during all oddball tasks. Among nonsmokers, nicotine increased target detection accuracy and subsequent memory recognition. Nicotine's enhancement on each respective measure was not task-content specific in either sample. CONCLUSIONS These data suggest that acute nicotine administration may exert direct beneficial effects on novelty detection and subsequent memory recognition in both smokers and nonsmokers. Moreover, these effects are not content-specific.
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Affiliation(s)
- Brett Froeliger
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27708, USA.
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Yun HY, Seo JW, Choi JE, Baek IH, Kang W, Kwon KI. Effects of smoking on the pharmacokinetics and pharmacodynamics of a nicotine patch. Biopharm Drug Dispos 2008; 29:521-8. [DOI: 10.1002/bdd.637] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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McKee SA, O'Malley SS, Shi J, Mase T, Krishnan-Sarin S. Effect of transdermal nicotine replacement on alcohol responses and alcohol self-administration. Psychopharmacology (Berl) 2008; 196:189-200. [PMID: 17912500 PMCID: PMC2862181 DOI: 10.1007/s00213-007-0952-3] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2006] [Accepted: 09/14/2007] [Indexed: 11/24/2022]
Abstract
RATIONALE Nicotine replacement is commonly used to treat tobacco use in heavy-drinking smokers. However, few studies have examined the effect of nicotine replacement on subjective and physiological responses to alcohol and alcohol drinking behavior. OBJECTIVE The primary aim of this within-subject, double-blind study was to examine whether transdermal nicotine replacement (0 mg vs 21 mg/day) altered response to a low-dose priming drink and subsequent ad libitum drinking behavior. MATERIALS AND METHODS Subjects (n=19) were non-treatment-seeking, non-dependent heavy drinkers who were daily smokers. Six hours after transdermal patch application, subjective and physiological responses to a priming drink [designed to raise blood alcohol levels (BALs) to 0.03 g/dl] were assessed. This was followed by a 2-h self-administration period where subjects could choose to consume up to eight additional drinks (each designed to raise BALs by 0.015 g/dl) or to receive monetary reinforcement for drinks not consumed. RESULTS We found that 6 h after patch application, tobacco craving associated with withdrawal relief was decreased, and systolic blood pressure and heart rate were increased in the active patch condition compared to the placebo patch condition. Subjective intoxication in response to the priming drink was attenuated in the active nicotine patch condition compared to 6 h of nicotine deprivation (i.e., placebo patch). During the self-administration period, subjects had longer latencies to start drinking and consequently appeared to consume fewer drinks when administered the active patch compared to the placebo patch. CONCLUSIONS In heavy drinkers, transdermal nicotine replacement compared to mild nicotine deprivation attenuated subjective and physiological alcohol responses and delayed the initiation of drinking.
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Affiliation(s)
- Sherry A McKee
- Department of Psychiatry, Substance Abuse Center-CMHC, Yale University School of Medicine, 34 Park St, Suite S-211, New Haven, CT 06519, USA.
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Sobue S, Sekiguchi K, Kikkawa H, Irie S. Effect of application sites and multiple doses on nicotine pharmacokinetics in healthy male Japanese smokers following application of the transdermal nicotine patch. J Clin Pharmacol 2006; 45:1391-9. [PMID: 16291714 DOI: 10.1177/0091270005282632] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The transdermal nicotine patch, which contains 25 mg nicotine per 30 cm(2), is designed to deliver approximately 15 mg nicotine to the blood circulation in 16 hours of application for the treatment of smoking cessation. It was applied to 3 different skin sites (upper arm, abdomen, and back) to examine regional variations in percutaneous nicotine absorption in a single-dose, 3-period, crossover study involving 9 healthy male Japanese smokers. Nicotine pharmacokinetics during once-daily application of the transdermal nicotine patch for 5 days was also investigated in 10 healthy smokers. There were statistically significant effects of application sites on percutaneous nicotine absorption. The ratios (90% confidence intervals) of AUC and C(max) for comparison to the upper arm were 102% (88, 117%) and 106% (95, 119%) for the back and 75% (65, 87%) and 75% (66, 84%) for the abdomen, respectively. These suggest that systemic exposure after application to the upper arm was greater compared with the abdomen but equivalent to the back. Following multiple doses, linear pharmacokinetics and no significant accumulation of nicotine concentrations were observed, and steady state was reached by day 2. Only mild itching and erythema were observed at the application sites. The transdermal nicotine patch was well tolerated in both studies.
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Affiliation(s)
- Satoshi Sobue
- Department of Clinical Pharmacology, Pfizer Global R&D, Tokyo Laboratories, Pfizer Japan Inc, Shinjuku Bunka Quint Bldg. 3-22-7, Yoyogi, Tokyo 151-8589, Japan.
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Tirnaksiz F, Yuce Z. Development of transdermal system containing nicotine by using sustained release dosage design. ACTA ACUST UNITED AC 2005; 60:763-70. [PMID: 16019001 DOI: 10.1016/j.farmac.2005.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2005] [Accepted: 06/08/2005] [Indexed: 11/29/2022]
Abstract
This study was carried out to develop a membrane-controlled transdermal formulation (TF) of nicotine by using sustained release dosage design (SRDD). TFs were prepared with polyethylene membrane as a rate-controlling barrier; a carbomer was used as the gel reservoir with or without propylene glycol (PG). The in vitro target flux (0.0535 mg cm(-2) h(-1)) was calculated according to SRDD calculations. Nicotine permeation through the membrane with or without transfer adhesive was also studied using diffusion cells. Nicotine permeated through membrane (without adhesive) with a flux of 0.0555 mg cm(-2) h(-1) and this value was similar to that of the in vitro target flux. The release from the TFs and from a commercial product (Nicotinell, 52.5 mg 30 cm(-2)) was studied using the FDA paddle method. The nicotine amount was increased from 22.7 to 56.5 mg in gel reservoir, and a plateau was reached beyond 45.4 mg of drug; the system attained the maximum thermodynamic activity with 56.5 mg of nicotine. The release rate from TFs (without adhesive layer) containing PG in the reservoir was very similar to the target release rate (1.07 mg h(-1)). The fluxes of nicotine from Nicotinell and TF containing 45.4 mg of nicotine were close to the in vitro target release rate.
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Affiliation(s)
- Figen Tirnaksiz
- Department of pharmaceutical technology, faculty of pharmacy, Gazi university, 06330 Etiler, Ankara, Turkey.
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Pongjanyakul T, Prakongpan S, Priprem A. Acrylic Matrix Type Nicotine Transdermal Patches: In Vitro Evaluations and Batch-to-Batch Uniformity. Drug Dev Ind Pharm 2003; 29:843-53. [PMID: 14570305 DOI: 10.1081/ddc-120024180] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Nicotine transdermal patches (NTPs) were fabricated using an acrylic pressure sensitive adhesive emulsion to form a transparent matrix film. An automated thin layer chromatography (TLC) plate scraper was used to control the thickness of the cast nicotine matrix film. The in vitro release behavior and permeation of nicotine across abdominal human epidermis (HE) from the NTPs was studied using United States Pharmacopeia (USP) dissolution apparatus 5 (paddle over disk) and modified Franz-diffusion cell, respectively. The release of nicotine from the NTPs showed a good linear correlation with the square root of time (R2 > 0.99). This indicated a matrix diffusion controlled-release mechanism. The surface morphology of the matrix of the NTP was uniform and nonporous before and after release, indicating that the dried adhesive nicotine matrix was a homogeneous single-phase film. Neither the nicotine content in the range 4.70-8.41% w/w nor the film thicknesses of the NTPs affected the apparent diffusion coefficient of nicotine in the acrylic matrix. A good relationship between the amount of nicotine permeated across the HE and the square root of time was also observed with R2 > 0.98. This study also showed that the NTPs provided a good delivery system with more than 65% of the nicotine delivery being controlled by the device. Moreover, the release of nicotine from six production batches met the criteria of USP 24. This finding presented a good potential of this method for upscaling to industrial manufacturing.
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Affiliation(s)
- Thaned Pongjanyakul
- Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand.
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Gariti P, Alterman AI, Barber W, Bedi N, Luck G, Cnaan A. Cotinine replacement levels for a 21 mg/day transdermal nicotine patch in an outpatient treatment setting. Drug Alcohol Depend 1999; 54:111-6. [PMID: 10217550 DOI: 10.1016/s0376-8716(98)00163-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study examined plasma cotinine replacement levels of 56 outpatient smokers administered a 21 mg/day transdermal nicotine patch (Nicoderm CQ ). The percentage of cotinine replacement ranged from 35 to 232% (mean 107%; median 90.5%). Four subject variables were found to be significantly correlated with percentage of cotinine replacement-baseline cotinine level, prior quit attempts, gender, and the Fagerström Tolerance Questionnaire score. A two-variable model consisting of baseline cotinine level and gender provided the most powerful predictor combination. The percentage of cotinine replacement was not predictive of post-treatment smoking. The relatively high levels of cotinine replacement obtained using the Nicoderm CQ 21 mg/day patch suggest cautious use of higher dose treatment with this particular patch.
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Affiliation(s)
- P Gariti
- University of Pennsylvania, School of Medicine, Philadelphia 19104, USA
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Abstract
Nicotine metabolism is exceedingly sensitive to perturbation by numerous host factors. To reduce the large variations and discrepancies in the literature pertaining to nicotine metabolism, investigators in future studies need to recognize and better control these host factors. Recent advances in the understanding of nicotine metabolism have suggested new approaches to elucidating underlying mechanisms of certain toxic effects associated with cigarette smoking.
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Affiliation(s)
- M J Seaton
- Department of Pharmacology, Pennsylvania State University College of Medicine, Hershey 17033
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