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Q: The side-effects of smoking whilst on nicotine patches. ( No Answer,   1 Comment )
Question  
Subject: The side-effects of smoking whilst on nicotine patches.
Category: Health
Asked by: pauluk-ga
List Price: $100.00
Posted: 20 Dec 2002 05:20 PST
Expires: 23 Dec 2002 11:41 PST
Question ID: 127274
a 'friend' is involved in a drink driving case. The driver wishes to
make a defence on the following grounds :
On the day in question, he had been to an all-day Christmas party,at
which he drank a lot, and from which he travelled home by taxi, with
no intention of driving. The next thing he knew, he was in his car,
having just crashed into 2 parked vehicles 50 years from his
home. Arrest followed. He had apparently gone out to buy cigarette,
although the shop was only a 3-minute walk from his home.
His theory is that something 'physical' happened to him to make him
behave in such a bizarre manner. He had been on Nicotine patches for 3
days in an effort to give up smoking. Having resisted all day at the
party, his resolve finally weakend, and he smoked something like 12
cigarettes in about 3 hours, forgetting that he was wearing a patch.
He wonders whether this could have had the effect of causing mental
confusion, such that his actions were outside his control.
He needs this answer as much for his own enlightenment, as to use in his defence.
For the answer to this question to be useful, it must include
references, and documentary evidence which would assist him in
his defence.
Answer  
There is no answer at this time.

The following answer was rejected by the asker (they received a refund for the question).
Subject: Re: The side-effects of smoking whilst on nicotine patches.
Answered By: rapidreference-ga on 20 Dec 2002 07:00 PST
 
Hello Pauluk-ga

Your friend may have suffered from "nicotine overdose." This situation
can occur with people who smoke while using nicotine patches. Symptoms
include dizziness, confusion, vomiting, etc. I've included some
annotated urls below that describe this condition in detail.

Familydoctor.org
Nicotine Patch Info
<http://familydoctor.org/handouts/191.html>
-warns of nicotine overdose

Medline Plus
Nicotine Overdose Summary
<http://www.nlm.nih.gov/medlineplus/ency/article/002510.htm>
-this entry provides an overview of nicotine overdose. It warns of the
possibility of seizure and even death.

Medhelp.org
Nicotine Overdose Case
<http://www.medhelp.org/forums/addiction/archive/257.html>
-this sites includes dialogue between a patient and doctor concerning
a case of suspected nicotine overdose.

Intellihealth.org
Health News - Ask the Expert
<http://www.intelihealth.com/IH/ihtIH/WSIHW000/333/24549/347056.html>
-another question/answer site concerning nicotine overdose

Google search keywords:

"nicotine patch" side effects
"nicotine overdose"


There are other sites out there documenting this condition but the
information repeats what I've already provided. Please do not hesitate
to submit a clarification request if you require additional
information, or, if you are uncertain about any of the information
I've provided here.

Thanks,

rapidreference-ga

Request for Answer Clarification by pauluk-ga on 20 Dec 2002 07:27 PST
hello rapid reference.
Thanks for speedy answer, but I already have most of the data you
refer to, as I've done my own searches. I suppose I need a more
clinical/professional answer, showing proven studies on the matter. It
will not be enough in a court to say 'I read this on the internet'

Clarification of Answer by rapidreference-ga on 20 Dec 2002 08:53 PST
Well, there is good and bad inormation on the Internet. I think
information provided from the U.S. National Library of Medicine
(Medline Plus) is highly credible.

I did run across the citation abstract below by searching PubMed, the
world's premier index of medical literature. It contains research
indicating that dermal exposure to nicotine can lead to intoxication.



Clinical Pharmacology and Therapeutics.1987 Jul;42(1):119-20 Related
Articles, Links

Prolonged absorption with development of tolerance to toxic effects
after cutaneous exposure to nicotine.

Benowitz NL, Lake T, Keller KH, Lee BL.

This report describes a patient who developed nicotine poisoning after
cutaneous application of nicotine sulfate. Measurement of nicotine and
metabolite levels in the blood demonstrated prolonged absorption of
nicotine despite vigorous skin decontamination. This suggests that the
skin may be a reservoir for slow release of nicotine into the
circulation. Despite extraordinarily high levels of nicotine, the
patient had full resolution of signs and symptoms of intoxication,
indicating rapid and profound development of tolerance.

<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3595064&dopt=Abstract>

Please submit additional clarification requests as necessary. I
promise to keep working on this until you are satisfied.

rapidreference-ga

Request for Answer Clarification by pauluk-ga on 20 Dec 2002 13:07 PST
hello, Rapid
well, no, actually the article says the patient had full resolution of
signs of intoxication (by nicotine, that is!). I.E he did NOT have the
signs!

Whilst I do appreciate the info you've given me, it's not what I paid
$100 for.
 
I'm a reasonably competent searcher (not as good as you!) and the
stuff you've given me isn't specific enough for my needs. No direct
parallels, and often hearsay.
I'd like info on how many cigarettes would need to be smoked to have
that effect.
I'd like to see if any court cases were fought on this issue. Similar
to the one in my question.
Maybe I misunderstood this whole Google.answer thing. I was expecting
an answer from an expert in that topic, not re-direction to other
web-sites. I already have over 100 pages of Web-site stuff...I asked
the question because It's Not Enough!

Clarification of Answer by rapidreference-ga on 20 Dec 2002 14:27 PST
Here is a case involving a gentleman suffering from delusion while on
the patch. It does not, however, state anything about whether this
person smoked while on the patch. Still, this is legal recognition of
delusional behavior while on the patch. Charges of child neglect were
reversed by the appellate court. I can't provide the full-text here so
am paraphrasing. Please let me know if this helps at all.

New York Law Journal
Dec 28, 2001
Man's Use of Nicotine Patch Voids Finding of Neglect 
CERISSE ANDERSON 
In re Alisa V., 4802

rapidreference-ga
Reason this answer was rejected by pauluk-ga:
The answer did not provide evidence that could be used in any defence.
Some answers were hearsay without documentary backup, some were
irrelevant to the issue. I gained nothing that I hadn't already
obtained from my own searches.

Comments  
Subject: Re: The side-effects of smoking whilst on nicotine patches.
From: rapidreference-ga on 20 Dec 2002 15:56 PST
 
Hello,

Rapidreference again. . .just wanted to say that I'll be offline soon.
Please stay tuned. I'll work more on this tomorrow.

Thanks

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