Pharmacology of Drugs of Abuse: Pharmacokinetics and Pharmacodynamics of Psychotropic Compounds

Guimarães, Marília Zaluar P.; Neves, Gilda

doi:10.1007/978-3-030-62855-0_8

Cited by 1 publication

(1 citation statement)

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“…The pharmacokinetic properties are crucial for the development of nicotine addiction ( Henningfield and Keenan, 1993 ; Guimarães et al, 2021 ). While the highly addictive cigarettes lead to a rapid uptake of nicotine into the blood and consequently into the brain, smoking cessation products such as nicotine patches or gums show a much slower uptake of nicotine ( Henningfield and Keenan, 1993 ; Guimarães et al, 2021 ). An important question regarding nicotine pouches is whether their pharmacokinetic properties resemble nicotine gums or cigarettes.…”

Section: Introductionmentioning

confidence: 99%

Small pouches, but high nicotine doses—nicotine delivery and acute effects after use of tobacco-free nicotine pouches

Mallock-Ohnesorg,

Rabenstein,

Stoll

et al. 2024

Front. Pharmacol.

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Tobacco-free nicotine pouches are new nicotine products for oral consumption. They can contain very high nicotine amounts that have not been addressed with clinical studies yet. Thus, nicotine delivery, effects on craving, and side effects were assessed using pouches with up to 30 mg nicotine. In this single-center, five-arm, crossover study, 15 regular cigarette smokers consumed tobacco-free nicotine pouches from different brands with 6, 20, and 30 mg for 20 min. Comparators were nicotine-free pouches and tobacco cigarettes. At baseline and predefined time points over a study period of 240 min, plasma nicotine concentrations, effects on cigarette craving, and side effects were assessed. Cardiovascular parameters including arterial stiffness were measured using a MobilOGraph. Consumption of 30 mg nicotine pouches has led to a higher nicotine uptake compared with the cigarette (Cmax: 29.4 vs 15.2 ng/mL; AUC: 45.7 vs 22.1 ng/mL × h). Nicotine uptake in the acute phase was rapid during use of the 30 mg pouch and cigarette. Extraction rate of nicotine differed between pouches. Use of all products has reduced acute cigarette craving, even the nicotine-free pouch. During consumption of the cigarette and the pouches with 20 and 30 mg, heart rate increased about 27, 12, and 25 bpm, respectively. Parameters for arterial stiffness were elevated and all pouches have induced mouth irritations. The pouches with 30 mg nicotine had overall the strongest side effects and may induce addiction. As craving was also reduced by products with less nicotine, it is questionable whether such high nicotine contents should be allowed on the market. A limit of nicotine content is warranted. The nicotine release rate varies across products and needs to be known to estimate the nicotine delivery.

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