I'm not here to call for censorship or to lecture those amateur chemists who are obsessed with finding the 'holy grail' of nicotine.
Just to say, holding an open 100ml bottle of pure nicotine in your hands is not the most comfortable feeling, even in strict laboratory conditions.
Playing with it at home is potentially lethal to yourself and others as you don't just have to drink it or spill it on your skin to be poisoned.
If you have an accident, make sure you've read the checklist below and made suitable emergency preparations, or funeral arrangements.
You can buy pure nicotine, but I will not tell you where or how, leave it to the chemists.
* In case of contamination, wash skin by flooding with water and scrubbing vigorously with soap.
* Emesis - patient may already be vomitting. Emesis is not advisable because it may be dangerous. If possible, give activated charcoal orally to adsorb any remaining nicotine. Administer charcoal slurry, aqueous or mixed with saline cathartic or sorbitol. The
FDA suggests 240 ml of diluent/30 g of charcoal. Usual charcoal dose is 30 to 100 g in adults and 15-30 g in children (1-2 g/kg in infants).
* Administer one dose of a cathartic, mixed with charcoal or given separately.
* Gastric lavage - may be indicated if performed soon after ingestion, or in patients who are comatose or at risk of convulsing. Protect airway by placement in Trendelenburg and left lateral decubitus position or by cuffed endotracheal intuba tion. Use tap water containing activated charcoal, if available.
* After control of any seizures present, perform gastric lavage. Volume of lavage return should approximate fluid given.
* Initiate artificial respiration using oxygen, is available.
Specific Drugs and Antidotes
* Mecamylamine is a specific antagonist of nicotine actions; however since it is only available in tablets, therefore it is not suitable for a patient who is vomiting, convulsive or hypotensive.
* either give atropine sulphate, (adult 0.4-2 mg; child 0.01 mg/kg, not to exceed 0.4 mg per dose) i.m. or i.v. and repeat every 3-8 min. until signs of parasympathetic toxicity are controlled. Repeat atropine frequently to maintain control o f symptoms. As much as 12 mg of atropine has been given safely in the first 2 hours in adult. Ensure proper oxygenation to avoid arrythmias associated with hypoxia. Interruption of atropine therapy may be rapidly followed by fatal pulmonary edema or respiratory failure.
* or give phentolamine 1-5 mg i.m. or i.v. to control signs of sympathetic hyperactivity, such as hypertension.
General Measures
* Control convulsions: Administer diazepam i.v. bolus (adult, 5-10 mg initially which may be repeated every 15 minutes PRN up to 30 mg; child, 0.25-0.4 mg/kg dose up to 10 mg/dose) or lorazepam i.v. bolus (adult, 4-8 mg; child, 0.05-0.1 mg/kg).
* Do not administer antacids since nicotine is better absorbed in an alkaline media.
* Monitor ECG and vital signs carefully.
Chronic Poisoning
Remove from further exposure to dust or smoke. Prognosis
Survival for more than 4 hours is usually followed by complete recovery.
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