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Self-poisoning among adults using multiple transdermal nicotine patches
A Woolf1, K Burkhart, T Caraccio
1Harvard Medical School, Boston, Massachusetts, USA.
Journal of Toxicology. Clinical Toxicology
|January 1, 1996
Summary
Multiple transdermal nicotine patches misused in suicide attempts caused severe poisoning. Patients experienced seizures, central nervous system changes, and respiratory failure, highlighting risks of increased accessibility.
Area of Science:
- Toxicology
- Emergency Medicine
- Pharmacology
Background:
- Transdermal nicotine patches are widely accessible for smoking cessation.
- Intentional misuse of transdermal nicotine patches can lead to significant toxicity.
- Understanding poisoning characteristics is crucial for clinical management.
Observation:
- A case series involving nine patients who applied multiple transdermal nicotine patches simultaneously.
- Cases primarily involved intentional misuse or suicide attempts.
- Seven of nine cases had co-exposure to other drugs, complicating the clinical picture.
Findings:
- All nine patients experienced medical complications, including seizures, central nervous system changes, cardiovascular effects, and respiratory failure.
- Eight patients required hospitalization, with all recovering.
- Plasma nicotine/cotinine levels did not correlate with illness severity.
Implications:
- Simultaneous application of multiple transdermal nicotine patches is a serious concern in adult suicide attempts.
- Increased accessibility of these patches may lead to further misuse.
- Clinical presentation can be complex due to co-intoxicants, necessitating comprehensive toxicological assessment.
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