From the Research
Treatment for nicotine overdose requires immediate medical attention, with supportive care being the primary approach, as stated in the most recent study 1, which emphasizes the importance of managing symptoms and providing care based on the severity of the overdose. The severity of symptoms determines the course of treatment, ranging from mild cases where stopping nicotine exposure and drinking water are sufficient, to more severe cases requiring medical intervention. For severe overdoses, medical professionals may administer:
- Activated charcoal (typically 1g/kg body weight) to prevent further nicotine absorption if the ingestion was recent, as supported by a recent study on the use of activated charcoal in poisoned patients 2
- IV fluids for hydration
- Anti-nausea medications like ondansetron (4-8mg) for vomiting
- Benzodiazepines such as diazepam (5-10mg) for seizures or agitation
- Atropine (0.5-1mg IV) for excessive secretions or bradycardia Severe cases may require respiratory support, cardiac monitoring, and management of blood pressure. The Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach is a widely accepted method for immediate assessment and treatment in clinical emergencies, including nicotine overdose 3. It is essential to note that nicotine overdose affects the nervous system by binding to acetylcholine receptors, initially stimulating them and then potentially blocking them, leading to symptoms like vomiting, increased heart rate, respiratory depression, and muscle paralysis. The half-life of nicotine is relatively short (1-2 hours), so symptoms typically resolve within 24 hours with proper treatment. In pediatric cases, liquid nicotine exposure can be particularly dangerous, and treatment should focus on supportive care and managing symptoms, as highlighted in a study on pediatric liquid nicotine ingestions 1. Overall, the primary goal of treatment is to manage symptoms, prevent further complications, and provide supportive care to ensure the best possible outcome for patients with nicotine overdose.