From the Guidelines
Nicotine poisoning symptoms include nausea, vomiting, increased salivation, abdominal pain, diarrhea, headache, dizziness, confusion, hearing and vision disturbances, weakness, and in severe cases, seizures, respiratory failure, and cardiac arrest. These symptoms can develop rapidly and are similar to those experienced by a nicotine-naive user 1. The symptoms of acute nicotine toxicity are generally mild and resolve within 12 hours with no treatment, but large exposures can be fatal. Key symptoms to look out for include:
- Gastrointestinal symptoms such as nausea, vomiting, abdominal pain, and diarrhea
- Neurological symptoms such as headache, dizziness, confusion, and hearing and vision disturbances
- Cardiovascular symptoms such as weakness and in severe cases, cardiac arrest
- Respiratory symptoms such as respiratory failure
It is essential to seek immediate medical attention if nicotine poisoning is suspected, as treatment is primarily supportive and focuses on managing symptoms while the body eliminates the nicotine. Healthcare providers may administer activated charcoal, provide intravenous fluids, and monitor vital signs, and in severe cases, may provide respiratory support, anti-seizure medications, or atropine for excessive secretions. Prevention is crucial, especially for children, who can experience toxicity from even small amounts of nicotine found in cigarettes, e-liquids, or nicotine replacement products 1.
From the Research
Symptoms of Nicotine Poisoning
The symptoms of nicotine poisoning can vary depending on the route and amount of exposure. Some common symptoms include:
- Bradycardia (slow heart rate) 2, 3
- Hypotension (low blood pressure) 2
- Impaired consciousness 2
- Nausea 4
- Palpitation 4
- Abdominal pain 4
- Repeated vomiting 4
- Diarrhea 4
- Cardiac arrest 3, 5
- Respiratory failure 2
- Hypoxia (lack of oxygen) 6
- Irreversible encephalopathy (brain damage) 6
Routes of Exposure
Nicotine poisoning can occur through various routes, including:
Treatment and Prognosis
Prompt treatment with appropriate respiratory and circulatory support can lead to good outcomes in cases of nicotine poisoning 3. In some cases, treatment with atropine and vasopressors may be necessary 2. If initial treatment is appropriate and the patient can survive the acute phase of nicotine poisoning, the prognosis is generally good 4.