Nicotine replacement therapy

Molyneux, Andrew

doi:10.1136/bmj.328.7437.454

Cited by 87 publications

(50 citation statements)

References 3 publications

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“…62 Nicotine replacement therapy, bupropion, and varenicline are agents indicated for use as aids to smoking cessation treatment. Nicotine replacement therapy is compatible with breastfeeding as long as the dose (assuming a cigarette delivers ∼1 mg of nicotine) is less than the number of cigarettes typically smoked, because nicotine passes freely into human milk and is orally absorbed as nicotine.…”

Section: Drugs For Smoking Cessation or To Treat Substance Abuse/ Alcmentioning

confidence: 99%

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The Transfer of Drugs and Therapeutics Into Human Breast Milk: An Update on Selected Topics

Sachs¹

2013

Pediatrics

468

198

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Many mothers are inappropriately advised to discontinue breastfeeding or avoid taking essential medications because of fears of adverse effects on their infants. This cautious approach may be unnecessary in many cases, because only a small proportion of medications are contraindicated in breastfeeding mothers or associated with adverse effects on their infants. Information to inform physicians about the extent of excretion for a particular drug into human milk is needed but may not be available. Previous statements on this topic from the American Academy of Pediatrics provided physicians with data concerning the known excretion of specific medications into breast milk. More current and comprehensive information is now available on the Internet, as well as an application for mobile devices, at LactMed (http://toxnet.nlm.nih.gov). Therefore, with the exception of radioactive compounds requiring temporary cessation of breastfeeding, the reader will be referred to LactMed to obtain the most current data on an individual medication. This report discusses several topics of interest surrounding lactation, such as the use of psychotropic therapies, drugs to treat substance abuse, narcotics, galactagogues, and herbal products, as well as immunization of breastfeeding women. A discussion regarding the global implications of maternal medications and lactation in the developing world is beyond the scope of this report. The World Health Organization offers several programs and resources that address the importance of breastfeeding (see http://www.who.int/topics/breastfeeding/en/).

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Section: Drugs For Smoking Cessation or To Treat Substance Abuse/ Alcmentioning

confidence: 99%

“…Shortacting products (eg, gum or lozenges) are recommended. 62 Infant exposure decreases proportionally with maternal patch doses. 63 In contrast, bupropion is excreted into human milk with exposures that may exceed 10% (range, 1.4%-10.6%) of the maternal dose.…”

Section: Drugs For Smoking Cessation or To Treat Substance Abuse/ Alcmentioning

confidence: 99%

The Transfer of Drugs and Therapeutics Into Human Breast Milk: An Update on Selected Topics

Sachs¹

2013

Pediatrics

468

198

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“…Molyneux (2004) states that the effectiveness of NRT in adolescents and children who smoke has not been established, and he also urges smokers not to smoke while using NRT. NRT, especially by transdermal patch, delivers more nicotine to the fetus than smoking does.…”

Section: The New Rulesmentioning

confidence: 99%

Critical Review

Ginzel¹,

Maritz

Marks

et al. 2007

J Health Psychol

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The recent expansion of Nicotine Replacement Therapy to pregnant women and children ignores the fact that nicotine impairs, disrupts, duplicates and/or interacts with essential physiological functions and is involved in tobacco-related carcinogenesis. The main concerns in the present context are its fetotoxicity and neuroteratogenicity that can cause cognitive, affective and behavioral disorders in children born to mothers exposed to nicotine during pregnancy, and the detrimental effects of nicotine on the growing organism. Hence, the use of nicotine, whose efficacy in treating nicotine addiction is controversial even in adults, must be strictly avoided in pregnancy, breastfeeding, childhood and adolescence.

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“…NRT has been expertly reviewed elsewhere (Molyneux 2004). The major goals of NRT are to 1) attenuate withdrawal symptoms, 2) eliminate craving; and 3) make smoking less rewarding.…”

Section: Smoking Cessationmentioning

confidence: 99%

Treatment of mild chronic obstructive pulmonary disease

Chee

Sin

2008

COPD

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Chronic obstructive pulmonary disease (COPD) is an epidemic in many parts of the world. Most patients with COPD demonstrate mild disease. The cornerstone of management of mild disease is smoking cessation, which is the only proven intervention to relieve symptoms, modify its natural history and reduce mortality. For asymptomatic patients, it is the only required therapy. Short-acting bronchodilators can be added on an as needed basis for those with intermittent symptoms and regularly for those with persistent symptoms. Long-acting bronchodilators can be substituted for those who remain symptomatic despite regular use of short-acting bronchodilators. Inhaled corticosteroids do not modify the natural history of COPD and as such cannot be recommended as standalone therapy for mild COPD. However, for patients with refractory and intractable symptoms, they may be used in combination with long-acting beta-2 agonists. Infl uenza and pneumococcal vaccination and pulmonary rehabilitation are other therapies that may be considered for select patients with mild disease. In this paper, we summarize the current standard of care for patients with mild COPD.

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Nicotine replacement therapy

Cited by 87 publications

References 3 publications

The Transfer of Drugs and Therapeutics Into Human Breast Milk: An Update on Selected Topics

The Transfer of Drugs and Therapeutics Into Human Breast Milk: An Update on Selected Topics

Critical Review

Treatment of mild chronic obstructive pulmonary disease

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