After a sharp quitting patients used daily tabakosoderzhaschie products for a long time, may develop withdrawal symptoms, which include: dysphoria, insomnia, irritability, anxiety, impaired concentration, decreased heart rate, increased trenbolone enanthate for sale appetite or increase in weight. An important symptom of withdrawal is also the desire to smoke.
In the treatment of tobacco dependence nicotine replacement therapy reduces the need for a number of cigarettes smoked, reduces the severity of withdrawal symptoms that occur with complete smoking cessation for those who have decided to quit smoking; facilitates temporary abstinence from smoking, but also helps to reduce the number of cigarettes smoked by those who can not or does not want to completely give up smoking.
After applying nicotine patch to the skin or hands hip approximately 95% of the released nicotine enters the systemic circulation. The remainder of the edges of the patch evaporates. All patches shows the average amount of nicotine that is absorbed in the average patient within 16 hours.
The concentration of nicotine in the blood plasma after application of the patch reaches a maximum after approximately 6-10 hours. The average maximum plasma concentration of nicotine in the patch after application of 15 mg / 16 hours of 9-15 ng / ml.
About 2 hours Nicotine is mainly excreted by the liver, its average plasma clearance of about 70 l / h. Trenbolone enanthate for sale is also metabolized in the kidneys and lungs. It identified more than 20 metabolites of nicotine, which are inferior to him in activity.
Communication nicotine blood plasma is less than 5%. Therefore disturbances nicotine binding while the use of other drugs or changes in the levels of plasma proteins in various diseases should not have a significant effect on the kinetics of nicotine.
The primary metabolite of nicotine in plasma – cotinine – has a half-life of 15-20 hours and its concentration trenbolone enanthate for sale exceeds that of nicotine by 10 times.
Urine cotinine derived mainly (15% of the dose) and trans-3-hydroxy-cotinine (45% of dose). From 10% to 30% of the dose of nicotine is excreted in the urine in unchanged form.
The progressive deterioration of renal function is accompanied by a reduction in total clearance of nicotine. It does not change the pharmacokinetics in patients with hepatic cirrhosis and severe slightly impaired liver function (index of 5 to Child-Pugh) and reduced in patients with liver cirrhosis with moderate hepatic impairment (index of 7 to Child-Pugh). Smokers are treated with hemodialysis, marked increase in nicotine concentration in the blood plasma.
In elderly patients, there was a slight reduction in total clearance of nicotine, that does not require dose adjustment.
When reapplying a patch nicotine concentrations were not significantly higher than those after a single dose of its imposition. When using three doses of nicotine patch concentration in plasma differed from dose proportional increase: with increasing the size of the patch corresponding increase in the concentration was slightly lower than expected. The pharmacokinetics of nicotine comparable to when applying the patch to the skin of the hand and thigh.
If the patch 15 mg / 16 hours, allowed to stand for 24 hours (instead of 16 hours), the concentration of nicotine during the last 8 hours reduces the average from 7.2 to 5.6 ng / ml. When using smaller patches can expect similar changes in the plasma concentration of nicotine.
For the treatment of tobacco trenbolone enanthate for sale dependence by reducing the need for nicotine, withdrawal symptoms, “cancel”, arising from the smoking cessation in patients with the proper motivation.
Hypersensitivity to nicotine or other components of the patch.
patches Nicorette should be used only after consulting the physician in patients undergoing major cardiovascular disease and hospitalized in this regard during the previous 4 weeks (including stroke, myocardial infarction, unstable angina, arrhythmia, coronary artery bypass grafting and angioplasty) or suffering from uncontrolled hypertension.
Nicorette patches should be used with caution in patients with moderate or severe hepatic impairment, severe renal insufficiency, worsening of duodenal ulcer and stomach.
Nicotine enters the body through replacement therapy or smoking, causes the release of catecholamines from the adrenal medulla. Therefore Nicorette patches should be used with caution in patients with uncontrolled hyperthyroidism or pheochromocytoma.
Pregnancy and lactation
nicotine crosses the placenta and affects the respiratory system and blood circulation of the fetus. Blood circulation is dose-dependent. Pregnant and lactating women smokers may use Nicorette patches only after consulting your doctor. The risk to the fetus associated with the use of Nicorette patches in pregnant women is not fully understood. The use of nicotine replacement therapy for pregnant women who can not quit smoking far outweighs the risk associated with continued smoking.
Nicotine in small amounts into breast milk and may influence the newborn, even at therapeutic doses. Therefore, at the time of treatment is recommended to refrain from breastfeeding.
Dosing and Administration
Adults and the elderly
Treatment starts with one patch of 15 mg / 16 h (30 cm2), which is applied to intact skin every day after waking up and removed before bedtime.
Initial duration of therapy is determined individually, it is usually at least 3 months. Then replacement therapy gradually overturned. For this purpose, 2-3 weeks daily superimposed one patch 10 mg / 16 h (20 cm2), and over the next 2-3 weeks – one patch 5 mg / 16 / h (10 cm2).
Apply patches for more than 6 months is generally not recommended. Some people stop smoking, you may need more long-term therapy.
patches trenbolone enanthate for salemay cause unwanted effects that are similar to those in the application of nicotine that enters the body through the other, and is largely dependent on the dose.
About 20% of patients in the first weeks of treatment noted moderate local skin reactions (redness, itching).
Some symptoms, such as dizziness, headache and insomnia may be manifestations of “cancellation” syndrome that develops in smoking cessation. After cessation of smoking may increase the incidence of aphthous ulcers, the cause of which is unknown.