Q1. (Answer = a) Due to neuromuscular blockade, hypotonicity rather than hypertonicity is expected in nicotine overdose. Q2. (Answer = b) A single cigarette has from 10 to 20 mg of nicotine compared to an average cigar that contains approximately twice as much. How can cigarettes be used so extensively if the quantity of nicotine is so near the alleged lethal amount of nicotine of 60 mg? Some of the nicotine is lost in sidestream smoke and some is incinerated. Further, the value of 60 mg is probably something of an underestimate. Q3. (Answer = b) Children ingesting cigarettes are in danger of slow nicotine absorbtion. Avoid Ipecac because the child might seize from nicotine and aspirate vomitus. Other forms of gastrointestinal decontamination should be attempted.
Q4. (Answer = b) Cotinine, an oxidized form of nicotine, is generally measured in urine to evaluate a person's smoking status. It is better to measure cotinine than nicotine because only 5% of smoked nicotine is excreted into the urine. Further, the average urinary concentration of nicotine in a smoker is 1.2 mg/L vs. an average cotinine concentration of 9.2 mg/L. The sensitivity of cotinine assay is, therefore, better than that of nicotine.
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