FOR THE PHYSICIAN

 

MEDICAL PROTOCOL

The Only Treatment Method That Deals Directly
With Nicotine Withdrawal Symptoms

 

The physical effects of nicotine addiction occur in a very specific part of the body. Nicotine is similar chemically to the neuro-transmitter “acetylcholine.” Because they are similar, both nicotine and acetylcholine compete to occupy the same receptor sites. Through the process known as tolerance, the body manufactures more nicotine receptor sites to accommodate the increased demand. When the level of nicotine in the blood drops below 5 milligrams, there is not a sufficient supply of nicotine to occupy the increased number of sites and physical withdrawal takes place.

When you block nicotine receptor sites, you replace the effects that nicotine has in the body.  Therefore, there are no cravings for nicotine or withdrawal symptoms. More importantly, because there is no increased demand for nicotine receptor sites, the body’s natural chemistry will revert back to that of a non-smoker. We have developed the precise combination of anticholinergics that allows patients to quit smoking without the usual withdrawal symptoms.

 

The Intake Process

Prior to receiving treatment by the Anticholinergic Block Method, a patient answers a smoking questionnaire and completes a medical history. Particular attention is paid to acute-angle glaucoma, prostatic hypertrophy, cardiac arrhythmias or bladder dysfunction. Surgical history also is recorded, noting any idiosyncratic reactions or prolonged refractory times in the decay of anticholinergic drugs. A routine examination is performed consisting of an EKG and pulmonary lung function test. Patients with the usual contraindications to anticholinergic drugs are not treated.

Patients who appear to be suitable candidates for treatment are further checked for possible adverse reaction through injection of an intramuscular dose of a solution containing atropine and scopolamine. Pupillary reflex is examined after five minutes. Patients who have normal papillary constriction and offer no complaint of excessive xerostomia are suitable candidates for treatment by the Anticholinergic Block Method.

In accordance with the Anticholinergic Block Method, suitable candidate patients are given one or more injections of specific acetylcholine antagonists which block the cerebral sites and stop both the patient’s craving for nicotine and withdrawal symptoms. The solution with which patients are injected comprises a carrier of diluent containing atropine and scopolamine. The carrier of diluent may be pure water, a normal saline solution, an aqueous solution containing procaine or any other diluent commonly employed as a carrier for pharmaceutical compounds administered by injection.

The precise composition of the solution may be tailored to the requirements of an individual patient. For patients who in prior attempts to cease smoking, have experienced or indicated a feeling of greater than normal irritability, nervousness, lack of concentration or gastro-intestinal disturbances, the amounts of atropine and scopolamine can be increased to provide greater blocking affinity at the cerebral sites. Hence, there is more effective relief against the craving for nicotine.  This treatment method alleviates the physical symptoms of nicotine withdrawal syndrome caused by the build-up of excessive acetylcholine upon cessation of smoking.

 Typically, following treatment some patients experience xerostomia, some lightheadedness and difficulty focusing. These effects dissipate in 6 to 8 hours. Patient complaints of altered taste and smell, however, can persist for approximately 24 hours. Treated patients are cautioned not to drink alcohol nor to drive for 12 hours. They are instructed not to take any medications with a synergistic effect. Patients who previously have experienced withdrawal symptoms will quickly note the absence of such symptoms using this treatment approach.  

Since withdrawal symptoms to nicotine cessation are most pronounced the first 24 to 48 hours, immediate and high levels of anticholinergic activity are achieved by subcutaneously injecting the prescribed anticholinergic drugs behind the auricular areas. Nicotine is eliminated in approximately three days, but the elimination of all delayed withdrawal symptoms may require a period of approximately two weeks. As a consequence, oral medication is recommended to maintain a low level of anticholinergic activity for a period of up to two weeks. This technique is based on laboratory evidence that approximately two weeks are required for significant decrease in enzyme synthesis of the end product (acetylcholine).

The anticholinergic method helps patients develop an aversion to cigarettes by also affecting taste and sensory receptors. The effect of dry mouth, for example, while disadvantageous in many instances, is helpful where it is a consequence of therapeutic techniques.

  

Physicians’ Notes

Muscarinic stimulation of ganglia and the adrenal medulla usually is thought to be modulatory to nicotine stimulation. All the actions of acetylcholine and its congeners at muscarinic receptors can be blocked by atropine. The nicotinic actions of cholinergic agonists refer to the initial stimulation, and often in high doses to subsequent blockade, of autonomic ganglion cells and the neuromuscular junction, actions comparable to those of nicotine. “The Pharmacological Basis of Therapeutics, 9th Edition, 1996.”

Since transmission at those sites is affected chemically, it can be effected by chemical means. With the use of  anticholinergic medications, these sites can be effectively blocked through the process of competitive inhibition.

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