A Case of Nicotine Poisoning; Disastrous Relationship

Marriage can be a sweet and a mixture of experiences but when they say for better and for worse, they do not mean taking the better and harming your spouse to be the worse. Let me paint a quick story for you and hopefully we make a case study from it.

A couple loved one another and the husband was always available for the wife at the beginning of the marriage. While we can say that the husband was caring, we can also attribute it to the husband not having a stable job at the time, so he had enough time to spend with his wife who would go to work and come back home to meet the dinning prepared.

Soon the husband got a job and he decided that he wanted to be able to provide for his family, but to do so, he needed to work. He would request for over time at work, and would not be available when the wife needed him. Soon they started to draw apart and this led to the wife acting strange in the house. Well, I always say that dialogue is the best but for these ones, they didn't want to talk about it. Soon the wife began to vape and this was something the husband didn't like but in other to annoy him more, she did it more and would piss him off.

Soon he began to notice that she was cheating and instead of him to ask her, he decided to do his private investigation by himself and he found out that she was chatting with a particular person and would use sweet words when chatting with the person. One day, he found a shirt of a person in their bedroom, and this was the height for him. Days later, he called his wife and told her he wanted to have a treat in the house. He gave a pre-mixed drink and he also had his cup. She drank and enjoyed it but when it was reaching the bottom of the cup, she began to feel wierd taste. She told him but he dismissed it saying she was just unnessarily paranoid.

As she finished the drink, she felt sharp pain in her chest, and she was in pain but soon she collapsed or thought she slept off. She woke up at night and wondered if she was drunk but it didn't feel like that because it wasn't her first time drinking. Soon she went to the rest room and she began to vomit every stomach content in her. Soon, she started to experience loss of breath, but struggled to grab her phone to dial the emergency unit before collapsing.

At the emergency and Accident Unit, health staffs began to work and medical practitioners realized that her breathing was erratic, and her blood rate and heart rate were high. Alcohol was smelt in her breath even when the breath was shallow which meant that the amount of oxygen in her blood would be low. She was also producing more saliva than normal and she was sweathing even when the hospital was well ventilated.

Within a short while, her blood pressure and heart rate decreased drastically and this gave room for suspicion that she was responding to something in her body. From all indications, it looked like she had experienced both rest and digest caused by the parasympathetic nervous system, and also fight and flight which was controlled by the sympathetic nervous system. With her initial response caused by the sympathetic nerves while the later response by the parasympathetic nerve.

Doctor began to wonder if she had consumed a large amount of acetylcholine which is the only reason why her synapses pull off a sympathetic response first before the acythylcholine fed into her parasympathetic system causing her to have the rest and digest phase which is inappropriate but there is a reason why this might not be the case and that is the fact that acetylcholine is quickly broken down in the body. So which other chemical acts like Acetylcholine?

Muscarinic Acetylcholine receptor which releases acetylcholine as well as muscarine which is found in mushrooms they do the same job of causing rest and digest but it doesn't have effect on breathing which means another receptor could be the cause and that is the Nicotinic Acetylcholine receptor which responds to nicotine. While the doctors are still trying to understand what was going on in her body, they noticed that her pupils were no longer reacting to light.

Blood test was done to ascertain if she was suffering from a poison and when the blood test result came, there was a high amount of nicotine in her blood similar to a person who had smoked over 200 cigarettes at once in one puff. Where did she get this high amount of nicotine in her system. The lady actually bought nicotine refills but she wouldn't have consumed all at once.

It was then visible that she was poisoned and her husband was pouring the vape juice into the drink she took. If she had not thrown up a large amount of the nicotine content from the body she might had stopped breathing, her heart stop pumping, and her brain dead and if test were done, only little amount of nicotine would have been left and since she vaped, it would have just been the cause of death. Doctors immediately gave her Atropine which is an anti-cholinergic but it is known to act on muscarinic acetylcholine receptors and not nicotinic receptors. She was placed on life support so as to help her with breathing throughout the period when the body would break down the nicotine but this wasn't enough because it was found late and her heart could no longer hold on. It stopped pumping, and the patient died. Currently there is no antidote for nicotinic acetylcholine poisoning so it was all left to her body to fight it which wasn't strong enough any longer.

---

---

^{Post Reference}

---

---

^{https://www.tandfonline.com/doi/full/10.1080/17425255.2022.2058930
https://onlinelibrary.wiley.com/doi/full/10.1002/brb3.1744
https://pmc.ncbi.nlm.nih.gov/articles/PMC5835582/
https://pmc.ncbi.nlm.nih.gov/articles/PMC10332868/
https://pmc.ncbi.nlm.nih.gov/articles/PMC7519620/
https://www.ncbi.nlm.nih.gov/books/NBK538516/
https://www.sciencedirect.com/science/article/abs/pii/S235200782200275X
https://poisoncenters.org/track/ecigarettes-liquid-nicotine
https://academic.oup.com/humrep/article/35/7/1693/5859935?login=false
https://pmc.ncbi.nlm.nih.gov/articles/PMC5885240/
https://www.cancer.org/cancer/risk-prevention/tobacco/guide-quitting-smoking/nicotine-replacement-therapy.html
https://pmc.ncbi.nlm.nih.gov/articles/PMC3880486/}

---

---

^{Image Reference}

---

---

^{Image 1 || Flickr || Woman Vaping on Electronic Cigarette
Image 2 || Getarchive || Marwan Ahmad Mohammed lies in his hospital bed
Image 3 || Pexels || Close-Up Shot of a Woman Holding a Glass of Juice}