Benowitz N L
Medical Service, San Francisco General Hospital Medical Center, California.
Ciba Found Symp. 1990;152:186-200; discussion 200-9. doi: 10.1002/9780470513965.ch11.
The pharmacokinetic and pharmacodynamic characteristics of a drug are important determinants of whether users become dependent on it and of the temporal patterns of drug use. Characteristics of cigarette smoking, which produces a high degree of dependence, and the use of nicotine gum, which has a relatively low risk of dependence, are compared. Nicotine from tobacco smoke is rapidly absorbed and transferred into the brain. This results in high brain concentrations and intensive psychological effects, with relatively little development of tolerance. The smoker may titrate the level of drug and associated psychological effects of nicotine. Thus, smoking provides a nearly optimal situation for behavioural reinforcement. Chewing nicotine gum results in slow absorption of nicotine, leading to lower levels of nicotine in the brain and substantial time for development of tolerance. Thus, the intensity of effect is less and the onset of effect is delayed from the onset of dosing, providing less opportunity for behavioural reinforcement. Pharmacokinetic and pharmacodynamic modelling techniques have been applied to these processes and used to assess the implications for understanding the daily smoking cycle.
一种药物的药代动力学和药效学特征是使用者是否对其产生依赖以及药物使用时间模式的重要决定因素。本文比较了产生高度依赖性的吸烟行为的特征和产生相对低依赖风险的尼古丁口香糖的使用特征。烟草烟雾中的尼古丁会迅速被吸收并转移到大脑中。这会导致大脑中尼古丁浓度升高和强烈的心理效应，且耐受性发展相对较少。吸烟者可以调整药物水平以及尼古丁相关的心理效应。因此，吸烟为行为强化提供了近乎最佳的条件。咀嚼尼古丁口香糖会导致尼古丁吸收缓慢，从而使大脑中的尼古丁水平降低，并有大量时间产生耐受性。因此，效应强度较小，且效应的发作从给药开始就会延迟，为行为强化提供的机会较少。药代动力学和药效学建模技术已应用于这些过程，并用于评估对理解每日吸烟周期的影响。
