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13 Cards in this Set

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What is the mechanism of action of nicotine?
Nicotine binds to ACh receptors, activating them. ACh receptors on dopaminergic neurons (esp. in nucleus accumbens) can activate these neurons, causing DA release (euphoria, pleasure, reward). Nicotine can also activate serotinergic neurons (esp. in amydala), which would result in decreased stress and anxiety.

Smoked, goes to lungs, enters bloodstream, goes to heart, then straight to brain. 10 seconds from inhale!
What are some adverse medical consequences of tobacco use?
Respiratory disease...cardiovascular disease...cancer...OSTEOPOROSIS...pregnancy/infertility issues. Macular degeneration. Can interfere with drug metabolism!! Prolonged wound healing.
How does rapidity of onset affect dependence likelihood?
Drugs that reach the brain FASTER (via IV and vasculature) have HIGHER levels of dependence. IV, smoking, intranasal.
Where is nicotine metabolized?
85-90% metabolized in LIVER. Half-life of nicotine ~2 hrs.
What is difference between normal and rapid metabolizers of nicotine?
Those who RAPIDLY METABOLIZE NICOTINE will smoke more, likely have more nicotine dependence, and have more severe withdrawal!

So if you metabolize nicotine faster, not a good sign.
What are the two main reinforcers to addiction?
Euphoria/pleasure (positive reinforcement) and cravings (negative)
What is relationship between intensity of counseling and efficacy for non-pharm. interventions?
Those with most INTENSE INTERVENTIONS have best likelihood of cessation.
How can doctors help with cessation?
Offer advice, advise cessation, set agreements, provide materials. Arrange for follow-up. Checking up on people is always good...makes them feel more important.
What is the ONE BIGGEST FACTOR in assessing nicotine dependence?
If they start smoking at the BEGINNING of the day (within 30 min of wake-up). Likely bc undergoing strong withdrawal.
What are different pharmacological treatments for smoking cessation?
Gum (some side effects)

Patch (preferred, fewer side effects)

Nasal spray (most effective, highest likelihood of abuse bc of rapid (fastest) delivery nasally

Bupropion - Effective (long-term) for certain populations. Not necessarily more efficacious than w/ combinatorial (bup. + patch) therapy.

Bupropion may be more effective for patients with depression, schizo.
Difference between female and male smokers?
Females tend to intake less nicotine. Females smoke for secondary (social, personal) reasons, than for actual nicotine maintenance.
Pregnancy complications from smoking?
Smaller children, growth retardation, premature births, malformations.
People with psychiatric disorders are MORE/LESS likely to smoke?
MORE LIKELY! SCHIZO's ~90%