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18 Cards in this Set
- Front
- Back
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What are some non-pharmacologic smoking cessation treatments?
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Counseling, achievable goals, remove triggers, social support
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What are some pharmacologic smoking cessation treatments?
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Bupropion SR, Varenicline, Nicotine replacement therapies, combination therapy, second line therapy (clonidine, nortriptyline)
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Who should not be treated?
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pregnant women, adolescents, smokeless tobacco users, light smokers (< 10 cigarettes per day)
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What are the five clinical interventions of smoking cessation? (the 5 A's)
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Ask about tobacco use
Advise to quit Assess willingness to make a quit attempt Assist by offering meds or refer for counseling and behavioral treatment Arrange follow-up |
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What are the key counseling points for smoking cessation?
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recognize danger situations, develop coping skills, withdrawal symptoms, provide encouragement
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How does a patient use the nicotine replacement gum?
How long can patient use this therapy? |
Chew gum slowly until you get tingling sensation then park it between the cheek and gum. Consider new piece when tingling is no longer present
Patient can use this up to 12 weeks or as needed |
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What are the side effects of nicotine replacement gum?
Counseling points? |
mouth soreness, stomachache, hiccups
caution with dentures and jaw issues; do not eat or drink 15 minutes before or during use |
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What are the side effects for the nicotine replacement inhaler (Nicotrol)?
How long can patient use this therapy? |
irritation around mouth and throat
Patient can use this up to 6 months and should taper dose at end |
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What are some counseling points for nicotine replacement lozenge?
How long can patient use this therapy? What are the side effects? |
Do not eat or drink 15 min before or during use
Use up to 3-6 months, should taper dose at end Side effects= hiccups, cough, heartburn |
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How long can patient use nicotine replacement nasal spray?
What are the side effects? Which patients should avoid this therapy and why? |
Can use for 3-6 months, taper at end
Side effects= nasal irritation Avoid in asthma patients, may cause dependence |
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How long can the nicotine replacement patch therapy be used?
What are the side effects? What are the contraindications? |
8-12 weeks (taper at end)
side effects= local skin irritation and insomnia (insomnia can be decreased if patch is removed before bedtime) contraindicated with severe eczema or psoriasis |
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What is the likely MOA of bupropion?
When should treatment be started? |
Likely due to inhibition of DA and NE neuronal uptake
Start 1-2 weeks before target quit date |
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What are the side effects of bupropion?
What are some contraindications? How long should patient be on treatment? |
Side effects= insomnia, dry mouth, headache
Contraindication: current MAOI use, history of seizures, or eating disorders Use 2-6 months |
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What is the brand name for Varenicline?
What is the MOA? Black Box Warning? |
Chantix
partial agonist for neuronal nicotinic acetylcholine receptor (increases DA levels which decreases cravings/withdrawals) possible neuropsychiatric adverse effects |
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When should Chantix be started?
What are the side effects? Counseling points? |
Start one week before target quit date
Side effects= HA, nausea, insomnia, abnormal/vivid/strange dreams Dose should be given with food and a full glass of water to decrease gastric upset |
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What are the 5 R's for Smokers unwilling to quit?
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Relevance
Risks Rewards Roadblocks Repitition |
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What does alcohol absorption rate depend on?
What lessens absorption? |
Absorption rates depend on contents in the stomach
High fats and carbohydrates lessen absorption |
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Does alcohol pass across the placenta to fetus?
When is alcohol most harmful in pregnancy? What is Fetal Alcohol Syndrome? |
Yes
Most harmful in first 3 months of pregnancy Disorder marked by mental retardation and behavior problems |
