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44 Cards in this Set

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On average, only about __?% of smokers attempting to quit will remain smokefree at one year.
7
Epidemiological data indicate that 70% of smokers want to quit and greater than _?_% of smokers in the United States have tried to quit smoking at least once.
80
Nicotine

carcinogen or addictor in cigarettes?
addictor
some carcinogens and toxins in cigarettes
ammonia, arsenic, cadmium, carbon monoxide, formaldehyde, hydrogen cyanide, and toluene
the top 3 smoking attributable causes of death in the United States
1) lung cancer, 2) ischemic heart disease, and 3) chronic obstructive pulmonary disease (COPD), respectively
Ischemic stroke risk doubles for cigarette smokers, and hemorrhagic stroke risk increases ____? times vs nonsmokers
2 to 4
There is a synergistic effect of smoking on stroke risk in women using ______(med)
oral contraceptives
In a study published in 2004, 18% of total deaths in the United States and 37.5% of preventable causes of death in the U.S. were found to be _____-related
tobacco
Neoplasms accounted for _?_% of smoking-attributable mortality, respiratory diseases including pneumonia, influenza, bronchitis, emphysema, and chronic airway obstruction accounted for 25%, and ischemic heart disease accounted for 22%.
40
Second hand smoke increases the relative risk of chronic obstructive pulmonary disease by __?_%.
55
the risk of coronary heart disease, after _?_ years of abstinence, becomes similar to that of a person who have never smoked.
15
Within the __?_ year mark, The risk of stroke for smoking cessators returns to the level of a person who has never smoked
5-15
Around the year mark, coronary heart disease, the leading cause of death in the United States, improves with smoking cessation to a point where excess risk is reduced by _?_% and continues to decline thereafter.
50
Those who quit at age 40 gained about _?_ years of life expectancy.
9
A smoker who quit at age 50 gained about _?_ years of life expectancy.
6
Smokers who quit at age 60 years gained at least _?_ years of life expectancy.
3
The addictive characteristics of nicotine are believed to be contributed to by its rapid action when inhaled and related, intense and/or short effects on ______ release in the brain.
dopamine
Nicotine reaches the brain within _?_ seconds of inhalation, and has a half-life of approximately 2 hours.
10
Although nicotine, cocaine, amphetamines and morphine act on different areas in the dopamine reward system that encompasses the mesolimbic portion of the brain… all are considered ___?___ and chronic, relapsing medical conditions that warrant clinical intervention.
addictions
After inhalation, nicotine predominantly binds to the nicotinic aceylcholine (nACh) receptors located in the __________-dopamine system of the brain within a matter of seconds.
mesolimbic
Nicotine specifically activates α4β2 nicotinic receptors in the Ventral Tegmental Area (VTA) causing an immediate dopamine release at the _______ (nAcc)
Nucleus Accumbens
Nicotine activates ______ nicotinic receptors that are localized to the neuronal bodies and terminal axons of the cells in the Ventral Tegmental Area (VTA)
α4β2
Tolerance is related to both the up-regulation (increased number) and the desensitization of nicotinic receptors in the ______ that occurs as a result of long-term exposure to nicotine
VTA
The half-life of nicotine is only __ hours
2
Typical withdrawal symptoms include four or more of the following:
dysphoric or depressed mood;
insomnia;
irritability, frustration, or anger;
anxiety;
difficulty concentrating;
restlessness or impatience;
decreased heart rate;
and increased appetite or weight gain
Treatment of "nicotine burnout" (anecdotal)
Ritalin
Zyban® (sustained-release _______) was the first non-nicotine, FDA-approved medication indicated for use as an aid to smoking cessation treatment
bupropion SR
bupropion SR believed to be a relatively weak inhibitor of neural reuptake of ______.
dopamine
Bupropion SR Contraindications:
Patients with a ______ disorder
seizure
bulimia or anorexia
MAOI-treated
Chantix (varenicline) is an α4__? Nicotinic Acetylcholine Receptor (nAChR) Partial Agonist
β2
varenicline functions as a nicotinic acetylcholine receptor partial ______
agonist
Varenicline binds to and partially stimulates the α4β2 receptor without creating a full nicotinic effect on the production of _______
dopamine
In the presence of nicotine, varenicline blocks the receptor, preventing ______ from binding, and thereby attenuating nicotine’s effect.
nicotine
When nicotine binds at the α4β2 nicotinic receptor in the ________ (VTA), it is believed to cause release of dopamine at the Nucleus Accumbens (nAcc)
Ventral Tegmental Area
Chantix was deliberately designed for the α4β2 receptor, as an α4β2 nicotinic receptor partial agonist (with dual agonist and antagonist properties) and physically prevents nicotine from binding and releases intrinsically less _______ at the nAcc.
dopamine
varenicline is a molecule whose absorption is not affected by ______, however, it is recommended it be taken after eating and with a full glass of water.
food
varenicline does not inhibit the ____ system in the liver
cytochrome P450
Varenicline has a half-life of approximately ______ and is excreted (over 90%) unchanged in the urine.
24 hours
Dose of Varenicline
Chantix 1 mg BID had higher efficacy rates at both end of treatment and at week 52 in the phase 2 studies
The most frequently reported adverse events (>10%) with Chantix were ____
nausea, headache, insomnia, and abnormal dreams
Dosage adjustment of Chantix is recommended in subjects with severe _____ impairment
renal
Chantix is not a controlled substance. Varenicline may produce mild physical _______ which is not associated with addiction.
dependence


(Lawyer-ese for "you might get addicted to Chantix")
Some of the most common stressors and triggers are:
feeling stressed, feeling down, talking on the phone, drinking liquor, like wine or beer, watching television, driving, finishing a meal, playing cards, work and family issues, taking a work break, being with other smokers, drinking coffee, seeing someone else smoke, cooling off after a fight, feeling lonely, and having sex
In the journey toward quitting smoking, the stages of change are:
1) Precontemplation – Smokers may not see health advice applying to themselves. The goal is to get them to think about change and personalize their risk factors.
2) Contemplation – Smokers are considering the benefits of quitting but also the barriers to quitting.
3) Preparation – Now is the time to develop a personalized quit plan, which involves setting a quit date.
4) Action – There is no one right way to quit. It is best to give people 3 good choices or options for quitting.
5) Maintenance – The maintenance phase can last months or years. Smokers need to keep reminding themselves why they quit.
6) Quit Smoking – This occurs when people quit and don't have any temptations to smoke again. Only about 20% of smokers achieve this.