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34 Cards in this Set

  • Front
  • Back
Signs of nicotine dependence?
Depressed mood, insomnia, irritability, anxiety, difficulty concentrating, restlessness, decreased heart rate, increased appetite or weight gain
Nicotine Dependence
Daily use of nicotine for at least several weeks that is followed by S&S after 24 hours of cessation
Nicotine Dependence Treatment
Nicotine replacement therapy
Non-pharmacological recommendations for Nicotine Dependence Treatment
Smoke-free environment
Family/friends support
Avoid dieting
Support groups
Use sugar-free suckers, carrot sticks, as a substitute for "hand to mouth activity"
Last line treatment for nicotine dependence therapy due to rebound HTN
2nd line treatment for nicotine dependence treatment
Nicotine Replacement Therapy
Nicotine gum, spray, lozenges, inhaler, & patches
Nicotine replacement therapy 1 year quit rates
Dosage of nicotine replacement therapy
Based on ppd smoked
Started high initially & weaned at specific time intervals
Total time treatment for nicotine replacement therapy
8-12 weeks
Bupropion (Zyban) drug class
Dopamine & norepi reuptake inhibitor
Bupropion MOA
Inhibits dopamine, norepi, and minimal serotonin reuptake
Bupropion ADEs
HTN, tachyarrhythmias, pruritis, changes in weight, constipation, xerostomia, confusion, dizziness, h/a, insomnia, tremor, anxiety, dysrhythmias, seizures (lowers threshold), psychosis, & vivid dreams
How is Bupropion distributed?
Highly bound to protein
How is Bupropion metabolized?
p450 pathway (hepatic)
How is Bupropion eliminated?
Renal & fecal
1/2 life of bupropion?
12-30 hours
Bupropion drug interactions
MAOIs, linezolid, systemic steroids (may lower seizure threshold)
Reduce risk of seizures with Bupropion by...
Avoiding in pts w/ hx of seizures or head trauma
How often is bupropion dosed?
Every 12 hours b/c it is a controlled release formulation
Do patients quit smoking "cold turkey" with bupropion use?
No, they set a quit date 1-2 weeks after they start the drug therapy (so they have a steady state of the drug in system)
Do they begin with a full dose on the first day of tx of bupropion?
No, dose is titrated up over 7 days
How long are patients treated with bupropion?
12 weeks
1 year quit rate of bupropion
Chantix MOA
Binds to nicotinic acetylcholine receptors
Chantix ADEs
N/V/C, dream disorder, h/a, insomnia
Chantix absorption
Complete systemic
Chantix elimination
Chantix DIs
None ID'd yet
Chantix dosing
Titrated over 7 days
Continue for 12 wks
May continue for 12 additinal weeks (can increase the likelihood of long-term quitting)
Combination therapy options
Long-term nicotine patch + other NRT (gum or spray)
Nicotine patch + inhaler
Nicotine patch + bupropion SR
Which drug should be used to combat weight gain in nicotine dependence treatment?
Bupropion SR or nicotine gum or lozenge
What should be combined with pharmacologic therapy to increase quit rates?
Behavioral changes & psychosocial treament
What should you do if there is no response from initial treatment?
1.Continue the same agent for longer
2. Switch to a different 1st-line agent
3. Combine 2 agents