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23 Cards in this Set
- Front
- Back
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Signs following abrupt cessation of nicotine
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Dysphoric or depressed mood
Insomnia Irritability, frustration, or anger Anxiety Difficulty concentrating Restlessness Decreased heart rate Increased appetite or weight gain |
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Non-pharmacological recommendations for nicotine treatment
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Smoke-free environment
Family/friends support Avoid dieting, but do recommend exercise & proper nutrition Support groups Use sugar-free suckers, carrot sticks, etc. as substitute for “hand to mouth activity” |
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Nortriptyline (Pamelor)
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2nd line treatment
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Clonidine
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Last line treatment due to risk of rebound HTN, ADE profile
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Nicotine Replacement Therapy Dosing
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Started high initially and weaned at specific time intervals for total treatment time of 8-12 wks
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Types of Nicotine Replacement Therapy
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Nicotine Gum (Nicorette)
Nicotine Spray Nicotine Lozenges Nicotine Inhaler Nicotine Patches (Nicoderm CQ) |
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Bupropion (Zyban) MOA
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Inhibits dopamine, norepi & minimal serotonin reuptake
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Bupropion (Zyban) ADE
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HTN, tachyarrhythmia, pruritis, changes in weight, constipation, xerostomia, confusion, dizziness, h/a, insomnia, tremor, anxiety, dysrhythmias, seizures, psychosis, vivid dreams
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Bupropion (Zyban) DI's
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MAOI’s, linezolid, systemic steroids (may lower seizure threshold)
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Bupropion (Zyban) metabolism
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Hepatic (Cyt P450)
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Bupropion (Zyban) Distribution
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highly protein bound
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Bupropion (Zyban) T1/2 life
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12-30 hrs
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T or F
Zyban must be tapered off when d/c? |
False
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T or F
Zyban can increase the risk of seizures? |
True
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How is Bupropion (Zyban) dosed?
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q12hrs
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T or F
Pts quit date is 1-2 days after starting Bupropion? |
False
Quit date should be set 1-2 weeks after start of therapy to allow drug to get to steady state |
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Bupropion (Zyban) treatment period
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12 weeks
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Varenicline (Chantix) MOA
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Binds to nicotinic acetylcholine receptors
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Varenicline (Chantix) ADE's
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N/V/C, dream disorder, h/a, insomnia
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T or F
Varenicline (Chantix) has many drug interactions. |
False
None ID's yet. |
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Varenicline (Chantix) Dosing
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Titrated over 7 days then continued for 12 wks
Can be continued an additional 12 wks |
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What are the three Combination Therapies for Nicotine Dependence Treatment
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Long-term (>14 weeks) nicotine patch + other NRT (gum and spray)
Nicotine patch + Nicotine inhaler Nicotine patch + bupropion SR |
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What are three options if there is no response to initial treatment?
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Continue the same agent for a longer duration
Switch to a different first-line agent Consider combination of two agents |
