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33 Cards in this Set
- Front
- Back
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what do the vapors in cigarettes contain?
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CO, HCN, benzene
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nicotine stimulates which NTs?
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NE, ACh, Dopa
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How many mg of nicotine does a cigarette contain?
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6-13 mg (1-3 is absorbed)
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nicotine has pharmacokinetic interactions due to the induction of which CYP?
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CYP1A2
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The induction of CYP1A2 by nicotine causes increased metabolism of which drugs?
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increased metabolism of olanzapine, caffeine, and theophylline
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what pharmacodynamic interactions does nicotine have?
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with OC: increased risk of CV events
beta blockers: antihypertensive effects benzodiazepines: dimished sedative effects |
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how long does it take for nicotine withdrawal symptoms to subside?
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2-4 wks
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what are the 5 A's of counseling?
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Ask pt if use tobacco
Advise pt to quit Assess readiness to quit Assist with quitting Arrange for followup care |
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what are 5 r's: motivation when pts are NOT ready to quit
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Relevance
Risk Rewards Roadblocks Repetition |
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What Rx txs are there?
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NRT, bupropion (Zyban), varenicline (Chantix), (clonidine, nortriplyine)
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Cravings, dizziness, cough, dry throat, nasal drip, and chest tightness are withdrawal symptoms that last how long?
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few days
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irritability and constipation last how long?
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1-2 wks
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bupropion SR:
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Wellbutrin SR and Zyban (Rx)
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nicotine gum
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Nicorette (OTC)
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nicotine inhaler
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Nicotrol (RX)
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nicotine patches
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Nicoderm CQ, generics and Prostep (OTC and Rx)
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nicotine lozenges
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Committ (OTC)
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2mg nicotine gum is for pts smoking how many cigarettes per day?
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< 25 cigarettes per day
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4mg nicotine gum is for pts smoking how many cigarettes per day?
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>25 cigarettes per day
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max of nicotine gum per day?
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24 pieces per day for up to 12 wks
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dosing of weeks 1-6 nicotine gum?
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1 piece q 1-2h (typically 9 pieces/day)
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dosing of weeks 7-9 of nicotine gum?
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1 piece q 2-4 hr
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dosing of weeks 10-12 of nicotine gum?
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1 piece of q4-8h
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how do you administer nicotine gum?
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chew slowly until tastes peppery or feel tingle in mouth (15 chews), stop chewing and park gum between cheeck and gums, when peppery taste disappears, chew a few more times until taste/tingle return then park in a new spot, chow slowly and intermittently and park for about 30 minutes or until taste/tingle disappear
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when do you avoid eating/drinking when chewing gum and/or lozenge?
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avoid eating/drinking anything but water for 15 mins before and after use
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patient who crave withing 30 mins of waking should use which lozenge?
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4mg
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is dosing of lozenge same are for gum?
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yes
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max dose of lozenges/day?
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20 lozenge/day
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nicotine patches are available in what doses?
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21 mg, 14mg, 7mg patches
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what is step 1 of nicotine patches?
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21mg/24hr, start patch for pts who smoke >10 cigs/day, use weeks 1-6
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what is step 2 for nicotine patches?
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14mg/24hr, start patch for pts who smoke < or equal to 10 cigs/day, use week 1-6, use weeks 7,8 for pts who start at step 1
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what is step 3 for nicotine patches?
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7mg/24fs/pts who started on step 2 use on weeks 7,8
pts who started on step 1 use on wks 9,10 evidence says 8 wk tx is as good as longer ones |
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dosing for Prostep?
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>15 cigs/day: 22mg/24hrs/6 wks
< or equal to 15 cigs/day 11mg/24hrs/6 wks Prostep much less common than Nicoderm |
