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33 Cards in this Set

  • Front
  • Back
what do the vapors in cigarettes contain?
CO, HCN, benzene
nicotine stimulates which NTs?
NE, ACh, Dopa
How many mg of nicotine does a cigarette contain?
6-13 mg (1-3 is absorbed)
nicotine has pharmacokinetic interactions due to the induction of which CYP?
The induction of CYP1A2 by nicotine causes increased metabolism of which drugs?
increased metabolism of olanzapine, caffeine, and theophylline
what pharmacodynamic interactions does nicotine have?
with OC: increased risk of CV events
beta blockers: antihypertensive effects
benzodiazepines: dimished sedative effects
how long does it take for nicotine withdrawal symptoms to subside?
2-4 wks
what are the 5 A's of counseling?
Ask pt if use tobacco
Advise pt to quit
Assess readiness to quit
Assist with quitting
Arrange for followup care
what are 5 r's: motivation when pts are NOT ready to quit
What Rx txs are there?
NRT, bupropion (Zyban), varenicline (Chantix), (clonidine, nortriplyine)
Cravings, dizziness, cough, dry throat, nasal drip, and chest tightness are withdrawal symptoms that last how long?
few days
irritability and constipation last how long?
1-2 wks
bupropion SR:
Wellbutrin SR and Zyban (Rx)
nicotine gum
Nicorette (OTC)
nicotine inhaler
Nicotrol (RX)
nicotine patches
Nicoderm CQ, generics and Prostep (OTC and Rx)
nicotine lozenges
Committ (OTC)
2mg nicotine gum is for pts smoking how many cigarettes per day?
< 25 cigarettes per day
4mg nicotine gum is for pts smoking how many cigarettes per day?
>25 cigarettes per day
max of nicotine gum per day?
24 pieces per day for up to 12 wks
dosing of weeks 1-6 nicotine gum?
1 piece q 1-2h (typically 9 pieces/day)
dosing of weeks 7-9 of nicotine gum?
1 piece q 2-4 hr
dosing of weeks 10-12 of nicotine gum?
1 piece of q4-8h
how do you administer nicotine gum?
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
when do you avoid eating/drinking when chewing gum and/or lozenge?
avoid eating/drinking anything but water for 15 mins before and after use
patient who crave withing 30 mins of waking should use which lozenge?
is dosing of lozenge same are for gum?
max dose of lozenges/day?
20 lozenge/day
nicotine patches are available in what doses?
21 mg, 14mg, 7mg patches
what is step 1 of nicotine patches?
21mg/24hr, start patch for pts who smoke >10 cigs/day, use weeks 1-6
what is step 2 for nicotine patches?
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
what is step 3 for nicotine patches?
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
dosing for Prostep?
>15 cigs/day: 22mg/24hrs/6 wks
< or equal to 15 cigs/day 11mg/24hrs/6 wks

Prostep much less common than Nicoderm