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43 Cards in this Set
- Front
- Back
Smoking causes _____ of some P450 isoforms
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Induction
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Smokers who quit may see increased levels of drugs like?
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Caffeine
Theophyllin Olanzapine Clozapine |
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All nicotine products are pregnancy category ____ except?
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D (gum is category C)
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5 A's of tobacco cessation
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Ask
Advise Assess Assist Arrange |
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Nicorette gum dosing (mg) for < 25 cig/day
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2 mg
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Nicorette gum dosing (mg) for > 25 cig/day
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4 mg
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May use gum up to ____ weeks
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12
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Nicorette gum taper schedule
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1 gum every 1-2 hours x 6 weeks,
1 gum every 2-4 hours x 3 weeks, 1 gum every 4-8 hours x 3 weeks |
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Maximum pieces of gum per day?
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24
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Nicotrol inhaler dosing
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6-16 cartridges daily, up to 6 months
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Benefit of Nicotrol inhaler versus gum/lozenge/patch
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Mimics smoking with hand-mouth action
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Nicotrol nasal spray dosing
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1 dose = 2 sprays (1 in each nostril)
- 1 or 2 doses per hour - max 40 doses per day |
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Avoid nicotrol nasal spray in?
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Severe reactive airway disease
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Nicotine patch dosing > 10 cig/day
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21 mg daily x 6 weeks,
14 mg daily x 2 weeks 7 mg daily x 2 weeks |
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Nicotine patch dosing < 10 cig/day
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14 mg daily x 6 weeks
7 mg daily x 2 weeks |
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How to avoid insomnia with nicotine patch?
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Wear for 16 hours instead of 24
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Which nicotine product is shown to reduce/delay weight gain associated with quitting smoking?
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Gum
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Nicotine lozenge dosing for people who smoke 1st cigarette within 30 minutes of waking up?
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4 mg lozenges
1 lozenge every 1-2 hours x 6 weeks, 1 lozenge every 2-4 hours x 3 weeks, 1 lozenge every 4-8 hours x 3 weeks |
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Nicotine lozenge dosing for people who smoke 1st cigarette more than 30 minutes after waking up?
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2 mg lozenges
1 lozenge every 1-2 hours x 6 weeks, 1 lozenge every 2-4 hours x 3 weeks, 1 lozenge every 4-8 hours x 3 weeks |
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Maximum # lozenges that can be used in 1 day?
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20 per day
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Minimum # lozenges that SHOULD be used in 1 day?
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9 per day
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Most common side effect from nicotine gum?
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Dyspepsia, mouth soreness, hiccups, jaw ache
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Most common side effect from nicotine patch?
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Local skin reactions, insomnia, vivid dreams
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Which nicotine formulation has the fastest delivery and is best for rapid relief of withdrawal?
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Nasal Spray
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Rx option best for smokers with a history of depression?
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Bupropion SR (Zyban)
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Dosing of Zyban?
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150 mg PO QAM x 3 days, then 150 mg PO BID
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When should Zyban be started?
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1-2 weeks before quit date
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What drug is a partial neuronal alpha-4/beta-2 nicotinic receptor agonist?
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Chantix (varenicline)
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Do NOT use Chantix in combination with?
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Nicotine replacement therapy
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Chantix dosing?
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Day 1-3: 0.5 mg PO daily
Day 4-7:0.5 mg PO BID Day 8 on: 1 mg PO BID |
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When should Chantix therapy be initiated?
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1 week prior to quit date
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Which medication, Chantix or Zyban, needs to be adjusted if CrCl < 30?
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Chantix
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Explain how to use nicotine gum?
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1.) Chew until peppery taste
2.) Park between cheek and gum 3) Alternate process until taste disappears (about 30 min) 4.) Do not eat or drink anything but water for 15 minutes before and during chewing |
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Explain how to use nicotine inhaler?
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1.) Frequent, continuous puffing for 20 minutes
2.) Each cartridge is a one time use (only good for 24 hours) 3.) Keep inhaler out of cold weather 4.) Only drink water while using |
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Explain how to use nicotine lozenges?
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1.) Dissolve in mouth- do not chew
2.) Only water can be drank while using 3.) Use 1 lozenge Q 1-2 hours for 6 weeks |
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Explain how to use nicotine patch?
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1.) Apply patch to hairless area of skin, betweenneck and waist in the morning
2.) Rotate sites 3.) Skin reactions are self-limited, but can be treated with hydrocortisone cream |
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Bupropion takes up to _____ to start working
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7 day
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Do not take Zyban if?
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Already on Wellbutrin
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Maximum daily dose of Zyban?
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450 mg/day
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What to do if you notice agitation, hostility, depression, or behavioral changes while on Zyban?
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Stop drug immediately and call physician
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When should Chantix be taken?
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After meals, with 8 ounces of water
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Most people take Chantix for how long?
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12 weeks
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If 12 weeks of therapy helps, some people use Chantix an additional _____ to stay cigarette free
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12 weeks
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