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LMAP2 > Smoking > Flashcards

Smoking Flashcards

1
Q

What are the main mediators of nicotine addiction in the brain?

A

Ventral tegmental area

Nucleus accumbens

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2
Q

Which receptor does nicotine have the highest binding affinity to?

A

Alpha-4-beta-2 nicotinic receptors

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3
Q

How quickly does inhaled nicotine reach the receptors?

A

7-10 seconds

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4
Q

What impact does smoking have of nicotinic receptors?

A

Smoking increases receptors x3-4 times, making it more addictive and harder to quit

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5
Q

What is chronic smoking?

A

Smoking is a chronic relapsing organic brain disease, and not a lifestyle choice

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6
Q

With combination therapy,. how more likely is a patient to quit?

A

4 times greater

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7
Q

What are the four main goals of behavioural support?

A
  • Reduce motivation to smoke
  • Bolster commitment to abstain
  • Enhance ability to cope with cravings
  • Ensure effective use of pharmacotherapy
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8
Q

Outline the standard NHS stop smoking services regime:

A

4-6 appointments over 6012 weeks

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9
Q

Outline the advantage of doctor delivered smoking cessation

A
  • Doctors are independent prescribers, used to tailoring treatment
  • Cessation advice can be more effective from doctors than counsellors and nurses
  • Smokers know, trust and want help to stop from their doctor
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10
Q

What are the examples of NRT?

A

skin patches, gums and inhalators ,lozenges, mini lozenges, oral spray, nasal spray , oral film

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11
Q

Why are there multiple options for NRT?

A
  • Allows choice in treatment
  • What works for one doesn’t work for another
  • Self determination-you guide, they decide
  • If the quit attempt fails, theres other options
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12
Q

What is the reality of smoking cessation?

A
  • 20-30% long term quit rate with support and treatment
  • 3-5% long term quit rate with willpower alone
  • 2 or 3 quit attempts with support and treatment for >50% smokers to stop long term
  • This makes it very cost effective
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13
Q

What is the long-term quit rate with support and treatment?

A

20-30%

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14
Q

What is the long term quit rate with willpower alone?

A

3-5%

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15
Q

What are the 5 main causes of death in the UK?

A

Ischaemic heart disease, stroke, COPD, Cancer, Pneumonia

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16
Q

What suggests high addiction in terms of smoking?

A

When waking at night to smoke

17
Q

Waiting for 2 hours after waking up, for a smoke, is considered to be what tier of addiction?

A

Mild addiction

18
Q

How long does it take nicotine receptors to downregulate?

A

8-12 weeks

19
Q

How would you test smoking cessation?

A

Carbon monoxide monitoring

20
Q

What number of cigarettes smoked per day suggests high addiction?

A

> 20

21
Q

What number of cigarettes smoked per day suggests moderate addiction?

A

10-20

22
Q

What number of cigarettes smoked per day suggests lower addiction?

A

<10

23
Q

When a patient wakes at night to smoke, what type of addiction is this?

A

Very high addiction

24
Q

When a patient smokes <30 minutes from waking, what type of addiction is this?

A

High addiction

25
Q

When a patient smokes for 30 minutes to 2 hours from waking, what type of addiction is this?

A

Moderate addiction

26
Q

When a patient smokes more than 2 hours from waking, what type of addiction is this?

A

Lower addiction

27
Q

What is the only safe level of smoking?

A

No smoking

28
Q

Why do smoking cravings occur?

A

The dopamine triggered by inhaled nicotine rapidly gets reabsorbed which leads to craving and low moods which leads to addiction

29
Q

What % increase in nicotine receptors does regular smoking cause?

A

300% increase

30
Q

How long does stopping smoking take?

A

24-48 hours for nicotine to leave the body

8-12 weeks for nicotine to down-regulate

31
Q

What is the average number of brief advice required to promote a quitter?

A

51

32
Q

What is the average number of NRT expected to promote a quitter?

A

23

33
Q

What is the average number of buproprion required to promote a quitter?

A

22

34
Q

What is the average number of varenicline required to promote a quitter?

A

11

35
Q

What is NRT based on?

A

Nicotine weaning

36
Q

What is buproprion?

A
  • Non-nicotine prescription tablet originally developed to treat depression
  • Modifies dopamine levels and noradrenergic activity
37
Q

What are the adverse effects on buproprion?

A

Insomnia
Headache
Dry Mouth
Nausea

38
Q

What are the two effects exhibited by varenicline as a partial agonist and block?

A

Blocking- Reduces the pleasurable effects of smoking and potentially the risk of full relapse after a temporary lapse
Stimulating-Relieves craving and withdrawal symptoms

LMAP2 (15 decks)

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