Nicotine & Smoking

Question 1

What are the advantages and disadvantages of Bupropion SR (Zyban)?

Answer 1

ADVANTAGES

1. Easy to use (pill)
2. No nicotine
3. Promotes weight loss
4. First-choice drug for smokers w/ depression

DISADVANTAGES

1. Prescription required
2. Small risk for seizures

Question 2

What are side effects of Bupropion?

Answer 2

Headache, constipation, dry mouth, blurred vision, insomnia, tachycardia, increased suicide risk

Question 3

What is Bupropion used for and what are its contraindications?

Answer 3

USES:
Decrease irritability, anxiety, depression, smoking cessation

Contraindications:
Psychotic disorders, hx of seizures, anorexia nervous, cocaine use, and alcohol withdrawal

Question 4

What are advantages and disadvantages of Varenicline (Chantix)?

Answer 4

ADVANTAGES:

1. Easy to use (pill)
2. No nicotine
3. Most effective drug for cessation

DISADVANTAGES:

1. Prescription required
2. May cause psych disturbances

Question 5

What are common side effects of Varenicline? What are contraindications? What do you monitor for?

Answer 5

SE: nausea, sleep disturbances, headaches, abnormal dreams

Contraindications: truck drivers, bus drivers, airplane pilots, air traffic controllers. Small CV risk w/ stable angina pts.

Monitor for: depression, SI, suicidal behavior, abnormal dreams

Question 6

What is Varenicline used for and what education should be provided to patients?

Answer 6

Most effective smoking cessation drug

Patient education: do not consume alcohol or nicotine (may increase toxic effects). Contact provider if experience psychiatric side effects or SI

Question 7

What is recommended to help pregnant women quit smoking?

Answer 7

Pharmaceutical nicotine (safer than tobacco smoke)

Question 8

How are children affected by nicotine? What are symptoms of toxicity?

Answer 8

Ingestion of tobacco and exposure to nicotine containing insecticides.

Symptoms: N/V, salivation, diarrhea, disturbed hearing & vision, confusion, & rapid, weak, irregular pulse. Death can result from respiratory paralysis.

Question 9

How is nicotine ingestion treated?

Answer 9

Activated charcoal. Ventilator assistance may be indicated for respiratory depression.

Question 10

What are advantages/disadvantages of the nicotine patch?

Answer 10

Advantages:

1. Nonprescription
2. Provides a steady level of nicotine
3. Easy to use
4. Unobtrusive

Disadvantages:

1. Cannot adjust dose if craving occurs
2. Nicotine released more slowly than other products

Question 11

What are advantages/disadvantages of nicotine gum?

Answer 11

Advantages: user controls dose and nonprescription

Disadvantages: unpleasant taste, cannot eat or drink while chewing gum, can damage dentition

Question 12

What has the fastest nicotine delivery and highest nicotine levels of all nicotine-based products?

Answer 12

Nicotine nasal spray