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part 2c > smoking cessatation > Flashcards

smoking cessatation Flashcards

1
Q

what what smoking increase the risk of

A
  • chronic diseases

- cancers

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2
Q

what is the main composition of a cigarette

A
  • tar
  • nicotine
  • carbon monoxide
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3
Q

how does tar effect the body

A 
tar causes particles to be inhaled 
these inhaled particles cause thick brown sticky residue in the lungs, teeth and fingers 
- causes narrowing of the bronchiles
increased secretion of mucous 
decreased activity of cilia 
development of cancer
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4
Q

how does carbon monoxide effect?

A 
Co takes over oxygen in rbc 
increase the production of rbc = blood gets thicker 
less o2 distrubuted to cells around the body 
the heart works harder 
bp increased 
increases risk of cvd 
reduced excercise tolerence 
fatigue
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5
Q

what does nicotine do?

A 
adversely effect every major systems 
brain - normal activity 
heart and arteries - high BP and HR 
eyes - reduced in peripheral vision 
metabolism - increased calories burned 
reproduxctive 
bones - oestop
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6
Q

how is addiction caused?

A

nicotine

  • activation of ‘reward pathway’
  • administration leads to pleasure or elevation
  • withdrawels

distrupts normal neurotransmitter activities
- chemical changes and addiction

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7
Q

when are withdrawel symptoms caused

A

when nicotine receptors are not activated

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8
Q

what is the development of dependence

A

1) smoking - deliver nicotine
2) nicotine travels to the brain
3) dopamine release - leading to feel of pleasure + calmness
4) drop in dopamine - withdrawel
5) desire for a another ciggarette

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9
Q

what is second hand smoke

A

inhalation of others smoke

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10
Q

what is the relation between smoking and drug metabolism

what are the drugs which are affected

A
  • polycyclic aromatic hydrocarbon in ciggarette smoke increase activity of several liver enzymes - cytochrome p450 system
  • enzyme induction= faster clearance of medication from body = decreasing efficacy

theophylline
cinacalcet
ropinirole
antiphsychotics

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11
Q

what are the barriers for smoking cessation

A

-withdrawel
-denail of pleasurable effect
lack of motivation
fear id failure
worries about gaining weight
worries about using nicotine replacement therapy (NRT)

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12
Q

how long till nicotine free in short term

A

72 hours

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13
Q

list some symptoms of nicotine withdrawel syndrome

A

-cravings
-increased apeptite - weight gain
dizziness
lack of concentration
heart rate decrease
constipation
cough
mood swings
sleep disturbances
anxiety

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14
Q

stages of change

A 
pre contemplation - ill live with it 
contemplation 
resistance 
prep
action 
relapse?
maintenance
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15
Q

identifying oppurtinities

A 
- coughing complaint
health check 
recuurent chest infection 
inhaler running out 
looking for nrt product
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16
Q

role of pharmacist

A
  • congratulate them
    -explain support which can be offered
    -say the benifits
    -find out if they are ready to give up
    -indiviudal support
    dicuss habit
    smoking diary
    personal benifits?
    how importnat not to give uo
17
Q

what are nice guideline interventions

A

-behavoural suport - 4 weeks after quit date
-NRT - small amount of nicotine without tabbaco and no
breief advice
bupropion
varenicline

18
Q

what is the 5 d

A 
delay 
drink water 
deep breathing 
do something different 
discuss craving with another
19
Q

what are the pharmacological interventions available

A 
-sublingual tablets 
lozenge 
gum 
nasal spray 
patches 
inhalator 
quick mist mouth spray

POM :
buproprion
varenicline

20
Q

what is NRT and how does it work

A
  • relieve symptoms of nicotine withdrawel
  • gradually reduce level of nicotine until free from addiction
  • patients can choose flavour, and way of formualtion, conset, indiviudual needs
21
Q

how long is NRT used for

A

8-12 weeks

22
Q

sublingual tablets

A

-left under the tongue to dissolve
- less than 20 ciggarettes - 1 tablet a hour
-more than 20 = 2 tablets
12 week treatment
avoid acdic beverages 15 mins before use - juices , coffee

23
Q

lozenges

A

-dissolve under toungue- one side to the other until dissolved
less than 30 cigg = 1-2 mg
-who smoke within half an hour of waking - 4mg
- can be used in pregnancy

24
Q

GUM

A

-20 cigg or less = 2mg
20-30 cigg = 2-4 mg
more than 30 = 4mg
chew until taste is strong and rest in cheeks and gum to absorb

25
Q

patches

A

reduction from steps of use
2 diff types - 16h and 24h
skin irritation
used in preg

26
Q

inhalator

A

whenever feel the urge to smoke

max- 16 catridges a day

27
Q

quick mist spray

A

1 or 2 spray whenever get the urge

4 sprays per hour max

28
Q

what are the pom medicines and why are they used?

A

-buproprion
varenicline

when otc does not work

29
Q

buproprion

A

anti-depressent
150mg prolonged release tablet
long half life
-centrally acting noroadrenaline/dopamine reuptake inhibitor
-antagonist at anticholinergenic receptor

30
Q

varenicline

A

bind to selective nicotine partial agonist - mimics stimulation of dopamine release
-block access to receptor = reduce pleasurable effect of smoking
mimic nicotine to reduce withdrawal effects

should quit 2 weeks prior taking it

NOT with pregancy or younger than 18

31
Q

e ciggarettes

A

small amount of nicotine via inhalation

32
Q

Stop smoking services provided by pharmacies are classified as what type of service?

A

Locally commissioned service

33
Q

is any of the options more effective than the other

A

no

34
Q

Nicotine concentrations within e-liquids should not exceed 0.2g/ml
true or false

A

true

35
Q

Quitting smoking may result in nicotine withdrawal syndrome. Which of the following is a withdrawal symptom?

A

Bradycardia

36
Q

How often should pharmacists provide advice to individuals who continue to smoke?

A

once every 12 months

part 2c (18 decks)

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