Exam 4 Drugs for smoking cessation Flashcards

1
Q

3 types of drugs used for smoking cessation

A
  1. nicotine replacement therapy
  2. bupropion (Zyban)
  3. varenicline (Chantix)
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2
Q

Nicotine functions as what?

A

potent vasoconstrictor

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3
Q

How is nicotine replacement therapy set up?

A

Pts must completely stop smoking prior to therapy
gum,lozenge, inhaler, nasal spray OTC
step down approach for 7-12 weeks
dosing gradually tapers down to wean off nicotine
designed to decrease cravings

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4
Q

Why must you quit smoking before starting nicotine replacement therapy?

A

nicotine raises cardio risk so cant smoke at the same time

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5
Q

what else is bupripion (Zyban) used for?

A

dopamine reuptake inhibitor = antidepressant (Wellbutrin)

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6
Q

Why should you avoid alcohol when taking bupripion?

A

risk for seizures

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7
Q

How long is the course of tx for bupripion?

A

7-12 weeks

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8
Q

Whats is the risk when used concurrent with patch?

A

emergent hypertension - monitor BP

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9
Q

varenicline (Chantix) is the newest smoking cessation drug, it is a partial neuronal ____-_ __ nicotinic receptor agonist and occupies nicotine receptor sites in the brain

A

alpha-4 B2

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10
Q

How does varenicline work?

A

prevents nicotine stimulation of mesolimbic dopamine system and stimulates dopamine activity but to a lesser extent than nicotine which results in decreased craving and withdrawal symptoms

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11
Q

2 oral side effects of varenicline (Chantix)

A
  1. xerostomia

2. taste alteration

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12
Q

5 general side effects of varenicline (Chantix) - risks increased when used with nicotine replacement therapy

A
  1. insomnia
  2. headache
  3. abnormal dreams
  4. nausea
  5. new reports of suicidal thoughts/ aggressive behavior / adverse cardiac events
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13
Q

What percent of smoking women want to quit?

A

70%

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14
Q

Average number of quit attempts?

A

8-11

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15
Q

Name of the program to help assist dental professionals with helping patients to quit smoking

A

Ask, Advise, Refer - 7-12 weeks long tx

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16
Q

What affect doe nicotine have on bone?

A

stimulates IL-6 which increase osteoclastic resorption and decreases estrogen protective effects on bone

17
Q

___% of inhaled smoke is absorbed in oral cavity

A

30% - cancer risk, higher in females

18
Q

4 desired effects of nicotine

A
  1. increased alertness
  2. muscle relaxation
  3. facilitation of concentration and memory
  4. decreased appetite
19
Q

8 harmful effects of nicotine

A
  1. irritability
  2. hypertension
  3. increased pulse rate
  4. induces nausea/vomiting
  5. dizziness
  6. CAD
  7. lung cancer
  8. oral cancer
20
Q

average age of initiation of smoking

A

14.5 years

21
Q

nicotine causes lower estrogen levels which has what 4 effects

A
  1. low birth weight babies
  2. pregnancy complications
  3. early menopause
  4. osteoporosis
22
Q

smoking ___ age of first heart attack and ___ risk for heart attack

A

lowers

raises

23
Q

periodontal disease can be caused by smoking because…

A

nicotine stimulates IL-6 which increase osteoclastic resorption, nicotine decreases estrogen-protective effects on bone

24
Q

name 10 cancer besides lung that can be due to smoking

A
  1. oral
  2. pharynx
  3. larynx
  4. esophagus
  5. bladder
  6. stomach
  7. cervix
  8. kidney
  9. pancreas
  10. acute myeloid leukemia
25
Q

____ additives are approved by the US government in the manufacturing of cigarettes

A

599 (when burned, cigarette smoke contains over 4000 chemicals, 40 known carcinogens - carbon monoxide, nitrogen oxides, hydrogen cyanide and ammonia)

26
Q

cigarette smoking = major cause of ___ cancer

A

esophageal (mouth cancers increase among people who smoke pipes and cigars)

27
Q

8 notable chemicals in cigarettes

A
  1. tar
  2. hydrogen cyanide
  3. benzene
  4. acetone
  5. formaldehyde
  6. ammonia
  7. carbon monoxide
  8. nicotine
28
Q

1 cigarette has how much nicotine?

A

8-9 mg (cigar 100-200 mg some up to 400 mg)

29
Q

what chemical is used in manufacturing gasoline and a known cause of acute myeloid leukemia

A

benzene