Exam #2: Treating Nicotine Dependence Flashcards
(39 cards)
What are the big three tobacco products?
1) Cigarettes
2) Smokeless
3) Cigars/ pipes
What are the physiologic effects of nicotine?
Epinephrine is released leading to:
1) Increased HR, BP, RR
2) Suppressed insulin output
3) Sudden glucose release
DA dump leads to feelings of pleasure
What pathologies do the physiologic effects of nicotine lead to?
- Heart disease
- Lung disease
- DM
Why does tobacco meet the definition of addiction?
Tobacco induces:
1) Tolerance
2) Withdrawal
3) Continued use in spite of harm
What is the definition of a cigarette? What is the nicotine dose of a cigarette?
Any roll of tobacco wrapped in paper or substance not containing tobacco
- 21mg of inhaled nicotine per pack
Why is menthol put in cigarettes?
Mild anesthesia
What is snus?
- Parked in upper lip and gum
- Marked to women
- No spitting
What is snuff?
Snorted
How many packs of cigarettes is tin of Kodiak equal to?
4 packs
What causes cancer in smokeless tobacco?
TSNA (Tobacco Specific Nitrosamines)
How is smokeless tobacco manipulated to increased absorption?
Free basing decreases acid levels and increases salivation
What is the definition of a cigar? What is the nicotine dose of a cigar?
Any roll of tobacco wrapped in TOBACCO
- 100-444mg of nicotine
Doesn’t have to be smoked to be absorbed
What are the 5 A’s?
- Ask= Id users
- Advise= urge to quit
- Assess= determine willingness to quit
- Assist= aid the patient
- Arrange= schedule follow-up
What are the 5 R’s?
- Relevance= why is it personal
- Risks= id. consequences
- Rewards= id. benefits
- Roadblocks= what are barriers
- Repetition= re-eval w/ each visit
What is NRT?
Nicotine Replacement Products
*No TSNAs
What is the “patch” as an NRT? Why do these need to be bridged with an alternative source of nicotine?
Long-acting nicotine
- 21mg dose but ONLY 17mg absorbed, which is LESS than a normal pack of cigs
How long do people need to be on the patch?
6 months
Should patients wear the patch at night?
Yes, but they can take it off with “bad dreams”
What are gum and lozenges used for?
Breakthrough cravings i.e. bridge the patch
When do patients get have a peak absorption from gum or lozenge? What is the implication?
15-20 min.
Need to take BEFORE they would have normally smoked
What is bupropion? What is the mechanism of action?
- Wellbutrin, an antidepressant that increases DA reward, mimicking nicotine
- Nicotine receptor blocker
What patients should NOT use wellbutrin?
Seizure hx Brain tumor CVA Brain surgery Alcoholics Anorexia/ Bulimia Hx of abuse LOC >30 min Skull Fx Inter-cranial bleed
What is Varenicline? What is the mechanism of action?
Chantix
- Binds nicotine receptor and activates it; also blocks nicotine
What should Chantix be taken with?
Water and a banana
