smoking cessation Flashcards
what are the leading causes of death due to smoking
lung cancer, COPD, ischemic heart disease
what main area in the brain does nicotine bind to and what are the receptor types
nACh (ligan gated) receptors in the nucleas acumbens, increasing dopamine release
what is the initial are that nicotine binds that isn’t beleived to have much to do with long term effects
nACh in ventral tegumental area
what makes a drug absorb well via the bucal route
small and lipophilic, passes first pass effect
which form of NRT delivery can last 24 hours
transdermal
what molecule is in NRT gum
nicotine polarcrilex
which form of NRT causes more nicotine to be absorbed, gum or lozenge
lozenge
how does the inhaler work
most absorbs into bucosa and some is swalled but most of swallowed goes through first pass
which NRT formulation has the fastest absorption
nasal spray
how does bupropion helps with smoking cessation
increases dopamine so smoking doesn’t feel rewarding and helps decrease withdrawal symptoms
how does varenicline work
partial agonist at nACh specifically at the beta ones in the reward center of the brain, stops nicotine from binding
how is nicotines durration and accumulation in the body normally assessed
by its metabolite cotinine
main NRT Drug drug interaction
cimetidine may decrease metabolism of nicotine
what are some second line therapies
clonidine and nortryptaline
when a patient is first starting NRT gum how should they use it?
chew one piece every 1-2 hours
