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PT: Hematology & Pulmonary > Smoking Cessation > Flashcards

Smoking Cessation Flashcards

(67 cards)

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1
Q

Treating tobaccos is a ______ treatment

A

gold standard

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2
Q

smoking cessation is a treatment for ____

A

CVD

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3
Q

Smoking cessation in patients with CVD reduces risk of death by ____% and reduces risk of future cardiac events by ____%

A

36%

50%

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4
Q

Standard treatments reduce risk of death in patients with CVD by ____%

A

15-35%

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5
Q

Smoking and respiratory disease

A
  • acute respiratory

- chronic respiratory

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6
Q

T/f it is best to quit smoking before you are 50

A

false!

Good at any age!

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7
Q

Stopping smoking at 30 results in ___ years life gained

A

10

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8
Q

Stopping smoking at 40 results in ____ years life gained

A

9

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9
Q

Stopping smoking at 50 results in ____ years life gained

A

6

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10
Q

Stopping smoking at 60 results in ____ years life gained

A

3

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11
Q

How many cigarettes in a pack?

A

20

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12
Q

How many packs are in a carton?

A

10

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13
Q

5 As to intervening

A 
Ask
Advise
Assess readiness to quit
Assist
Arrange
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14
Q

What do you do if patient is not ready to quit?

A

enhance motivation (5 Rs)

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15
Q

What do you do if patient is ready to quit?

A

design treatment plan

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16
Q

What do you do if patient has recently quit?

A

relapse prevention

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17
Q

When should you follow up with smoking cessation?

A

1 week
1 month

**and many more

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18
Q

Stage 1 readiness to quit

A

not ready in next month

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19
Q

Stage 2 readiness to quit

A

ready to quit in next month

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20
Q

Stage 3 readiness to quit

A

recent quitter (within past 6 months)

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21
Q

Stage 4 readiness to quit

A

former tobacco user 9quit >6 months ago)

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22
Q

What are the recommendations for those in pregnant smokers?

A

no recommendation

- insufficient evidence of effectiveness

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23
Q

Who is pharmacotherapy not recommended for (smokers)?

A
  • smokeless tobacco users
  • smoking <10 per day
  • adolescents (NRT minors Rx)
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24
Q

What is the recommended treatment in those who cannot use pharmacotherapy (smokers)?

A

behavioral counseling

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25
What are the 3 pharmacologic methods to smoking cessation?
NRT bupropion varenicline
26
NRT rationale for use
- reduce physical withdrawal - eliminate immediate, reinforcing effects of nicotine - allows to focus on behavioral and psychological aspects
27
NRT approximately ___ the quit rates
doubles
28
NRT vs smoking
- No carbon monoxide - no oxidants - absorbed more slowly - absorbed via venous system - flat dose response curve - 7000 chemicals not present
29
t/f smoking is a flat dose response curve
false! | dose dependent
30
NRT precautions
- patients with underlying CVD - recent MI - serious arrhythmias - serious or worsening angina
31
Nicotine gum dosing
2mg >30 mins from waking | 4mg <30 mins from waking
32
do not use more than ____ pieces of gum per day
24
33
t/f you need to taper on gum
true
34
T/F do not eat or drink 15 mins before or while using gum
True
35
Side effects of gum
``` Mouth soreness Hiccups Dyspepsia Jaw ache May stick to dental work ```
36
Lozenge dosing
2mg >30 min from waking | 4mg <30 min from waking
37
Do not use more than _____ lozenges per day
20
38
How long does it take to dissolve lozenge?
20-30 mins
39
How long does the gum usually last?
30 mins
40
T/f transdermal patch avoids hepatic first pass metabolism
True
41
How long does nicotine delivery last in patch?
24 hours
42
Dosing of patch if you smoke <10 cigs per day
14mg x 6 weeks | 7mg x 2 weeks
43
What is the dosing if you smoke >10 cigs per day?
21mg x 4 weeks 14mg x 2 weeks 7mg x 2 weeks
44
T/f it is okay to cut the patch to adjust dosing
False
45
T/f you must remove patch before MRI procedures
True
46
Side effects of patch within 1st hour
Mild itching Burning Tingling
47
Other side effects of patch
Vivid dreams | Headache
48
When should you contact doctor with patch?
If skin stays red >4 days or swells or rash
49
Bupropion MOA
Affect DA and NE
50
Bupropion clinical effects
Decrease cravings | Decrease withdrawal symptoms
51
Bupropion CI
- seizure disorder - wellbutrin - MAOI - anorexia or bulimia - undergoing abrupt discontinuation of alcohol or sedatives
52
Burprion warning and precaution
Suicide risk
53
Bupropion side effects
- insomnia - dry mouth - nausea
54
When should you recommend taking 2nd dose of burporpion?
By 5pm
55
Who should use bupropion in caution?
- history of seizure - history of cranial trauma - meds that lower seizure threshold - severe hepatic cirrhosis - depressive or psychiatric disorders
56
Bupropion dosing
150mg QAM 3 days 150mg BID 7-12 weeks **8 hours apart
57
When should you start bupropion?
1-2 weeks prior to quit date
58
T/f you must taper off of bupropion
False
59
Varenicline MOA
Competitively inhibits binding of nicotine
60
Varenicline clinical effects
- decrease symptoms of withdrawal | - block DA stimulation (reinforcement and reward)
61
Varenicline warnings and precaution
Risk of suicide
62
Varenicline ADE
- nausea - headache - insomnia - abnormal dreams
63
Varenicline dosing
1-3 0.5mg QD 4-7 0.5mg BID 8-end 1mg BID Up to 12 weeks
64
When should you start taking varenicline?
1 week prior to quit date
65
Which smoking cessation medication may give vivid or unusual dreams?
Varenicline
66
What is recommended 1st line in smoking cessation?
Long acting patch + short acting NRT Bupropion + patch
67
What therapies can be recommended, but not first line?
Long term patch + gum (2mg) Long term patch + nasal spray Standard patch + inhaler Standard patch + bupropion

PT: Hematology & Pulmonary (8 decks)

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