Smoking Cessations Kerr!

Question 1

For Smoking Cessations

List the Nicotinic Drugs

(memorize Generic Names)

Answer 1

Nicotine Patch Generic Name

-Nicodern CQ/Habitrol

Nicotine Gum Generic Name

-Nicorette

Nicotine lozenge

• Commit

Nicotine Inhaler

-Nicotrol lnholer

Nicotine Nasal Spray

• Nicotrol NS

Question 2

For Smoking Cessations

List Non-Nicotinic Drugs

(memorize the generic names)

Answer 2

• Buprorpion Sustained release (Buprorpion SR)

Zyban or Wellbutrin
Can be used
w/NRT

Start 1-2 weeks
before quit date.

• Varenicline

Tartrate

Chontix

Start 1 week
before quit date

Question 3

What are the adverse effects of Nicotine Inhaler?

Answer 3

• Mouth and throat irritation
• Cough

• Side effem generally caused by
inappropriate use

Question 4

What are the adverse effects of Nicotine Nasal
Spray?

Answer 4

• Nasal irrttation
• Sneezing
• Cough
• Teary eyes

Question 5

What are the adverse effects of Nicotine Patch?

Answer 5

• local skin irritation
• insomonia

Question 6

What are the adverse effects of Nicotine Gum?

Answer 6

• hiccups
• Dyspepsia
• mouth sorness

Question 7

What are the adverse effects of Nicotine lozenge?

Answer 7

• Dyspepsia
• local irrttation mouth & throat
• Rarely causes coughing & hiccups

Question 8

What are the adverse effects of Sustained release
bupropion (Zyban or Wellbutrin)?

Answer 8

• Insomnia
• Dry mouth
• Anxiety

Question 9

What are the adverse effects of Varenidine
tartrate Chontix ?

Answer 9

• Nausea
• Insomnia
• Abnormal dreams

Question 10

Nicotine inhaler

Precautions/Contraindications

Answer 10

Reactive Airway Disease

Question 11

Nictotine Nasal Spray

Precautions

Answer 11

Reactive Ariway diseases

Not recomended for pts with Chronic Nasal diseases ( nasal polyps & sinusitis)

Question 12

Sustrained Release Buprooion

Contraindications

Answer 12

• Seizure disorders
• Current use of bullrin or MAO inhibitor
• Eating disorder (bulimia, anorexia)
• Alcohol
• Head trauma

Moniter Blood presssure

Question 13

Varenicline Tartlrate

Precaustions

Answer 13

• women breasfeeding should avoid
• pt with kidney problems -adjust dose

Question 14

Nictoine Patch

Precutions

Answer 14

• Caution with 6 months of MI

Question 15

Nictotine Gum

Precuations

Answer 15

• poor dentition
• maybe inappropriate for use for pts with compelete or partial denture (hard for them to chew)

Question 16

Nictotine Lozenge

Precautions

Answer 16

• Xerostomia

Question 17

TREATING TOBACCO DEPENDENCE:
A 2-PART PROBLEM

Answer 17

Question 18

Why is it so hard to quit: Nicotine addiction?

Answer 18

Question 19

What are the symptoms of Nicotine Withdrawal?

Answer 19

■Irritability/frustration/anger

■Anxiety

■Difficulty concentrating

■Restlessness/impatience

■Depressed mood/depression

■Insomnia

■Impaired performance

■Increased appetite/weight gain

■Cravings

Question 20

WHAT WORKS (5A’s)

Answer 20

• Ask about tobacco use and secondhand smoke exposure
• Advise to quit
• Assess interest in quitting
• Assist in quit attempt (referral and or pharmacotherapy)
• Arrange for a follow-up

Question 21

Is Treating Tobacco is within the
Scope of Practice of dentists?

Answer 21

Yes

•New York State Education Department has deemed that treating tobacco use is part of the scope of practice for dentistry, this includes prescribing smoking cessation products.

Question 22

Nicotine replacement therapy (NRT)

&

FDA labeling

Is it Safe?

Answer 22

• NO safety concerns association with using more than one NRT
• NO significant safety concerns association with using NRT at the same time as a cigarettes
• Use for longer than 12 weeks is safe

Question 23

Assist-Prescribe FDA-Approved Medications

Answer 23

Question 24

First Line Pharmacotherapy

in combatting smoking?

Answer 24

• Combination long- and-short acting Nicotine Replacement Therapy (NRT) (e.g., patch and gum, patch and inhaler)
• Varenicline alone
• Bupropion SR with NRT (long- or short-acting)

Question 25

**•What is NRT at the POC?** **•Rationale for NRT at the POC** **•Who will hand the patient NRT?** **•What kind of NRT will be on stock?** **•How to distribute NRT at POC?**

Answer 25

**•What is NRT at the POC?** –Distribution of a free starter pack of NRT to all smokers by clinic staff during the clinic visit **•Rationale for NRT at the POC** –NRT doubles the success rate of patients’ quit attempts –Inconvenience of purchasing RNT or filling a prescription creates barriers –The clinic is an opportune time to intervene **•Who will hand the patient NRT?** –Dental Students **•What kind of NRT will be on stock?** •Nicotine Patch, Gum, and Lozenge **•How to distribute NRT at POC?** –Take faculty-approved NRT request form to dispensary, where NRT is stored.

Question 26

What is the The most effective treatment for smoking cessation

Answer 26

**a combination of pharmacotherapy and counseling**