Tobacco, Caffeine, Etc Flashcards Preview

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Flashcards in Tobacco, Caffeine, Etc Deck (13)
1

What is a good smoking Index for a measure of Nicotine dependence? 

Number of cigs/day

OR

 

TTFC: Time to first cig

<30 min moderate

<5 min severe

2

What is the role of the physician in tobacco addiction? What should we be doing?  

the 5As! Ask, Advise, Assess, ASsist, Arrange

Brief physician advice has been shown to increase quitting 

3

What are the stages of Change in Quitting Smoking? 

Pre-contemplation

Contemplation

Preparation

Action

Maintenance

Terminatoin

4

How is Nicotine metabolized? What are the Pharmacokinetics? 

Pharmacology depends on delivery route 

Smoking fastest in 10 sec and half life 2 hours

 

Metabolized in Liver to Continine which can be measured to verify if pt quit smoking

5

Who do you see nicotine intoxication in? what are the symptoms? What's the problem later on? 

 

Treatment? 

Mostly seen in kids who eat cigarretes or people who use patches and cigarates

Can be fatal due to peripheral nicotinic receptor stimulation!!!

 

Symptoms: Tachy, HTN, Salivation, N/V, Sweating, palpitations, ubcreased alertbess, SEIZURES in some!!!!!

 

*May see hypotension, Bradycardia and shock several hours after

 

Tx: supportive, LAvage or charcoal if ingested

Treatment of Bradycardia in kids w/ Atropine

6

What are symptoms of nicotine withdrawal? 

feeling really awful

decresaed HR, increased appetite, restlessmness, poor concentration etc

 

 

7

What are the FDA approved MEdications for Smoking Cessation? (note: not approved for maintenance like in alcohol)? 

NRT - Nicotine Replacement Therapy 

Bupriopion

Chantrix (Varenicline) 

 

 

8

What are the contraindications for NRT in smoking cessation therapy? 

Do not use if: 

 

 

Recent MI

Smoking

Pregnancy/breast feeding 

Adolescents

9

What are the different types of NRT? and a Pro/Con of each? 

Transdermal - use in pregnancy and continuous long term use; can cause skin irritation

 

Gum - on demand sypply an good for oral fixation; must be chewed properly

Nasal Spray - easy to use but higher abuse/dependence and effects (rhinitis, watery eyes, coughing) 

Inhaler/Puffer - harder to uses 

Tablets/Lozenges - can cause mouth/gums soreness

 

10

What is Buprioprion? How does it work? Who should NOT use it? 

decreases withdrawal symptoms when used alone and can be used in conjunction w NRT which is better!!!

 

Affects NE and Da neurons w/ Nicotine receptors = NDRI

CONTRAINDICATED if pt has a history of seizure disorder or eating disorder 

11

What is Varenicline? How does it Wpork? What are risks? 

Chantrix/Varenicline is a Partial Agonist for the nicotine receptor (alpha4beta2 subunit) and has modera ffinity for 5HT3 receptors

 

Caution in people w/ renal impairment

 

Side Effects - N/HA, Insomnia, WEIRD DREAMS and FDA warning for increased Suicide Risk

12

What are symptoms of caffeine intoxication? 

DEATH can result from people who have too much w/ pre-existing arrhythmias!!

 

Causes restlessness, insomnia, tachycardia 

Frequent urination and diarhea, muscle twitching, agitation etc

13