Tobacco Cessation Flashcards
(39 cards)
An alkaloid that is contained in the leaves of
plants
As is distributed quickly through the
bloodstream and crosses the blood–brain barrier
Reaches the brain within 8–20 seconds with
inhalation
The elimination half-life in the body is
around two hours.
metabolized in the liveR
Nicotine
How long is the elimination half-life of the nicotine in the body?
2 hours
How long does nicotine take to reach the brain?
8-20 seconds
Nicotine is metabolized in the _____
Liver
- Stimulates adrenal glands
- Releases adrenaline – surge causes immediate release of glucose
- Increased heart rate, breathing activity, and blood pressure
- Pancreas produces less insulin – causing increased blood sugar or glucose
- Dopamine released – feeling of contentment is higher
- Acetylcholine and Norepinephrine released – concentration and memory
- Increased levels of beta-endorphin – reducing anxiety
Nicotine
For chewing tobacco, dipping tobacco, snus and
snuff, the amount released into the body tends to
be ______ than smoked tobacco
much greater
Research indicates development of brain continues to
occur until the age of ____
25
______ changes the way synapses are formed,
can harm the parts of the brain that control attention and
learning.
It in e-cigarettes and other tobacco products
can also prime the adolescent brain for addiction to other
drugs such as cocaine.
Nicotine
Treatment should address the ____ and _____ aspects of dependence
physiological
and the behavioral
\_\_\_\_\_\_ symptoms Symptom Duration Chest tightness A few days Constipation, stomach pain 1-2 weeks Cough, dry throat A few days Cravings for tobacco Frequent in first 2-3 days Depressed mood, irritable 1-4 weeks Dizziness 1-2 days Difficulty concentrating A few days Fatigue 2-4 weeks Hunger Up to several Weeks Insomnia 1 week
Withdrawal symptoms
Most withdrawal symptoms subside in about ____
1 week
Benefits of \_\_\_\_\_\_ Time Benefit 20 minutes Blood pressure returns to normal 8 hours Normal oxygen blood level 24 hours Carbon monoxide eliminated from lungs – start to clear mucus 48 hours Nicotine is eliminated Smell and taste improve 3 days Lung capacity begins to improve Breathing become easier 2-12 months Circulation improves 5 years Risk of lung cancer decreases 10-15 years Reduced risk of other cancers
Quitting smoking
BENEFITS OF _________
Decreased risk of Oral, Head and Neck Cancer
Decreased risk of tooth decay
Decreased progression of gum recession
Decreased risk of High Cholesterol
Decreased risk of High Blood Pressure
Decreased risk for Heart Attack or Stroke
QUITTING SMOKELESS TOBACCO
What are the 5 A’s of cessation?
Ask Advise Assess Assist Arrange
What are the 4 things we must check with a physician before pharmacotherapy?
Hypothyroidism
Insulin-dependent diabetes
Active peptic ulcer
Anti-depressant medications
150 mg sustained release tablet Begin taking 1 week prior to quitting Double dose after 3 days Advantages: Easy to use Can be used with Nicotine Replacement Therapy Adverse Effect: Insomnia, dry mouth, nervousness/difficulty concentrating, rash, constipation, seizu
BUPROPION SR
ZYBAN
How long should the aids be used to increase success rate in cessation?
12 weeks
0.5 mg and 1.0 mg tablet
Days 1-3: take one 0.5 mg tablet in the AM
Days 4-7: take 0.5 mg tablet twice daily
Weeks 2-12: take 1.0 mg tablet twice daily
Advantages:
Easy to use and offers a new mechanism of action for
patients who have failed with other agents
Adverse Effects:
Nausea, insomnia, vivid dreams, constipation, vomiting,
Neuropsychiatric Symptoms (behavior changes, agitation,
depressed mood, suicidal ideation or behavior)
VARENICLINE
CHANTIX®
2 mg (smoke < 25 cig/day) or 4 mg (smoke ≥ 25 cig/day)
Week 1-6: 1 piece every 1-2 hours
Week 7-9: 1 piece every 2-4 hours
Week 10-12: 1 piece every 4-8 hours
Max of 24 pieces per day. No food or beverage 15 min before or
during use
Advantages:
May delay weight gain and satisfy oral cravings
Adverse Effects:
Mouth/jaw soreness, hiccups, dyspepsia
(GUM – NICORETTE, ZONNIC)
2 mg (smoke > 30 min after waking) and 4 mg (smoke ≤ 30
min after waking)
Week 1-6: 1 lozenge every 1-2 hours
Week 7-9: 1 lozenge every 2-4 hours
Week 10-12: 1 lozenge every 4-8 hours
Max. of 20 lozenges/day. No food or beverage 15 min. before or during use.
Do not chew or swallow lozenge
Advantages:
May delay weight gain and satisfy oral cravings
Adverse Effects:
Nausea, hiccups, cough, heartburn, headache, insomnia
(LOZENGE – COMMIT, ZONNIC)
7 mg, 14 mg, 21 mg (24 hour release)
Advantages:
Provides consistent Nicotine for 24 hrs, easy to use.
Adverse Effects:
Local skin reaction, headache, insomnia, vivid dreams
-Set and forget
(TRANSDERMAL PATCH - NICODERM CQ)
0.5 mg metered spray per 50 mcL 1-2 doses per hour 8-40 doses/day Maximum 5 doses/hr One dose = 2 sprays (1 per nostril) Advantages: Patients can titrate therapy to help with withdrawal Adverse Effects: Nasal/throat irritation, rhinitis, tearing, sneezing, headache, cough
(NASAL SPRAY – NICOTROL NS)
10 mg cartridge – delivers 4 mg inhaled nicotine vapor
6-16 cartridges/day
Begin with 1 cartridge every 1-2 hours
Best effects with continuous puffing for 20 min.
Advantages:
Patients can titrate amount to manage withdrawal and
mimics hand-to-mouth ritual
Adverse Effects:
Mouth/throat irritation, cough, headache, rhinitis, dyspepsia
(ORAL INHALER – NICOTROL)
Do all smoking tobacco products contain carcinogens?
Yes
