Tobacco cessation Flashcards
pack year history
cig packs per day X number of years smoked
what are the 5 As in tobacco sessation
ASK
Advise
ASSESS
ASSIST
Arrange
most effective way to quit smoking
counselling plus medication
Combining a long acting NRT with a short acting can be most effective- patch with bupropion
NRTs
nicotine patch - nicoderm is OTC
nicotine gum - NIcorette also OTC
nicotine losenge- Nicorette mini
Nicotine inhaler- RX
Nicotine nasal spray- RX
NRTS warnings
avoid in asthma COPD, post MI arrythmia and prenancy
patch plus gum can help with Cravings
patch remove before MRIs
Hums and lozenge- do not eat/drink 15 mins before or during use
patch dosing>10cig per day
21mg x 6 weeks
14 mg x 2 weeks
7mg x2 weeks
gum and lozenge dosing <30mins after waking
4 mg Q1-2 x6 weeks
4mg q2-4 x 3 weeks
4mg q4-8 x 3 weeks
bupropion
zyban, well butrin
ZYban used for smoking cessation start 1 week before quit date
150mg qam for a week then 150mg BID max dose 300
what are some risks of bupropion
MOOD changes, dry mouth, weight loss, anxiety, tachycardia, insomnia
varenicline
chantix start 1 week before quit date
MOOD Alteration- neuro AE
insomnia
AE- nausea HA abnormal dreams
counseling on patch
apply on clean surface
wear for 24 hours
rotate application site
never cut the patch
remove if MRI, Vivid dream
counseling on nicotine gum
park between cheek and gum
do not eat or drink 15 mins before chewing
do not use more than 1 at a time
use atleast 9 per day for the first 6 weeks
MOA of varenicline or chantix
partial nicotinic receptor agonist
gum lozenge >30mins after waking
2 mg Q1-2 x6 weeks
2mg q2-4 x 3 weeks
2mg q4-8 x 3 weeks
what drugs should be avoided with bupropion
MAO, linezolid IV methylene blue
seizure
hx of anorexia/bulimia
