39 cessation tabagisme

Question 1

Motivational interviewing steps (5A)

Answer 1

Ask (ouvre le sujet)

Assess (readiness to change)

Advice - clear tell pt to stop smoking is

Assist: self help ou ressources

Arrange follow up

Question 2

Stade du changement de Prochaska

Answer 2

precontemplation
contemplation
preparation
action
maintenance

Question 3

Pharmacotherapy choices (4)

Answer 3

Varenicline

Buproprion

Nicotine replacement therap:
- Nicotine patch
- gums
- lozenge (aka pastilles)
- inhaler

Nortriptyline

Question 4

Pharmacotherapy combination (prefered choices to start with)

Answer 4

Varenicline plus Nicotine patch > Varenicline alone > NRT or Buproprion

Question 5

Varenicline when to start

Answer 5

1w before quit date 0.5mg/d x3d

and increase dose to BID then increase to 1 mg

ad 12 months

Question 6

Varenicline effets secondaires

Answer 6

headache
Insomnia
abnormal dreams
GI upset

Note: NO evidence that varenicline increases neuropsychaitric adverse events

self harm ?? myth?

Question 7

Varenicline brand name

Answer 7

champix

Question 8

Nicotine replacement therapy options:

Answer 8

• Nicotine patch
• gums
• lozenge (aka pastilles)
• inhaler

Question 9

how to choose dose of the Nicotine replacement therapy

Answer 9

depedning how many cigarets a day

Question 10

nicotine patch adverse effect

Answer 10

local irritation

Question 11

bupropion when to start and what dosage

Answer 11

begin 1w before quit date at 150mg/d x 3d

then 150mg BID

Question 12

bupropion side effects

Answer 12

Insomnia, headache, dizziness,
xerostomia,
tachycardia
weight loss

Question 13

bupropion counter indications

Answer 13

Avoid in seizure disorder, eating disorder, alcohol withdrawal

Question 14

Nortriptyline (2nd line) side effects

Answer 14

Sedation, dry mouth

Second-line due to side effects

Question 15

most effectice therapy is when

Answer 15

there is a combination

either nicotine replacement theries together or NRT + other med