Block 3 Flashcards
(237 cards)
Nicotine metabolism occurs where?
80% in liver via CYP2A6
20% in lungs and kidneys
Nicotine inactive metabolite is…?
Cotinine
Nicotine withdrawal Sx kick in when?
Appear in 1-2 days
Peak in 1 week
Subside in 2-4 weeks
How do you assess addiction level for nicotine?
Based on # of cigs/day
Heavy ≥ 25
Moderate 11-24
Light 1-10
What is the Fagerstrom Test?
Assess nicotine dependence
Assess possibility of severe withdrawal
When do you use the Transtheoretical model? What are the parts to it?
To assess readiness to quit smoking
Precontemplation (no plan within 6 months)
Contemplation (thinking of change within 6 months, no plan)
Preparation (plan to change within 30 days w/ plan)
Action (has changed but less than 6 months)
Maintenance (has changed but greater than 6 months)
Termination (no temptation + change will be maintained)
In the “assist” section of smoking cessation, what is STAR?
Set a quit date preferable within 2 wks
Tell a family member, friend, etc
Anticipate challenges like withdrawal
Remove tobacco products/paraphernalia
In the “arrange” sectio of smoking cessation, when should you follow-up with patients?
Within 1 week of quit date
Second contact should be within 1 month
Nicotine MOA?
Stimulates the nicotine receptors in the ventral tegmental area of the brain, leading to the dopamine release
When is it contraindicated to use nicotine replacement therapy?
If they had any cardiovascular events in the past 2 wks
When should you start using nicotine replacement therapy products?
Start on the quit date
Dose and administration of nicotine patches are based on what criteria?
3 steps = more than 10cigs/day
2 steps = less than 10cigs/day
How long do you use the nicotine patches?
3 steps = step 1 for 6 wks, step 2 for 2 wks, step 3 for 2wks
2 steps = step 2 for 6 wks, step 3 for 2 wks
AE of nicotine patches?
Vivid dreams, insomnia
Patient education points for nicotine patches?
Apply on hairless area between neck and waist, rotate areas
Dont apply after lotion use
If you experience sleep disruptions while using the patches, remove them at night
Dose and administration of nicotine gum are based on what criteria?
2mg if you smoke your first cigarette greater than 30 min after waking
4mg if you smoke your first cigarette within 30min of waking
***lozenges follow the same schedule
How long do you use the nicotine gum?
Initially, follow this schedule:
1 piece every 1-2 hours for 6 weeks.
Then every 2-4 hours for 2 weeks.
Then every 5-8 hours for 2 weeks.
PRN afterwards
***lozenges do NOT follow this schedule
Nicotine gum AE?
Mouth soreness and dyspepsia
Patient education points for nicotine gum?
Do not eat or drink 15 min before and while gum is in mouth
“Chew and park” method
Chew each piece for 30 min.
How long do you use the nicotine lozenges?
Use 1 lozenge every 1-2 hours (at least 9; maximum 20) for 6 weeks.
Then every 2-4 hours for 2 weeks.
Then every 4-8 hours for 2 weeks.
PRN afterwards
Nicotine lozenge AE?
Throat irritation, hiccups, indigestion/heartburn, nausea
Patient education points for nicotine lozenges?
Do not eat or drink 15 min before and while lozenge is in mouth
Move lozenge from side to side while dissolving in mouth; do not chew
Dose and administration of Nicotine Inhaler (Nicotrol)?
1 cartridge = 80 puffs = 4 mg of nicotine
Use 6-16 cartridges a day; can put away partially used cartridge and reuse when needed
up to 6 months :O
Patient education points for nicotine Inhaler (Nicotrol)?
Use like smoking a cigarette
Decreased delivery if below 40 degrees Fahrenheit; keep in warm area or coat pocket