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NAPLEX > Chapter 43: Tobacco Cessation > Flashcards

Chapter 43: Tobacco Cessation Flashcards

1
Q

What are the “5 A’s” for treating tobacco use and dependence

A
  • Ask about tobacco use
  • Advise to quit
  • Assess willingness to make a quit attempt
  • Assist in quit attempt
  • Arrange follow up
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2
Q

The combination of ____ and ___ is more effective than either one alone for smoking cessation

A

Counseling and medication

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3
Q

The non-nicotine chemicals in tobacco smoke induce which CYP enzyme

A

1A2

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4
Q

Smokers who quit can experience side effects from supratherapeutic levels which drugs

A

Caffeine, theophylline, warfarin

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5
Q

Women age >/= ___ years who smoke should not take ____ due to an increased risk of CV events

A

35 years

estrogen-containing OCs

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6
Q

Treatment guidelines promote the use of behavioral counseling over drugs for which populations?

A

Pregnant women, adolescents, “light smokers” using < 10 cig/day

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7
Q

Which vaccines should smokers receive and which age group should receive them

A 
Pneumovax 23 (age 19-64 years)
influenza vaccine
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8
Q

Dosing schedule for Nicotine patch if patient smokes > 10 cig/day

A

21 mg patch (weeks 1-6)
14 mg patch (weeks 7-8)
7 mg patch (weeks 9-10)

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9
Q

Initial dose of Nicotine patch if patient smokes < / = 10 cig/day

A

14 mg patch

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10
Q

Initial dose for gum/lozenge if first cigarette is > 30 min upon waking

A

2 mg

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11
Q

Initial dose for gum/lozenge if first cigarette is < / = 30 min upon waking

A

4 mg

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12
Q

Minimum pieces of gum/lozenge per day during the first 6 weeks

A

9

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13
Q

NRT warnings

A

Avoid in immediate post-MI period, arrhythmias, angina and pregnancy
Inhaler/nasal spray: avoid in asthma, COPD

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14
Q

Side effect from Nicotine patch

A

vivid dreams

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15
Q

Side effect from Nicotine inhaler

A

mouth and throat irritation

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16
Q

Side effect from Nicotine nasal spray

A

nasal irritation

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17
Q

T/F: nicotine patch does not need to be removed before an MRI

A

false

18
Q

Which formulation and strength of NRT can reduce or delay weight gain

A

4 mg gum or lozenge

19
Q

Patients should not do this before or during use of gum/lozenge

A

do not eat or drink 15 min before or during use

20
Q

Bupropion MOA

A

blocks reuptake of DA and/or NE resulting in reduced cravings and other withdrawal symptoms

21
Q

Varenicline MOA

A

partial alpha-4 beta-2 nicotinic receptor agonist

22
Q

When are Bupropion & Varenicline started

A

1 week before the quit date (since they reduce cravings)

23
Q

T/F: Bupropion & Varenicline need to be tapered when they are d/c

A

False

24
Q

Bupropion SR brand name for smoking cessation

A

Zyban

25
Q

Varenicline brand name

A

Chantix

26
Q

Bupropion SR dosing & max dose

A

150 mg QAM for 3 days, then 150 mg BID

Max dose: 300 mg/day

27
Q

Bupropion BW

A

Increased risk of suicide thinking and behavior in children, adolescents and young adults taking antidepressants

28
Q

Bupropion CI

A

Seizure disorder, hx of anorexia/bulemia; with MAOi, linezolid or IV methylene blue

29
Q

Bupropion & varenicline warnings

A

Serious neuropsychiatric events

30
Q

Bupropion SE

A

Dry mouth, insomnia, tremors, weight loss

31
Q

To decrease risk of insomnia with Bupropion, take the first dose upon waking up and take the 2nd dose __ hours after the first dose

A

8

32
Q

Varenicline SE

A

nausea, insomnia, abnormal dreams, HA

33
Q

To decrease risk of nausea with varenicline, how can it be taken

A

Take after eating with a full glass of water

34
Q

If a patient is concerned about weight gain, which treatments can be used for smoking cessation

A

Gum, lozenge and bupropion SR

35
Q

If a patient is concerned about depression, which treatments can be used for smoking cessation

A

Bupropion SR

36
Q

If a patient has a history of seizures, which treatments for smoking cessation should be avoided

A

Bupropion SR and Varenicline

37
Q

When applying a nicotine patch, how long should you press down on the patch to the skin

A

~10 sec

38
Q

How long should a nicotine patch be worn

A

24 hrs

39
Q

If a patient is having vivid dreams from the nicotine patch, what can the patient be counseled to do

A

remove the patch prior to bedtime (after about 16 hrs) and apply a new one in the morning

40
Q

Do not use the same site to apply a nicotine patch for at least ___

A

1 week

41
Q

T/F: The nicotine patch can be cut

A

false

42
Q

How to chew nicotine gum

A
  • chew slowly until there is a tingle or peppery flavor in the mouth
  • Park it in between the cheek and gum
  • When the tingle or flavor goes away, begin chewing slowly again until it returns, then park the gum again
  • Repeat until most of the flavor or tingle is gone (~30 min)
  • Do not eat or drink 15 min before or during chewing

NAPLEX (74 decks)

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