drugs in smoking cessation Flashcards
bupropion - indication
to aid smoking cessation in combination with motivational support in nicotine dependent patients
MHRA bupropion - risk of serotonin syndrome with use with other serotonergic drugs
e.g. SSRIs, SNRIs etc
if serotonin syndrome suspected, dose reduction or discontinuation, depending on severity of symptoms, should be considered
contraindications for bupropion
- Hx seizures
- bipolar disorder
- CNS tumour
- acute BZDPN withdrawal
- acute alcohol withdrawal
- earring disorders
- severe hepatic cirrhosis
Is bupropion appropriate for patient with epilepsy
no, contraindicated in hx seizures
bupropion is contraindicated in the following mental health disorder
bipolar disorder
a common side effect of bupropion is insomnia. how can this be reduced?
avoid taking at bedtime
monitoring requirements for bupropion
BP before and during treatment
bupropion - patient and carer advice
- instruct patients and carers to report any clinical worsening of depression, suicidal behaviour or thoughts and unusual changes in behaviour
brand name for bupropion
zyban
use caution when giving NRT in patients with this metabolic disorder because
DM - BGC should be monitored closely when initiating treatment
common symptoms of nicotine withdrawal
- malaise
- headache
- dizziness
- sleep disturbance
- coughing
- influenza like symptoms
- depression
- irritability
- increased appetite
- weight gain
- restlessness
- anxiety
- drowsiness
- aphthous ulcers
- decreased HR
- impaired concentration
avoid the following drinks 15 mins before using oral NRT because
Acidic beverages, such as coffee or fruit juice, may decrease the absorption of nicotine through the buccal mucosa and should be avoided for 15 minutes before the use of oral nicotine replacement therapy.
NRT transdermal patches - directions
applied on waking to dry, non-hairy skin on the hip, trunk, or upper arm
hold in position for 10-20 seconds to ensure adhesion
place next patch on different area and avoid using same site for several days
how to use NRT chewing gym
Chew the gum until the taste becomes strong, then rest it between the cheek and gum; when the taste starts to fade, repeat this process. One piece of gum lasts for approximately 30 minutes.
NRT how to use lozenges
Slowly allow each lozenge to dissolve in the mouth; periodically move the lozenge from one side of the mouth to the other. Lozenges last for 10–30 minutes, depending on their size.
