Exam 4: Smoking Cessation

Question 1

List the 3 types of drugs that can be used for smoking cessation therapy

Answer 1

1. Nicotine replacement therapy
2. bupropion (Zyban) - Dopamine reuptake inhibitor
3. varenicline (Chantix)

Question 2

What effect does nicotine have on the vascular system

Answer 2

Potent vasoconstrictor

Question 3

List the contraindications of Nicotine replacement therapy

Answer 3

1. Hypersensitivity to nicotine
2. Smokers folloing Post-MI
3. Life-Threatening Arrythmias
4. Angina
5. Active TMD (chewing gum)
6. Pregnancy
7. Non-smokers (aka children wanting to get a buzz)

Question 4

Why are patients not allowed to smoke while taking nicotine?

Answer 4

Patients must completely stop smoking prior to therapy

**nicotine raises cardiovascular risk, so can’t smoke at same time

Question 5

List the forms that nicotine can be given in

Answer 5

Gum
Lozenge
Inhaler
Nasal Spray

Question 6

How long does one take nicotine replacement therapy aids

Answer 6

Used in step-down approach for 7-12 weeks (3 months)

• dose used is less than what is obtained through smoking
• decreasing dosage w/ time

Question 7

What is the MOA of buPROPion (Zyban)

Answer 7

Dopamine reuptake inhibitor

(Antidepressant = Wellbutrin)

Question 8

What are the risks with buPROPion?

Answer 8

1. Risk for seizures: avoid alcohol and other drugs
2. Risk of treatment emergent hypertension with concurrent patch use.
3. Adverse psychological events

Question 9

How long does treatment with buPROPion last?

Answer 9

7-12 weeks

Question 10

What is the MOA with varenicline (Chantix)

Answer 10

Partial neuronal alpha4 B2 nicotinic receptor agonist

- occupies nicotine receptor sites in the brain

Question 11

Action of varenicline has what effects?

Answer 11

• Prevents nicotine stimulation of mesolimbic dopamine system associated with nicotine addiction
• Stimulates dopamine activity, but to a much lesser extent than nicotine does.
• *Results in decreased craving and withdrawal symptoms

Question 12

Name the side effects with varenicline

Answer 12

Oral: xerostomia and taste alteration
General: insomnia, headache, abnormal dreams, nausea, suicidal thoughts, aggressive behavior, adverse cardiac events

Question 13

When are the side effects of varnicline increased?

Answer 13

when the drug is used with nicotine replacement therapy