General Flashcards
How many COPD deaths are attributed to smoking?
90%
What percentage of moderate to severe COPDers still smoke?
20.4-43%
Behaviour change model: Pre-contemplation
Tobacco user is not thinking of quitting within the next six months.
Behaviour Change Model: Contemplation
Tobacco user is considering quitting within the next 6 months
Behaviour Change Model: Preparation
Tobacco user is planning to quit within the next 6 months
Behaviour Change Model: Action
Tobacco user has quit within the last 6 months
Behaviour Change Model: Maintenance
Tobacco user has quit for 6 months or more
What percentage of tobacco users are in the Contemplation stage?
35%
What percentage of tobacco users are in the preparation stage?
11%
What is the 5A Approach?
Ask, Assess, Advise, Assist & Arrange
How long does it take for nicotine levels to peak in the brain?
7 seconds
How do you choose a starting dose of NRT?
NRT dosages are based on number of daily cigarettes, and the time they have their first cigarette.
If person smokes 20+ cigarettes daily or within 30 minutes of waking…they should start at higher dose.
Nicotine Patch Dosage
21, 14 & 7 mg
21 cig+ start with 21 otherwise start with 14
How long does the patient wear each dosage of patch?
3-4 weeks, unless starting with 14mg then 6-8 weeks
Nicotine Gum Dose
20+ cigs - 4 mg gum
What is the bite, bite, park technique?
After chewing gum for initial 30 seconds; park the gum between gums & teeth then rechew with craving
Nicotine Inhaler Dosage
4 mg of nicotine/ puff
3-12 weeks use at least 6 but no more that 12 cartridges per day. Each cartridge should last 20 minutes.
Nicotine Lozenge
Suck until strong flavour appears and then parked in the side of the mouth
Nicotine Mouth Spray Dosage
1-2 sprays every 30-60 minutes
Max dose of Nicotine Mouth Spray
2 sprays/ episode, 4 sprays/ hour, 64 sprays/day
What is Bupropion?
Helps reduce withdrawal symptoms by inhibiting dompamine & noradrenaline reuptake…mimics the effects of nicotine
Bupropion dosage
150 mg once daily for 3 days, followed by 150 mg twice daily (at least 8 hrs apart) Do not exceed 300 mg
Bupropion Treatment
Should start while still smoking, 1-2 weeks to achieve “steady state levels”
7-12 weeks up to a year if needed
What is Varenicline?
Helps reduce withdrawal symptoms by blocking the alpha-4 beta-2 nicotinic acetylcholine receptor
Varenicline Dosge
0.5 mg daily for days 1-3 then 0.5 mg twice daily for days 4-7 then 1.0 mg twice daily thereafter
Start medication while still smoking for 1-2 weeks
Varenicline Treatment
12 weeks up to 24 if required
Should not be used with other NRT
Reducing Risk for Relapse
prepare to deal with social situations (avoid, leave, distract, delay and use self-talk
