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Opath > messadi - 1/12 - methods of quitting tobacco use > Flashcards

messadi - 1/12 - methods of quitting tobacco use Flashcards

1
Q

tobacco dependence is a two part problem:

A

physiological

behavioral

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2
Q

true or false

tobacco is a chronic brain disease

A

true

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3
Q

true or false

change is a process and not a single step

A

true

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4
Q

why do people choose NOT to quit? 7 reason

A
  1. nicotine is stimulant and gives you energy affects DO and NE gives high
  2. smoking is a social behavior
  3. smoking helps with stress managment, and relaxation
  4. smoking helps control body weight [esp women]
  5. smoking elevates mood [antidepressant]
  6. Automatic smoking
  7. multiple failed quit attempts
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5
Q

___ % try to quit and know to quit but only ___% succesfully quit

A

70 % know

3% succeed

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6
Q

_____ _____ helps pts learn to cope with these difficult situations without having a cig

A

behavioral counseling

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7
Q

nicotine pharmacodynamics: withdrawal effect

which 7 are MOST PROMINENT

A

anger/ irritable

anxiety

craving

difficulty concentrate

hugner/ weight gain

impatience

restlessness

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8
Q

tobacco cessation intervention

waht are the 5 As

A

Ask

advise

assess

assist

arrange

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9
Q

waht type of question is this:

do you ever smoke or live in a household with smoker?

A

ask question of the 5 A’s

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10
Q

advise with a ____ , ___ , ___ way

A

clear

strong

personalized

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11
Q

occasional or light smoking is still harmful

waht type of quesiton is this

A

adivse question

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12
Q

assess ____ or ____ to make a quit to attempt

A

willingness

readiness

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13
Q

assist when the pt is ____

A

ready to quit

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14
Q

pt who are i nthe process of quitting ins in the ___ stage

pt who have been off tobacco for MORE THAN 6 MONTHS are in ____ stage

pt is ready to quit [in the next 30 days — ____ stage)

not ready to quit is _____ stage

A

action

maintenance

preparation

contemplation or pre-contemplation

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15
Q

arrange for ___ ___. this can be the difference bt quitting and not for some pts

A

follow up couseling

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16
Q

___ % of all smokers are addictied by the time they reach ____>

A

90%

19

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17
Q

the additional “A” is what

A

anticipate

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18
Q

benefits of quitting

2 weeks to 3 months

A

circulation improves

walking easier

lung function increase to 30%

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19
Q

benefit of quit

1 - 9 months

A
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20
Q

benefit of quitting 1 year

A
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21
Q

benefit of quitting 5 years

A
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22
Q

benefit of quit after 10 years

A
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23
Q

benefit of quitting after 15 years

A
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24
Q

what are the 2 methods for quitting:

  1. non pharamlogical includes ___ and other ___
  2. pharamological: ____
A

non pharmalogical : couseling and nondrug approaches

pharmalogical - FDA approved meds

25
Q

waht is the success rate of cold turkey and categorized as what type of method

A

5%

non-pharm

26
Q

other non pharm methods or alternative methods 5 of them

A
    1. acunpuncuture and hypotherapy = NOT EFFECTIVE
  2. massage therapy
  3. aversion therapy [suggest smoke till they are sick]
  4. formal cessation programs:
    - group programs

telephone counseling

27
Q

what are the 1st line of therapy…

psychotropics = antipsychotic meds

NRT?

A

nicotine replacement therapy

patches, inhaler, nasal spray, gum, lozenge

28
Q

true or false

pt can continue to use all forms of tobaccon upon intiation of the NRT regimen

A

false

STOP, as opposed to the pharmacological agents you can smoke up to 1 week before quitting

29
Q

true or false

can the effectivnes of nicotine gum be reduced with food and drinks

A

true

they should stop eating and drnking around 15 - 30 min before using gum

30
Q

lozenge delievers ___ % more nicotine than the gum

A

25%

31
Q

dosing of lozenge is based on ____ as an indicator or nicotine addiction

A

TIME to FIRST cig [ttfc]

32
Q

with the patch

  1. nicotine is well absorbed across the skin
  2. delivery to ____ avoids hepatic 1st pass metabolism
  3. plasma nicotine is ____ …
A

true

  1. systemic circulation
  2. lowers
33
Q

true false

apply to the same area each day

do use the same area again for at least 1 week

A

false, do NOT APPLY same area

false, do NOT use the same area for at least 1 week

34
Q

remove patch before an ___ procedure

remove the patch during ____ time of the day.

A

MRI procedure

night time

35
Q

___ and ___ you can titrate the dose, but ___ you cant

A

lozenge and gum you can titrate dose

patch you can NOT titrate dose

36
Q

the fastest nicotine replacement product taht goes to the brain is

A

nicotine spray

37
Q

nicotine inhaler, delievers ___ mg of nicotine absorbed through the ___ ___

A

4 mg

buccal mucosa

38
Q

____ is contraindicated in pt with seizures and is used as a reuptake inhibitor for ____ and ___

A

bupropion

NE

dopamine

39
Q

true or false

pt with any other antidepressants, alcohol, or eating disorders [greater risk for seizures] are also contraindicated for use of bupropion

A

true

40
Q

Bupropion sr:

pts should begin therapy _______ weeks _____ to their quit date to ensure that therapeutic plasma levles of the drgu are achieved.

A

1 to 2 weeks PRIOR

41
Q

if by 12 weeks, no diff in pt so doesnt stop smoking or doesnt see the effect of the bupropion, you should ____

A

stop use and 12 weeks is the cut off time

42
Q

true or false

  1. bupropion might benefical for pts wtih depression
  2. but if they are takig other anit depressants than shouldnt use bupropion
A

true

true

43
Q

varenicline is a ___ neuronal nicotinic ____ receptor agonist

A

alpha4beta2

Ach R agonist [competively inhibits nicotine from binding]

44
Q

_____ has neuropsychiatric symptoms and throughts of suicide

A

varenicline

45
Q

___ also is a partial nicotinic agonist like varenicline

A

lobeline [indian leaf]

46
Q

waht are the short acting formulation and what is the one long acting

A

short term:

gum

inhaler

nasal spray

long acting = patch

47
Q

which two are the most expensive products as opposed to the cigs

A

inhaler and bupropion

48
Q

to max success, interventions should include ___ and ___ meds

A

counseling

one or more meds

49
Q

first line meds that increase long term smoking cessation reates include:

A
  1. bupropion SR
  2. nicotine replacement therapy [gum inhaler, lozenge, patch, nasal spray]
  3. varenicline
50
Q

in smokers, clinicians may rely on the abscence of bleeding on probing as a MARKER of health in the same way as when assening non-smokers

true or false

A

false, smokers will not have bleeding less inflammation but doesnt not mean they have less periodontal disease

51
Q

waht % of the periodontitis cases among adults int he US is associated with smoking

  1. 7
  2. 1
  3. 9
  4. 3
A

41.9

52
Q

a patient has a fagerstrom scale of 8 this indicates a high plaque rate

high nicotine dependence

low nicotine dependence

stong correlation with oral cancer incidence

A

high nicotine dependence

53
Q

the basis for dosing nicotine lozenges is

the number of cig smoked daily

the time of first cig smoked

the number of years the smokers have been smoking

the numbr of previeous quitting attempt

A

the time of first cig smoked

54
Q

waht is the annual death rate attributed to smoking in the US

805, 000

443,000

11,000

1 mil

A

443,000

55
Q

cigars has less nicotine content than cigarettes

true or false

A

false can have 20x more than cigs and 440mg nicotine than cigs

56
Q

which statement is the least correct about Cannabis

  • its use has decrease in the USA in the last 25 years
  • increase in the last 10 years
  • role in oral cancer development is still controversial
  • used in the most age groups including teenagers
A

wrong: use has decreased in the uSA in the last 25 years

INCREASED IN THE LAST 25 YEARS

57
Q
A
58
Q
A

Opath (6 decks)

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