Nicotine Flashcards
The α4β2 nicotinic acetylcholine receptor (nAChR) is the site of action of nicotine. Which of the following statements is not correct?
A In the central nervous system (CNS), these receptors are pentameric ion channel complexes
B There are two α subunits
C There are four β subunits
D Activation of nAChR leads to Na+/Ca2+ ion channel fluxes
E These receptors are found in the dopamine (DA) neurons which connect the ventral tegmental area to the nucleus accumbens.
In tobacco dependence, the primary site of action of nicotine is the α4β2 nAChR, and the endogenous transmitter acting on nAChRs is acetylcholine. nAChRs in the CNS are pentameric ion channel complexes, which are composed of two α and three β subunits. Activation of nAChRs leads to Na+/Ca2+ ion channel fluxes and neuronal firing. nAChRs are located presynaptically on several neurotransmitter-secreting neuron types in the CNS, including mesolimbic DA neurons that project from the ventral tegmental area to the nucleus accumbens. In addition, nAChR activation on mesolimbic DA neurons leads to DA secretion in the nucleus accumbens.
Which of these is a metabolite of nicotine that can be tested for to determine a patient’s use of nicotine?
A mecylamine
B ethyl glucuronide
C cotinine
D benzoylecgonin
E none of the above
Cotinine is a metabolite of nicotine that can be tested for to determine a patient’s use of nicotine. It can be detected in urine, blood, saliva, and hair. Mecamylamine is a noncompetetive antagonist at the nicotine receptor. Ethyl glucuronide is a metabolite of ethyl alcohol that can be detected for up to 3 days and benzoylecognine is the metabolite of cocaine that is tested for by most cocaine urinalyses.
Which of these is not part of the Fagerstrom test for nicotine dependence?
A How soon after you wake up do you smoke your first cigarette?
B Do you find it difficult to refrain from smoking in places where it is forbidden (e.g., in church, at the library, in cinema, etc)?
C Which cigarette would you hate most to give up?
D How many cigarettes per day do you smoke?
E all above are part of the Fagerstrom test for nicotine dependence.
Six questions above constitute the Fagerstrom test for nicotine dependence. They are: How soon after you wake up do you smoke your first cigarette?
Do you find it difficult to refrain from smoking in places where it is forbidden (e.g., in church, at the library, in cinema, etc)?
Which cigarette would you hate most to give up?
How many cigarettes per day do you smoke?
Do you smoke more frequently during the first hours after awakening than during the rest of the day?
Do you smoke even when you are ill enough to be in bed most of the day?
The answers to these questions are multiple-choice responses that are scored by points ranging from 0-3. The total number of points is a measure of the severity of the respondent’s dependence on nicotine.
Several non-nicotine pharmacotherapy agents can assist in the treatment of nicotine dependence. Which of these works by a partial agonist action on nAChRs?
A Bupropion
B Varenicline
C Nortriptyline
D Clonidine
E Naltrexone
Varenicline acts as a partial agonist of α4β2 nAChRs. Bupropion blocks reuptake of dopamine and norepinephrine, and its high-affinity, noncompetitive nAChR antagonism reduces nicotine reinforcement, withdrawal, and craving. Nortriptyline blocks reuptake of norepinephrine and serotonin, probably reduces withdrawal symptoms and comorbid depressive symptoms, and has side effect that limit its utility. Clonidine is a 2-adrenoreceptor agonist that reduces nicotine withdrawal symptoms. Finally, naltrexone is an endogenous opioid peptide receptor antagonist that reduces nicotine craving and withdrawal in combination with a transdermal nicotine patch; it may also reduce alcohol use and obviate cessation-induced weight gain.
Bupropion (Zyban) most likely works as a smoking cessation aid by inhibiting which of the following receptors?
A Serotonin and glutamate
B Dopamine and norepinephrine
C Gamma-aminobutyric acid and glutamate
D Acetylcholine and epinephrine
E Serotonin and norepinephrine
B Dopamine and norepinephrine
Which of the following is the mechanism of action of varenicline in patients trying to quit smoking?
A Antagonist of opioid receptors thus blocking the reward pathway when stimulated by nicotine
B Reuptake inhibitor of norepinephrine and dopamine
C Reversible inhibitor of acetylcholine hydrolysis by acetylcholinesterase thus enhancing cholinergic function
D Partial agonist of nicotinic acetylcholine receptors
D Partial agonist of nicotinic acetylcholine receptors
Complications of smoking during pregnancy (True/False): Preeclampsia
A.True
B.False
B.False
Statements regarding the use of varenicline (Chantix) for smoking cessation (True/False) It has both nicotine receptor–agonist and nicotine receptor–antagonist properties
A.True
B.False
A.True
Statements regarding the use of varenicline (Chantix) for smoking cessation (True/False): It has been shown to be effective in combination with other agents for cessation
A.True
B.False
B.False
The U.S. Public Health Service (USPHS) guidelines on tobacco cessation recommend against the use of all SSRIs for smoking cessation
A.True
A.False
A.True
Bupropion is contraindicated in patients with an eating disorder
A.True
B.False
A.True
ccording to the Task Force on Community Preventive Services convened by the Centers for Disease Control and Prevention, there is sufficient evidence to recommend the following public policy initiatives to reduce or prevent tobacco use EXCEPT?
A.Increasing the unit price of tobacco products
B.Mass media educational campaigns as part of a comprehensive approach
C.Smoking bans and restrictions in public places
D.Laws preventing purchase of tobacco by minors
D.Laws preventing purchase of tobacco by minors
