Nicotine Addiction Flashcards
What are the effects of nicotine on the body?
increased arousal
Increased HR, BP, RR,
What is the effect of nicotine on blood sugar levels?
Hyperglycemia
True or false: nicotine is the cause of the cardiac disease, not the smoking itself
True
What are the neurotranmitters that are increased in the brain in reponse to nicotine?
Dopamine/NE
Acetylcholine
5HT, GABA
How is tobacco addiction a habit?
Learned behavior that is precticed over time
The smell of dopamine releases what neurotransmitter in addicted individuals?
Dopamine
What is the definition of a cigarette?
ANy roll of tobacco wrapped in paper or any substance not containing tobacco
What ingredient in cigarettes provides a mild anethesia?
Menthol
True or false: there is no such thing as a “light” cigarette
True
What are tobacco specific nitrosamines found in? Why is this concerning?
chew–highly carcinogenic and end up in lung
Why is snuff, in some respects, more concerning than cigarettes?
Contains more nicotine per dose
What is the definition of a cigar?
Any roll of tobacco wrapped in leaf tobacco or any substance containing tobacco
How much nicotine is contained within one cigar?
100-444 mg
True or false: the only way to get the nicotine found in a cigar is through smoking it
False–absorbed through mouth/lips
What are the five A’s of tobacco treatment?
Ask Advise Assess Assist Arrange
What is the relevance part of the 5 Rs?
Why it is personal
What is the risks part of the 5 Rs?
identify consequences
What is the rewards part of the 5 Rs?
Identify benefits
What is the roadblocks part of the 5 Rs?
What are the barriers
What is the repetition part of the 5 Rs?
Re-valuate with each visit
What is the ask part of the 5 As
Identify users
What is the advise part of the 5 As?
Strongly urge users to quit
What is th assess part of the 5 As?
Determing willinness to quit
What is the assist part of the 5 As?
aid the pt
What is the arrange part of the 5 As?
Schedule f/u
True or false: there are no TSAs in nicotine treatment options, like the patch
True
How many mg of nicotine are absorbed with the patch?
17 mg
What is the timeframe for treatment for nicotine addication?
6 months
What is a common side effect of the patch? What is the treatment for this?
Vivid dreams–take off during sleeping
True or false: unless the patient is adamant anout it, you never use just nicotine gum
True– too low of a dose
What is the major problem with nicotine gum?
Slow absorption
Why should pts never chew on a lozange?
Will cause nausea
True or false: you should never inhale a nicotine nasal spray
True
What is the fasstest route of nicotine that is not cigarretes?
Nasal spray (10 minutes)
True or false: the inhaler treatment for nicotine addiction is not inhaled, but puffed, and absorbed through the mouth
True
How does wellbutrin work to treat tobacco addiction?
Replaces the nicotine effects of dopamine
True or false: it is safe to use wellbutrin for patients with CVD, COPD, or if they’re on other antidepressants
True
True or false: alcoholics are safe to receive wellbutrin
False
What is the MOA of chantix (varenicline)?
Partial agonist for nicotine receptors—Blocking nicotine from binding
Is it okay to take chantix on a full stomach
Yes, you have to
When should you monitor pts livers when on chantix
Elderly or known liver failure
What are the two major side effects of chantix?
Suicidal thoughts
Szs
What form of tobacco are all of the treatments off label?
Spit tobacco
What are the treatments for spit tobacco addiction?
Gum
Patch
Lozange
What types of nicotine replacement should not be given to spit tobacco users?
Nasal spray
Oral inhaler
What is the best treatment for spit tobacco users?
Chantix
What is the indication for too much nicotine replacement? Too little?
Too much = nausea
Too little = cravings
Why is caffeine use higher in pts who use nicotine
p450 enzyme upregulated, thus clears caffeine faster
Why is pain tolerance lower in tobacco users?
higher clearance or opiates (endogenous or not)
Spit tobacco contains high levels of what vitamin? Why is this concerning?
K–will increase coagulation time is trying to quit
Which form of tobacco affects coumadin metabolism more: spit or cigarettes?
Spit
How long can it take for coumadin levels to reach optimal levels in patients who are quitting smoking?
- 5 months
How long does it take after quitting tobacco for stroke risk to return to presmoking levels?
5-15 years
How long does it take after quitting tobacco for throat CA risk to return to presmoking levels?
5-15 years
How long does it take after quitting tobacco for lung CA risk to get to 1/2 presmoking levels?
10 years
How long does it take after quitting tobacco for coronary heart disease risk to return to presmoking levels?
15 years
True or false: hookah is more safe than cigarettes?
very false-much, much worse
What is the problem with the propylene glycol used in e-cigarettes?
When heated, turns into carcinogen
What is the problem with the refill tanks for e-cigarettes?
Very, very concentrated, and look like candy
True or false: there is an association between tobacco use, and SIDS
True
What are the problems with secondhand smoke exposure in children?
Bronchitis
Asthma
Poor lung development
What is the primary age to start using tobacco?
10-14 yo
True or false: kids who start smoking have a higher risk of depression and suicide
True
What is third hand smoke?
Smoking deposits on materials