nicotine dependence and smoking cessation

Question 1

nicotine receptor associated with addiction

Answer 1

alpha4-Beta2 nicotinic receptor

Question 2

nicotine stimulates

Answer 2

CNS nAch receptors leading to dopamine relsease

Question 3

nicotine half life is

Answer 3

short only baout 2 hours

Question 4

smoking is a slow or rapid delivery

Answer 4

rapid

Question 5

repeated use of nicotine leads to

Answer 5

increase tolerance

Question 6

nicotine withdrawal symptoms

Answer 6

negative effects: insomnia , anxiety

Question 7

why do smokers keep smoking?

Answer 7

• pharmacologic addiction

- psychological dependence on smoking

Question 8

smoking rates has decreased ?

Answer 8

yass, but it is uneven in groups

Question 9

secondhand smoke exposure in adults? what about children?

Answer 9

adults: lung cancer and CHD
children: SIDS, asthma, ear infections and slowed lung growth

Question 10

quitting is beneficial?

Answer 10

yasssss of course!!!

• increased life expectancy

most benefit if quit early but it is never to late

Question 11

tx. with evidence of efficacy

Answer 11

• pharmacotherapy
• behavioral counseling
• combination

Question 12

pharmacologic tx.

Answer 12

• nicotine replacement
• bupropion
• varenicline

Question 13

skin patch (nicotine replacement)

Answer 13

• long acting, slow onset

- fixed dose but constant leads to best compliance because of simple to use

Question 14

oral or nasal (nicotine replacement)

Answer 14

• short-acting and faster onset

- user controls dose leading to more fluctuations of nicotine blood levels

Question 15

varenicline-chantix

Answer 15

• binds selectively to alpha4-beta2 nicotinic receptor
• has a dual mechanism: partial agonist (reduce craving by stimulating receptor) and antagonist (blocks nicotine from binding)

Question 16

bupropion-zyban

Answer 16

• norepinephrine and dopamine reuptake inhibitor and releasing agent
• decrease craving
• decrease withdrawl symptoms

Question 17

internet based interventions can lead to a ___ abstinence

Answer 17

6 month

Question 18

5As model of breif counseling

Answer 18

• Ask
• advise
• assess
• assist
• arrange

Question 19

physician intervention

Answer 19

it is good to to a routine advice but a brief counseling is even better

Question 20

a newer way to assess

Answer 20

do not ask if a smoker if they are ready to quit just offer tx.

Question 21

what about those who are not interested in quitting?

Answer 21

try to leave an open door; it is imperative to not judge and try to understand the patient’s view point

• it is still ok to give advice to quit by making suggesting to adopt a smoke-free home and car

Question 22

Are e-cigarettes FDA approved?

Answer 22

Nope

Question 23

Should E-cigarettes be used in Hospital and care services?

Answer 23

Nope