Pharmacology of Smoking Cessation

Question 1

Smoking: What are the known medications to treat dependence?

Answer 1

Nicotine Replacement Therapy, Varenicline, Buproprion and off label treatments (Clonidine and Nortriptyline)

Question 2

Smoking: What is necessary for the treatment to work?

Answer 2

Patient must have desire to quit.

Question 3

In what patients are these medications to treat smoking patients unsafe?

Answer 3

Pregnant or Breast feeding patients

Question 4

Nicotine: Consideration

Answer 4

Should quit PRIOR to initiating (only one, the others are all started before quitting)

Question 5

Nicotine: Adverse effect

Answer 5

HR and BP effects, therefore avoid in patients with CV hx.

Question 6

Varenicline: MOA

Answer 6

alpha(4)beta(2) nicotinic acetylcholine receptor partial agonist.

Question 7

Varenicline: Block Box Warning + Drug interactions

Answer 7

Black Box: Neuropsychiatric symptoms

- Avoid combining with Nicotine Replacement Therapy!

Question 8

Bupropion: MOA

Answer 8

NE/DA reuptake inhibitor

Question 9

Bupropion: Black box warning + drug interactions

Answer 9

Black Box: Neuropsychiatric symptoms

- Avoid combining with MAOIs