Smoking Flashcards

0
Q

Smoking Cessation

A
  1. Varenicline: partial agonist at alpha4-beta2 subunit of nicotinic acetylcholine receptor; 1st line therapy
  2. Nicotine patch: continuous nicotine delivery weans patient off nicotine; dose gradually decreased; no peaks or troughs as associated w smoking so eliminates nicotine withdrawal sx; wear for 16 hours/day but not while sleeping (can cause headaches); pt should not continue to smoke while wearing patch bc can get MI
  3. Nicotine chewing gum: whenever urge to smoke, 2-4 months
  4. Bupropion (Zyban)
    - quit rates similar to nicotine replacement therapy; up to 2 months; can take in combo w nicotine replacement;
    adverse effects: dry mouth, insomnia, headaches
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1
Q

Health risks associated with smoking

A
  1. Cardiovascular dz: CAD, acute MI, stroke; dose dependent relationship bw smoking and CVD
  2. COPD risk: increases w smoking in dose dependent manner
  3. Malignancy: smoking increases risk of cancer in lungs, oral cavity, esophagus, larynx/pharynx, bladder, cervix, pancreas
  4. PUD
  5. Osteoporosis: decreases peak bone mass and increases rate of bone loss
  6. Premature skin aging
  7. PVD, Buerger’s disease
  8. Adverse effects during pregnancy: smoking increases risk of spontaneous abortion, fetal death, neonatal death, sudden infant death syndrome, low birth weight
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2
Q

Most important causes of smoking-related mortality

A
  1. lung cancer
  2. COPD
  3. atherosclerotic cardiovascular disease
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3
Q

Behavioral modification and smoking

A

crucial for long term smoking cessation

patch or gum should be used in conjunction w smoking withdrawal clinic (behavioral program)

quit rates higher with combo

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