Smoking Flashcards
0
Q
Smoking Cessation
A
- Varenicline: partial agonist at alpha4-beta2 subunit of nicotinic acetylcholine receptor; 1st line therapy
- 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
- Nicotine chewing gum: whenever urge to smoke, 2-4 months
- 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
1
Q
Health risks associated with smoking
A
- Cardiovascular dz: CAD, acute MI, stroke; dose dependent relationship bw smoking and CVD
- COPD risk: increases w smoking in dose dependent manner
- Malignancy: smoking increases risk of cancer in lungs, oral cavity, esophagus, larynx/pharynx, bladder, cervix, pancreas
- PUD
- Osteoporosis: decreases peak bone mass and increases rate of bone loss
- Premature skin aging
- PVD, Buerger’s disease
- Adverse effects during pregnancy: smoking increases risk of spontaneous abortion, fetal death, neonatal death, sudden infant death syndrome, low birth weight
2
Q
Most important causes of smoking-related mortality
A
- lung cancer
- COPD
- atherosclerotic cardiovascular disease
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