Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CSP 2 > Smoking > Flashcards

Smoking Flashcards

1
Q

What % of middle-aged smokers die of smoking-related illness?

A

50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why do people smoke?

A

Initiation - social reasons

Maintenance - pharmacological reasons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Light smokers can be described as…?

Whereas heavy smokers are…?

A

peak seekers

trough maintainers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Over 97% of quit attempts last less than…?

A

6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What % of smokers rarely (if ever) go a day without a cigarette?

A

Over 95%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How many % resume smoking after a major smoking-related health crisis?

A

70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name some signs of addiction.

A

 Continued use despite knowledge of harmful effects
 Withdrawal symptoms and urges to use the drug during abstinence
 Failure of attempts to stop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q 
Addiction is a product of...
Person
Drug 
Circumstances 
Explain this further.
A

Person, e.g. mental health, personality, coping skills, individual biochemistry etc.

Drug, e.g. its reinforcing properties

Circumstances, e.g. lack of alternatives, stress, access to drug, society views, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why is nicotine addictive?

A

Mildly pleasant stimulation
Tolerance develops to aversive effects so frequent dosing becomes possible
Neuroadaptation develops.
Sensitisation to dopaminergic effects, increased
density of ACH receptors.
Discomfort if nicotine level is low, sensitivity to cues
Other chemicals in smoke likely to play a role, e.g. MAO inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Nicotine depletion leads to a gradual increase in …?
How do cigarettes affect this?
This develops the drive to smoke/nicotine hunger.

A 
mild discomfort (irritability, worsening of mood, etc.)
Cigarettes alleviate this immediately and so are perceived as attractive and rewarding – illusion of positive effect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Nicotine stimulates ______ receptors in what area of the brain?
This leads to…?

A

acetylcholine
ventral-tegmental area
dopamine release in nucleus accumbens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the main subjective reasons for smoking?

A

stress relief, boredom relief, enjoyment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the main objective measures of smoking benefits?

A

 Smokers weigh less than non-smokers

 Smoking may increase vigilance, but no evidence that smokers perform better

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cigarette consumption is a weak indicator of blood nicotine levels. What three things are more important?

A

Depth of inhalation, number of puffs, and

length of butts left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name some other ways to measure dependence.

A

Time to first cigarette in the morning
Carbon monoxide in expired breath
Nicotine in body fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How long is nicotine’s half life?

A

2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How does success differ quitting with and without support?

A

Relapse rate is similar, but starting from much higher initial quit rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Name some subjective withdrawal symptoms.

A

 Mood changes, e.g. irritable, depressed, restless.
 Difficulty concentrating
 Urges to smoke
 Increased hunger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How long do the mood changes generally last in withdrawal?

A

Average duration < 4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How long does the difficulty concentrating generally last in withdrawal?

A

< 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the average weight gain after quitting?

A

5-6kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are some less frequent withdrawal symptoms?

A

 Night-time awakening
 Constipation (17%, 9% severe)
 Mouth ulcers (40%, 8% severe), respiratory tract
infections
 Productive cough (coughing and breathlessness improve within a month)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the main objective signs of withdrawal?

A

 Big drop in heart rate
 Decrease adrenaline and cortisol output
 Decreased tremor
 Increased skin temperature
 Decreased metabolism of caffeine and other drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q 
How does abstinence affect...
clomipramine?
clozapine?
amitriptyline?
diazepam?
olonzapine?
A

1, 2 increases
3 does not change
4 unclear
5 increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q 
How does abstinence affect...
ethanol?
risperidone?
buproprion?
lorazepam?
haloperidol?
A

1,2,3,4 does not change

5 increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What can predict relapse? (3)

A

Urges to smoke
Depression
Weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Withdrawal symptoms are worse in smokers with…?

A

high pre-abstinence nicotine intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the rationale behind nicotine replacement therapies?

A

Abrupt cessation of nicotine intake causes withdrawal discomfort so access to nicotine via alternative routes
provides relief and assists with transition to complete abstinence.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How much nicotine do NRT products provide?

A

Most current NRT products provide about 50% of the daily intake from smoking.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Nicotine in the doses of NRT is considered harmless. What are the dangers of smoking mainly due to?

A

combustion products and other chemicals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Is NRT safe?

A

Yes, particularly compared to smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Can NRT cause dependence?

A

NRT cannot cause new dependence (users are already dependent on nicotine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Dependence on NRT is more likely with which products?

A

Faster absorption products

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What % of oral NRT users use it at 1 year?

A

<10%

35
Q

Nicotine delivery by cigarettes and NRT products - which is the fastest?
Which is the slowest?

A

Cigarettes (about 7 minutes)

Patch (more than 2 hours)

36
Q

What dosage does nicotine chewing gum come in?

A

2mg and 4mg (6mg to be launched soon)

37
Q

How long does the gum take to reach plateau?

A

30 mins

38
Q

How should you advise patients to use the gum?

A

10-15 pieces a day, hourly (each piece lasts 30 mins)
Recommend use for up to 3 months
Start chewing slowly, takes a few days to get used to

39
Q

What slows down the absorption of nicotine from gum?

A

acidic drinks

40
Q

What types of transdermal patches are there?

A

16 hour and 24 hour patches

41
Q

How long does it take for the transdermal patches to reach plateau?

A

Hours

42
Q

Side effect of transdermal patches?

A

Nightmares (with the 24h patches)
SOME Redness of skin
LOOK OUT FOR ALLERGIC REACTION

43
Q

How should you advise patients to use the transdermal patches?

A

Use for two months
Put a new patch on each morning (upper arm, side of torso or other hairless part of body) - don’t put it in the same place

44
Q

How long does it take for the nicotine nasal spray to reach plateau?

A

only minutes

45
Q

How should you advise patients to use the nicotine nasal spray?

A 
One shot (0.5mg) in each nostril hourly
Recommend use for up to 3 months
46
Q

Who is the nicotine nasal spray especially useful for?

A

highly dependent smokers who can tolerate it

47
Q

How is the inhalator absorbed?

How long does it take to reach plateau?

A

Absorbed through mouth like gum etc.

30 minutes

48
Q

How should you advise patients to use the inhalator?

A

Recommend puffing vigorously for some 10-20 minutes every hour
Shallow puffing as good as inhalation
Each cartridge lasts for several puffing sessions - replace cartridge when weak (not after single
use)
Warming the cartridge improves delivery

49
Q

How many puffs of the inhalator = one puff from a cigarette?

A

10

50
Q

How long does the microtab take to reach plateau?

How long do the pills take to dissolve under the tongue?

A

30 min

20 minutes

51
Q

How should you advise patients to use microtabs?

A

Recommend 15-30 tablets a day
May sting initially
Recommend use for up to three months

52
Q

Novartis ‘1mg’ lozenge is supplied in how many/day packs?

A

10/day packs

53
Q

Nicotine mouth spray - nicotine speed and levels same as?

Faster than?

A

same as 4mg gum

faster than lozenge

54
Q

Side effect of quick mist mouth spray?

A

Hiccups

55
Q

Mouth strip - how many mg of nicotine?

A

2.5mg

56
Q

Mouth strip - how long does it take to dissolve?

A

3 minutes

57
Q

Why does Sweden have a 5% smoking prevalence (compared to 16% in the UK)?

A

Due to snus

58
Q

Are electronic cigarettes safe?

A

Several of the carcinogens in cigarette smoke were found in EC vapour, but at levels of some hundred times lower.
Some risks may yet emerge but these are unlikely to exceed some 5% of risks of smoking.

59
Q

How should NRT be combined?

A

Combination of patch with faster acting products should allow sufficient nicotine level, and dose increase when needed

60
Q

Bupropion - what is this?

A

Initially developed as an antidepressant.

Selective inhibitor of neuronal re-uptake of noradrenaline and dopamine

61
Q

Contraindications of bupropion.

A 
 Current or previous seizure disorder
 Known CNS tumour
 Benzodiazepine or alcohol withdrawal
 Eating disorders
 Hepatic cirrhosis
 Bipolar disease
 Taking MAOI’s
 Pregnancy or breast feeding
 Age <18 years
62
Q

Risk factors for seizures to look out for before prescribing bupropion. (4)

A

Alcohol abuse, History of head trauma, Hypoglycaemia, Use of stimulants or anorectic products

63
Q

Drug interactions of bupropion. (3)

A

Beta-blockers, Antiarrythmics (Type 1C), Codeine base medications, etc.

64
Q

Dosage of bupropion.

A

150mg daily for the first 6 days, then 150mg twice daily from day 7 (8 hours apart).
FOR 8 weeks.
Set quit day between day 8 and 14

65
Q

Common side effects of bupropion. (4)

A

 Insomnia
 Headache
 Dry mouth
 Rash

66
Q

Uncommon side effects of bupropion. (2)

A

 Seizure

 Severe allergic reaction

67
Q

Zyban is the brand name for…?

A

bupropion

68
Q

Champix is the brand name for…?

A

varenicline

69
Q

Varenicline is a … agonist.

A

α4β2 Receptor Partial Agonist

70
Q

How does nicotine result in release of dopamine?

A

Binding of nicotine at the α4β2 nicotinic receptor in the ventral tegmental area is believed to cause release of dopamine at the nucleus accumbens.

71
Q

How does varenicline work?

A

Has dual agonist and antagonist activities - it binds to the receptors in the VTA and causes release of dopamine in the nucleus accumbens.

72
Q

Which medication is most effective in terms of quitting rates?

A

Champix/varenicline - more than doubles your chance of success

73
Q

What is the half life of Champix?
Cmax?
Steady state?

A

~24 hours
Cmax within 3 to 4 hours
Steady state reached within 4 days

74
Q

Dose adjustments may need to be made for what group of patients using Champix?

A

Severe renal impairment

75
Q

Side effect of Champix?

How can this be helped?

A

Nausea

Tablet after meals, or anti-emetic medication (not normally used)

76
Q

Champix contraindications. (2)

A

 End-stage renal disease

 < 18 years of age

77
Q

Champix precautions. (2)

A

 Pregnancy and lactation

 Renal impairment – reduce to 1mg/day

78
Q

What packs of Champix are available?

A

Initiation blister packs (2-weeks) - 11 x 0.5 mg tablets plus 14 x 1mg tablets

Maintenance packs (2-weeks) - 28 x 0.5 mg or 56 x 0.5 mg tablets. 
28 x 1mg or 56 x 1mg tablets

4-week packs also available

79
Q

How should you prescribe Champix (in terms of dosing)?

When should patients quit smoking?

A

Days 1-3 - 0.5 mg once daily
Days 4-7 - 0.5 mg twice daily
From Day 8 - 1mg twice daily
Quit date 1-2 weeks after starting treatment

80
Q

I smoke 10 a day and want to quit. Shall I gradually cut down to 5 a day then 2 a day etc.?

A

No, this extends withdrawal discomfort and exhausts
resources. If done ad-lib with NRT or Champix, can
be helpful.

81
Q

Can I still smoke marijuana?

A

Not advised as lowers chance of success in stopping

smoking (possibly because mixed/associated with tobacco).

82
Q

What Stop-Smoking Specialist Services do?

A 
 Assess
 Set up a quit date
 Prepare for quitting
 Provide intensive treatment over 4 weeks of abstinence
 Relapse prevention over one year
83
Q

Henry has put on 2 kg in first two weeks of abstinence, and asks what to do. A good advice would be to…?

A

Focus on not smoking and leave the weight problem for later

84
Q

Sally became tearful and irritable in the first week of abstinence. She is using 5 Microtabs a day. What could help her?

A

Using more NRT (15-30 microtab pills a day)

CSP 2 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions