smoking cessatation Flashcards
what what smoking increase the risk of
- chronic diseases
- cancers
what is the main composition of a cigarette
- tar
- nicotine
- carbon monoxide
how does tar effect the body
tar causes particles to be inhaled these inhaled particles cause thick brown sticky residue in the lungs, teeth and fingers - causes narrowing of the bronchiles increased secretion of mucous decreased activity of cilia development of cancer
how does carbon monoxide effect?
Co takes over oxygen in rbc increase the production of rbc = blood gets thicker less o2 distrubuted to cells around the body the heart works harder bp increased increases risk of cvd reduced excercise tolerence fatigue
what does nicotine do?
adversely effect every major systems brain - normal activity heart and arteries - high BP and HR eyes - reduced in peripheral vision metabolism - increased calories burned reproduxctive bones - oestop
how is addiction caused?
nicotine
- activation of ‘reward pathway’
- administration leads to pleasure or elevation
- withdrawels
distrupts normal neurotransmitter activities
- chemical changes and addiction
when are withdrawel symptoms caused
when nicotine receptors are not activated
what is the development of dependence
1) smoking - deliver nicotine
2) nicotine travels to the brain
3) dopamine release - leading to feel of pleasure + calmness
4) drop in dopamine - withdrawel
5) desire for a another ciggarette
what is second hand smoke
inhalation of others smoke
what is the relation between smoking and drug metabolism
what are the drugs which are affected
- polycyclic aromatic hydrocarbon in ciggarette smoke increase activity of several liver enzymes - cytochrome p450 system
- enzyme induction= faster clearance of medication from body = decreasing efficacy
theophylline
cinacalcet
ropinirole
antiphsychotics
what are the barriers for smoking cessation
-withdrawel
-denail of pleasurable effect
lack of motivation
fear id failure
worries about gaining weight
worries about using nicotine replacement therapy (NRT)
how long till nicotine free in short term
72 hours
list some symptoms of nicotine withdrawel syndrome
-cravings
-increased apeptite - weight gain
dizziness
lack of concentration
heart rate decrease
constipation
cough
mood swings
sleep disturbances
anxiety
stages of change
pre contemplation - ill live with it contemplation resistance prep action relapse? maintenance
identifying oppurtinities
- coughing complaint health check recuurent chest infection inhaler running out looking for nrt product
role of pharmacist
- congratulate them
-explain support which can be offered
-say the benifits
-find out if they are ready to give up
-indiviudal support
dicuss habit
smoking diary
personal benifits?
how importnat not to give uo
what are nice guideline interventions
-behavoural suport - 4 weeks after quit date
-NRT - small amount of nicotine without tabbaco and no
breief advice
bupropion
varenicline
what is the 5 d
delay drink water deep breathing do something different discuss craving with another
what are the pharmacological interventions available
-sublingual tablets lozenge gum nasal spray patches inhalator quick mist mouth spray
POM :
buproprion
varenicline
what is NRT and how does it work
- relieve symptoms of nicotine withdrawel
- gradually reduce level of nicotine until free from addiction
- patients can choose flavour, and way of formualtion, conset, indiviudual needs
how long is NRT used for
8-12 weeks
sublingual tablets
-left under the tongue to dissolve
- less than 20 ciggarettes - 1 tablet a hour
-more than 20 = 2 tablets
12 week treatment
avoid acdic beverages 15 mins before use - juices , coffee
lozenges
-dissolve under toungue- one side to the other until dissolved
less than 30 cigg = 1-2 mg
-who smoke within half an hour of waking - 4mg
- can be used in pregnancy
GUM
-20 cigg or less = 2mg
20-30 cigg = 2-4 mg
more than 30 = 4mg
chew until taste is strong and rest in cheeks and gum to absorb
patches
reduction from steps of use
2 diff types - 16h and 24h
skin irritation
used in preg
inhalator
whenever feel the urge to smoke
max- 16 catridges a day
quick mist spray
1 or 2 spray whenever get the urge
4 sprays per hour max
what are the pom medicines and why are they used?
-buproprion
varenicline
when otc does not work
buproprion
anti-depressent
150mg prolonged release tablet
long half life
-centrally acting noroadrenaline/dopamine reuptake inhibitor
-antagonist at anticholinergenic receptor
varenicline
bind to selective nicotine partial agonist - mimics stimulation of dopamine release
-block access to receptor = reduce pleasurable effect of smoking
mimic nicotine to reduce withdrawal effects
should quit 2 weeks prior taking it
NOT with pregancy or younger than 18
e ciggarettes
small amount of nicotine via inhalation
Stop smoking services provided by pharmacies are classified as what type of service?
Locally commissioned service
is any of the options more effective than the other
no
Nicotine concentrations within e-liquids should not exceed 0.2g/ml
true or false
true
Quitting smoking may result in nicotine withdrawal syndrome. Which of the following is a withdrawal symptom?
Bradycardia
How often should pharmacists provide advice to individuals who continue to smoke?
once every 12 months
