Brainscape's Knowledge GenomeTM

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


See full index

Rotation Prep Mod 3 > Smoking Cessation > Flashcards

Smoking Cessation Flashcards

1
Q

Important questions to ask during smoking cessation counseling

A

How much do you smoke?
When is your first cigarette of the day?
When/Why did you start smoking?
Are you ready to quit?
Have you tried to quit in the past?
- what products/techniques did you try?

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

Exclusions to smoking cessation self care

A

Serious heart disease
- recent MI
- irregular heartbeat
- stable angina
uncontrolled HTN
Pregnant/breastfeeding
< 18 yo
Active PUD

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

NRT dosage forms

A

Gum (OTC)
Lozenge (OTC)
Transdermal patch (OTC / Rx)
Nasal spray (Rx)
Inhaler (Rx)

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

Nicotine gum dosing

A

First cigarette > 30 min after waking
- 2 mg Q1-2H for 6 weeks
First cigarette < 30 min after waking:
- 4 mg Q1-2H for 6 weeks

Decrease to Q2-4H in weeks 7-9, and Q4-8H in weeks 10-12

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

Chew and park technique for nicotine gum

A

chew slowly ->
stop chewing at first sign of peppery taste or tingling sensation ->
park between cheek and gum ->
chew again once taste/tingle fades ->
wash rinse repeat until taste fully dissipates

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

Nicotine gum precautions/ contraindications

A

pregnant patients
recent MI, serious arrhythmias, and unstable angina pectoris

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

Nicotine gum ADE

A
  • mouth soreness/irritation
  • hiccups
  • dyspepsia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what should patients avoid around using nicotine gum

A

acidic beverages (decreases absorption)

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

Nicotine gum advantages

A
  • satisfy oral cravings
  • may delay weight gain
  • pts can titrate therapy to manage withdrawal symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Nicotine gum disadvantages

A
  • gum chewing may not be socially acceptable
  • gum is difficult to use with dentures
  • patients must use proper chewing technique to minimize ADE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Nicotine lozenge dosing

A

First cigarette > 30 min after waking
- 2 mg Q1-2H for 6 weeks
First cigarette < 30 min after waking:
- 4 mg Q1-2H for 6 weeks

Decrease to Q2-4H in weeks 7-9, and Q4-8H in weeks 10-12

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

Nicotine lozenge prescribing instructions

A

allow lozenge to completely dissolve
do not chew or swallow
avoid acidic beverages

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

Nicotine lozenge precautions/ contraindications:

A

Pregnant patients
Patients with recent MI, serious arrhythmias, and unstable angina pectoris

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

Nicotine lozenge ADE

A
  • nausea
  • dyspepsia
  • HA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Nicotine lozenge advantages

A
  • satisfy oral cravings
  • easy to use and conceal
  • pts can titrate therapy to manage withdrawal symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Nicotine lozenge disadvantages

A
  • GI adverse effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Nicotine inhaler dosing

A
  • 6-16 cartridges (24-64mg) per day for 3 months
  • gradual reduction in dose over 6-12 weeks
  • can be used for up to 6 months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Nicotine inhaler prescribing instructions

A

store at room temp
frequent puffing for best results
avoid acidic beverages

19
Q

Nicotine inhaler instructions for use

A
  • inhale into back of throat or puff in short breaths
  • nicotine cartridges are depleted after about 20 minutes of puffing (does not have to be used all at once, open cartridge retains potency for 24hrs)
  • mouthpiece is reusable; clean regularly with mild detergent
20
Q

Nicotine inhaler precautions / CI

A
  • Pregnant patients
  • Patients with recent MI, serious arrhythmias, and unstable angina pectoris
  • use with caution in patients with bronchospastic disease
21
Q

Nicotine inhaler ADE

A
  • local irritation in mouth and throat
  • coughing
  • rhinitis
22
Q

Nicotine inhaler advantages

A
  • pts can easily titrate therapy to manage withdrawal
  • mimics the hand-to-mouth ritual of smoking
23
Q

Nicotine inhaler disadvantages

A
  • initial throat or mouth irritation can be bothersome
  • cartridges should not be stored in warm conditions or used in cold conditions
  • patients with underlying bronchospastic disease must use the inhaler with caution
24
Q

Nicotine nasal spray dosing

A

1-2 0.5mg doses per hr increasing as needed for symptom relief
- MDD 40mg (80 sprays) or 5mg (10 sprays) per hr
Best results: at least 8 doses/day
Can be used up to 3 months

25
Q

Nicotine nasal spray directions for use:

A
  • prime the pump before first use or if not used for 24 hrs
  • clear nose, tilt head back slightly, and insert tip of bottle into nostril
  • do not sniff or inhale while spraying
  • wait 2-3 minutes before blowing nose
  • wait 5 minutes before driving or operating heavy machinery (can cause tearing, coughing, or sneezing)
26
Q

Nicotine nasal spray Precautions/CI

A
  • Pregnant patients
  • Recent MI, serious arrhythmias, unstable angina pectoris
  • High dependency potential
  • Severe reactive airway disease or chronic nasal disorders (rhinitis, nasal polyps, sinusitis)
27
Q

Nicotine nasal spray ADE

A
  • mild to severe nasal irritation in first 2 days reported by 94% of users
  • nasal congestion
  • changes in smell
28
Q

Nicotine nasal spray advantages

A
  • easily titrate therapy to rapidly manage withdrawal symptoms
29
Q

Nicotine nasal spray disadvantages

A
  • nasal/throat irritation
  • higher dependence potential
  • pts with chronic nasal disorders or severe reactive airway disease should avoid
30
Q

Nicotine patch dosing

A

smoke > 10 cigarettes per day
- 21mg patch daily for 6 weeks, 14mg patch for 2 weeks, then 7 mg patch for 2 weeks

smoke </= 10 cigarettes per day
- 14mg patch daily for 6 weeks, then 7 mg patch daily for 2 weeks

31
Q

Nicotine patch prescribing instructions

A
  • should be applied at beginning of the day to a hairless location between the neck and waist
  • no restrictions to activities while wearing the patch
32
Q

Nicotine patch precautions/CI

A
  • Pregnant patients
  • Recent MI, serious arrhythmias, unstable angina pectoris
  • dermatologic conditions
33
Q

Nicotine patch ADE

A
  • local skin reactions
  • insomnia and/or vivid dreams
34
Q

Nicotine patch advantages

A
  • consistent nicotine levels
  • easy to use and conceal
  • fewer compliance issues
35
Q

Nicotine patch disadvantages

A
  • pts cannot titrate the dose
  • allergic reactions to adhesive
  • pts with dermatologic conditions should not use
36
Q

Common combination therapy

A
  • Bupropion SR + Nicotine patch
  • Nicotine patch (>14weeks) + other NRT PRN
  • Nicotine patch + nicotine inhaler
37
Q

Chantix (Varenicline) MOA

A

partial nicotine agonist

38
Q

Chantix (Varenicline) dosing

A

Initial:
- Days 1-3: 0.5mg PO QD
- Days 4-7: 0.5mg PO BID

Maintenance:
- 1mg PO BID

Continue maintenance dose for at least 11 weeks (12 weeks total)

39
Q

Chantix (Varenicline) approaches to quit date: Fixed date

A

Start varenicline and quit on day 8

40
Q

Chantix (Varenicline) approaches to quit date: Flexible date

A

Start varenicline and quit between days 8 and 35

41
Q

Chantix (Varenicline) approaches to quit date: Gradual quit date

A

Start varenicline, reduce smoking by 50% by week 4, reduce an additional 50% by week 8, wash rinse and repeat with goal of abstinence by week 12

42
Q

Chantix (Varenicline) altered kidney function dosing

A

CrCl< 30
- initial dose 0.5mg QD
- max maintenance dose 0.5mg BID

43
Q

Chantix (Varenicline) hepatic impairment dosing

A

no dose adjustment necessary

44
Q

Chantix (Varenicline) ADE

A
  • increased risk of MI and other CV events
  • abnormal dreams, nightmares, sleepwalking
  • N/V
  • seizures
  • depression, suicidal ideation
  • skin rash
  • weight gain

Rotation Prep Mod 3 (4 decks)

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