Smoking Cessation Flashcards
What is the average age for someone who starts smoking?
15
How are we currently dosing smoking products right now?
We are basing it off of the number of cigarretes they are currently taking.
If someone smokes within the first 30 minutes of waking up how does that affect outcome of quitting?
Heavily decreases ability to quite smoking. Still possible just requires more therapy
What are the aspects of smoking?
Mood altering effects
Instant reinforcement
Nicotine–> dopamine
What occurs with nicotine withdrawal
Cranky, irritability
What are the two ends of the psychological spectrum that smoking affects?
Calms people down
Makes people less depressed
What is the rule of 3?
First 3 minutes. Can you go 3 minutes to overcome your nitfit?
3 days to try and squash the nic addiction
3 weeks to try and reevaluate the psych addiction
How does nicotine work in terms of metabolism?
Increases Catecholamines and increases the rate of metabolism.
Hence people drop weight when they smoke
What does smoking do to the enzymes?
Increases enzyme production
What does an increase in enzyme production lead to?
Leads to a decreased drug concentration as we have increased metabolism of drug products
Would we worry about an individual who is taking a chronic medication and quits smoking?
Generally no, things like psychotropic agents, methadone and some oncology agents we might be concerned with.
What is the 1st smoking cessation method that generally works for some individuals?
Cold Turkey. Just one day decides to quite without the addition of NIT therapy
Why do we avoid failure in smoking cessation/
Mood and mentality. Instead celebrate and dig into if you stopped smoking for this long (ie 4 days) HOW did you do that!
What are the impacts of counselling to stop smoking>?
Available, may or may not work,.
What is a primary goal with smoking cessation?
Celebrate the little strives in the attempt to quit
What are the two types of counselling that may occur with somking cessation?
Addictions and pharmacist counselling
What is the roles of gimmicks?
People who just tried something, says it helped. We would more so see it as a crutch then an actual therapy though.
What is Lobelia plant?
Used to be an old historical treatment that was a nicotine like substance that was used to tease the nicotine recpetors to hopefully have some impact.
Not used anymoreW
What is bantron?
Lobelia plant herbal. Not around anymore
What is Nikoban
Lobelia plant herbal. Not around anymore
What is Butt-Out
Lobelia plant herbal. Not around anymore
What was the usage of silver acetate?
Supposedly smoking stopping product historical and not used anymore
What is Tabinil?
Historical contained silver acetate
What is Smokerette lozenges?
Historial contained silver acetate
What is a primary method needed for quitting?
Motivation required
What is the issue with the smoking cessation program in pharmacy
Developing a PLAN takes a long time! sometimes we have to tell patients to refer to product monograph
What NTR is available in Canada?
Gum, Mist, Lozenge, Patch, Inhaler
What two strengths do we get for nicotine gum>
2mg and 4mg
How is nicotine gum meant to be used (How do u use it)
Chew chew, park
What is the issue with the usage of nicotine gum?
Its the lag time associated with the gum.
What is recomended for duration of use for each piece of gum?
30 minutes
How do we determine nicotine gum dosage?
we focus on the number of cigs used in a day Higher number (25) means more mg
How should we schedule Nic gum?
We generally want to try and schedule it to a frequency that decreases the amount of Nic fits an individual has.
What is the benefit of scheduled nic gum?
Decreases the next urge
How do we generaly taper the dose of nic gum?
Half it every month of usage, Its very flexible though
What are side effects of using Nic gum?
Throat Irritation
Jaw fatique
Burping/hiccups.
Nausea
What might occur using the gum?
Addiciton to the gum
Smoking during the gum use?
More supported as we are possibly decreasing the number of cigs used in a day which is a bonus.
What is a transdermal nicotine option?
This is for someone who wants to have a consistent level of nicotine throughout the day.
What type of level do we see with the usage of the patch?
Flat line
Where can we apply the patch?
Anywhere needs to be dry and hair freee though?
How long should we wait between applicaiton of the patch in a specific area?
7 days. So we need to rotate the patch each day
What are the side effects of the patch?
Irritation to area, local reaction
headache insomnia nausea (Patch or withdrawal?)
What is a question we may ask with regards to side effects before giving a patch?
How do you react with bandaids?
What are the signs of withdrawal when using the patch?
Should dose according to the need. If someone is irritabl, headaches the dose may not be enough
What are some side effects that arent as common with the patch?
Dreams/nightmares, may need to consider taking off patch at night, but issue is we wake up with withdrawal
What is the schedule for a patch?
Whenever they feel the need to use it for that duration. Step 1 Step 2 Step 3. ALl schedules are a good schedule
What are some components we need to consider when weaning off of the patch?
Eliminate dependency
Allow for behaviour changes
Become aware of cessation benefits
Get over stress from quitting smoking
What is the success rate of using a patch vs other products?
20% more as compared to the usage of other products year over year
Can you use other products while on the patch?
Yes and no, other products are rescue at this point and provide more nicotine in the moments that we may need it a bit more. The issue is that you would need to have it.
(Chew gum while on patch during times of stress)
While on patch do we schedule other therapy?
NO it is prn to get you over the hurdle
What is the nic inhaler?
Inhaled that is buccal absorbed. we suck on it in short breaths to deliver instant nicotine to the back of throat
What are Nic lozenges?
Parked in the cheek between the hits and it lasts about 30 minutes.
Should Nic lozenges be scheduled?
Yes, similar to the gum
With then ic mini lozenges how many does one use?
weeks 1-5 8-15/day
Weeks 7-9 4-8 day
Weeks 10-12 2-4 a day
What is the fastest method for delivering nicotine?
Quickmist, this is sprayed into the mouth and is absorbed into the buccal areas of cheak.
How fast does toe Quikcmist Nic work?
60 seconds
How long after using quickmist should food or drink be avoided?
15 minutes. This is because we are decreasing the amount of nicotine absorbed as it is washed away down the throat
