Smoking Cessation Flashcards
What are the stages of change for smoking cessation?
- pre-contemplation
- contemplation
- preparation
- action
- maintenance
- relapse
What are the main components in cigarettes
- benzene
- formaldehyde
- acetone
- tar
- nicotine
What AE are smoking associated with?
- cancer (lung, pancreas, kidney, bladder, lip, oral cavity, and esophagus/larynx)
- cardiovascular effects
- delayed wound healing
- dermatologic effect
- endocrine(insulin resistance)
- musculoskeletal effects-increased risk of lumbar disease decrease and delayed bone healing
- pregnancy: low birth weight, preterm or extremely preterm births
- COPD
- sexual dysfunction: erectile dysfunction 2x more likely
Non-pharm things for smoking
- support from family/co-workers
- set a quit date (no more smokes around)
- keep track of triggers - try to avoid triggers as much as possible
- try to break routine
- – suggest 2 common reduction techniques - systematically increase amount of time between cigarettes from easiest to hardest throughout the day
- smokers help line
- do not set quit date right before an event
What is an e-cigarette vaporizing?
- propylene glycol, vegetable oil, flavouring and also sometimes nicotine
What can e-cigarettes cause?
- popcorn lung (some case reports)
Why are nicotine inhalers better for you than e-cigarettes?
-inhalers do not have propylene glycol
What is the dosing of zyban?
- 150 mg daily for 3 days, and then 150 mg BID (SR)
_____ disturbance can be a major issue with zyban
sleep (need to make sure there is an 8 hour dose here btw the 2 pills)
What is the efficacy of bupropion?
- 18-19% efficacy around the year period (10% is for placebo)
What are the major contraindications with zyban?
- seizure history, those that are receiving wellbut. for depression
- current or past hx of anorexia or bulimia
- alcohol or benzo withdrawal
What are the main SE of zyban?
- insomnia, headache, appetite suppression, nausea, dry mouth
What are the major DIs associated with zyban?
- carbamazepine
- antidepressant (2D6 inhibitors)
What is the MOA associated with champix?
- partial agonist of the nicotine receptor
What is the dosing of champix?
- 0.5 mg for 3 days, 0.5 mg BID for 4 days, then 1 mg BID for 2 weeks (declining renal fx, decrease dose)
What is the efficacy of champix?
- 26%
What are the AE associated with champix?
- nausea
- abnormal dreams
Champix should be taken how?
- take after meal with a full glass of water to avoid nausea
What disease states do you need to be aware of when giving someone champix?
- cardiovascular, seizures
What is the efficacy of using a combination NRT product?
- 22%
How do you know if a person is having withdrawal sx with nicotine?
- cravings for cigarettes
- mood changes and irritability
- headache
- weight gain
- trouble concentrating
- increased appetite
- depression
- anxiety
- trouble sleeping
- nightmares/bad dreams
What are the signs of nicotine toxicity?
- nausea
- no nicotine cravings
- abdominal cramping
- agitation
- muscle twitches
- breathing rapidly
- coma
- confusion
- convulsions
- depression
- fainting
- headache
What are the absolute CI associated with nicotine?
- free flap surgical patients- risking a lack of blood flow to the area would make a graft not take
- patients should not use an NRT 2 weeks before or 2 weeks after this
- also serious arrhythmias
- angina
- serious fracture
- orthopaedic surgery
Smoking increases the clearance of what?
- caffeine!
- when someone stops smoking, you need to decrease their coffee intake by half
What are the endpoints with smoking cessation products
- that they have stopped smoking
- no withdrawal sx
- decreased risk of things like lung cancer, cardiovascular disease, COPD, stroke
- SE are negative endpoints
