Smoking cessation Flashcards
Single most effective way to help patients stop smoking
varenicline or Chantix (partial agonist at the alpha 4 beta 2 nicotinic acetylcholine receptor
what are updated recommendations about varenicline?
black box warning about possible increased risk for suicidality and depression have been removed. Also history of depression is no longer a contraindication to varenicline treatment. Only avoid if active unstable psychiatric status or recent suicidal ideation.
What are some of the adverse side effects associated with varenicline?
MI, ischemia, arrhythmia. Risks are minimal. Cardiac disease is not an absolute contraindication
do we worry about liver function with patients who will take varenicline?
no, and routine monitoring is not needed.
screening for lung cancer?
annual low dose CT scan for pts who are ages 55-80 yrs have 30 pack year smoking history who currently smoke or quit in the last 15 years.
varenicline benefit?
high affinity nicotine receptor partial agonist that increases long term rates for smoking more effective than nicotine replacement therapy and bupropion.
no increased risk for suicide or depression and so psychiatric history is not a contraindication to its use.
bupropion is helpful for smoking cessation
helps quit smoking helps reduce post cessation weight gain contraindicated in eating disorders and history of seizures and can destabilize mood in bipolar pts
pharmacological therapy for smoking cessation.
Risk for lower lung cancer
benefit begins after 5 years after quitting but never reaches the same incidence found in non smokers.
does decrease risk for new primary lung cancer but magnitude of benefit is uncertain.
