smoking cessation Flashcards

1
Q

name nicotine replacement drugs

A

nicotine, varenicline, buproprion

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2
Q

MOA of nicotine replacement drugs

A
  • In CNS activates nicotinic Ach receptors, increasing NT levels and causing euphoria and relaxation.
  • this also prevents withdrawal symptoms by maintaining receptor activation.
  • varenicline = partial agonist of nicotinic receptor = reduces withdrawal and rewarding effects of smoking by preventing binding of tovacco derived nicotine to receptors
  • bruproprion increases conc of NA and dopa in synapse by stopping reuptake
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3
Q

SE nicotine replacement drugs

A
  • local irritation or GI upset if oral
  • palpitations and abnormal dreams
    varenicline = nausea, headache, insomnia and abnormal dreams. rare = suicidal ideattion

buproprion = dry mouth, GI upset, neuro and psych effects e.g. headache, low conc, dizzy, insomnia, depression, agitation
- hypersensitviity

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4
Q

Nicotine replacment therapy caution use where?

A
  • heamodynamically unstable e.g. post MI
  • both used carefully if at risk of seizures - e.g. hx, head injury, alcohol use as threshold lowered
  • careful in psych disease due to suicidal ideation
  • careful in hepatic and renal impairment
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5
Q

what enzyme is buproprion metabolised by

A
  • cyp450
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6
Q

what interactions does buproprion have

A
  • if used with MOA-i/TCA = increased SE
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7
Q

What is the indication for continuous release patch vs immediate release

A
  • continuous to prevent cravings

- immediare - stops urge to smoke

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8
Q

when should you start NRT ?

A
  • before cessation attempt or when stopped smoking.
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9
Q

dosage of NRT

A

If smoke > 10/day = rx high dose patch for 6-8 weeks, then wean to medium, then low dose patch for 2 weeks beach before stopping

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10
Q

when to start buproprion or varenicline

A
  • 1-2 weeks before target quite date .

- low start dose, titrate over 1st week and continue 9-12 weeks. stop if attemp of cessation fails

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11
Q

should you wear NRT patch overnight

A

no - causes insomnia

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12
Q

where to apply NRT patch

A

dry hairless patch, rotate site each time

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13
Q

if patient has smoking cessation drugs on NHS and fails. then how long after can they get another prescription

A

6 months

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