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PHAY0010 > Smoking Cessation [completed] > Flashcards

Smoking Cessation [completed] Flashcards

1
Q

≥ 2 moderate exacerbations OR
≥ 1 leading to hospitalisationHow does smoking harm the body?

A

It affects all parts of the body including:
Lungs - 84% of lung cancer deaths
83% of COPD deaths
Heart - doubles risk of heart attack
- increases BP and heart rate
Fertility - can cause impotence or inability to conceive
Bones - increases risk of osteoporosis.

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2
Q

What happens 8 hours after someone quits smoking?

A

Nitrogen and carbon monoxide levels in blood reduce by more than a half

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3
Q

What happens 48 hours after someone quits smoking?

A

Lungs start to clear out smoking debris

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4
Q

What happens 72 hours after someone quits smoking?

A

Breathing is easier

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5
Q

What happens 1 year after someone quits smoking?

A

Risk of heart disease reduces by half

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6
Q

What happens 10 years after someone quits smoking?

A

Risk of lung cancer falls to half of a smoker

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7
Q

What happens 15 years after someone quits smoking?

A

Risk of heart attack is now the same as someone who has never smoked.

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8
Q

What is the main reason people smoke?

A

Nicotine addiction

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9
Q

What is nicotine replacement therapy?

A

Low level nicotine without tar, carbon monoxide and other bad chemicals found in tobacco smoke.

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10
Q

What does nicotine replacement help to reduce?

A

Withdrawal symptoms such as bad mood and cravings

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11
Q

What are the strengths available of nicotine patches?

A

16 hours/ 24 hours
7mg/ 14mg/ 21mg

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12
Q

Why does the amount of nicotine vary in different nicotine patch preparations?

A

Allows for a structured step down programme over a 10-12 week period

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13
Q

How do you apply a nicotine patch?

A

Apply to a clean dry hairless site on hip, upper arm or chest
Apply in the morning
Remove the 16 hr patch one hour BEFORE BED

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14
Q

What are some advantages of a nicotine patch?

A

Convenient
Discreet
Easy to use

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15
Q

What are some disadvantages of a nicotine patch?

A

24 hour patch can cause sleep disturbances

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16
Q

Who may a 24 hour nicotine patch be more beneficial for?

A

People who get strong cravings in the morning

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17
Q

Why should the patient be advised to switch sites of nicotine patch application daily?

A

to avoid skin irritation

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18
Q

How is nicotine in mouth sprays absorbed?

A

Rapidly through the buccal mucosa
Peak plasma levels after 13 mins.

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19
Q

How often are nicotine mouth sprays to be used?

A

4 sprays per hours and no more than 64 sprays in 24 hours

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20
Q

When should nicotine mouth sprays be used?

A

When a person would usually smoke a cigarette or if the get a craving

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21
Q

What are some advantages of a nicotine mouth spray?

A

Rapid action
Relieves breakthrough cravings

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22
Q

What are some disadvantages of a nicotine mouth spray?

A

Side effects such as irritation of throat or nose

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23
Q

How is nicotine gum absorbed?

A

VIa buccal mucosa
Peak plasma levels after 20-30 minutes

24
Q

What strengths of nicotine gum are available?

A

2mg, 4mg and 6mg

25
Q

How should a nicotine gum be used? What is the ‘chew and rest’ technique?

A

Chew slowly until taste become strong.
Then rest between gum and cheek.
Start chewing the gum again once the taste has faded to release more nicotine.
One gum piece last 30 minutes.

26
Q

What are some advantages of nicotine gum?

A

Relieves breakthrough cravings

27
Q

What are some disadvantages of nicotine gum?

A

Can be hard to use correctly as not like normal gum

28
Q

What strength of nicotine inhalators are available?

A

15mg
Each cartridge lasts 40 minutes
Can use up to 6 cartridges per day

29
Q

How is a nicotine inhalator used?

A

Cartridge inserted into the mouthpiece
Air drawn into mouth through mouthpiece (can be Depp or shallow puffing)

30
Q

What are some advantages of a nicotine inhalator?

A

It addresses the behavioural as well as psychological dependence - mimics hand to mouth action of normal cigarettes

31
Q

What are some disadvantages of a nicotine inhalator?

A

May cause throat irritation
Cough
Dry mouth
INDISCREET

32
Q

What strength of nicotine sublingual tablets are available?

A

2mg - person should use 1 or 2 tablets per hour
No more than 40 tablets in 24 hours

33
Q

How do you use a nicotine sublingual tablet?

A

Place tablet under the tongue and let it slowly disintegrate over 30 minutes
DO NOT SWALLOW

34
Q

What are some disadvantages of nicotine sublingual tablets?

A

may cause throat irritation
unpleasant taste

35
Q

What are some advantages of nicotine sublingual tablets?

A

discreet
easy to use

36
Q

What strengths of nicotine lozenges are available?

A

1mg, 2mg, 4mg
maximum 15 lozenges in 24 hours

37
Q

How do you use nicotine lozenges?

A

Place in mouth and allow to dissolve
Periodically move lozenge from one side of the mouth to another
Complete dissolving should take 10-20 minutes
DO NOT SWALLOW

38
Q

What are some advantages of nicotine lozenges?

A

relieves breakthrough cravings
discreet

39
Q

What are some disadvantages of nicotine lozenges?

A

can cause irritation to tongue or mouth
won’t work if lozenge is chewed or swallowed

40
Q

How is nicotine in a nicotine NASAL spray absorbed?

A

Through the nasal mucosa

41
Q

What strength of nicotine NASAL spray is available?

A

200 sprays (100 doses) - maximum 64 sprays per daay

42
Q

How is a nicotine NASAL SPRAY used?

A

One spray into each nostril twice an hour
Prime device before use or if not used in two to three days
Insert spray tip into nostril pointing towards the back of the nose and press down quickly and firmly
Repeat.

43
Q

What are some advantages of a nicotine NASAL spray?

A

Good for HIGHLY dependent smokers
Fast acting relief.

44
Q

What are some disadvantages of a nicotine NASAL spray?

A

side effects: sneezing, runny nose, watery eyes and cough

45
Q

Why are e-cigarettes not reccomended for smoking cessation by NICE?

A

Limited knowledge on long term benefits and harm
Not licensed medications but may be regulated by Tobacco and related products regulation
Less harmful than cigarettes but NOT risk free

46
Q

What is dual support for smoking cessation?

A

Use of a long acting formulation (PATCH for all day craving control) and a fast acting formulation such as mouth spray, gum or lozenge (tackles breakthrough cravings)

47
Q

What is the benefits of using 2 products for smoking cessation?

A

More likely to quite for good

48
Q

Outline the cycle of change when someone stops smoking for good?

A

Pre-contemplation: no intention to change behaviour/ don’t know that problem exists
Contemplation : aware that smoking is an issue but no commitment to change
Preparation: want to take action to correct problem and think change is good. believe they can make the change happen
Action: modifying behaviour - stop smoking and using NRT
Maintenance: most difficult step as they need to maintain smoke free status to achieve… LASTING EXIT

49
Q

What can happen is a person does not make a lasting exit during smoking cessation?

A

Relapse: falling back into old habits + smoking again
Cycle starts again but as they’ve already gone through the cycle of change they may ave developed - e.g. already knowing they have a problem and change will be beneficial.

50
Q

What is important for people who are trying to stop smoking?

A

Resilience
Support systems
Other coping mechanisms

51
Q

Pharmacists are ideally placed to offer smoking cessations services to patients. What do these services include?

A

Access to 1 to 1 behavioural support with a trained stop smoking advisor and supply of nicotine replacement therapy with a product that is best for that person.

52
Q

What is Zyban (bupropion)?

A
  • Prolonged release tablets
  • Originally for depression but found to be helpful in quitting smoking
  • Usually POM but can be supplied under PGD
  • Quit date is 1-2 weeks after starting Zyban
53
Q

What is the dose for Zyban?

A

Dose is 150mg once daily for 6 days then 150mg twice daily for 7-9 weeks

54
Q

What is Champix (Vareniciline)?

A
  • Tablet
  • Reduces cravings for nicotine and blocks the rewarding and reinforcing effects of smoking
  • Quit date is 1-2 weeks after starting Champix
55
Q

What is the dose for Champix?

A

Day 1 - 3 : 0.5mg ONCE A DAY
Day 4 - 7 : 0.5mg TWICE A DAY
THEN 1mg TWICE A DAY for 11 weeks

56
Q

What does motivational interviewing consist of?

A

Expressing empathy
Develop discrepancy
Avoid argumentation
Roll with resistance
Support self-efficacy

PHAY0010 (27 decks)

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