Smoking Cessations Kerr! Flashcards
For Smoking Cessations
List the Nicotinic Drugs
(memorize Generic Names)
Nicotine Patch Generic Name
-Nicodern CQ/Habitrol
Nicotine Gum Generic Name
-Nicorette
Nicotine lozenge
- Commit
Nicotine Inhaler
-Nicotrol lnholer
Nicotine Nasal Spray
- Nicotrol NS
For Smoking Cessations
List Non-Nicotinic Drugs
(memorize the generic names)
- Buprorpion Sustained release (Buprorpion SR)
Zyban or Wellbutrin
Can be used
w/NRT
Start 1-2 weeks
before quit date.
- Varenicline
Tartrate
Chontix
Start 1 week
before quit date
What are the adverse effects of Nicotine Inhaler?
- Mouth and throat irritation
- Cough
• Side effem generally caused by
inappropriate use
What are the adverse effects of Nicotine Nasal
Spray?
- Nasal irrttation
- Sneezing
- Cough
- Teary eyes
What are the adverse effects of Nicotine Patch?
- local skin irritation
- insomonia
What are the adverse effects of Nicotine Gum?
- hiccups
- Dyspepsia
- mouth sorness
What are the adverse effects of Nicotine lozenge?
- Dyspepsia
- local irrttation mouth & throat
- Rarely causes coughing & hiccups
What are the adverse effects of Sustained release
bupropion (Zyban or Wellbutrin)?
- Insomnia
- Dry mouth
- Anxiety
What are the adverse effects of Varenidine
tartrate Chontix ?
- Nausea
- Insomnia
- Abnormal dreams
Nicotine inhaler
Precautions/Contraindications
Reactive Airway Disease
Nictotine Nasal Spray
Precautions
Reactive Ariway diseases
Not recomended for pts with Chronic Nasal diseases ( nasal polyps & sinusitis)
Sustrained Release Buprooion
Contraindications
- Seizure disorders
- Current use of bullrin or MAO inhibitor
- Eating disorder (bulimia, anorexia)
- Alcohol
- Head trauma
Moniter Blood presssure
Varenicline Tartlrate
Precaustions
- women breasfeeding should avoid
- pt with kidney problems -adjust dose
Nictoine Patch
Precutions
- Caution with 6 months of MI
Nictotine Gum
Precuations
- poor dentition
- maybe inappropriate for use for pts with compelete or partial denture (hard for them to chew)
Nictotine Lozenge
Precautions
- Xerostomia
TREATING TOBACCO DEPENDENCE:
A 2-PART PROBLEM
Why is it so hard to quit: Nicotine addiction?
What are the symptoms of Nicotine Withdrawal?
■Irritability/frustration/anger
■Anxiety
■Difficulty concentrating
■Restlessness/impatience
■Depressed mood/depression
■Insomnia
■Impaired performance
■Increased appetite/weight gain
■Cravings
WHAT WORKS (5A’s)
- Ask about tobacco use and secondhand smoke exposure
- Advise to quit
- Assess interest in quitting
- Assist in quit attempt (referral and or pharmacotherapy)
- Arrange for a follow-up
Is Treating Tobacco is within the
Scope of Practice of dentists?
Yes
•New York State Education Department has deemed that treating tobacco use is part of the scope of practice for dentistry, this includes prescribing smoking cessation products.
Nicotine replacement therapy (NRT)
&
FDA labeling
Is it Safe?
- NO safety concerns association with using more than one NRT
- NO significant safety concerns association with using NRT at the same time as a cigarettes
- Use for longer than 12 weeks is safe
Assist-Prescribe FDA-Approved Medications
First Line Pharmacotherapy
in combatting smoking?
- Combination long- and-short acting Nicotine Replacement Therapy (NRT) (e.g., patch and gum, patch and inhaler)
- Varenicline alone
- Bupropion SR with NRT (long- or short-acting)
•What is NRT at the POC?
•Rationale for NRT at the POC
•Who will hand the patient NRT?
•What kind of NRT will be on stock?
•How to distribute NRT at POC?
•What is NRT at the POC?
–Distribution of a free starter pack of NRT to all smokers by clinic staff during the clinic visit
•Rationale for NRT at the POC
–NRT doubles the success rate of patients’ quit attempts
–Inconvenience of purchasing RNT or filling a prescription creates barriers
–The clinic is an opportune time to intervene
•Who will hand the patient NRT?
–Dental Students
•What kind of NRT will be on stock?
•Nicotine Patch, Gum, and Lozenge
•How to distribute NRT at POC?
–Take faculty-approved NRT request form to dispensary, where NRT is stored.
What is the The most effective treatment for
smoking cessation
a combination
of pharmacotherapy and counseling
