Test 3 Nicotine / Smoking Cessation Flashcards
What happens to nicotine when it gets in the body?
it gets metabolized into cotinine (has half-life of 16hrs)
effects of nicotine on the body
– Pleasure – Arousal, enhanced vigilance – Improved task performance – Anxiety relief – ↑ Heart rate – ↑ Cardiac output – ↑ Blood pressure – Coronary vasoconstriction – Cutaneous vasoconstriction – Appetite suppression – Increased metabolic rate – Skeletal muscle relaxation
Which chemicals are involved with the effects of nicotine?
- dopamine
- NE
- acetylcholine
- glutamate
- serotonin
- β-endorphin
- GABA
dopamine causations
- pleasure
- appetite suppression
NE causations
- arousal
- appetite suppression
acetylcholine causations
- arousal
- cognitive enhancement
glutamate causations
- learning
- memory enhancement
serotonin causations
- mood modulation
- appetite suppression
β-endorphin causations
reduction of anxiety and tension
GABA causations
reduction of anxiety and tension
withdrawal effects of nicotine
- Irritability / frustration / anger
- Anxiety
- Difficulty concentrating
- Restlessness / impatience
- Depressed mood/depression
- Insomnia
- Impaired performance
- Increased appetite/weight gain
- Cravings
time period of symptoms
- Most symptoms manifest within the first 1–2 days
- peak within the first
week and subside within 2–4 weeks
the 5 A’s used in tobacco cessation
- ask about tobacco use
- advise quitting
- assess readiness to quit
- assist with quitting
- arrange follow up care
assessing Readiness to quit
- relevance
- risks
- rewards
- roadblocks
- repetition
brief counseling intervention
- ask about tobacco use
- advise quitting
- refer to other resources
What are the types of nicotine replacement?
- gum
- patch
- lozenge
- nasal spray
- inhaler
- bupropion SR
- varenicline
What are precautions to keep in mind with NRT?
patients with underlying cardiovascular disease
nicotine gum
contains buffering agents to enhance buccal absorption of nicotine
dosing of nicotine gum
- if TTFC is within 30 min = 4mg
- if TTFC is more than 30 min = 2mg
- wk 1-6: 1 piece q 1-2 hr
- wk 7-9: 1 piece q 2-4 hr
- wk 10-12: 1 piece q 4-8 hr
- want to use 9 pieces per day to be successful but no more than 24 pieces per day
warning / precaution of nicotine gum
- don’t drink coffee, tea, or soda before or during this because they are acidic and will decrease absorption
- don’t consume anything 15 min before or during use
adverse effects of nicotine gum
\+ if chewing too rapidly or continuously: - nausea / vomiting - lightheadedness - irritation of throat and mouth - hiccups - indigestion \+ other side effects: - mouth soreness - hiccups - dyspepsia - jaw muscle ache
nicotine lozenge
- contains buffering agents to enhance buccal absorption of nicotine
- delivers 25% more nicotine than gum dose
dosing of nicotine lozenge
- if TTFC is within 30 min = 4mg
- if TTFC is more than 30 min = 2mg
- wk 1-6: 1 piece q 1-2 hr
- wk 7-9: 1 piece q 2-4 hr
- wk 10-12: 1 piece q 4-8 hr
- want to use 9 pieces per day to be successful but no more than 20 pieces per day
- will completely dissolve in 20-30 min
- do not chew
- rotate to different areas of mouth
warning / precaution of nicotine lozenge
- don’t drink coffee, tea, or soda before or during this because they are acidic and will decrease absorption
- don’t consume anything 15 min before or during use