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pt care III > tobacco > Flashcards

tobacco Flashcards

1
Q

what product has the highest nic content

A

cigars

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2
Q

When inhale cigarette (directly or secondhand) inhaling more than _____ chemicals, _____ of these are hazardous ______ are known carcinogens

A

When inhale cigarette (directly or secondhand) inhaling more than 7,000 chemicals
Hundreds of these are hazardous
70 are known carcinogens

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3
Q

______ cancer is the leading cause of cancer related death in US for both men and women

A

Lung cancer is the leading cause of cancer related death in US for both men and women

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4
Q

what causes a majority of lung cancer

A

smoking

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5
Q

SMOKING EFFECTS ON THE MOUTH
 breath?
 Perio?
 throat?
 Reduced senses?
 Unhealthy tissue
 Delayed?
 cancers?
 staining?
 Poor response to?
 lesions?
 Sores?

A

 Bad breath
 Periodontal (gum) disease
 Sore throat/hoarseness
 Reduced smell/taste
 Unhealthy tissue
 Delayed healing
 Oral cancer
 Throat cancer
 Teeth staining
 Poor response to dental treatment
 Oral lesions
 Sores on mouth, lips, tongue

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6
Q

all smokeless product contain

A

carcinogens and nic

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7
Q

SMOKELESS TOBACCO EFFECTS
ON THE MOUTH
breath?
 Irritates and inflames?
 cancer?
 Increased risk of?
 Painful?
 staining?
 disease?

A

SMOKELESS TOBACCO EFFECTS
ON THE MOUTH
 Bad breath
 Irritates and inflames tissue= Tissue changes
 Oral cancer
 Increased risk of tooth decay
 Painful ulcers
 Teeth staining
 Periodontal/Gum disease

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8
Q

 Approximately _____ Americans are diagnosed with OPC (oral and/or pharyngeal cancer)
 ________die each year from disease

A

 Approximately 42,000 Americans are diagnosed with OPC (oral and/or pharyngeal cancer)
 8,000 die each year from disease

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9
Q

 ____% of OPC can be attributed to tobacco use, heavy
alcohol consumption and in many cases both

A

75%

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10
Q

prevalence of e cigs increasing where?

A

high schoolers and adolescents due to fruit flavors

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11
Q

“VAPING”…..
 Act of inhaling and exhaling what? which is produced by?
 E-cigarettes do not produce? , but rather an? often mistaken for? , that actually consists of?
 Vapor is generated from?

A

“VAPING”…..
 Act of inhaling and exhaling the aerosol, often referred to as vapor, which is produced by an e-cigarette or similar device.
 E-cigarettes do not produce tobacco smoke, but rather an aerosol, often mistaken for water vapor, that actually consists of fine particles.
 Vapor is generated from a solid, semi-solid, or liquid substance

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12
Q

components of vape pens

A

COMPONENTS
 Battery
 Heating element
 Atomizer
 Cartridge/pod
 Indicator light

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13
Q

E-LIQUID INGREDIENTS

A

 Vegetable glycerin
 Propylene glycol
 Flavorings
 Nicotine**
 Other compounds/chemicals: Diacetyl and Benzoic acid

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14
Q

e liquid ingredients deemed safe?

A

 Ingredients may be deemed safe for use and/or ingestion
 But not evaluated for inhalation and heat

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15
Q

e liquid 3rd hand exposure?

A

 Can remain on surfaces for weeks to months
 Potential for 3rd hand exposure or accidental ingestion by
children

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16
Q

e liquid effects in pregnancies

A

 May cause adverse effects during or after pregnancy
 Nicotine can cross the placenta

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17
Q

nic salts
hit?
 More like a?
 nicotine concentrations?
 Potential to be more?
 nicotine solutions available?
 Each pod contains same amount of nicotine as?

A

“Smoother hit”
 More like a cigarette rush
 Higher nicotine concentrations
 Potential to be more addictive
 1.8 % - 5% nicotine solutions available
 Each pod contains same amount of nicotine as an
entire pack of cigarettes**

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18
Q

AEROSOL composition

A

 Volatile organic compounds
 Nicotine
 Ultrafine particles
 Heavy metals – nickel, tin, lead

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19
Q

why ?

HEALTH CONCERNS ASSOCIATED
 POPULARITY OF DEVICES
 Easy to get? how?
 Flavorings?
 design?
 11 to 17-year olds think?

A

 Easy to get: Via online, convenience stores*, Smoke/vape shops
 Flavorings make these devices appealing
 Discreet use/sleek design
 11 to 17-year olds think e-cigarettes are less
harmful than smoking

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20
Q

HEALTH CONCERNS ASSOCIATED with vaping
 Increased heart rate due to? =Higher risk for?
 blood pressure?
 bronchitis?
 lung disease?
 “popcorn lung”?
 glycemic control?

A

 Increased heart rate due to spike in adrenaline=Higher risk for heart attack
 Increased blood pressure
 Increase in bronchitis
 Increase in lung disease
 “popcorn lung” – bronchiolitis obliterans
 May cause blood sugar levels to rise

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21
Q

vaping EFFECTS ON ORAL HEALTH
 Chemical vapors produced can alter or damage what cells?
 ulcerations?
 Oral cancer?
 Indicates an inflammatory response where/cells?
 May lead to greater risk for?
 throat?
 Dry?

A

 Chemical vapors produced can alter or damage epithelial cells
 Oral ulcerations
 Oral cancer may result
 Indicates an inflammatory response in the PDL fibroblasts
 May lead to greater risk for periodontal disease
 Sore throat
 Dry mouth

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22
Q

vaping heat and chemicals effect in the mouth
 Dry?
 Bone?
 Inflam?
 Increased?
 Tooth?

A

 Dry mouth
 Bone loss
 Inflammation
 Increased plaque, calculus
 Tooth decay

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23
Q

nic as a stim can induce what habit?

A

bruxism

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24
Q

NICOTINE
 Distributed quickly through the ___________ and
crosses the ____________barrier
 Reaches the brain within __________seconds with inhalation
 Elimination half-life?
 Nicotine is metabolized in the?

A

 An alkaloid that is contained in the leaves of plants
 Distributed quickly through the bloodstream and
crosses the blood–brain barrier
 Reaches the brain within 8–20 seconds with inhalation
 Elimination half-life of nicotine is around two hours
 Nicotine is metabolized in the liver

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25
Q

nic physio effects
adrenal glands
heart
panc
NTs released?

A
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26
Q

 The amount of nicotine absorbed by the body
from smoking depends on:

A

 type of tobacco
 whether the smoke is inhaled
 whether a filter is used

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27
Q

smoke vs. smokeless tobacco and nic into body

A

more in smokeless

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28
Q

nic and braind dev

A

 Research indicates development of brain continues to occur until the age of 25
 Nicotine changes the way synapses are formed
 can harm the parts of the brain that control attention and learning
 The nicotine in e-cigarettes and other tobacco products can also prime the adolescent brain for addiction to other drugs such as cocaine.

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29
Q

HOW (nic) IMPACTS YOUTH/YOUNG ADULTS

A

 Depression
 Anxiety
 Mood disorders
 Addiction
 Difficulty paying attention
 Reduced impulse control

30
Q

nic addiction cycle (increased usage)

A
31
Q

TOBACCO DEPENDENCE:
A 2-PART PROBLEM

A
32
Q

WITHDRAWAL SYMPTOMS

A
33
Q

timeframes

BENEFITS OF QUITTING SMOKING
20 min
8hrs
24hrs
48hr
3days
2-12 months
5yrs
10-15 yrs

A

f

34
Q

quitting smokeless tobacco decreases risk for:
 cancer?
 teeth?
 gums?
 cholesterol?
 bp?
 infarctions?

A

 oral, head and neck cancer
 tooth decay
 progression of gum recession
 high cholesterol
 high blood pressure
 heart attack or stroke

35
Q

what product has the highest 1 year cessation rates

A

nic gum and lozenges

36
Q

the 5 A’s for user

A
37
Q

how to ask about tobacco use

A

◼ “Do you ever smoke or use any type of tobacco?”
◼ “Do you use any form of e-cigarette or vaping device?”
◼ “Do you, or does someone in your household smoke?”

38
Q

pack year figure

A

Number of cigs per day/20 x number of years of smoking = number of pack years

39
Q

advising quitting

A

(clear, strong, personalized)
◼ Best results if you can personalize this and be open, non-judgmental

40
Q

ways to assists with the quit at different stages

A

◼ Not ready to quit: provide motivation
◼ Ready to quit: design a treatment plan
◼ Recently quit: relapse prevention

41
Q

Transtheoretical Change
Model
(Stages of Change)

A
42
Q

arranging follow up care

A

greater success with more appts

43
Q

Quit-line available 24
hours a day, 7 days a
week?

A

1-800-quitnow

44
Q

CESSATION OPTIONS
 Cold Turkey (no additional help)
 Replacement?
 Medications*
 Therapy?
 Apps?
 Combination?
 Hypnotherapy?
 Acupuncture?
 Yoga, meditation?
 Herbs?

A

 Cold Turkey (no additional help)
 Nicotine Replacement Therapy (NRT’s)*
 Medications*
 Behavioral Therapy
 Counselor/Coach, app/tech use, telephone counseling (1-800-QUITNOW)
 Apps – QuitNow!, KWIT, Smoke Free, Quitters Circle, Quick Tracker
 Combination Therapy: Multiple uses of NRTs, NRTs and medications
 Hypnotherapy – Reveri app
 Acupuncture
 Yoga, meditation
 Herbs

45
Q

contraindications for pharm agents

A

Hypothyroidism
Insulin-dependent diabetes
Active peptic ulcer
Anti-depressant medications

46
Q

BUPROPION SR (ZYBAN)
what is this?
when to begin?
when to double dose?

A

)
 150 mg sustained release tablet
 Begin taking 1 week prior to quitting
 Double dose after 3 days

47
Q

zyban advantages

A

 Easy to use
 Can be used with Nicotine Replacement Therapy

48
Q

zyban adverse effects
sleep, mouth, nerves, concentration, GI, convolutions?

A

Insomnia, dry mouth, nervousness/difficulty
concentrating, rash, constipation, seizures

49
Q

starter and maintenence?

How to write the prescription for zyban

A

Rx: Zyban Starter Pack
Disp: 1 (one) package
Sig: Take as directed
0 refills

Rx: Zyban Maintenance Pack
Disp: 1 (one) package
Sig: Take as directed
2 refills

50
Q

dosage/ days and weeks frame

VARENICLINE
(CHANTIX®)

A

 0.5 mg and 1.0 mg tablet
 Days 1-3: take one 0.5 mg tablet in the AM
 Days 4-7: take 0.5 mg tablet twice daily
 Weeks 2-12: take 1.0 mg tablet twice daily

51
Q

chantix advantages

A

Easy to use and offers a new mechanism of action for
patients who have failed with other agents (decreases dopamine for less withdrwl effects)

52
Q

chantix adverse effects
sleep, GI, nn, nausea?

A

Nausea, insomnia, vivid dreams, constipation, vomiting, Neuropsychiatric Symptoms (behavior changes, agitation, depressed mood, suicidal ideation or behavior)

53
Q

starter/maintence?

chantix prescription

A

Chantix® Starting Month/Pack
Disp: 1 (one) package
Sig: Take as Directed
0 Refills

Chantix® Continuing Month/Pack
Disp: 1 (one) package
Sig: Take as Directed
2 refills

54
Q

chantix quitting methods

A

3 ways: fixed , flexible and gradual quit approaches

55
Q

dosage (wks; 1-6, 7-9, 10-12)? max per day? food?

(GUM – NICORETTE, ZONNIC)

A

 Week 1-6: 1 piece every 1-2 hours
 Week 7-9: 1 piece every 2-4 hours
 Week 10-12: 1 piece every 4-8 hours
 Max of 24 pieces per day. No food or beverage 15 min before or during use

56
Q

nic gum pros

A

 May delay weight gain and satisfy oral cravings

57
Q

nic gum cons

A

Mouth/jaw soreness, hiccups, dyspepsia

58
Q

dosages possible for dif cases? (wks: 1-6,7-9, 10-12)? max per day? food?

(LOZENGE – COMMIT, ZONNIC)

A

 2 mg (smoke > 30 min after waking) and 4 mg (smoke ≤ 30 min after waking)
 Week 1-6: 1 lozenge every 1-2 hours
 Week 7-9: 1 lozenge every 2-4 hours
 Week 10-12: 1 lozenge every 4-8 hours
 Max. of 20 lozenges/day. No food or beverage 15 min. before or during use.
Do not chew or swallow lozenge

59
Q

advantages of the nic lozenge

A

May delay weight gain and satisfy oral cravings

60
Q

cons of nic drop

A

Nausea, hiccups, cough, heartburn, headache, insomnia

61
Q

dosages

(TRANSDERMAL PATCH - NICODERM CQ)

A

 7 mg, 14 mg, 21 mg (24-hour release)

62
Q

pros of slapping on a nic patch

A

Provides consistent Nicotine for 24 hrs, easy to use.

63
Q

cons of wearing a fucking patch releaseing nic on your skin 24hrs a day
local, head, sleep?

A

Local skin reaction, headache, insomnia, vivid dreams (sex)

64
Q

(NASAL SPRAY – NICOTROL NS)
 dose per 50mcl
 usual doses per hour?
 doses/day?
 Maximum doses/hr?
 One dose = ?

A

 0.5 mg metered spray per 50 mcL
 1-2 doses per hour
 8-40 doses/day
 Maximum 5 doses/hr
 One dose = 2 sprays (1 per nostril)

65
Q

pros of the sweet ass nic spray

A

Patients can titrate therapy to help with withdrawal

66
Q

cons of spraying fucking nic into your nose

A

Nasal/throat irritation, rhinitis, tearing, sneezing, headache, cough

67
Q

(ORAL INHALER – NICOTROL)
 ___ mg cartridge – delivers ____ mg inhaled nicotine vapor
 cartridges/day?
 Begin with ___ cartridge every ____ hours
 Best effects with?

A

 10 mg cartridge – delivers 4 mg inhaled nicotine vapor
 6-16 cartridges/day
 Begin with 1 cartridge every 1-2 hours
 Best effects with continuous puffing for 20 min

68
Q

pros of having a nic enhanced inhaler with blue tiger camo and no stock

A

Patients can titrate amount to manage withdrawal and
mimics hand-to-mouth ritual

69
Q

cons of the nic inhaler

A

Mouth/throat irritation, cough, headache, rhinitis, dyspepsia (indigestion)

70
Q

umkc super cool smoking cessation program consists of

A

 Prep-work by the student
 Initial Visit Appointment
 Follow-Up Visit Appointment(s)
maybe free hugs too idk

71
Q

is smoking cool?

A

only if youre drunk or have a topcoat on then kinda

pt care III (14 decks)

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