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Patient Care III > Tobacco Cessation > Flashcards

Tobacco Cessation Flashcards

1
Q

 An alkaloid that is contained in the leaves of
plants
 As is distributed quickly through the
bloodstream and crosses the blood–brain barrier
 Reaches the brain within 8–20 seconds with
inhalation
 The elimination half-life in the body is
around two hours.
 metabolized in the liveR

A

Nicotine

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2
Q

How long is the elimination half-life of the nicotine in the body?

A

2 hours

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3
Q

How long does nicotine take to reach the brain?

A

8-20 seconds

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4
Q

Nicotine is metabolized in the _____

A

Liver

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5
Q
  • Stimulates adrenal glands
  • Releases adrenaline – surge causes immediate release of glucose
  • Increased heart rate, breathing activity, and blood pressure
  • Pancreas produces less insulin – causing increased blood sugar or glucose
  • Dopamine released – feeling of contentment is higher
  • Acetylcholine and Norepinephrine released – concentration and memory
  • Increased levels of beta-endorphin – reducing anxiety
A

Nicotine

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6
Q

For chewing tobacco, dipping tobacco, snus and
snuff, the amount released into the body tends to
be ______ than smoked tobacco

A

much greater

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7
Q

Research indicates development of brain continues to

occur until the age of ____

A

25

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8
Q

______ changes the way synapses are formed,
 can harm the parts of the brain that control attention and
learning.
 It in e-cigarettes and other tobacco products
can also prime the adolescent brain for addiction to other
drugs such as cocaine.

A

Nicotine

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9
Q

Treatment should address the ____ and _____ aspects of dependence

A

physiological

and the behavioral

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10
Q 
\_\_\_\_\_\_ symptoms
Symptom Duration
Chest tightness A few days
Constipation, stomach pain 1-2 weeks
Cough, dry throat A few days
Cravings for tobacco Frequent in first 2-3 days
Depressed mood, irritable 1-4 weeks
Dizziness 1-2 days
Difficulty concentrating A few days
Fatigue 2-4 weeks
Hunger Up to several Weeks
Insomnia 1 week
A

Withdrawal symptoms

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11
Q

Most withdrawal symptoms subside in about ____

A

1 week

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12
Q 
Benefits of \_\_\_\_\_\_
Time Benefit
20 minutes Blood pressure returns to normal
8 hours Normal oxygen blood level
24 hours Carbon monoxide eliminated from lungs –
start to clear mucus
48 hours Nicotine is eliminated
Smell and taste improve
3 days Lung capacity begins to improve
Breathing become easier
2-12 months Circulation improves
5 years Risk of lung cancer decreases
10-15 years Reduced risk of other cancers
A

Quitting smoking

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13
Q

BENEFITS OF _________
 Decreased risk of Oral, Head and Neck Cancer
 Decreased risk of tooth decay
 Decreased progression of gum recession
 Decreased risk of High Cholesterol
 Decreased risk of High Blood Pressure
 Decreased risk for Heart Attack or Stroke

A

QUITTING SMOKELESS TOBACCO

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14
Q

What are the 5 A’s of cessation?

A 
Ask
Advise
Assess
Assist
Arrange
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15
Q

What are the 4 things we must check with a physician before pharmacotherapy?

A

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

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16
Q 
 150 mg sustained release tablet
 Begin taking 1 week prior to quitting
 Double dose after 3 days
 Advantages:
 Easy to use
 Can be used with Nicotine Replacement Therapy 
 Adverse Effect:
 Insomnia, dry mouth, nervousness/difficulty 
concentrating, rash, constipation, seizu
A

BUPROPION SR

ZYBAN

17
Q

How long should the aids be used to increase success rate in cessation?

A

12 weeks

18
Q

 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
 Advantages:
 Easy to use and offers a new mechanism of action for
patients who have failed with other agents
 Adverse Effects:
 Nausea, insomnia, vivid dreams, constipation, vomiting,
Neuropsychiatric Symptoms (behavior changes, agitation,
depressed mood, suicidal ideation or behavior)

A

VARENICLINE

CHANTIX®

19
Q

 2 mg (smoke < 25 cig/day) or 4 mg (smoke ≥ 25 cig/day)
 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
 Advantages:
 May delay weight gain and satisfy oral cravings
 Adverse Effects:
 Mouth/jaw soreness, hiccups, dyspepsia

A

(GUM – NICORETTE, ZONNIC)

20
Q

 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
 Advantages:
 May delay weight gain and satisfy oral cravings
 Adverse Effects:
 Nausea, hiccups, cough, heartburn, headache, insomnia

A

(LOZENGE – COMMIT, ZONNIC)

21
Q

 7 mg, 14 mg, 21 mg (24 hour release)
 Advantages:
 Provides consistent Nicotine for 24 hrs, easy to use.
 Adverse Effects:
 Local skin reaction, headache, insomnia, vivid dreams
-Set and forget

A

(TRANSDERMAL PATCH - NICODERM CQ)

22
Q 
 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)
 Advantages:
 Patients can titrate therapy to help with withdrawal
 Adverse Effects:
 Nasal/throat irritation, rhinitis, tearing, sneezing, 
headache, cough
A

(NASAL SPRAY – NICOTROL NS)

23
Q

 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.
 Advantages:
 Patients can titrate amount to manage withdrawal and
mimics hand-to-mouth ritual
 Adverse Effects:
 Mouth/throat irritation, cough, headache, rhinitis, dyspepsia

A

(ORAL INHALER – NICOTROL)

24
Q

Do all smoking tobacco products contain carcinogens?

A

Yes

25
Q

When inhale cigarette (directly or secondhand) inhaling more than ______ chemicals

A

7,000 chemicals

26
Q

____ chemicals are known carcinogens in cig smoke

A

69

27
Q 
The following are consequences linked to \_\_\_\_\_\_\_ exposure
Children Adults
• Middle ear disease
• Respiratory symptoms
• Impaired lung function
• Lower respiratory illness
• SIDS
• Nasal irritation
• Lung cancer
• Coronary heart disease
• Reproductive effects in 
women
– Low birth weight
A

Secondhand smoke exposure

28
Q

______ is the leading cause of cancer related

death in US for both men and women

A

Lung cancer

29
Q

Smoking accounts for more than ____% of lung

cancer cases reported in men

A

90%

30
Q

Smoking accounts for more than __% of lung

cancer cases reported in women

A

89%

31
Q

Smokeless tobacco CONTAINS OVER ____ CHEMICALS

KNOWN TO CAUSE CANCER

A

28 chemicals

32
Q 
Approximately \_\_\_\_\_\_ Americans are diagnosed 
with OPC (oral and/or pharyngeal cancer)
A

42,000

33
Q

 ____% of OPC can be attributed to tobacco use, heavy

alcohol consumption and in many cases both

A

75%

34
Q

___% of leukoplakia’s caused by tobacco use

A

70%

35
Q

 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.

A

Vaping

36
Q

What are the 4 components of aerosol?

A

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

37
Q 
 Use nicotine salts 
 Higher nicotine concentrations 
 Potential to be more addictive
 3% and 5% nicotine solutions available
 2 flavors – Menthol, Virginia Tobacco
 Each pod contains same amount of nicotine as an 
entire pack of cigarettes
A

JUUL device

38
Q

 Uses nicotine salts
 Higher nicotine concentrations
 Potential to be more addictive
 1.8%, 2.4%, and 5.0%
 3 flavors – Golden Tobacco, Menthol, Rich Tobacco
 Each pod contains same amount of nicotine as an
entire pack of cigarettes**

A

VUSE

39
Q

 Name given to vaping-related lung illness
 High prominence in late 2019 and early 2020
 As of February 18, 2020– 2,807 hospitalized cases
 69 deaths associated with this across the states
 Associated with Vitamin E acetate

A

EVALI

Patient Care III (12 decks)

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