Tobacco Cessation Flashcards
5 A’s
Ask about use Advise to quit Assess willingness Assist in quit attmpt Arrange f/u
tobacco smoke induces what enzyme?
CYP1A2
smokers who quit can experience SE from supratherapeutic levels of caffeine, theophylline, fluvoxamine, zyprexa, clozapine and the R-isomer of warfarin
Who should not take estrogen-containing OC?
Women > 35 years old who smoke
What are exceptions to drug treatment?
behavioral counseling should be used for pregnant women, adolescents, and light smokers using < 10 cigarettes a day
Nicotine Patch Initial dosing?
> 10 cigarettes = 21mg patch
< 10 cigarettes = 14mg patch
use for 10 weeks. Taper down by 7mg after weeks 6 and 8.
Nicotine gum dosing?
1st cigarette > 30 min = 2mg
1st cigarette < 30 min = 4mg
minimum is 9 pieces/day during first 6 weeks
Safety/SE/Monitoring for NRT
Avoid in post-MI, arrhythmias, angina, pregnancy
Patch: vivid dreams
Notes for NRT
Combo tx with short-acting NRT and patch = most effective. ex) short-acting gum to reduce cravings
Patch must be removed before an MRI
Gum and lozenge can delay weight gain
MoA of Bupropion SR?
blocks reuptake of DA and NE
MoA of Varenicline?
partial nicotinic receptor agonist
Dosing for Zyban?
Start at least 1 week before quit date
Max dose = 300mg/day
Zyban SE/safety/monitoring
c/i in seizures, anorexia, MAOI, linezolid or IV methylene blue
warnings; neuropsych events, htn
Notes for Zyban
do not use with other forms of bupropion
to decrease insomnia, take 2nd dose 8 hours after the first dose
Varnicline dosing?
start 1 week before quit date
warnings for chanix?
serious neuropsych events, seizures
SE = dose-dependant nausea, insomnia, abnormal dreams, h/a
