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NAPLEX!!! > Tobacco Cessation - Chapter 43 > Flashcards

Tobacco Cessation - Chapter 43 Flashcards

1
Q

The 5 As Model for treating tobacco use

A

Ask
Advise
Assess
Assist
Arrange

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2
Q

The 5 As: Ask

A

Ask the patient about their tobacco use, and identify and document the patient’s tobacco use status, at every patient

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3
Q

The 5 As: Advise

A

Advise the patient to quit. In a professional manner, advise and urge every patient to quit

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4
Q

The 5 As: Assess

A

Assess the patients readiness to quit.

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5
Q

The 5 As: Assist

A

Assist in the quit attempts. Encourage the patient to quit and show them support each and everytime you see them. Offer any medications if applicable, as well as lozenges, gum, patches, etc.

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6
Q

The 5 As: Arrange

A

Arrange follow ups for the patient. Having regular follow ups can hold patients accountable and more likely to continue to stay on track!

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7
Q

Smoking is the ________ cause of preventable dealht in the US

A

leading

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8
Q

Known risk factors for smoking

A

Heart disease, stroke, pregnancy complications, COPD, cancers

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9
Q

Pack-year smoking history

A

Cigarette packs/day x number of years smoked

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10
Q

Phone number for national tobacco quit-lines

A

1-800-QUIT-NOW

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11
Q

What is one of the essential components of tobacco cessation

A

Counseling

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12
Q

What are the two counseling components of tobacco cessation?

A

Behavioral counseling and social support

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13
Q

Should medications be offered to every patient trying to quit

A

Yes - to all patients who do not have other contraindications

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14
Q

Why are medcation a recommended?

A

Help prevent withdrawals and symptoms like anxiety, depression, irritability, insomnia, poor concentratio, restlessness, increased appetite, and urges

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15
Q

What is the most effective strategy for quitting smoking?

A

Counseling + medications

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16
Q

Five nicotine replacement therapies

A

Gum
Lozenge
Inhaler
Nasal Spray
Patches

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17
Q

Two non-nicotine drugs

A

Bupropion and Varenicline

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18
Q

First line options

A

Replacement therapy
Non-nicotine therapy

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19
Q

Best first line options

A

Patch + one short acting
Varenicline + patch

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20
Q

In what populations is behavioral counseling preferred over any kind of drug therapies

A

Pregnant women (no nicotine at all)
Adolescents
Smokeless tobacco users
Light smokers

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21
Q

Are electronic cigarettes recommended for people who are trying to quit smoking?

A

No - there are even more health concerns with e cigarettes

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22
Q

Smoking induces which CYP enzyme?

A

CYP1A2

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23
Q

What medications can patients who quit smoking see supratherapeutic levels of due to CYP1A2 no longer being induced?

A

Caffeine
Theophylline
Fluvoxamine
Olanzapine
Clozapine
Warfarin

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24
Q

What medications should women who smoke and are over the age of 35 avoid?

A

Anything containing estrogen

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25
What vaccines should smokers receive?
Influenza Pneumoccoal
26
Nicotine patch status
OTC
27
Nicotine patch brand name
NicoDerm CQ
28
How are nicotine patches dosed?
Based on your daily number of cigarettes
29
Who should avoid nicotine patches?
Pregnant patients, patients with recent MI, have arrythmias, worsening angina,
30
Side effects of nicotine patches
Insomnia Vivid dreams Skin Irritation
31
Who is not allowed to purchase nicotine products?
Anyone under the age of 21. FDA prohibits it
32
Big counseling point for patches
Remove before getting an MRI
33
Which form of nicotine replacement therapy has the highest adhearence?
Patch
34
Nicotine gum brand name
Nicorette
35
How is nicotine gum dosed?
Based on the timing of first cigarette after wake up
36
Nicotine lozenge brand name
Nicorette Mini
37
How is nicotine lozenges dosed?
Based on the timing of first cigarette after wake up
38
Nicotine gum status
OTC
39
Nicotine lozenge status
OTC
40
Nicotine inhaler status
RX
41
Nicotine nasal spray status
RX
42
How long can you use a nicotine inhaler?
For up to 6 months
43
How long can you use nicotine nasal spray?
For up to 3 months
44
Nicotine main side effect
Insomnia
45
Nicotine Inhaler side effect
Mouth and throat irritation
46
Nicotine nasal spray side effect
Nasal irritation
47
Do not eat or drink for ______ minutes before or after using nicotine gum and lozenge
15
48
What strength of nicotine gum and lozenge helps delay weight gain associated with quitting smoking?
4 mg
49
Inhaler positive
It provides the hand to mouth motion and could be used as a coping mechanism in patients trying to quit
50
True or false: nasal spray has the lowest risk of dependence
False
51
Nasal Spray has the ______ delivery
Fastest
52
Bupropion MOA
Blocks neural reuptake of dopamine and/or norepinephrine, which reduces cravings and withdrawal symptoms
53
Bupropion should be started _____ before your quit date
1-2 weeks
54
Does bupropion need to be tapered when d/ced?
No
55
Bupropion BBW
Suicidal thoughts and behaviors especially in young adults and adolescents
56
Which form of Bupropion is used for smoking cessation?
SR
57
Contraindications for Bupropion
Seizure history History of anorexia and or bulimia Concurrent use with MAOI IV use of Methylene Blue
58
Bupropion side effects
Dry Mouth Insomnia Tremors Weight Loss
59
To decrease insomnia:
Take the first dose first thing in the morning, and the 2nd dose 8 hours later
60
Varenicline MOA
Partial neuronal alpha-4 beta-2 nicotinic receptor agonist
61
Varenicline should be started _____ before the quit date
1-2 weeks
62
Does Varenicline need to be tapered when d/ced?
No
63
True or False: Varenicline is recommended over bupropion?
True
64
True or False: Varenicline monotherapy is preferred over Varenicline + NRT
False
65
Varenicline side effects
Nausea Insomnia Vivid dreams Headache
66
Ways to decrease nausea
Take right after eating with a full class of water
67
What to use to help slow the weight gain associated with quitting
Gum Lozenge Bupropion SR
68
What to use to help with depression and quitting
Bupropion SR
69
Avoid with dentures
Gum
70
Avoid with COPD/Asthma
Inhaler Nasal Spray
71
Avoid with skin conditions
Patch
72
Avoid in patients with seizures
Bupropion Varenicline
73
Steps to applying/removing the patch
Remove the old patch before placing a new one 1. Remove the backing of the patch and apply the sticky side to clean, hairless skin 2. Press firmly on the patch for ~15 seconds 3. Wear for up to 24 hours - if you have side effects around sleeping, remove the patch before bedtime 4. Discard the patch by folding the sticky ends together. You can place it back in the pouch and throw in the trash 5. Wash your hands after applying and removing the patch 6. Rotate the application site. Do not wear in the same place every time 7. Do not cut the patch or wear more than one at once
74
Steps for chewing gum
1. Chew slowly until the tingly or peppery flavor occurs in the mouth 2. Park the gum in the cheek 3. When the tingly/peppery flavor goes away, slowly chew more until the flavor returns 4. Repeat until most of the flavor is gone (Takes about 30 minutes) 5. Do not eat or drink 15 minutes before or after chewing
75
Lozenges counseling points
Do not eat or drink for 15 minutes before or during use Do not chew or swallow the lozenge, allow it to dissolve It takes ~20-30 minutes to have it fully dissolve May cause warm or tingling sensation Do not use more than one lozenge at a time
76
Inhaler counseling points
Inhale deeply into the back of the throat or puff in short breaths Each cartridge provides about 20 minutes of active puffing Clean the mouthpiece with soap and water regularly Keep at room temperature
77
78
Varenicline can ________ the effects of alcohol
Increase

NAPLEX!!! (21 decks)

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