Tobacco Cessation (final review) Flashcards
What cancers are causally linked to smoking? (10)
- oropharynx
- larynx
- esophagus
- trachea, bronchus, lung
- acute myeloid leukemia
- stomach
- pancreas
- kidney & ureter
- cervix
- bladder
What chronic illnesses are causally linked to smoking? (11)
- stroke
- cataracts, blindness
- periodontitis
- aortic aneurysm
- coronary heart disease
- pneumonia
- vascular disease
- respiratory effects
- COPD
- hip fractures
- reproductive disease
Smokeless tobacco effects in the mouth include: (7)
- bad breath
- irritated & inflamed tissue
- oral cancer
- increased risk of tooth decay
- painful ulcer
- teeth staining
- periodontal/gum disease
Approximately _____ % of Americans are diagnosed yearly with oral/pharyngeal cancer
_______ of these cases succumb to disease
42,000; 8000
____ % of oral/pharyngeal cancer cases can be attributed to tobacco use and/or heavy alcohol consumption
75%
75% of oral/pharyngeal cancer cases can be attributed to:
tobacco use and/or heavy alcohol consumption
_____% of leukoplakias are caused by tobacco use
70
List the cessation options for tobacco cessation:
- cold turkey
- NRTs
- medications
- behavioral therapy
- combination therapy
- hypnotherapy
- acupuncture
- yoga, meditation
- herbs
NRTs:
nicotine replacement therapy
Behavioral therapy for tobacco cessation include:
counselor/coaching & apps
What is combination therapy for tobacco cessation:
multiple uses of NRTs, NRTs & medications
Bupropion SR is also known as:
Zyban
Bupropion SR is a:
smoking cessation aid (prescription)
Give directions for dosage & usage of Zyban:
150 mg sustained release tablet; begin taking one week prior to quitting, double dose after three days
What are the advantages of the prescription Zyban?
- easy to use
- can be used with NRT
What are the adverse effects of the prescription Zyban?
- insomnia
- dry mouth
- nervousness/difficulty concentrating
- rash
- constipation
- seizures
Varenicline is also known as:
chantix (prescription)
Give directions on dosage & usage of Varenicline (chantix):
0.5 mg & 1.0 mg tablets
Days 1-3: take one 0.5 mg tablet in morning
Days 4-7: take 0.5 mg tablet BID
Wees 2-12: take 1.0 mg tablet BID
What are the advantages of the prescription Varenicline (Chantix)?
- easy to use
- offers new mechanism of action for patients who have failed with other agents
List the adverse effects of the prescription Varenicline (Chantix):
- nausea
- insomnia
- vivid dreams
- constipation
- vomiting
- neuropsychiatric symptoms
Discuss the neuropsychiatric symptoms that may be associated with the prescription Varenicline (Chantix):
- behavioral changes
- aggitation
- depression
- suicidal ideation or behavior
Nicotine replacement therapy options include:
- gum
- lozenges
- transdermal patch
- nasal spray
- oral inhaler
Nicorette & Zonnic are examples of what type of NRT?
Gum
What are the two dosage options for Nicorette & Zonnic?
2mg for <25 cigs per day
4mg for 25+ cigs per day
What are the directions for Nicorette & Zonnic? (2mg or 4mg options= same directions)
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
What is the maximum amount of Nicorette & Zonnic per day?
24 pieces per day
What is an important directio to tell patients when discussing Nicorette or Zonnic?
No food or beverage 15 min before or during use
The advantages & disadvantages of Nicorette & Zonnic include:
Advantages:
1. may delay weight gain
2. may satisfy oral cravings
Disadvantages:
1. mouth/jaw soreness
2. hiccups
3. dyspepsia
Zonnic may be:
gum or lozenge
Commit & Zonnic are examples of what type of NRT?
Lozenge
What is the dosage options for Commit & Zonnic lozenges?
2 mg for patients who smoke after 30 min of waking
4 mg for patients who smoke within 30 min of waking
Give directions for the NRTs Commit & Zonnic (same directions for both dosages)
Week 1-6: 1 lozenge every 1-2 hours
Weeks 7-9: 1 lozenge every 2-4 hours
Weeks 10-12: 1 lozenge every 4-8 hours
What is maximum amount of Commit & Zonnic a patient can take per day?
20 lozenges per day
What is an important direction to give patients that utilize Commit or Zonnic lozenges for NRTs:
No food or beverage 15 min before or during use, do not chew or swallow lozenge
List the advantages & disadvantages of use of Commit or Zonnic lozenges as NRTs:
Advantages:
1. may delay weight gain
2. may satisfy oral cravings
Disadvantages:
1. nausea
2. hiccups
3. cough
4. heartburn
5. headache
6. insomnia
Nicoderm CQ is an example of what type of NRT?
Transdermal patch
What are the dosage options for the NRT Nicoderm CQ?
-7 mg
-14 mg
- 21 mg
(all 24-hour release)
For a patient smoking less than or equal to 10 cigs per day, what are their transdermal patch directions?
14mg/day for 6 weeks
7 mg/day for 2 weeks
For a patient smoking more than 10 cigs per day, what are their transdermal patch directions?
21mg/day for 6 weeks
14mg/day for 2 weeks
7mg/day for 2 weeks
List the advantages & disadvantages to the NRT transdermal patches (Nicoderm CQ):
Advantages:
1. Provides consistent nicotine for 24 hours
2. easy to use
Disadvantages:
1. local skin reaction
2. headache
3. insomnia
4. vivid dreams
What are the top three most common NRTs?
-gum
-lozenge
-transdermal patch
Nicotrol NS is an example of what type of NRT?
nasal spray
What is the dosage of Nicotrol NS?
0.5 mg metered spray per 50 mcL
Describe the dosage for Nicotrol NS:
1-2 doses per hour
8-40 doses per day
Maximum of 5 doses per hour
For Nicotrol NS one dose=
Two sprays (one per nostril)
List the advantages & disadvantages of Nicotrol NS:
Advantages:
1. patients can titrate therapy to help with withdrawal
Disadvantages:
1. Nasal/throat irritation
2. rhinitis
3. tearing
4. sneezing
5. headache
6. cough
Nicotrol is an example of what type of NRT?
Oral inhaler
Describe the dosage of Nicotrol oral inhaler:
10 mg cartridge- delivers 4 mg inhaled nicotine vapor
How many cartridges per day can one use of Nicotrol oral inhaler?
6-16 cartridges per day
When beginning use of Nicotrol oral inhaler, begin with:
1 cartridge every 1-2 hours
The best effects with Nicotrol oral inhaler occur with:
continuo puffing for 20 min
List the advantages & disadvantages of the NRT nicotrol oral inhaler:
Advantages:
1. Patients can titrates amount to manage withdrawal
2. mimics hand-to-mouth ritual
Disadvantages:
1. mouth/throat irritation
2. cough
3. headache
4. rhinitis
5. dyspepsia
