Tobacco Cessation (FINAL REVIEW) Flashcards
What cancers are causually linked to smoking? (10)
- oropharynx
- larynx
- esophagus
- trachea, bronchus, lung
- acute myeloid leukemia
- stomach
- pancreas
- kidney & ureter
- cervix
- bladder
What chronic illnesses are causually linked to smoking? (11)
- stroke
- cataracts, blindness
- periodontitis
- aortic aneurysm
- CHD
- pneumonia
- vascular diseases
- respiratory effects
- COPD
- hip fractures
- reproductive effects
Smokeless tobacco effects on the mouth include: (7)
- bad breath
- irritated and inflamed tissue
- oral cancer
- increased risk of tooth decay
- painful ulcers
- teeth staining
- periodontal/gum disease
Approximately ____ Americans are diagnosed yearly with oral/pharyngeal cancer
____ of these cases succumb to disease
42,000; 8,000
____ % 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
- Acupunture
- Yoga, meditation
- Herbs
NRTs:
Nicotine replacement therapy
Behavioral therapy for tobacco cessation includes:
Counselors/coaching and apps
What is combination therapy for tobacco cessation?
Multiple uses of NRTs, NRTs and medications
Bupropion SR is also known as:
Zyban
Bupropion SR (Zyban) is a:
smoking cessation aid (prescription)
Give directions for dosage and usage of zyban:
150mg sustained release tablet; begin taking 1 week prior to quitting; double dose after 3 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 and usage of Varenicline (chantix):
0.5mg and 1.0mg tablet
- Days 1-3: take one 0.5mg tablet in the morning
- Days 4-7: take 0.5mg tablet BID
- Weeks 2-12: take 1.0 mg tablet BID
What are the advantages of the prescription Varenicline (chantix)
Easy to use and offers a 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 symtpoms
Discuss the neuropsychiatric symptoms that may be associated with the prescription Varenicline (Chantix):
- behavioral changes
- agitation
- depression
- suicidal ideation or behavior
Nicotine replacement therapy options include:
- gum
- lozanges
- transdermal patch
- nasal spray
- oral inhaler
Nicorret and Zonnic are examples of what type of nicotine replacement therapy?
gum
What are the two dose options for Nicorette and Zonnic?
2mg for less than 25 cigs per day
4mg for 25 cigs per day or more
What are the directions for Nicorette and Zonnic (2mg or 4mg option 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 or Zonnic per day?
24 pieces
What is an important direction to tell patients when discussing Nicorette or Zonnic?
no food or beverage 15 minutes before or during use
The advantages of Nicorette and Zonnic include:
The disadvantages of Nicorette and 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 lozange
Commit and Zonnic are examples of what type of NRT:
Lozenge
What are the dosage options for Commit and Zonnic?
2mg for patients who smoke after 30 minutes of waking
4mg for patients who smoke within 30 minutes of waking
Give directions for the NRTs Commit and 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 the maximum amount of Commit and Zonnic?
20 lozenges per day
What is an important direction to tell patients that utilize commit or zonnic lozenges for NRTs?
- no food or beverage 15 minutes before or during use
- do not chew or swallow lozenge
List the advantages and disadvantages of use of Commit or Zonnic Lozenges for NRTs:
Advantages:
- may delay weight gain
- may satisfy oral cravings
Disadvantages
- nausea
- hiccups
- cough
- heartburn
- insomnia
- headache
NicoDerm CQ is an example of what type of NRT?
Transdermal patch
What are the dosage options for the NRT NicoDerm CQ?
7mg
14 mg
21Mg
(all 24-hour release)
For a patient smoking less than or equal to 10 cigs per day, what are the transdermal patch directions?
- 14mg per day for 6 weeks
- 7mg per day for 2 weeks
For a patient smoking more than 10 cigs per day, what are the transdermal patch directions?
- 21mg per day for 6 weeks
- 14mg per day for 2 weeks
- 7mg per day for 2 weeks
List the advantages & disadvantages to the NRT transdermal patches (NicoDerm CQ):
Advantages:
1. provides consistent nicotine for 24 hrs
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 for Nicotrol NS?
0.5 mg metered spray per 50 mcL
Describe the doses for Nicotrol NS:
1-2 doses per hour
8-40 doses per day
maximum of 5 doses per hour
For Nicotrol NS, one dose=
2 sprays (1 per nostril)
List the advantages and disadvantages of Nicotrol NS:
Advantages:
1. Patients can titrate therapy to help 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 4mg of inhaled nicotine vapor
How many cartridges per day can one use of Nicotorl 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:
continuous puffing for 20 min
List the advantages and disadvantages of Nicotrol oral inhaler as an NRT:
Advantages:
1. Patients can titrate amount to manage withdrawal
2. Mimics hand-to-mouth ritual
Disadvantages:
1. mouth/throat irritation
2. cough
3. headache
4. rhinitis
5. dyspepsia
