W24 Smoking Flashcards
what is the problem with smoking
increases morbidity as well as mortality and increases the risk of
cancer
cardiovascular disease
respiratory disease
what are the 3 main causes of issues from a ciggarette
Tar
Carbon monoxide
Nicotine
what is tar
collective term for various particles suspended in cigarette smoke, these particles can cause cancer (carcinogens)
what does tar do
stick brown residue that can stain the lungs and teeth
what does tar do to the broncioles
narrows
increases secretion of mucous
decreased activity of cilia
development of cancers
what is carbon monoxide and what effect does it have
odourless gas that takes the place of oxygen in the blood by binding to haemoglobin 200 x more effectively than oxygen.
Describe how carbon monoxide leads to increased risk of CVD
CO replaces O2 in RBC
increase production of RBC making blood thicker
less o2 distributed to cells around the body
heart works harder increasing BP and heart rate
increased risk of CVD as reduced exercise tolerance leading to fatigue
what effect does nicotine have on the body
adversely affects every system in the body
how does nicotine affect the brain
disrupts activity
how does nicotine affect the heart and arteries
raises blood pressure and heart rate
how does nicotine affect the eyes
reduces peripheral vision
how does nicotine affect the metabolism
increases calories burned but decreases endurance by wasting energy in the effort.
how does nicotine affect the reproductive system
erectile dysfunction
fertility problems
how does nicotine affect the bones
osteoporosis
how does nicotine work
it disrupts normal neurotransmitter activity causing chemical changes and addiction.
how is addiction caused
activation of the reward pathway, administration leads to pleasure or elation giving positive reinforcement. Withdrawal symptoms occur when nicotine receptors are not activated
describe the mechanism of nicotine dependance
smoking delivers nicotine
nicotine travels to the brain quickly
dopamine released leading to feeling of pleasure or calmness
eventually dopamine drops leading to withdrawal symptoms
desire for another cigarette
what is second hand smoke
Second hand smoke (SHS) is the inhalation of other peoples smoke
what is SHS also known as
Passive smoking
environmental tobacco smoke
involuntary smoking
how does SHS affect adults
Lung cancer up by 24%
Heart disease up by 25%
Stroke
how do polycyclic aromatic hydrocarbons in cig smoke affect the metabolism
they increase the activity of several liver enyzmes, this induction results in faster clearance of medication from the body reducing serum drug levels and decreasing efficacy.
what drugs are affected by the increase in activity of liver enzymes from polycyclic aromatic hydrocarbons
theophylline
cinacalcet
ropinirole
antipsychotics
what are some barriers to smoking cessation
nicotine cravings and withdrawal symptoms
denial of the pleasurable effects of smoking
lack of motivation
fear of failure
social and situational triggers
worries about weight gain
concerns about the use of nicotine replacement therapy
habit sometimes as hard as nicotine addiction
Describe the effect of quiting smoking at different times
20 mins - BP and Pulse falls
8 Hours - Nicotine and CO levels in blood reduce by half o2 levels return to normal
24 hours - CO eliminated from the body, lungs start to clear mucus and smoking debris
48 hours - nicotine eliminated ability to taste and smell improved
72 hours - breathing easier, bronchial tubes begin to relax and energy levels increase
2 - 12 weeks - circulation improves
3 - 9 months - cough, wheezing and breathing problems improve as lung function increases by 10%
5 years - risk of heart attack falls to half relative to a smoke
10 years - risk of lung cancer falls to half that of smoker, risk of heart attack falls to same as someone who has never smoke
what symptoms might someone experience in nicotine withdrawal
craving
increased appetite
dizziness
lack of concentration
decreased heart rate
cough
constipation
sleep disturbances
mood swings
anxiety
tingling sensation
what two factors are integral into someone being able to quit smoking
how motivated they are
their level of nicotine dependance
What opportunities are there to help someone quit smoking
NMS
MUR
Health Checks
Complaining of Cough
Customers looking at NRT products
Frequently running out of inhaler before next one due
Patients treated for recurrent chest infections
Patients enquiring NRT products
Purchase of smokers toothpaste or mouthwast
New years resolutions
beginning of lent
government advertising campaigns
other health campaigns such as stoptober
introductions of new smoking cessation products to the market
newspaper headlines or media reports on smoking or smoking related illnesses
What is the role of the pharmacist in helping with smoking cessation
know the products available and who they are suitable for
use your communication skills to be confident, motivational and listen carefully to what your patient is saying
provide individualised care to those confronting adiction
provide information and support tools
remember your patients and their situations
come out of the dispensary and talk
prepare them for what is ahead
dont forget drug interactions
how can we help council patients
express empathy
develop discrepancy
avoid argumentation
roll with resistance
support self efficacy
what are the top 5 ds
delay drink water deep breathing do something different discuss the craving with another person
what forms of nicotine replacement therapy exist
sublingual tablets lozenge gum nasal spray patches inhalator quick mist mouth spray
how does nicotine replacement therapy work
helps to relieve the symptoms of nicotine withdrawal allows the individual to gradually reduce the level of nicotine.
what points should be brought up to a patient to help them pick a NRT
number of cigs per day
time to 1st cig
speed at which nicotine delivered from NRT
ease of use
importance of behavioural replacement ability to adjust and titrate the dose
local irritant effects
how long should a NRT be used for
8-12 weeks for the best success of stopping smoking
