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Smoking Cessation

Lozenge, gum and patch

QuestionAnswer
Health benefit of quitting: 2w-3mo Circulation improves Walking becomes easier Lung function increases up to 30%
Health benefit of quitting: 1-9mo Lung cilia regain normal function Ability to clear lungs of mucous increases Coughing/fatigue/shortess of breath decrease
Health benefit of quitting: 1year Excess risk of CHD decreases to half that of a continuing smoker
Health benefit of quitting: 5years Risk of stroke is reduced to that of people who have never smoked
Health benefit of quitting: 10years Lung cancer death rate drops to half that of a continuing smoker Risk of cancer of mouth, throat, esophagus, bladder, kidney, pancreas decrease
Health benefit of quitting: 15years Risk of CHD is similar to that of people who have never smoked
Electronic Cigarettes: How do they work? Battery warms cartridge that contains nicotine and delivers the vaporized nicotine
Electronic Cigarettes: Does the FDA support them as safe? No
Nicotine Dependence: What is the test used to determine nicotine dependence? Fagerstrom Test
Nicotine Dependence: What to the ranges mean? (0-2, 3-4, 5, 6-7, 8-10) 0-2: very low 3-4: low 5: medium 6-7: high 8-10: very high
Nicotine Dependence: What does a score of 5+ signify? Substantial nicotine dependence
Nicotine Dependence: How do you treat physiological dependence? Use meds for cessation
Nicotine Dependence: How do you treat behavioral dependence? Use a behavior change program
What are some withdrawal effects? Irritability, frustration, anger, anxiety, difficulty concentrating, restlessness, impatience, depressed mood, depression, insomnia, impaired performance, increased appetite, weight gain, cravings
Drug interactions with smoking: What meds will it interfere with? Hormonal contraceptives: CV side effects, stroke, MI, Thromboembolism
Drug interactions with smoking: what can smoking do to drugs in the body? enhance metabolism of other drugs, resulting in reduced pharmacologic response
What are the 5 A's? Ask Advise Assess Assist Arrange
What are the 5 A's for? The entire process of quitting smoking
What are the 5 R's? Relevance Risks Rewards Roadblocks Repetition
What are the 5 R's for? Methods for increasing motivation to quit
Transtheoretical model of change: what are the 5 stages? Pre-contemplation Contemplation Preparation Action Maintinence
Transtheoretical model of change: What is pre-contemplation? Not thinking of quitting within the next 6 months
Transtheoretical model of change: What is contemplation? Considering quitting in the next 6mo but not 30 days Are aware of the need to quit and the benefits of quitting
Transtheoretical model of change: What is Preparation? Ready to quit in the next 30 days Patients are ready to take action
Transtheoretical model of change: What do you do during preparation? Set a quit date in 2-14 days identify triggers offer follow up assistance throughout quit attempt
Transtheoretical model of change: What is action? Actively trying to quit for good, quit within the last 6 mo
Transtheoretical model of change: What happens in Action? Withdrawal symptoms, risk for relapse
Transtheoretical model of change: What is maintenance? Patient has been tobacco free for 6+ mo
Transtheoretical model of change: What happens during maintenance? talk about slips, encourage healthy behaviors, offer tips for relapse prevention
Non-Pharm therapy: What are some methods of non pharm therapy? Cold turkey acupuncture hypnotherapy massage therapy
Nicotine gum: Precautions Patients with CV disease Recent MI (within 2 weeks) Serious arrhythmias Serious or worsening angia
Nicotine gum: Dosing 2mg-smoke after 30 mins of waking 4mg-smoke within 30 mins of waking
Nicotine gum: Dosing schedule 1-6w: 1 piece q 1-2 hours 7-9w: 1 piece q 2-4 hours 10-12w: 1 piece q 4-8 hours
Nicotine gum: What decreases the effectiveness of the gum? Coffee, wine, juices, soft drinks
Nicotine gum: How long should you wait if you drink something before you chew gum? 15 minutes
Nicotine gum: Side effects and cautions Mouth soreness, hiccups, dyspepsia, jaw muscle ache, MAY STICK TO DENTAL WORK
Nicotine Lozenge: Dosage 2mg-smoke after 30 mins of waking 4mg-smoke within 30 mins of waking
Nicotine Lozenge: Dosing schedule 1-6w: 1 piece q 1-2 hours 7-9w: 1 piece q 2-4 hours 10-12w: 1 piece q 4-8 hours DONT USE MORE THAN 20 A DAY
Nicotine Lozenge: How many do you use/day and for how long? 9/day for 6 weeks
Nicotine Lozenge: What decreases the effectiveness of the lozenge? Coffee, wine, juices, soft drinks
Transdermal Patch: What strength does it come in? 7, 14, 21 mg/day
Transdermal Patch: Dosing for light smoker (10 or less a day) for Nicoderm CQ and generic 10 or less cigarettes a day Step 2 - (14mg for 6 weeks) Step 3 - (7mg for 2 weeks)
Transdermal Patch: Dosing for heavy smoker (more than 10 a day) for Nicoderm CQ Step 1 - (21mg for 6 weeks) Step 2 - (14 mg for 2 weeks) Step 3 - (7 mg for 2 weeks)
Transdermal Patch: Dosing for heavy smoker (more than 10 a day) for generic Step 1 - 21 mg for 4 weeks Step 2 - 14 mg for 2 weeks Step 3 - 7 mg for 2 weeks
Transdermal patch: Where to put it? Upper body
Transdermal patch: What to do if skin stays red for 4 days or longer? Refer to PCP
Created by: carlypentland