Term
What is the cause of the majority of ADRs in smoking (including CA)? |
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Definition
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Term
Quitting for how long will lead to significant decrease in risk of CVD? |
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Definition
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Term
What 4 things are smoking related factors that lead to CVD? |
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Definition
Increased thrombogenesis, CO, Oxidative damage, Hyperlipidemia |
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Term
What is the greatest ADR of nicotine? |
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Definition
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Term
T or F: Nicotine is depressant and not a stimulant. |
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Definition
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Term
Where is nicotine absorbed when smoked? |
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Definition
Both the mouth and the respiratory tract. |
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Term
Nicotine binds to ______ receptors in CNS, RS, NS and ______? |
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Definition
Nicotinic, Autonomic Ganglia |
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Term
Nicotine has ___ chronotropic and ____ ionotropic effects on the CV system? |
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Definition
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Term
What does nicotine increase in the CV system? |
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Definition
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Term
ADRs and MOA of buproprion? |
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Definition
Seizure Risk with doses >450mg/day or 150mg at 1 time. Insomnia, dry mouth. MOA is weak inhibitor of NE, Ser and Dopa uptake |
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Term
Buproprion and nicotine patch have what ADR when combined? |
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Definition
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Term
Buproprion dose/instructions |
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Definition
Start 2 wx before quitting. 150mg PO qAM x 3 days, then 150mg BID x 7-12 weeks. May use up to 6 mo. |
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Term
Varenicline (Chantix): Cat? MOA? |
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Definition
Cat: C. MOA: Partial nicotinic,ACH receptor agonist. Reduces cravings |
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Term
Varenicline (Chantix): Common ADRS and precautions |
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Definition
common GI probs, sleep disturbances (abnormal dreams). Take with full glass of water. |
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Term
Which first line pill for smoking sessation is associated with behavioral/psych ADRS |
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Definition
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Term
Varenicline dosing/instructions |
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Definition
Start 1 wk before quitting and continue for 12 weeks. If quits continue for 12 more weeks. Dose: Days 1-3 0.5 mg PO QD. Day 4 0.5 mg PO BID. Day 8 and on 1mg PO BID |
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Term
Two second line agents used to quit smoking but not FDA approved |
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Definition
Clonidine and nortriptyline |
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Term
What is the best way to increase success with quitting smoking? |
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Definition
Pharm therapies w/ counseling or behavioral therapy |
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Term
Different effects of nic on resp systems (high dose vs low dose) |
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Definition
Low dose increases respirations by activating chemoreceptors in aortic arch and carotid bodies. High dose dose it by directly stimulating resp center. Toxic dose leads to respirtory depression by inhibiting resp centers in breain stem and acting on NMJ |
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Term
Nicotines actions on CNS cause |
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Definition
Appetite supression, mild euphoria, increased memory, concentration and arousal, tremors, convulsions, NV |
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Term
BBB and placenta / nicotine |
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Definition
Nic cross BBB and placenta |
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Term
What induces nicotine metabloism? |
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Definition
The tar from smoking via CYP450 |
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Term
nicotine can induce metabolism of what 4 things? |
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Definition
Opioids, BDZ, Beta Blockers and Theophyline |
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Term
The three methods of quitting? |
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Definition
Aversion therapy (common w/ accupunture or hypnosis). Abrupt Withdrawl, NRT |
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Term
The 5 As for patient willing to quit smoking |
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Definition
Ask, Advice, Assess, Assist,Arrange |
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Term
The 5 Rs for patients not interested in quitting smoking |
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Definition
Relevence (determine benefits), Risk, Rewards, Roadblocks, Repetiton (nag them) |
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Term
To decrease addiction NRT administration of nicotine differs from cigarettes how? |
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Definition
The dose is lower and given more gradually. |
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Term
Which NRT is most similar to cigarettes when it comes to amount of nicotine in blood? |
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Definition
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Term
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Definition
NRT is safe in CVD even w/ smoking combo |
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Term
T or f: NRT increases risk of acute MI |
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Definition
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Term
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Definition
For someone that smokes less than 24 cigs a day it is 2mg x24 max. For someone that smokes more its 4mg x 24 max. Max duration is 12 weeks. |
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Term
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Definition
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Term
Nic Inhaler doses and ADR |
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Definition
6-16 cartridges/day x 6mo. ADR: mouth/throat irritation |
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Term
Nic inhaller instructions |
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Definition
Best effects with continuous frequent puffing for 20 min |
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Term
Nic Nasal spray dose/duration/Adr |
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Definition
1-2 sprays per house (2 sprays=1mg). Max = 5 mg (10 sprays) per hour or 40 sprays per day. Durration: 3-6mo. ADRs=Nasal irritation |
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Term
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Definition
21mg/24 hours x 4 weeks. Then 14 mg/24hrs x 2 weeks, then 7mg/24 x 2 weeks. |
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Term
Which patch comes in what alternative doses? |
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Definition
Nicotrol comes in 15mg, 10mg, 5mg |
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Term
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Definition
local skin reaction, insomnia, vivid dreams, vasospasm at the site of the patch |
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Term
How do you determine the dose to give of nicotine lozanges? |
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Definition
A smoker that needs a cig within 30 min of waking is given 4mg lozenge, if they don’t need it that early they get 2 mg lozenge |
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Term
Nicotine lozange dose schedule |
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Definition
1 lozange q 1-2 hours x 6wx, then decrease to every 2-4 hours for 3 weeks, and finally every 4-8 for the last 3 weeks. |
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Term
Effects of nicotine on fetus? |
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Definition
It may be a teratogen, can lead to obstretrical complications and possibly SIDS. Thought the benefits of NRT outweight the risks so pts are advised to proceed. |
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Term
NRT can be combined with what drug to reduce cravings? |
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Definition
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Term
Which drug concidered to be first line is still not part of the official guidelines? |
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Definition
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