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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