PNN Smoking Cessation Questions And Answers Already Graded A+

Combination or single form of nicotine replacement? - ️️Recommend combination therapy with two NRT; combining a long-acting form (patch) with a short-acting (gum, nasal spray, lozenge, or inhaler) on PRN basis. Combo works better than a single form of nicotine replacement. This can be helpful for patients who have cravings throughout the day Bupropion and varenicline can also be used in combination with nicotine replacement therapies Interactions with Cigarette smoking? - ️️Cigarette smoke induces CYP1A2 substrates, such as theophylline (Theo-Dur), olanzapine (Zyprexa), Clozapine (Clozaril), and Fluvoxamine (Luvox). This may result in the need for higher doses of these drugs in patients who smoke What are some counseling points regarding Nicotine gum? - ️️Short-acting: allows flexible dosing; may ↓ or delay weight gain. Peak level 20 min after starting to chew S/E: Dyspepsia, mouth soreness, hiccups Caution: arrhythmias, Pregnancy category C 1) Tell your patients to "chew and park" the gum 2) Chew slowly until feel a tingling sensation or a peppery flavor, then "park" in between gum & cheek 3) Once they no longer feel a tingling sensation (after a couple of min), they should repeat "chew and park" cycle. Recommend using different areas of mouth 4) They should continue for 30 min or until the flavor/tingling goes away 5) Tell your patients not to eat or drink anything except water 15 minutes before and during. Acidic foods or beverages (orange juice) can ↓ the amount of nicotine absorbed and decrease the effectiveness of the gum What is the dosage for Nicotine patch (NicoDerm CQ) (OTC)? - ️️If they smoke > 10 cigarettes/day: 10 week plan - 21 mg/day x 6 weeks - 14 mg/day x 2 weeks - 7 mg/day x 2 weeks If ≤ 10 ciagrettes/day or < 45 kg, follow the 8 week plan - 14 mg/day for 6 weeks and then - 7 mg/day for 2 weeksWhat are some counseling points regarding Nicotine patch (NicoDerm CQ)? - ️️Patch is the simplest NRT product to use & provides the most continuous-release nicotine delivery - Worn for 24 hr, or for 16 hr to avoid insomnia S/E: local skin reaction, insomnia, vivid dreams - DO NOT CUT THE PATCH. REMOVE BEFORE MRI What are some counseling points for Nicotine lozenge (Nicorette)? - ️️1) > 18 years old 2) Do not eat/drink 15 minutes before & during dose 3) Dissolves within 20-30 min; not chewed and can be used in smokers with temporomandibular joint disease, poor dentition, or dentures What is the dosing for Nicotine Lozenge (Nicorette)? - ️️Dosage: choosing dose (2 mg or 4 mg) - If 1st cigarette within 30 min or awakening, use 4 mg - If 1st cigarette after 30 min of awakening, use 2 mg Taper schedule - Week 1 to 6: one lozenge every 1-2 hours (6 weeks) - Week 7 to 9: one lozenge every 2-4 hours (3 weeks) - Week 10 to 12: one lozenge every 4-8 hours (3 weeks) MAX: 5 lozenges Q6 hours or 20 lozenges/day