front 1 Canadian Tobacco, Alcohol, and Drugs Survey (CTADS) conducted q2yrs on behalf of health canada. what are the 2 sub groups? | back 1 1. students grade 7-12 2.all canadians ages 15 or older(2017) |
front 2 Higher % males were current smokers ..... daily smokers are abt 11% and occasional are abt 4% | back 2 (17% vs 13% females) |
front 3 1 in 6 canadians smokes ... | back 3 canadians 12 and older |
front 4 smoking rate amng 15-17 yr olds smoke free households...... and ...... in those with smokers | back 4 is 7% 22% |
front 5 Tobacco-Related Morbidity in Canada | back 5 - Associated with an increased risk of |
front 6 Each day, 100 Canadians die of tobacco-related illness what r the main causes? | back 6 cancers, CV disease, respiratory diseases |
front 7 In 2002, 17% of deaths in Canada were attributed to tobacco meaning it is .... | back 7 Responsible for more deaths than obesity, physical inactivity, or hypertension. Second-hand smoked caused 831 deaths in Canada in 2002 |
front 8 wat are some tobacco prdts | back 8 cigarettes pipe tobacco cigars smokeless/chewing tobacco(in tin cans) |
front 9 according to CTADS 2017 results: | back 9 e-cigarette an Increase from 13% (3.9 million) in 2013 |
front 10 23% of youth aged 15-19 had ever tried an e-cigarette | back 10 CTADS 2017 results: |
front 11 vaping prdts dont contain tobacco but..... | back 11 may or may not vontain nicotine |
front 12 vaping pdts produce an aerosol that may contain dozens of chemicals including: | back 12 -glycerol -flavours -propylene glycerol -nicotine |
front 13 2019 Smoke Free NS Youth Vaping Survey found that -670 youth (16-18y/o) and young adults (19-24y/o) WHO VAPE
surveyed | back 13 Average age of onset of vaping = 16 years old 27.8% had NEVER tried tobacco |
front 14 Nova Scotia’s Ban on Flavoured Vape | back 14 Came into effect April 1, 2020 |
front 15 Pharmacist’s Role: Assessing Change what are the stages of change? | back 15 The stages of change: |
front 16 Pharmacology of Nicotine: via inhalation what is the bioavailability? tmax? | back 16 50%, Tmax 15 mins |
front 17 tobacco Metabolism: | back 17 Metabolism: |
front 18 Excretion: | back 18 T1/2 elimination with oral inhalation = 1-2 hours. |
front 19 Pharmacology of Nicotine nicotine binds to ? | back 19 nicotinic cholinergic receptors (nAChRs) in the brain |
front 20 Repeat exposure to nicotine leads to ..... | back 20
neuroadaptation (AKA TOLERANCE) |
front 21 what are Non-Pharmacological Treatments for tobacco(nicotine additction) | back 21 Dose-dependent response to counselling→ increased time = increased quit time. <3 mins counseling = 13.4% abstinence >10mins counseling = 22% abstinence Optimal total contact time found to be 91-300 mins -Leads to abstinence rates of ~28% |
front 22 what are some Other evidence-based non-pharm activities that improve quit rates: | back 22 -Set a target quit date |
front 23 Tobacco/Nicotine Cessation Products: | back 23 habitrol thrive nicorette quick mist nicorette gum nicoderm patch |
front 24 Nicotine Replacement Therapy | back 24 Evidence: |
front 25 NRT is Considered first line due to.... | back 25 Due to long term safety and efficacy data |
front 26 Dosing oral NRT: | back 26 -Specific products will have slightly different
recommendations |
front 27 what is the rule Rule of thumb for the day in terms of cravings? | back 27 10-20 pieces/doses per day (one each time a craving occurs) |
front 28 How to use nicotine gum: | back 28 “Bite, bite, park.” |
front 29 How to use nicotine lozenge: | back 29 Park, tingle, move, park, tingle etc |
front 30 How to use nicotine spray: | back 30 -Open mouth and spray |
front 31 what are some ADRs for NRT (nicotine replacement therapy) | back 31 -Oral: Tingling in mouth |
front 32 NRT Contraindications | back 32 - Immediately post MI |
front 33 important NRT tips | back 33 Don’t swallow too much with gum or chew the lozenges→ nicotine
doesn’t absorb |
front 34 Tobacco/Nicotine Cessation Products: | back 34 NDRI→ Norepinephrine, dopamine reuptake inhibitor -Thought to mimic the effects of nicotine on the brain, thus allowing the patient to stop using nicotine. |
front 35 what is the zyban Dosing for smoking cessation? | back 35 -Start taking 1-2 weeks before selected quit date |
front 36 .......i Not recommended for pts with hx of seizure, eating disorder,
alcohol use disorder | back 36 zyban (bupropion) |
front 37 zyban causes what type of interactions.... | back 37 Inhibits CYP 2D6→ beware drug interactions |
front 38 Evidence for zyban : | back 38 -Superior to placebo- OR 1.86 (95% CI 1.63-2.1) |
front 39 ....superior to bupropion – OR varenicline vs bupropion 1.59 (1.29-1.96) | back 39 Varenicline (champix) |
front 40 - Tolerability usually dictates its use consider side effects | back 40 - Stimulation |
front 41 Varenicline (Champix) | back 41 Alpha4beta2 |
front 42 whats unique abt varenicline and its interaction with the receptor? | back 42 Binds to nicotine receptors fully |
front 43 champix Dosing: | back 43 -0.5mg PO OD x 3 days then |
front 44 Evidence for varenicline | back 44 Vs Placebo: OR 2.88 (2.40-3.47) |
front 45 what dictates varenicline use? | back 45 same as zyban tolerability dictates use: Mental illness ≠ CI |
front 46 what are the odds ratio for placebo compared to other smoking cessation pharmaco therapies? | back 46 1: 1.68(nicotene gum) 1: 1.9(nicotene transdermal patch) 1: 2(nicotene inhaler, nicotene lozenges or mouth spray) 1: 1.85(bupropion) 1: 2.7(patch plus prn inhaler, lozenge or mouth spray) 1: 2.89 (varenicline (champx)) |
front 47 (1-5min) | back 47 “on a scale of 1-10, how ready |
front 48 Patient MP | back 48 -start with 2mg gum: 1 piece q 1-2 hrs prn max 20 pieces a day |