Tobacco cessation fall 2011 Instructor (1)_ For use in lecture (3)

Nicotine nasal spray directions for use(cont’d if

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Unformatted text preview: NICOTINE NASAL SPRAY: DIRECTIONS for USE (cont’d) If nose runs, gently sniff to keep nasal spray in nose Wait 2–3 minutes before blowing nose Wait 5 minutes before driving or operating heavy machinery (s pray may cause tearing, coughing, and sneezing) Avoid contact with skin, eyes, and mouth If contact occurs, rinse with water immediately Nicotine is absorbed through skin and mucous membranes NICOTINE NASAL SPRAY: ADDITIONAL PATIENT EDUCATION What to expect (first week): Hot peppery feeling in back of throat or nose Sneezing Coughing Watery eyes Runny nose Side effects should lessen over a few days Regular use during the first week will help in development of tolerance to the irritant effects of the spray If side effects do not decrease after a week, contact health care provider NICOTINE NASAL SPRAY: SUMMARY DISADVANTAGES Need for frequent dosing can compromise compliance. Nasal/throat irritation may be bothersome. Higher dependence potential. Patients with chronic nasal disorders or severe reactive airway disease should not use the spray. ADVANTAGES Patients can easily titrate therapy to rapidly manage withdrawal symptoms. NICOTINE INHALER Nicotrol Inhaler (Pfizer) Nicotine inhalation system consists of: Mouthpiece Cartridge with porous plug containing 10 mg nicotine and 1 mg menthol Delivers 4 mg nicotine vapor, absorbed across buccal mucosa NICOTINE INHALER: DOSING Start with at least 6 cartridges/day during the first 3-6 weeks of treatment Increase prn to maximum of 16 cartridges/day In general, use 1 cartridge every 1-2 hours Recommended duration of therapy is 3 months Gradually reduce daily dosage over the following 6–12 weeks Air in Aluminum laminate sealing material Porous plug impregnated with nicotine Mouthpiece Nicotine cartridge Air/nicotine mixture out Sharp point that breaks the seal Sharp point that breaks the seal NICOTINE INHALER: SCHEMATIC DIAGRAM Reprinted with permission from Schneider et al. (2001). Clinical Pharmacokinetics 40:661–684. Adis International, Inc. NICOTINE INHALER: DIRECTIONS for USE Align marks on the mouthpiece NICOTINE INHALER: DIRECTIONS for USE (cont’d) Pull and separate mouthpiece into two parts NICOTINE INHALER: DIRECTIONS for USE (cont’d) Press nicotine cartridge firmly into bottom of mouthpiece until seal breaks NICOTINE INHALER: DIRECTIONS for USE (cont’d) Put top on mouthpiece and align marks to close Press down firmly to break top seal of cartridge Twist top to misalign marks and secure unit During inhalation, nicotine is vaporized and absorbed across oropharyngeal mucosa...
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Tobacco cessation fall 2011 Instructor (1)_ For use in lecture (3)

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