{[ promptMessage ]}

Bookmark it

{[ promptMessage ]}

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

Following populations patients with a history of

Info iconThis preview shows pages 141–151. Sign up to view the full content.

View Full Document Right Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: following populations: Patients with a history of seizure Patients with a history of cranial trauma Patients taking medications that lower the seizure threshold (antipsychotics, antidepressants, theophylline, systemic steroids) Patients with severe hepatic cirrhosis Patients with depressive or psychiatric disorders BUPROPION SR: DOSING Initial treatment 150 mg po q AM x 3 days Then… 150 mg po bid Duration, 7–12 weeks Patients should begin therapy 1 to 2 weeks PRIOR to their quit date to ensure that therapeutic plasma levels of the drug are achieved. BUPROPION: ADVERSE EFFECTS Common side effects include the following: Insomnia (avoid bedtime dosing) Dry mouth Less common but reported effects: Tremor Skin rash BUPROPION: ADDITIONAL PATIENT EDUCATION Dose tapering not necessary when discontinuing treatment If no significant progress toward abstinence by seventh week, therapy is unlikely to be effective Discontinue treatment Reevaluate and restart at later date BUPROPION SR: SUMMARY DISADVANTAGES The seizure risk is increased. Several contraindications and precautions preclude use in some patients. ADVANTAGES Easy to use oral formulation. Twice daily dosing might reduce compliance problems. Bupropion might be beneficial for patients with depression. VARENICLINE Chantix (Pfizer) Nonnicotine cessation aid Partial nicotinic receptor agonist Oral formulation VARENICLINE: MECHANISM of ACTION Binds with high affinity and selectivity at α 4 β 2 neuronal nicotinic acetylcholine receptors Stimulates low-level agonist activity Competitively inhibits binding of nicotine Clinical effects ↓ symptoms of nicotine withdrawal Blocks dopaminergic stimulation responsible for reinforcement & reward associated with smoking VARENICLINE: PHARMACOKINETICS Absorption Virtually complete after oral administration; not affected by food Metabolism Undergoes minimal metabolism Elimination Primarily renal through glomerular filtration and active tubular secretion; 92% excreted unchanged in urine Half-life 24 hours VARENICLINE: WARNING In 2008, Pfizer added a warning label advising patients and caregivers: Patients should stop taking varenicline and contact their healthcare provider immediately if agitation, depressed mood, or changes in behavior that are not typical for them are observed, or if the patient develops suicidal ideation or suicidal thoughts. VARENICLINE: DOSING Patients should begin therapy 1 week PRIOR to their quit date. The dose is gradually increased to minimize treatment-related nausea and insomnia....
View Full Document

{[ snackBarMessage ]}

Page141 / 162

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

This preview shows document pages 141 - 151. Sign up to view the full document.

View Full Document Right Arrow Icon bookmark
Ask a homework question - tutors are online