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

Do not leave patch on skin for more than 24

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Unformatted text preview: Do not leave patch on skin for more than 24 hours—doing so may lead to skin irritation Adhesive remaining on skin may be removed with rubbing alcohol or acetone Dispose of used patch by folding it onto itself, completely covering adhesive area TRANSDERMAL NICOTINE PATCH: ADDITIONAL PATIENT EDUCATION Water will not harm the nicotine patch if it is applied correctly; patients may bathe, swim, shower, or exercise while wearing the patch Do not cut patches to adjust dose Nicotine may evaporate from cut edges Patch may be less effective Keep new and used patches out of the reach of children and pets Remove patch before MRI procedures TRANSDERMAL NICOTINE PATCH: ADD’L PATIENT EDUCATION (cont’d) Side effects to expect in first hour: Mild itching Burning Tingling Additional possible side effects: Vivid dreams or sleep disturbances Headache TRANSDERMAL NICOTINE PATCH: ADD’L PATIENT EDUCATION (cont’d) After patch removal, skin may appear red for 24 hours If skin stays red more than 4 days or if it swells or a rash appears, contact health care provider—do not apply new patch Local skin reactions (redness, burning, itching) Usually caused by adhesive Up to 50% of patients experience this reaction Fewer than 5% of patients discontinue therapy Avoid use in patients with dermatologic conditions (e.g., psoriasis, eczema, atopic dermatitis) TRANSDERMAL NICOTINE PATCH: SUMMARY DISADVANTAGES Patients cannot titrate the dose to acutely manage withdrawal symptoms. Allergic reactions to the adhesive may occur. Patients with dermatologic conditions should not use the patch. ADVANTAGES Provides consistent nicotine levels. Easy to use and conceal. Once daily dosing associated with fewer compliance problems. NICOTINE NASAL SPRAY Nicotrol NS (Pfizer) Aqueous solution of nicotine in a 10-ml spray bottle Each metered dose actuation delivers 50 mcL spray 0.5 mg nicotine ~100 doses/bottle Rapid absorption across nasal mucosa NICOTINE NASAL SPRAY: DOSING & ADMINISTRATION One dose = one spray in each nostril = 1mg of nicotine Start with 1–2 doses per hour For best results, patients should use at least 8 doses daily for the first 6–8 weeks Termination: Gradual tapering over an additional 4–6 weeks NICOTINE NASAL SPRAY: DIRECTIONS for USE (cont’d) Prime the pump (before first use) Re-prime (1-2 sprays) if spray not used for 24 hours Blow nose (if not clear) Tilt head back slightly and insert tip of bottle into nostril as far as comfortable Breathe through mouth, and spray once in each nostril Do not sniff or inhale while spraying NICOTINE NASAL SPRAY:...
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Tobacco cessation fall 2011 Instructor (1)_ For use in lecture (3)

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