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

Need for frequent dosing can compromise compliance

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Need for frequent dosing  can compromise  compliance Gastrointestinal side  effects (nausea, hiccups,  and heartburn) may be  bothersome. ADVANTAGES Might satisfy oral cravings. Might delay weight gain (4- mg strength). Easy to use and conceal. Patients can titrate therapy  to manage withdrawal  symptoms. A variety of flavors are  available.
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TRANSDERMAL NICOTINE  PATCH Nicoderm CQ   (GlaxoSmithKline); generic Nicotine is well absorbed across the skin Plasma nicotine levels are lower and fluctuate less  than with smoking
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TRANSDERMAL NICOTINE  PATCH: DOSING Product Light Smoker Heavy Smoker Nicoderm CQ 10 cigarettes/day Step 2 (14 mg x 6 weeks) Step 3 (7 mg x 2 weeks) >10 cigarettes/day Step 1 (21 mg x 6 weeks) Step 2 (14 mg x 2 weeks) Step 3 (7 mg x 2 weeks) Generic  (formerly Habitrol) 10 cigarettes/day Step 2 (14 mg x 6 weeks) Step 3 (7 mg x 2 weeks) >10 cigarettes/day Step 1 (21 mg x 4 weeks) Step 2 (14 mg x 2 weeks) Step 3 (7 mg x 2 weeks)
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TRANSDERMAL NICOTINE  PATCH: DIRECTIONS for USE Choose an area of skin on the  upper body or upper outer part of  the arm Make sure skin is clean, dry,  hairless, and not irritated Apply patch to different area each  day Do not use same area again for at  least 1 week
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TRANSDERMAL NICOTINE  PATCH: DIRECTIONS for USE   (cont’d) Remove patch from protective pouch Peel off half of the backing from patch
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TRANSDERMAL NICOTINE  PATCH: DIRECTIONS for USE   (cont’d) Apply adhesive side of  patch to skin Peel off remaining  protective covering Press firmly with palm of  hand for 10 seconds Make sure patch sticks well  to skin, especially around  edges
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TRANSDERMAL NICOTINE  PATCH: DIRECTIONS for USE   (cont’d) Wash hands: Nicotine on hands can get into eyes or nose  and cause stinging or redness 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
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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
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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
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