Terms in this set (10)
Once a cartridge is opened, it is only good for 1 day. After using the inhaler contiuously for a total of 20 minutes, remove the used cartridge and throw it away out of reach of children and pets. The mouthpiece is reusable. Clean the mouthpiece with soap and water regularly. Delivery of nicotine from the inhaler declines significantly in cold weather; the inhaler and cartridge should be kept in an inside pocket or other warm area.
Which of the following drug levels would increase in a patient who stops smoking?
Smoking induces the metabolism of caffeine, theophylline, olanzapine and clozapine, and some other agents. If a patient suddenly stopped smoking but continued to take these medications, the concentration would increase as the induction effect wears off.
In 2016, the Food and Drug Administration removed which boxed warning for Chantix?
Acute renal failure
Serious psychiatric events
Serious neuropsychiatric events including depression, suicidal ideation, suicide attempt and completed suicide have been reported in patients taking Chantix. These risks are still present, especially in patients with depression, anxiety disorders, or schizophrenia, or in those who have been treated for mental illnesses in the past (listed in the warnings section of the package labeling). However, new data confirms that the benefits of smoking cessation outweigh the risks of using Chantix so the boxed warning was removed.
HG is a 17-year-old female who is interested in tobacco cessation. She asks about starting on nicotine gum. What advice should the pharmacist offer?
FDA prohibits sale of nicotine products to individuals younger than 18 years of age (REMS).
A patient asks the pharmacist for advice on using the Nicorette mini-lozenge. The patient states that she does not feel much benefit after using one. The pharmacist asks how the patient uses the lozenge, and the patient replies she chews it and swallows it. Which of the following counseling statements for the lozenge is correct? (Select ALL that apply).
The lozenges should be used in combination with Chantix.
A prescription will be required if the patient wishes to use this beyond 2 weeks.
Use 1 lozenge every 1-2 hours during the first 6 weeks of treatment.
Do not eat or drink anything for 15 minutes before or during lozenge use.
Dissolve the lozenge in the mouth; do not chew.
The lozenge should be allowed to dissolve in the mouth rather than chewing or swallowing it. Acidic beverages (e.g., coffee, juices, soft drinks) interfere with the buccal absorption of nicotine, so eating and drinking anything except water should be avoided for 15 minutes before or during use of the nicotine lozenge.
History of Present Illness: BH is a 56 year old female who presents to the clinic for an evaluation so she can quit smoking. The pharmacist reviews her profile before starting the visit.
Allergies: Wellbutrin (seizures)
Past Medical History:
Smokes 1.5 packs per day. First cigarette usually smoked 10 minutes after awakening when she has her morning coffee.
Height: 5' 5" Weight: 186 pounds
Lexapro 20 mg PO daily
BH is concerned that she will gain more weight when she stops smoking. She is already overweight and struggles because of her depression.
Select the tobacco cessation options that is/are preferred for BH? (Select ALL that apply.)
Zyban plus nicotine patch
Nicotine patch plus nicotine lozenge
no chantix due to seizure, wellbutrin/zyban seizure
nicotine long acting and short acting fomulation (patch+gum/lozenge) or nicotine patch +zyban
Chantix DDI with alcohol
Can increase alcohol effect and blackout
B is a female patient who is starting bupropion for tobacco cessation. Which of the following statements concerning bupropion are correct? (Select ALL that apply.)
Patients should not stop smoking until at least 1 week after starting bupropion.
Her dose should be titrated to 450 mg daily.
Doses should be taken at least 8 hours apart.
It is safe to use in patients taking Forfivo.
Do not use if she has either anorexia or bulemia.
Which of the following products is/are available over-the-counter? (Select ALL that apply.)
Nicotine nasal spray
Which of the following statements is true regarding varenicline use for tobacco cessation?
Varenicline should be started the day after the patient's quit date.
Varenicline is contraindicated in pregnancy.
Varenicline should be taken with food and a full glass of water.
Varenicline is not associated with any gastrointestinal side effects.
Varenicline has a boxed warning for seizure risk.
Varenicline should be taken with food and a full glass of water. It is not contraindicated in pregnancy but should be used with caution.