CC Jan 2016 Varenicline

echoecho's version from 2016-03-01 23:36


Question Answer
*** According to a recent Cochrane review, Varenicline (Chantix) is more effective then what medications used for smoking cessation?Bupropion (Wellbutrin) or nicotine replacement therapy
Postmarked in reports raised concerns regarding what? Possible associations between Varenicline and adverse neuropsychiatric and cardiovascular events
Since 2009, the FDA has required a black-box warning advising monitoring Varenicline users for Serbs neuropsychiatric events including what?Behavior change, hostility, depression and suicidality
Could postmarking reports establish causality?no
Why is determining whether the frequency of such events differs from that observed in similar patients not using Varenicline? The size of the relevant population is unknown
Confounding by indication is an additional concern, give an example?smoking itself and nicotine withdrawal are associated with agitation
More formal studies are largely reassuring, although in some cases the confidence intervals for effect size wer too _______ to definitely rule out harm?wide
In the above Cochrane review, the relative risk of Varenicline-associated neuropsychiatric adverse events was?0.53 (95% confidence interval, 0.17 to 1.67)
What are findings came from other studies in way of adverse psychiatric side effects1) significantly higher rates of insomnia and abnormal dreams 2) is not associated with suicidal behavior. 3) lower rates of neuropsychiatric adverse events than those using nicotine replacement therapy
What are the stroke effects when using this medication?there was a nonsignifiicant trend toward higher stroke rates
What caution is advised when using this med in patients at high risk for cardiovascular events?caution is warranted because confidence intervals for cardiovascular risk are wide enough to be consistent with a doubling of risk
*** SUMMARY = Despite the FDA black box warning regarding neuropsychiatric effects associated with Varenicline, can postmarking reports establish causality?no
*** SUMMARY = Some but not all studies show a minor increase in cardiovascular events, however, use of Varenicline in those at high risk for cardiovascular events should be undertaken with _________?caution
*** SUMMARY = According to a recent Cochrane review, Varenicline is more effective than either what two meds for smoking cessation?bupropion or nicotine replacement therapy