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Public Health Lect. 8 Pharm of Quitting Part 3

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alchemist04's version from 2016-06-01 13:35

Section

Question Answer
Bupropion Initial treatment dosing is?150 mg PO AM for 3 days
Bupropion Usual treatment dosing is?150 mg PO BID for 7-12 wks
Pt shd begin treatment with Bupropion ----- wk prior to quitting to assure --------- levels of drug are achieved when patient is no longer smokingone week prior to quitting smoking, to ensure therapeutic plasma levels
Bupropion pregnancy category is?Cat. B, use only if clearly indicated
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Question Answer
What are the common side effects of Bupropion?(1) Insomnia (2) Dry mouth (3) Tremor (4) Skin rash
T or F, Bupropion can be used w/ NRT?True
T or F, Dose tapering is not necessary when discontinuing treatmentTrue
T or F, if no significant treatment by the 7th wk, discontinue treatmentTrue, revalue and restart at later date
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Question Answer
What are the advantages of Bupropion SR (1)(1) Dosing is 2x per day
What are the advantages of Bupropion SR (2)(2) Can be used w/ NRT
What are the advantages of Bupropion SR (3)(3) Could benefit smokers suffering from depression
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Question Answer
What is Bupropion bioavailability?5-20%, low
T or F? Bupropion undergoes extensive hepatic metabolism with CYP2B6True
Bupropion ----- % is eliminated from the urine and ------ is eliminated form feces87% Urine, 10% feces
What is Bupropion half life?21 hrs, when metabolized, it has a half life of 20-37 HOURS
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Question Answer
What are the disadvantages of Bupropion SR (1)(1) Increase risk of seizure
What are the disadvantages of Bupropion SR (same for Varenicline) (2)(2) Avoid use in pt with Anorexia or bulimia or pt on Seizure med
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Question Answer
T or F? Chantix is a nonnicotitine containing cessation aidTrue, it contains no nicotine.
What is the clinical effect of Varenicline (Chantix)? (1)(1) It decreases symptoms of nicotine withdrawal.
What is the clinical effect of Varenicline (Chantix)? (2)(2) decreases nicotine craving
T or F? Chantix is a nonnicotine gum that contain cessation aidFalse. Chantix is an Oral pill and a non nicotine drug.
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Question Answer
What are the advantages of Varenicline (Chantex)? (1)(1) Oral med w/ 2x dosing per day (better than 3x per day)
What are the advantages of Varenicline (Chantex)? (2)(2) Different MOA for smokers that failed previous attempts
What are the advantages of Varenicline (Chantex)? (3)(3) Early trial suggests that the med is superior to Bupripion
What is the disadvantage of Varenicline (Chantex)?It can cause N/V, Sleep disturbance like Insomnia & Abnormal dreams, Constipation, and flatulence.
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Question Answer
True or false? Varenicline is not affected by food, it is virtually complete absorbedTrue, high bioavalability
T or F? Varenicline undergoes minimal metabolismTrue
T or F? ---- % is excreted unchanged in urineTrue, 92% is excreted from the urine
What is the half life of Varenicline?24 hrs
What is Chantex preg cat?Cat C
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Question Answer
Varenicline dosing regiment (Days 1-3)0.5 mg QD
Varenicline dosing regiment (Days 4-7)0.5 mg BID
Varenicline dosing regiment (Day 8 and till end of treatment)1 mg BID
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Question Answer
True or False, Dosing regiment shd start 1 wk prior to their quit dateTrue. And gradually increase to minimize treatment related nausea and insomnia
True or False? Dose shd be taking after food + full glass of waterT
True or False, to discontinue Chantix, tapering is neededFalse, tapering is not necessary when discontinuing treatment
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Question Answer
T or F? Combination therapy could be use for any patient outside those that have tried to quitFalse, Combination therapy is reserved for pt that could not quit on monotherapy.
Examples of Combination therapy is (1)(1) NRT (long acting - Patch) + NRT (Short acting - gum, lozenge, inhaler, nasal spray)
Examples of Combination therapy is (2)(2) Bupropion SR + NRT
T or F? The safety and efficacy of combination of varenicline w/ NRT or Bupropion has not been establishedTrue
T or F? To quit smoking, dosing must be in accordance to regiment and NOT as needed?True
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