Nicotine Replacement Therapy (NRT) Quiz
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Questions and Answers

What is smoking considered a major cause of in the developed world?

  • Morbidity and mortality (correct)
  • Cancer
  • Cardiovascular disease
  • Neurodevelopmental disorders

    • What characterizes nicotine dependence?

  • A behavioural disorder only
  • A condition with remission and relapse, hard to cure (correct)
  • A chronic condition with easy cure
  • A mental disorder only

    • What is a criterion for nicotine dependence?

  • Strong desire to smoke
  • Increased doses of nicotine to obtain the same pleasurable effects
  • All of the above (correct)
  • Tolerance to nicotine

    • What is the half-life of nicotine?

    <p>40-120 minutes</p> Signup and view all the answers

    What is the major metabolite of nicotine?

    <p>Cotinine</p> Signup and view all the answers

    What happens when nicotine reaches the brain?

    <p>Dopaminergic receptors are activated, releasing dopamine</p> Signup and view all the answers

    What happens with chronic nicotine exposure?

    <p>Desensitization of receptors and tolerance</p> Signup and view all the answers

    What is a consequence of tolerance to nicotine?

    <p>Decreased responsiveness to nicotine</p> Signup and view all the answers

    What is a characteristic of withdrawal symptoms in dependence?

    <p>Increased noradrenergic outflow secondary to deactivation of the reward system</p> Signup and view all the answers

    How many toxins are inhaled per cigarette smoked?

    <p>4000</p> Signup and view all the answers

    What is the purpose of the 5As of quitting?

    <p>To provide pharmacotherapy and counselling</p> Signup and view all the answers

    What is the role of a pharmacist in smoking cessation?

    <p>To apply the 5As of quitting and the 5Rs of quitting</p> Signup and view all the answers

    What is the purpose of the Fagerström test?

    <p>To assess nicotine dependence level</p> Signup and view all the answers

    Which of the following is not a method of assessing nicotine dependence?

    <p>Blood pressure measurement</p> Signup and view all the answers

    What is the benefit of smoking cessation?

    <p>Both A and B</p> Signup and view all the answers

    What is a characteristic of nicotine dependence?

    <p>It is not determined by how much cigarettes you smoke</p> Signup and view all the answers

    What is recommended when applying a patch for nicotine replacement therapy?

    <p>Apply the patch to clean hairless skin on the chest or upper arm</p> Signup and view all the answers

    What is the benefit of using combination therapy in nicotine replacement?

    <p>It doubles the successful quit rates</p> Signup and view all the answers

    What is the first line pharmacotherapy for nicotine replacement?

    <p>Varenicline</p> Signup and view all the answers

    What should be avoided when using nicotine replacement therapy?

    <p>Second-hand smoke</p> Signup and view all the answers

    What is an important consideration when selecting a pharmacotherapy for nicotine replacement?

    <p>All of the above</p> Signup and view all the answers

    What is a non-pharmacological intervention for nicotine replacement?

    <p>Avoiding triggers and changing routines</p> Signup and view all the answers

    What is the name of the model used to assess willingness to change?

    <p>Stages of change</p> Signup and view all the answers

    Which of the following NRT forms is not available in Australia?

    <p>Nasal spray</p> Signup and view all the answers

    What is the primary difference between various forms of NRT?

    <p>Rate of nicotine delivery</p> Signup and view all the answers

    Can a patient continue smoking while on NRT?

    <p>Yes, without any restrictions</p> Signup and view all the answers

    How should a patient use nicotine gum?

    <p>Chew the gum slowly until the flavor becomes strong</p> Signup and view all the answers

    What is the recommended duration for using a lozenge?

    <p>20-30 minutes</p> Signup and view all the answers

    How should a patient use the nicotine inhalator?

    <p>Take a shallow puff every 2 seconds</p> Signup and view all the answers

    What is the correct way to use the nicotine mouth spray?

    <p>Point the nozzle towards the open mouth and press the top of the dispenser</p> Signup and view all the answers

    Study Notes

    Nicotine Replacement Therapy (NRT)

    • Combination therapy is more effective than monotherapy, doubling successful quit rates.
    • NRT forms: gums, lozenges and mini lozenges, inhalator, transdermal patch, quickmist mouth spray, and nasal spray (not available in Australia).
    • All NRT forms have equal efficacy, differing in the rate of nicotine delivery.

    Instructions for Use

    • Patch: apply in the morning or bedtime, remove before bedtime if applied in the morning or remove in the morning if applied at bedtime (16 hours), and replace next day (24 hours).
    • Gums: chew 1 piece slowly until flavor becomes strong, park between the cheek and gum, and chew again when flavor fades.
    • Lozenges: place between the cheek and gum, suck slowly until taste is strong, stop sucking until taste fades, and continue to suck again when taste fades.
    • Inhalator: insert cartridge into mouthpiece, take a shallow puff every 2 seconds or take 4 deep puffs every minute, and continue for up to 20 minutes.
    • Mouth Spray: point the spray nozzle towards the open mouth, press the top of the dispenser to release one spray into the mouth, and avoid the lips.

    Smoking Cessation

    • Smoking is a major cause of preventable morbidity and mortality in the developed world.
    • Benefits of quitting smoking: reduced risk of diseases, improved health, and increased life expectancy.

    Pharmacokinetics of Nicotine

    • Nicotine is a colourless, odourless naturally occurring alkaloid with a short half-life of 40-120 minutes.
    • Nicotine plasma concentration range: 10-80 ng/ml, with 20-35 ng/ml for regular smokers.
    • Metabolized by CYP2A6 mainly, CYP2B6, CYP2E1, and CYP1A2.
    • Cotinine is nicotine's major non-addictive metabolite.

    Pathophysiology of Dependence

    • Nicotine absorption into the pulmonary venous circulation reaches the brain in less than 10-20 seconds.
    • Activation of dopaminergic receptors releases rewarding neurotransmitters, leading to desensitization and upregulation of receptors with chronic exposure.
    • Tolerance: decreased responsiveness to nicotine, requiring increasing doses to obtain the same effects.
    • Dependence: withdrawal symptoms upon reduction or abstinence, with a strong tendency to relapse post-quitting.

    Role of Pharmacist

    • Applying the 5As of quitting: Ask, Advise, Assess, Assist, and Arrange.
    • Applying the 5Rs of quitting: Relevance, Risks, Rewards, Roadblocks, and Repetition.
    • Applying the AAH: Ask, Advise, and Help.

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    Smoking Cessation PDF

    Description

    Test your knowledge about Nicotine Replacement Therapy, including combination therapy, NRT forms, and instructions for use.

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