Treatment of Nicotine Addiction in Primary Care

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Bupropion • Begin bupropion a week before the quit date • Normal dose 150mg bd, (reduce in elderly, liver/renal disease) • Contra-indicated in patients with epilepsy, anorexia nervosa, bulimia, bipolar disorder or severe liver disease. • The most common side effects are insomnia (up to 30%), dry mouth (10-15%), headache (10%), nausea (10%), constipation (10%), and agitation (5-10%) • Interaction with antidepressants, antipsychotics and antiarrhythmics Bupropion increases the odds of quitting about 2 fold Hughes J, et al. Antidepressants for smoking cessation. Cochrane Database Systematic Reviews 2007
Nortryptiline • Tri-cyclic antidepressant • Not licensed for smoking cessation • Low cost • Side-effects include sedation, dry mouth, lightheadedness, cardiac arrhythmia • Contra-indicated after recent myocardial infarction Nortryptiline increases the odds of quitting about 2 fold Hughes J, et al. Antidepressants for smoking cessation. Cochrane Database Systematic Reviews 2007
Page 1 and 2: Treatment of Nicotine Addiction in
Page 3 and 4: Objectives • Definitions • Epid
Page 5 and 6: Definitions • Addiction is a prim
Page 7 and 8: Is Nicotine Addictive? • Of prima
Page 9 and 10: Is Nicotine Addictive? • Cigarett
Page 11 and 12: Is Nicotine Addictive? • Nicotine
Page 13: Aspects of Nicotine Addiction Socia
Page 16 and 17: How Prevalent Is The Problem? •To
Page 18 and 19: Adolescent Smoking Nearly all smok
Page 20 and 21: Mental health • Psychotic disorde
Page 23 and 24: The cycle of change Ambivalent to c
Page 25 and 26: The cycle of change Action! a cessa
Page 27 and 28: Self-Help Materials • Appear to i
Page 29 and 30: Individual Counseling • Improves
Page 32 and 33: Pharmacotherapy Pharmacotherapy + b
Page 34 and 35: NRT: Nicotine patches 20 15 10 Ciga
Page 36 and 37: NRT: Nicotine gum 20 Cigarette (1-2
Page 40 and 41: Cahill K, et al. Nicotine receptor
Page 42 and 43: Side Effects • On June 16, 2011,
Page 44 and 45: HIV Disease: Changing Paradigm •
Page 46 and 47: Acute Myocardial Infarction NY: Dis
Page 48 and 49: “Cessation of smoking is more lik
Page 50 and 51: Impact of Cigarette Smoking on Mort
Page 52: Cigarette Smoking and Quality Of Li
Page 55 and 56: Smoking And Mental Health
Page 57 and 58: Smoking and Schizophrenia •High p
Page 59 and 60: Smoking & Bipolar Disorder •High
Page 61 and 62: Smoking and Depression (Continued)
Page 63 and 64: SSRIs and Smokers with Anxiety Diso
Page 65 and 66: Smoking and Alcohol Dependence (Con
Page 67 and 68: Organization U.S. Dept. of Health &
Page 70 and 71: Conclusions •Tobacco use is a maj

Treatment of Nicotine Addiction in Primary Care

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