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Quick Guide to Pharmacotherapy in Tobacco Treatment
NICOTINE REPLACEMENT (NRT)
Combining long-acting NRT (patch) with a short-acting NRT (gum, lozenge, or inhaler)
is more effective than using a single type of NRT
7 mg, 14 mg, 21 mg Dose: 1 patch every 24 hrs.
LOZENGE or MINI-LOZENGE
NASAL SPRAY (Nicotrol® NS)
INHALER (Nicotrol® Inhaler)
BUPROPION SR (Zyban®/ Wellbutrin SR®)
May be combined with nicotine replacement
150 mg tablets
Dose: 150 mg once per day (days 1-3) Duration:
0.5 mg, 1 mg tablets Dose: Starting Month Pack =
Continuing Month Pack = 1 mg twice per day
* If quit at 12 wks, consider 12 more weeks of drug
Source: Fiore MC, Jaen CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Quick
Reference Guide for Clinicians, Rockville, MD: U.S. Department of Health and Human Services. Public
Health Service. April 2009. Inclusion of this adult dosage chart is strictly for the convenience of the
prescribing provider. Please consult the Physicians’ Desk Reference for complete product information and
contraindications. This chart does not indicate or authorize insurance benefit coverage for any of these
medications. This chart is provided by the Massachusetts Department of Public Health’s Tobacco Cessation
5A Tobacco Intervention
ASK ABOUT TOBACCO USE AT EVERY VISIT
Implement an office system that ensures that, for every patient at every visit,
tobacco-use status is queried and documented.
ADVISE ALL TOBACCO USERS TO QUIT
“I strongly advise you to quit smoking and I can help you.”
ASSESS READINESS TO QUIT
Ask every tobacco user if s/he is willing to make a quit attempt at this time:
• If willing to quit, provide assistance (see below).
• If unwilling to quit, provide motivational intervention.
ASSIST TOBACCO USERS IN QUITTING
Provide brief counseling:
Recommend use of combination or single pharmacotherapy (patch, gum,
lozenge, nasal spray, inhaler, bupropion, or varenicline) unless contraindicated.
Be aware of insurance coverage. MassHealth covers all FDA-approved
medications. Many health plans cover some or all medications.
Provide supplementary educational materials.
Refer to QuitWorks: fax consent signed by patient to 1-866-560-9113 for
proactive call to assess and arrange treatment.
At subsequent visit, review patient follow-up report from QuitWorks.
Congratulate success, encourage maintenance.
• Ask for recommitment to total abstinence
• Review circumstances that caused lapse
• Assess pharmacotherapy use and problems.
Consider referral to more intensive treatment.
For More Information:
Make smoking history.
FINAL PAPER AUSTRALIAN CHEMISTRY OLYMPIAD Please note that this answer book will be photocopied when returned and then split so that answers are sent to the appropriate markers. For this reason it is extremely important that you observe instructions 5 to 7. Instruction to candidates You are allowed 10 minutes to read this paper, and 3 hours to complete the questions. You are not
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