This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
PHARMACOTHERAPY FOR SMOKING CESSATION
Kitiyot Yotsombut, RPh, MSc (Clin Pharm)Faculty of Pharmaceutical Sciences, Chulalongkorn University
Model for the nicotine addiction cycle during daily cigarette smoking
Benowitz NL. Clin Pharmacol Ther 2008;83:531‐41.
Nicotine withdrawal symptoms• At least 4 or more symptoms following abrupt cessation or rapid decreasing of nicotine products within 24 hours. • Decreased heart rate• Anxiety • Depression • Unstable mood, emotional sensitive• Insomnia• Agitation • Increased appetite, craving
DSM IV (The Diagnostic and Statistical Manual of Mental Disorders 4th edition)
The severity of nicotine withdrawal symptoms Fagerström Test for nicotine dependence (FTND)
Thai version of HSI 5R: Risk // Relevance // Reward // Roadblock // Repetition
Monoamine (DA/NE/5‐HT) reuptake inhibitors Regimen of bupropion SR 150 mg tab
Day 1 to day 3Qoumem (150 mg)1 tablet each dayDay 4 to day 7Qoumem (150 mg)1 tablet twice a dayDay 8 to end of treatmentQoumem (150 mg)1 tablet twice a day
****** Dosing interval should not less than 8 hours
Regimen of nortriptyline
Day 1 to day 3Nortriptyline (10 mg) 1 tablet each dayDay 4 to day 7Nortriptyline (25 mg) 1 tablet each dayDay 8 to day 14 Nortriptyline (25 mg) 2 tablet twice a dayDay 15 to end of treatmentNortriptyline (25 mg) 3 tablet twice a day
****** Dosing titration should be individualized****** Gradual titration before drug discontinuation