Home' Australian Pharmacist : Australian Pharmacist December 2014 Contents Australian Pharmacist December 2014 I © Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
COUNSELLING IN PRACTICE
1. Which ONE of the following
statements about smoking is
a) 20% of deaths in Australia result from
b) Quitting smoking before the age of 35
almost nullifies excess risk of smoking-
c) Smoking is only associated with
cardiovascular, respiratory and
d) a) and b).
2. Which ONE of the following
statements about pharmacotherapy
and smoking cessation is CORRECT?
a) Pharmacotherapy should be offered to
all motivated smokers who show signs
of nicotine dependence.
b) Bupropion is the most effective form of
pharmacotherapy for smoking cessation.
c) The effectiveness of pharmacotherapy
may be increased with the addition of
counselling and support.
d) NRT is first-line therapy for pregnant
3. Which of the following statements
about NRT are correct?
a) Long-acting forms of NRT (i.e . patches)
can be combined with shorter-acting
forms of NRT (i.e. gum).
b) It is essential to quit smoking before
c) Indigestion may be reduced by chewing
NRT gum slowly.
d) a) and c).
4. Petra, 34, wants to quit smoking.
Petra has diabetes and depression,
and currently takes insulin and
fluvoxamine. Which ONE of the
following statements is MOST
a) NRT has no clinically significant drug
interactions, so Petra can use NRT to
quit smoking without affecting her
b) Quitting smoking may reduce the
effectiveness of fluvoxamine.
c) Petra should be referred to her doctor to
discuss smoking cessation.
d) b) and c).
5. Sam, 45, has requested Nicabate
14 mg patches. He has just decided
to quit smoking, and his sister
has had good success with these
patches. Sam currently smokes about
eight cigarettes a day, the first with
his morning coffee two hours after
waking. Sam takes no medicines, and
has no medical conditions. Which of
the following recommendations is
MOST appropriate for Sam?
a) Sam should use a 16 hour patch, rather
than a 24 hour patch.
b) Sam has a low level of nicotine
dependence, therefore another dose
form may be more appropriate.
c) Sam should start on a Nicabate 21 mg
patch, and step-down to a 14 mg patch
in a few weeks.
d) None of the above.
QUITLINE, and provide her with PSA Self
Care Fact Cards Smoking and Staying a
You also ask Kirsty to follow up with
you in a week, so you can discuss her
progress, and address any problems or
concerns she is having.
1. Zwar N, Richmond R, Borland R et al. Supporting smoking
cessation: a guide for health professionals. Melbourne:
The Royal Australian College of General Practitioners.
2011[Updated Jul 2014]. At: www.racgp.org.au/download/
2. Quit Victoria. Deaths and disease from smoking. 2014. At:
3. Samet J. Smoking cessation: benefits versus risks of using
pharmacotherapy to quit. Circulation. 2014;129(1):8–10.
4. Psychotropic Expert Group. Therapeutic guidelines:
psychotropic. Version 7. Melbourne: Therapeutic
5. Australian Government. Quitline. Benefits of quitting. 2012.
6. Scollo MM, Winstanley MH. Smoking cessation. In: Tobacco
in Australia: facts and issues. 4th edn. Melbourne: Cancer
Council Victoria; 2012. At: www.tobaccoinaustralia.org.au/
7. Rossi S, ed. Australian medicines handbook. Adelaide:
Australian Medicines Handbook; 2014. At: www.amh.net.
8. Chase E, McMenamin, Halpin H. Medicaid provider
delivery of the 5A’s for smoking cessation counseling.
Nicotine Tob Res 2007;9(11):1095–1101.
9. Product information. eMIMS. St Leonards: CMP Medica
10. Quit SA. Nicotine replacement therapy. Guidelines for
healthcare professionals on using nicotine replacement
therapy for smokers not ready to stop smoking. 2007. At:
11. McRobbie H, Hajek P. Nicotine replacement therapy
in patients with cardiovascular disease: guidelines
for health professionals. Addiction 2001;96:1547–51.
12. National Institute for Health and Care Excellence. Smoking
cessation services. 2013. At: www.nice.org.uk/guidance/
13. Sansom LM, ed. Australian pharmaceutical formulary and
handbook. 22nd edn. Canberra: Pharmaceutical Society
of Australia; 2012.
14. Pharmaceutical Society of Australia. Non-prescription
medicines in the pharmacy – a guide to advice and
treatment. Canberra: The Pharmaceutical Society of
15. Quit Victoria. Nicotine mouth spray. 2013. At: www.
16. NSW Government. Health. Medication interactions with
smoking and smoking cessation. 2012. At: www0.health.
Kirsty’s case continued
Upon further discussion, Kirsty mentions
that she has not tried pharmacotherapy
in any of her past quit attempts, and
has never sought support from a health
professional or QUITLINE.
You explain to Kirsty that it is common
to need more than one attempt to quit
smoking, and that attempts to quit are
most successful when pharmacotherapy
is combined with support and
counselling. Kirsty tells you that she
would be interested to try NRT to help
As Kirsty suffers from reflux, you suggest
that she try patches rather than oral or
inhaled NRT, as these might precipitate
her symptoms. You assess that Kirsty
has moderate dependence on nicotine,
so suggest that she start with Nicabate
21 mg patches, as a 24 hour patch may
help to reduce her cravings first thing
in the morning. She should apply a
new patch to a non-hairy, clean, dry
part of her arm each day, ensuring
she rotates the site. You refer her to
Links Archive Australian Pharmacist November 2014 Australian Pharmacist January 2015 Navigation Previous Page Next Page