Page 22 - Delaware Medical Journal - March 2016
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TOBACCO CESSATION MEDICATIONS
program, is strongly recommended for secondary prevention in patients with ACS.7 Pharmacotherapy plays a vital role in smoking cessation by treating nicotine dependence and managing withdrawal approved by the FDA: nicotine replacement therapy (NRT), bupropion, and varenicline. Evidence suggests that smokers who use term abstinence.8
patch, gum, lozenge, inhaler, and nasal spray. Each has its own advantages and drawbacks, and the choice of product should be tailored for each patient. There is concern among both smokers and
FIGURE 2
The Delaware Quitline Fax Referral Form. Available at https://www. healthydelaware.org/Content/Images/ Marketing-Materials/Downloads/ Quitline-Fax-Referral-Form.pdf
physicians about the adverse cardiovascular effects of NRT, however increasing evidence has shown that NRT is safe to use in smokers with ACS.9,10 NRT results in a slower absorption of nicotine into the circulation than cigarettes, thereby producing lower peak plasma levels and decreased cardiovascular effects.11 In addition, NRT CAD.12
Buproprion is an atypical antidepressant that is a weak inhibitor of norepinephrine and dopamine uptake. Although contraindicated in smokers with seizure disorders,13 it is safe and effective in patients with known CAD.14 of buproprion is its dampening effect on weight gain, which is a common concern among smokers attempting to quit.
Varenicline is a partial nicotinic receptor agonist that prevents nicotine stimulation of the dopaminergic system resulting in
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Del Med J | March 2016 | Vol. 88 | No. 3
