Discussion: Use of nicotine gum
Discussion: Use of nicotine gum
A nurse who provides care on an acute medicine unit has frequently recommended the use of nicotine replacement gum for patients who express a willingness to quit smoking during their admission or following their discharge. For which of the following patients would nicotine gum be contraindicated?
A. A patient whose stage III pressure ulcer required intravenous antibiotics and a vacuum dressing
B. A patient with a history of angina who experienced a non-ST wave myocardial infarction
C. A patient who received treatment for kidney failure due to an overdose of acetaminophen
D. A patient whose pulmonary embolism was treated with a heparin infusion
A patient who has been taking buspirone (BuSpar) for 1 week calls the clinic and reports to the nurse that the drug is not working. The patient informs the nurse that she is still having symptoms of anxiety. The nurse will tell the patient that
A. she will report this to the physician immediately.
B. it may take up to 6 months for the drug to relieve her anxiety.
C. optimum relieDiscussion: Use of nicotine gum t going to work for her and the medication needs to be changed.
Why is this medication prescribed?
Nicotine chewing gum is used to help people stop smoking cigarettes. Nicotine chewing gum should be used together with a smoking cessation program, which may include support groups, counseling, or specific behavioral change techniques. Nicotine gum is in a class of medications called smoking cessation aids. It works by providing nicotine to your body to decrease the withdrawal symptoms experienced when smoking is stopped and as a substitute oral activity to reduce the urge to smoke.
How should this medicine be used?
Nicotine gum is used by mouth as a chewing gum and should not be swallowed. Follow the directions on your package label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use nicotine gum exactly as directed. Do not use more or less of it or use it more often than directed on the package label or as recommended by your doctor.
If you smoke your first cigarette more than 30 minutes after waking up, use the 2-mg gum. People who smoke their first cigarette within 30 minutes of waking up should use the 4-mg gum. Nicotine gum may be used regularly by chewing one piece of gum every 1 to 2 hours for the first 6 weeks, followed by one piece every 2 to 4 hours for 3 weeks, and then one piece every 4 to 8 hours for 3 weeks. If you have strong or frequent cravings, you may chew a second piece within one hour. To improve your chances of quitting smoking, chew at least 9 pieces of nicotine gum each day for the first 6 weeks.
Chew nicotine gum slowly until you can taste the nicotine or feel a slight tingling in your mouth. Then stop chewing and place (park) the chewing gum between your cheek and gum. When the tingling is almost gone (about 1 minute), start chewing again; repeat this procedure for about 30 minutes. Avoid eating and drinking for 15 minutes before and during chewing of nicotine gum.
Do not chew nicotine gum too fast, do not chew more than one piece of gum at a time, and do not chew one piece too soon after another. Chewing one piece of gum after another continuously may cause hiccups, heartburn, nausea, or other side effects.
Do not chew more than 24 pieces a day.
You should stop using nicotine gum after 12 weeks of use. If you still feel the need to use nicotine gum after 12 weeks, talk to your doctor.
What special precautions should I follow?
Before using nicotine gum,
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: insulin; medications for asthma; medications for depression; medications for high blood pressure; and other medications to help you quit smoking.
- tell your doctor if you have or have ever had a heart attack, heart disease, irregular heart rate, ulcers, diabetes, or high blood pressure not controlled by medication; if you are under 18 years of age; or if you are on a sodium-restricted diet.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using nicotine gum, stop using it and call your doctor.
- do not smoke cigarettes or use other nicotine products while using nicotine gum because nicotine overdose can occur.