Handout: Patient Needs Influence Drug Selection

Description: 
This table lists patient needs/characteristics that need to considered when determining which smoking cessation medication is optimal.

This table lists patient needs/characteristics that need to considered when determining which smoking cessation medication is optimal.


Drug

Patient Needs/Characteristics

Bupropion (ZybanTM)

  • Postponed weight gain

  • Simultaneous help with depression

  • Alternative to gum, when chewing is a problem

  • Alternative to patch, e.g., skin problems, frequent swimming

  • Patient's suicide risk should be low
  • Low maintenance (wants to take only 1 tablet twice daily)
  • Prescription drug needed for third-party reimbursement

Varenicline (ChantixTM)

  • Alternative to gum, when chewing is a problem

  • Alternative to patch, e.g., skin problems, frequent swimming

  • Patient's suicide risk should be low
  • Low maintenance (wants to take only 1 tablet twice daily)

  • Prescription drug needed for third-party reimbursement

Nicotine Gum

  • Oral stimulation

  • Tension release of gum chewing

  • Minimal exposure to nicotine, when a treatment is wanted only during worst cravings

  • An adjunct to another drug, e.g., bupropion

  • Alternative to patch, e.g., skin problems, frequent swimming

  • Control of nicotine intake

  • Ability to adjust dosage according to need

  • A flavored agent to hold in the mouth as an alternative to smokeless tobacco (although not FDA approved for this purpose)

Nicotine Inhaler

  • A relatively fast burst of nicotine during a craving

  • Hand-to-mouth motion reminiscent of smoking

  • Alternative to gum, when chewing is a problem

  • Minimal exposure to nicotine, when a treatment is wanted only during worst cravings

  • An adjunct to another drug, e.g., bupropion

  • Prescription drug for third-party reimbursement

  • Alternative to patch, e.g., skin problems, frequent swimming

  • Control of nicotine intake
  • Ability to adjust dosage according to need

Nicotine Nasal Spray

  • A fast burst of nicotine during a craving

  • Alternative to gum, when chewing is a problem
  • Ability to minimize exposure to nicotine and use only during worst cravings

  • An adjunct to another drug, e.g., bupropion
  • Prescription drug for third-party reimbursement

  • Alternative to patch, e.g., skin problems, frequent swimming

  • Control of nicotine intake

  • Ability to adjust dosage according to need

Nicotine Patch

  • Inconspicuous treatment

  • Ability to forget about treatment during the day

  • An even dose of nicotine throughout the day

  • Postponed weight gain

  • Prescription drug for third-party reimbursement

  • Alternative to gum, when chewing is a problem

  • Alternative to gum, lozenge, inhaler when patient sips a lot of acidic beverages which interfere with absorption through the mouth

  • Low-maintenance treatment (only have to apply in morning)

Nicotine Lozenge

  • Oral stimulation

  • Alternative to gum, when chewing is a problem

  • Minimize exposure to nicotine and use only during worst cravings

  • An adjunct to another drug, e.g., bupropion

  • Alternative to patch, e.g., skin problems, frequent swimming

  • Ability to control nicotine intake

  • Ability to adjust dosage according to need

  • A flavored agent to hold in the mouth as an alternative to smokeless tobacco (although not FDA approved for this purpose)

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