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Microsoft word - nrt how to use_2.doc

How to Use …
Nicotine Patches
• Remove patch from the sachet and then peel off the plastic backing. • Wave the patch in the air for 20 seconds to evaporate the alcohol off the patch. • Apply the patch to clean, dry, hairless skin, such as on the front or side of the chest, upper arm, sole of the foot, buttock or hip. • Do not use the same area on two consecutive days. • Do not apply to broken or inflamed skin. • Do not apply lotion, oil or talcum powder to the skin before putting on the patch as this • The 24 hour patch should be removed in the morning, and a new one put on. • The 16 hour patch should be removed before going to bed, and new one put on in the
Sticking Tips:

• If you have difficulty with getting the patch to stay on, when you put the patch on your skin, keep your hand on the patch for 20 seconds – this should help. • If you continue to have problems, use some tape such as Micropore or other surgical tape (i.e. Opsite, Tegaderm or similar). These are available from most Chemist shops.
Skin Reactions:

• Some patches may contain alcohol in the glue, which could cause a skin reaction, and if the skin under the patch becomes pink and/or itchy, before applying the next patch, try this. When you have peeled off the backing, leave the patch, sticky side up, for a few minutes before applying to your skin. Alternatively, put the patch in an area where the skin is less sensitive such as the shoulder, buttock or sole of the foot. • Important - If you develop blisters or sores under the patch, remove the patch and contact
Reducing the Dosage:

Patches are designed so that the dosage can be reduced gradually. When you are ready your
Advisor will talk to you about this.
Stopping smoking is the single most effective intervention for improving your
health. It is recommended that you do not smoke whilst using this product.

How to Use …
Nicotine Chewing Gum
• Chew one piece of gum slowly until taste becomes strong. • This is called the “Chew Park” routine. • Repeat the chew park routine for about 30 minutes. • If you don’t follow the chew park routine, the gum will not be so effective. • Use up to 15 pieces of gum a day, aim for using one piece every hour (you may need fewer if you are using with another product). • Coffee, juices and fizzy drinks may reduce the absorption of nicotine and should not be taken for 15 minutes before chewing the gum.
Reducing the Dosage:

Gum is designed so that the dosage can be reduced gradually. When you are ready your
Advisor will talk to you about this.
Side Effects:

Side effects can include jaw ache, hiccups and gastric problems.
Stopping smoking is the single most effective intervention for improving your
health. It is recommended that you do not smoke whilst using this product.

How to Use …
Nicotine Microtab
• If you have a dispenser, place the circular blister pack in the tablet dispenser with the flat side facing down. Close the dispenser and make sure the tablet is in the correct position to be pushed out of the blister. • Press out a Microtab and place the tablet under the tongue and allow it to slowly dissolve. This will release the nicotine through the lining of the mouth. Do not chew or swallow. • In general you should use one Microtab every hour, but discuss with your Advisor
Reducing the Dosage:
The Microtab is designed so that the dosage can be reduced gradually. When you are
ready your Advisor will talk to you about this.
Stopping smoking is the single most effective intervention for improving your
health. It is recommended that you do not smoke whilst using this product.

How to Use …
Nicotine Inhalator
• Take a tray from the box and peel back the foil. • Separate the mouthpiece by twisting the two halves until the two marks line up. The • Take a cartridge and push it firmly into the bottom of the mouthpiece until the seal • Replace the top of the mouthpiece, line up the marks and push the top and bottom together firmly to break the top seal of the cartridge. Twist to lock. • Nicotine is obtained by inhaling deeply or by shallow puffing. The amount of nicotine absorbed through the lining of the mouth is the same, whichever method of inhalation is used. • One cartridge is equivalent to two to three normal cigarettes. You should use six to 12 cartridges per day, but you may need fewer if you are using the inhalator with another product. • The inhalator works best at room temperature. In cold surroundings (below 15oC or 59oF) more inhalations will be needed to get the same amount of nicotine as when using the inhalator at room temperature. Reducing the Dosage:
The Inhalator is designed so that the dosage can be reduced gradually. When you are
ready your Advisor will talk to you about this.
Side Effects:

Side effects can be mild throat irritation and coughing.
Stopping smoking is the single most effective intervention for improving your
health. It is recommended that you do not smoke whilst using this product.

How to Use …
Nicotine Lozenge
The nicotine is slowly released and absorbed through the lining of the mouth.
1mg:
• Suck slowly until the taste becomes strong. • Rest the lozenge between the gum and cheek. • Suck again when the taste has faded. Do not chew. It is important to suck the • Coffee, juices and fizzy drinks may reduce the absorption of nicotine and should not • Talk to your Advisor about how many, and how often you should use. Most people will use one lozenge every hour. Do not use more than 25 in a day.
2 & 4mg:
• One lozenge should be placed between the gum and cheek, and allowed to • At intervals, the lozenge should be moved from one side of the mouth to the other; the action should be repeated for 20 to 30 minutes until the lozenge is completely dissolved. • The lozenge should not be chewed or swallowed whole. Users should not eat or drink while a lozenge is in the mouth as this may reduce the absorption of nicotine. • Talk to your Advisor about how many, and how often you should use. Most people will use one lozenge every hour. Do not use more than 25 of the 2 mg or 15 of the 4mg in a day. Reducing the Dosage:
The lozenge is designed so that the dosage can be reduced gradually. Your Advisor will
talk to you about this, and you can agree when you are ready to do this.
Side Effects:

Using this product correctly can reduce the chances of side effects which can include:
stinging in mouth, gastric irritation and hiccups
Stopping smoking is the single most effective intervention for improving your
health. It is recommended that you do not smoke whilst using this product.

How to Use …
Nicotine Mini Lozenge
• The nicotine is slowly released and absorbed through the lining of the mouth. • Put one NiQuitin Mini in the mouth, occasionally moving it from one side of the mouth to the other. It takes about 10 minutes to dissolve. Take no more than 15 lozenges in one day. • The lozenge should not be chewed or swallowed whole. Users should not eat or drink while a lozenge is in the mouth as this may reduce the absorption of nicotine. • Talk to your Advisor about how many, and how often you should use. Most people will use one lozenge every hour. Do not use more than 15 in a day. Reducing the Dosage:
The lozenge is designed so that the dosage can be reduced gradually. Your Advisor will
talk to you about this, and you can agree when you are ready to do this.
Side Effects:

Using this product correctly can reduce the chances of side effects which can include:
stinging in mouth, gastric irritation and hiccups
Stopping smoking is the single most effective intervention for improving your
health. It is recommended that you do not smoke whilst using this product.

How to Use …
Nicotine Nasal Spray
• If using the spray for the first time or if the spray has not been used for two to three days, prime the nasal spray by placing the nozzle between first and second finger with the thumb on the bottom of the bottle. Press firmly and quickly until a fine spray appears. (Point the spray away from you and not near children or pets). • Insert the spray tip into one nostril, pointing the top towards the back of the nose. Press firmly and quickly, whilst breathing in through that nostril. Repeat in the other nostril. • Repeat every half hour (or as discussed with your advisor). Maximum of 64 sprays a day.

Do not leave the nasal spray in the light.
Reducing the Dosage:
The nasal spray is designed so that the dosage can be reduced gradually. Your Advisor
will talk to you about this, and you can agree when you are ready to do this.
Side Effects:
Side effects can include watery, red eyes, nasal irritation like nasal congestion, a
runny/leaky nose, sneezing and aggravation of pre-existing upper respiratory conditions,
cough, itchy throat and disturbances of smell.
If you have a deviated septum or other nasal issues you should consult your GP
before use.

Stopping smoking is the single most effective intervention for improving your
health. It is recommended that you do not smoke whilst using this product.

How to Use …
Nicorette Quick Mist
Priming
If you are using QuickMist for the first time, or if you have not used the spray for two days,
you will need to first prime the spray pump.
• Point the spray safely away from you and any other adults, children or pets that are • Press the top of the QuickMist with your index finger three times until a fine mist • NOTE: priming reduces the number of sprays you may get from a QuickMist canister so only do this when necessary.
Using Nicorette QuickMist

• After priming if needed, point the spray nozzle as close to your open mouth as • Press the top of the dispenser and release one spray into your mouth, avoiding the lips. Do not inhale while spraying, to avoid getting spray down your throat. For best results, do not swallow for a few seconds after spraying. • If after the first spray cravings are not controlled within a few minutes, a second • You should not be eating or drinking while you spray QuickMist.
About QuickMist

• Most smokers will require one or two sprays every 30 minutes to one hour. • You may use up to four sprays per hour, but do not use more than two sprays at a time. Use no more than 64 sprays in any 24 hour period. • Each mouthspray contains at least 150 sprays.
Stopping smoking is the single most effective intervention for improving your
health. It is recommended that you do not smoke whilst using this product.

How to Use …
ChampixTM
The dose gradually increases over the first week: This is the suggested way of taking Champix, although your advisor may recommend something slightly different if you are having side effects, or if you still need some additional support after the 12 week course. Champix are slow release and should be swallowed whole with a full glass of water, ideally a little while after food. Do not take on an empty stomach, as it is more likely to make you feel, or actually be sick. Ginger may help if you do feel sick - you could try some ginger tea. Discuss this with your advisor if the problem persists. If you miss a tablet don’t worry. If you are due to take your next tablet within four hours,
then skip the one you have missed. If it is longer than four hours then take your missed
tablet. Do not take a double dose of this medicine.
Possible side effects include nausea, dreaming, constipation and wind. Champix
occasionally makes some people dizzy or sleepy. Do not drive or operate complex
machinery until you know you are not affected and please monitor your mood whilst
taking Champix.
Stop taking Champix at once if you experience agitation, depressed mood, changes in
behaviour or suicidal thoughts. If you have any difficulties, please discuss it with your
advisor.
You should stop smoking completely on your quit date and take Champix for the full 12 weeks of treatment to increase your chances of staying stopped long term. If you continue to smoke, it will greatly reduce your chances of quitting successfully. Do not use nicotine replacement products while using Champix. They do not work well
together and it may increase unwanted side effects.
If you slip-up and have a puff or a cigarette after your quit date while taking Champix, the nicotine will not have its full effect, and the cigarette will not be as enjoyable or satisfying. Don't let it lead you back to full-time smoking. You can still keep taking Champix after a slip-up and keep going with your quit attempt. Think of your reasons for quitting and what you have achieved so far. Talk to a friend or call your advisor. ChampixTM
Champix works by reducing both withdrawal symptoms, and the satisfying effects of smoking. It is a twelve week course of tablets which is only available on prescription. You can carry on smoking until your quit date in the second week of taking Champix. It is not magic and you will still need to try hard not to smoke at all. When you puff on a cigarette, nicotine travels through your lungs, into your bloodstream and to your brain. It attaches to receptors in your brain to release a brain reward chemical called dopamine. When you take Champix, it fills the receptors and releases a smaller amount of dopamine than the nicotine would have. This reduces withdrawal symptoms when you stop smoking, such as cravings, negative moods and poor concentration. However, it may not stop withdrawal symptoms completely. When Champix has built up in your body it blocks nicotine from attaching to the receptors. It can take between one and two weeks or so for Champix to build up enough to work properly. How to Use …
The course of tablets lasts two months. Quit between days 8 and 14.

Take one tablet each morning for 6 days, and then take 1 tablet twice a day - 1 in the
morning and 1 in the evening, keeping the tablets 8 hours apart.
Common side effects include: dry mouth, insomnia, headache and indigestion. If you suffer
from insomnia, only take 1 tablet once a day in the morning.
Avoid driving or operating machinery if you experience drowsiness as a result of taking the
drug.

If you are elderly,
only take 1 tablet once a day in the morning. You will need to have
your blood pressure checked before you start the tablets and during your treatment.
Do not use in combination with NRT

Whilst taking Zyban it is very important that you tell the doctor or pharmacist before taking
any other new medicines, either prescribed or bought over the counter.
Stop taking the medicine immediately and inform your doctor if you experience any
of the following severe allergy symptoms after taking Zyban:

• Sudden wheezing, tightness of the chest or throat, or difficulty breathing • Swollen eyelids, face, lips, tongue or other part of the body • Skin rash or blistering of the skin, especially if widespread or if they also have a sore • Pain in the muscles or joints. • Skin lumps or hives • Sudden collapse such as a faint • Seizure (fit or convulsion) • Blackout

Source: http://www.healthpromcornwall.org/pdf/NRT%20Champix%20and%20Zyban%20How%20to%20Use.pdf

Evaluation of prochlorperazine buccal tablets (bukatel) and metoclopramide oral tablets in the treatment of acute emesis

Evaluation of Prochlorperazine Buccal Tablets (Bukatel) and Metoclopramide Oral Tablets in the Treatment of Acute Emesis SANJAY SINGH*, DEEPIKA R SHARMA**, ADARSH CHAUDHARY*** The dizziness associated with vertiginous disorders is often accompanied with nausea and/or vomiting. Anti-emetic effect of prochlorperazine (PCZ) is diminished by its low bioavailability owing to a signifi

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