Accuse of cigarettes: The doctor should know the medicinal treatment

Accuse of cigarettes: The doctor should know the medicinal treatment
Accuse of cigarettes: The doctor should know the medicinal treatment
World Health Organization tobacco or health cooperative centre, Capital University of Medical Sciences subsidiary the intersection of Beijing and Xiao Dan the intersection of time and tobacco Wang, hospital of Chaoyang, reliance whether one disease has become common understanding already. In the ninth Chinese Medical Association that was held a few days ago breathes the disease and studies the annual meeting, 2000 more than participate the meeting, breathe doctor until NanShan and would rather breathe the branch General Board Liu also Zhong, president of Chinese Medical Association, lead, until <>. The proposal requires the respiratory medicine doctor should not only take the lead to accuse of cigarettes, but also know the speciality treats the method, offer high quality, professional lines, individual to tobacco reliance person, give up smoking guidance and treat. The first speciality of our country accuses of the cigarette guide and releases at the meeting too. Tobacco reliance is a kind of chronic, high recuring disease. World Health Organization has already listed it in international disease and classified (ICD-10, F17.2) ,Confirm tobacco reliance threatens human health biggest at present, but a main cause of the death that can be prevented and treated. Generally, the smoker with tobacco reliance needs to intervene repeatedly and make great efforts many times and realizing and giving up effectively. The medicine is the effective May of 2008 of treatment means, relevant tobacco that public National Health Administration of U.S.A. issues will use and rely on the new clinical practice guide of treating, recommend a gleam of that can increase the long-term tobacco and give up the result reliably 7 kinds to give up smoking and use medicine clinically on the basis that more than 8000 pieces of literature summarize. They are: 5 kinds of nicotine substitute the treatment (NRT) Give up smoking medicine,last pharmaceutical and nicotine to last pharmaceutical chewing nicotine on glue, nicotine inhalant, nicotine mouth Buccal tablet, nicotine nose; Two non- nicotine give up smoking medicine, hydrochloric acid fit non- the intersection of he and ketone clear up slice and cut down Nick to be blue slowly. The guide has also recommended two kinds of Line two and given up smoking medicines - -Coke first take the place of the forest with go definitely ' Seldom employ on clinic at present) . NRT course of treatment should last 8- 12 weeks NRT medicine, through providing the nicotine for human body so as to replace or replace partly from the nicotine that is got in the tobacco, thus lighten the nicotine and give up symptom, such as absent minded, anxious, irascible, depressed, etc. Though NRT can not totally dispel and give up symptom, has lightened the discomfort of giving up smoking in the course. The evidence indicates, mainly smoke and greater than or equal to the result of crowd of No. 10 Branch to every day prominently by NRT treatment. NRT use for, assist, give up smoking safe and effective, probably can enable possibility that give up smoking for a long time. Different NRT products offer the nicotine in different way, does not have evidence that indicate that the difference exists on each other's curative effect yet at present, the medicine should comply with the wills of persons who give up smoking to choose. The smoker often fails to use the sufficient NRT medicine, thus can't reach the best therapeutic effect. NRT course of treatment should last 8- 12 weeks, and a few smokers may need to treat for a longer time (5% may need the one -year long course of treatment) . There is no safe problem in the treatment of long-term NRT. Behind myocardium infarction in the near future ' In two weeks) , it is used that serious arrhythmia, unstable angina pectoris patient are careful. The gravidic smoker should encourage it to give up smoking through non- medicine way. 5 kinds of different persons who could help tobacco reliance in period of pregnancy of NRT products do not have a final conclusion to give up smoking yet, whether as to nursing period the patient is too effective to assess yet. The non- nicotine medicine prospect of giving up smoking is wide Hydrochloric acid set up non- his ketone ' Clear up pharmaceuticals slowly) It is first that can help non- nicotine that give up smoking give up smoking medicine effectively. Non- his ketone is oral medicine that hydrochloric acid is fitted, the dosage is 150mg / slice, begin to take in one week before giving up smoking at least, the course of treatment is 7- 12 weeks. The side effect has mouthes that is done, apt to surge making, insomnia, having a headache and dizzy, etc. Epilepsy patient, apositia or the vigorous one of abnormal appetite, take and contain the person who fits non- his ketone composition medicine now, or the persons who took single amine oxidase inhibitor within last 14 days forbid. It cuts down blue Nick to be whether a new kind of non- nicotine give up smoking medicine, sanction used in the tobacco to rely on treatinging by U.S.A. FDA in 2006, the evidence grade recommended using is A. Cutting down Nick blue will have high affinity and alternative to neuronal �� 4�� 2 nicotine acetylcholine receptor, it is some excited pharmaceuticals of nicotine acetylcholine receptor, have excited and antagonistic double regulating action at the same time. Cut down Nick blue and bind with receptor and give play to the role of excited pharmaceutical, stimulate the receptor to release dopamine, contribute to, relieve, it stops to be thirsty to sum, give up the symptom by various to tobacco smoke; Meanwhile, the resisting the characteristic short of moneyly of it can prevent the nicotine and be accorded with by the body, reduce, smoke pleasant sensation, reduce to the expectation of smoking, thus reduce and reply sucking. Cut down Nick to be blue to have 0.5mg and the intersection of 1mg and two dosage form, begin, treat 1- 2 week before giving up smoking day, the course of treatment is 12 weeks, can also treat 12 weeks more, consider decrement at the same time. Whom FDA recommend cut down Nick to be blue to use dosage as 2mg/d (1mg, 2 times / d) . But evidence suggests, 1mg/d is effective. In a clinical trial participated in by 15 centres such as China, Singapore and Thailand of the near future, cut down Nick to be blue to give up smoking curative effect to be prominent, main the intersection of curative effect and the intersection of terminal and 9- 12 week (include 12 week) Measure, verify by CO, give up smoking, lead, cut down Nick to be blue to treat the group (50.3%) continuously 4 week Higher than the placebo group (31.6%) notably . It is digestive tract symptom and nervous system symptom to cut down Nick's blue common bad reaction, the most common one is disgusting, but the great majority are light, intermediate, and can lighten with time. Because cut down Nick blue and nearly excrete from the urine out the human body with the true features, so the patient not complete of the serious renal function ( removing rate lt of anhydride of skin; 30ml/min) Should use cautiously. It is prescribed medicine to cut down Nick blue, because it has some nicotine that resists function short of moneyly, so does not recommend jointly using with NRT medicine. Uniting the treatment can have improved success rate and jointly used a gleam of medicine to already verify it is an effective tobacco that relies on therapeutic method, can improve success rate. Effective union drug therapy includes: 1. Long nicotine Cheng stick to slice ( gt; 14 weeks) + other NRT medicine ( Glue and nose gush out pharmaceuticals such as chewing) . 2.The nicotine is stuck slice + nicotine inhalant. 3.Nicotine stick to block + hydrochloric acid set up non- his ketone ' The evidence grade is A) . In a word, in the therapeutic course of giving up smoking, it is medicines usually used that NRT, hydrochloric acid fits non- his ketone and cuts down Nick blue. These medicines can save the effective treatment means of the life, cooperates with the behavior to intervene the treatment and improve the success rate of giving up smoking. Other commonly used clinical precautionary measures of using and comparing with treatment relying on of tobacco, if breast X-ray take pictures and intestinal cancer sift check, bar early canceration ascertain, test, not light to treat intermediate hypertension and treatment of hyperlipemia accord with the cost-effective principle, and the applicable crowd is extensive, the clinician Should encourage every have, give up smoking smoker of will accept, give up smoking consultation and drug therapy.


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