🙅🙅WORLD NO SMOKING DAY MAY 31ST🙅🙅
TOBACCO
Cigratte smoke is heterogenous aerosol produced by incomplete combustion of tobacco leaf
🚫🚫ON AN AVERAGE,SMOKERS LOSE MORETHAN ONE DAY OF LIFE EVERY WEEK🚫🚫
MAIN STREAM SMOKERS::
smoke emerging from mouth peice during puffing
3.3 billion particles per mililiter of mainstream smoke and morethan 4000 constituents including 43 known carcinogens which are antigenic,cytotoxic,mutagenic
SIDE STREAM SMOKE::
smoke emitted b/w puffs at burning cone and from the mouth piece
side stream smoke has more partculate mater especialy carcinogens
CONTENTS::
chemical carcinogens-
polycyclic aromatic hydrocarbons
polonium 210
N-NitrosoNorNicotine(NNN)
🔺nicotine is an alkaloid causing both ganglionic stimulant & a depressent
🔺it readily crosses BBB & stimulates nicotine receptors in brain
🔺increases BP,HR,CO,force of myocardial contraction
🔺increases coronary blood flow & peripheral vascular constriction
🔺mobilisation of free fatty acids
🔺nicotine is responsible for tobbacco ADDICTION
NNK
4 aminobiophenyl,2-napthylamine
polycyclic aromatic hydrocarbons
metal carcinogens-
arsenic
nickel
cadmium
chromium
potential promoters-
acetaldehyde
phenol
irritants-
nitrogen dioxide
formaldehyde
cilia toxins-
hydrogen cyanide
carbon monoxide~
🔺200times more affinity for hb than oxygen
🔺impairs release of oxygen from hb
🔺polycythemia
🔺CNS impairement
🔺imp causes of COPD
tumor accelarators-
indole
carbazole
Co-carcinogens-
phenol
cresol
catechol
EFFECTS::
CVS-
CHD
sudden death
subarachnoid haemorrhage
thromboangitis obliterans
malignant HT
RS-
Acute resp tract infection-influenza
cilia toxins-impairs tracheobronchial clearance
increased risk of lung cancer in smokers exposed to asbestose by synergestic fashion
MATERNAL-
10 Cigarates pwr day can cause fetal hypoxia
fetal carboxyhaemoglobin levels increased
low birth weight
prematurity
sudden infant death syndrome
spontaneous abortion
premature rupture of membranes
placenta previa
abruptio placenta
GIT::
increased prevalance of peptic ulcer
impairs healing of ulcers
increased pyloric reflux
decreased bicarbonate secretions from pancrease
🚫🚫SMOKING & CANCER🚫🚫
Causal association between smoking and cancer-mnemonic
Highly associated-PROBE SLL
©Pancreatic cancer
©Renal cell cancer
©Oropharyngeal cancer
©Bladder cancer
©Esophageal cancer
©Stomach cancer
©Lung cancer
©Laryngeal cancer
Probable association-CLAP
©Colorectal cancer
©Liver cancer
©Acute myeloid leukemia
©Prostate cancer
No association-ABC SOLT
©Acute lymphocytic leukemia
©Breast cancer
©Childhood cancer
©Skin cancer
©Ovarian cancer
©Lymphoma
©Testicular cancer
SMOKING INDEX::
SI=NO OF CIGRATTE/DAY X TOTAL DURATION IN YEARS
SI < 100 MILD smoker
SI 101-300 MODERATE
SI >300 HEAVY smoker
©LUNG CANCER COMMON IF SMOKING INDEX IS > 300©
PACK YEAR:
NO OF PACKS YEAR=1 PACKET OF CIGARATTE/DAY X NO OF YEARS
((one pack=20 cigarrates))
The risk of developing lung cancer is 40times in patients who smoke 2 packs per day for 20years
DISEASES WITH SMOKING AS PROTECTIVE FACTOR::
Ulcerative Colitis
PIH,Eclampsia
Alzemier’s Disease
Parkinson’s disease
Sarcoidosis
Fibroid Endometriosis
Lung Carcinoid
Nasopharyngeal Carcinoma
Negative Symptoms of Schizophrenia
Primary Sclerosing Cholangitis
sarcoidosis
Hypersensitivity pneumonitis
Recurrent aphthous ulcers
PHARMACOTHERAPY
nicotine containing chewing gums 2 or 4 mg chewed over 20-30mins repeated up to 60mg/day
transdermal nicotine patch;started as high dose patch,21mg/day for 6weeks followed by intermediate dose patch,14mg/day for 2-4weeks followed by low dose patch,7mg/day for 2-4weeks
nicotine nasal spray
nicotine inhaler:6-16 catridges/day for 12 weeks
bupropion hydrochloride:
Should start 1w bef quiting smoking at a dose of 150mg oraly od for 3days followed by 150mg oraly bd for 7-12w
varenicline-DOC
2nd line:
Clonidine
TOBACCO
Cigratte smoke is heterogenous aerosol produced by incomplete combustion of tobacco leaf
🚫🚫ON AN AVERAGE,SMOKERS LOSE MORETHAN ONE DAY OF LIFE EVERY WEEK🚫🚫
MAIN STREAM SMOKERS::
smoke emerging from mouth peice during puffing
3.3 billion particles per mililiter of mainstream smoke and morethan 4000 constituents including 43 known carcinogens which are antigenic,cytotoxic,mutagenic
SIDE STREAM SMOKE::
smoke emitted b/w puffs at burning cone and from the mouth piece
side stream smoke has more partculate mater especialy carcinogens
CONTENTS::
chemical carcinogens-
polycyclic aromatic hydrocarbons
polonium 210
N-NitrosoNorNicotine(NNN)
🔺nicotine is an alkaloid causing both ganglionic stimulant & a depressent
🔺it readily crosses BBB & stimulates nicotine receptors in brain
🔺increases BP,HR,CO,force of myocardial contraction
🔺increases coronary blood flow & peripheral vascular constriction
🔺mobilisation of free fatty acids
🔺nicotine is responsible for tobbacco ADDICTION
NNK
4 aminobiophenyl,2-napthylamine
polycyclic aromatic hydrocarbons
metal carcinogens-
arsenic
nickel
cadmium
chromium
potential promoters-
acetaldehyde
phenol
irritants-
nitrogen dioxide
formaldehyde
cilia toxins-
hydrogen cyanide
carbon monoxide~
🔺200times more affinity for hb than oxygen
🔺impairs release of oxygen from hb
🔺polycythemia
🔺CNS impairement
🔺imp causes of COPD
tumor accelarators-
indole
carbazole
Co-carcinogens-
phenol
cresol
catechol
EFFECTS::
CVS-
CHD
sudden death
subarachnoid haemorrhage
thromboangitis obliterans
malignant HT
RS-
Acute resp tract infection-influenza
cilia toxins-impairs tracheobronchial clearance
increased risk of lung cancer in smokers exposed to asbestose by synergestic fashion
MATERNAL-
10 Cigarates pwr day can cause fetal hypoxia
fetal carboxyhaemoglobin levels increased
low birth weight
prematurity
sudden infant death syndrome
spontaneous abortion
premature rupture of membranes
placenta previa
abruptio placenta
GIT::
increased prevalance of peptic ulcer
impairs healing of ulcers
increased pyloric reflux
decreased bicarbonate secretions from pancrease
🚫🚫SMOKING & CANCER🚫🚫
Causal association between smoking and cancer-mnemonic
Highly associated-PROBE SLL
©Pancreatic cancer
©Renal cell cancer
©Oropharyngeal cancer
©Bladder cancer
©Esophageal cancer
©Stomach cancer
©Lung cancer
©Laryngeal cancer
Probable association-CLAP
©Colorectal cancer
©Liver cancer
©Acute myeloid leukemia
©Prostate cancer
No association-ABC SOLT
©Acute lymphocytic leukemia
©Breast cancer
©Childhood cancer
©Skin cancer
©Ovarian cancer
©Lymphoma
©Testicular cancer
SMOKING INDEX::
SI=NO OF CIGRATTE/DAY X TOTAL DURATION IN YEARS
SI < 100 MILD smoker
SI 101-300 MODERATE
SI >300 HEAVY smoker
©LUNG CANCER COMMON IF SMOKING INDEX IS > 300©
PACK YEAR:
NO OF PACKS YEAR=1 PACKET OF CIGARATTE/DAY X NO OF YEARS
((one pack=20 cigarrates))
The risk of developing lung cancer is 40times in patients who smoke 2 packs per day for 20years
DISEASES WITH SMOKING AS PROTECTIVE FACTOR::
Ulcerative Colitis
PIH,Eclampsia
Alzemier’s Disease
Parkinson’s disease
Sarcoidosis
Fibroid Endometriosis
Lung Carcinoid
Nasopharyngeal Carcinoma
Negative Symptoms of Schizophrenia
Primary Sclerosing Cholangitis
sarcoidosis
Hypersensitivity pneumonitis
Recurrent aphthous ulcers
PHARMACOTHERAPY
nicotine containing chewing gums 2 or 4 mg chewed over 20-30mins repeated up to 60mg/day
transdermal nicotine patch;started as high dose patch,21mg/day for 6weeks followed by intermediate dose patch,14mg/day for 2-4weeks followed by low dose patch,7mg/day for 2-4weeks
nicotine nasal spray
nicotine inhaler:6-16 catridges/day for 12 weeks
bupropion hydrochloride:
Should start 1w bef quiting smoking at a dose of 150mg oraly od for 3days followed by 150mg oraly bd for 7-12w
varenicline-DOC
2nd line:
Clonidine
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