Best Time To Apply Nicotine Patch - bicycle-progs61’s diary

Using the Nicotine Patch, Nicotine Gum, Nicotine Nasal Spray or Nicotine Inhaler

Comments about Equate Nicotine Patches: If something is needed to help reduce nicotine cravings and help one quit smoking, then these seem to be effective.

Generic Name: nicotine oral/patches/nasal NIK oh teen

Brand Names: Commit, Habitrol, Leader Nicotine Polacrilex, Nicoderm, Nicorelief, Nicorette, Nicotrol

What is nicotine.

Nicotine is the primary ingredient in tobacco products.

Nicotine in medical products is used to aid in smoking cessation. Using a controlled amount helps reduce nicotine withdrawal symptoms when you quit smoking. It works by providing low levels, which may help you to quit smoking by lessening physical signs of withdrawal symptoms.

Nicotine may also be used for other purposes not listed in this medication guide.

Important information

Do not use nicotine if you are pregnant. It could cause harm to the unborn baby. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment.

You may not be able to use certain forms of this medicine if you have medical conditions that could interfere with use. Nasal or sinus problems allergies, nasal polyps, sinusitis could affect safe use of the nasal spray form of nicotine. Mouth or dental problems may affect safe use of nicotine gum or lozenges. A skin condition may affect safe use of nicotine transdermal patches. Talk with your doctor about the best form of nicotine for you to use.

Slideshow: Where There s Smoke There s Fire: Know The Risks Before You Light Up

Do not smoke while you are using nicotine. Stop smoking as soon as your treatment begins. Smoking while using this medication can be dangerous. The nicotine transdermal patch may burn your skin if you wear the patch during an MRI magnetic resonance imaging. Remove the patch before undergoing such a test.

Before using nicotine

You may not be able to use certain forms of nicotine if you have medical conditions that could interfere with use. Nasal or sinus problems allergies, nasal polyps, sinusitis could affect safe use of the nasal spray form of nicotine. Mouth or dental problems may affect safe use of nicotine gum or lozenges. A skin condition may affect safe use of nicotine transdermal patches. Talk with your doctor about the best form of nicotine for you to use.

Before using nicotine, tell your doctor if you have:

heart disease, an irregular heartbeat, high blood pressure or chest pain;

a jaw condition called TMJ temporomandibular joint disease;

an overactive thyroid;

diabetes;

pheochromocytoma tumor of the adrenal gland ;

liver or kidney disease;

a stomach ulcer; or

asthma or chronic pulmonary disease.

Nicotine oral lozenges may contain phenylalanine. Tell your doctor if you have phenylketonuria PKU.

Nicotine can cause harm to an unborn baby. Do not use nicotine if you are pregnant. Tell your doctor if you become pregnant during treatment. Use an effective form of birth control while you are using this medication. Nicotine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

The nicotine transdermal patch may burn your skin if you wear the patch during an MRI magnetic resonance imaging. Remove the patch before undergoing such a test.

How should I take nicotine.

Use nicotine exactly as it was prescribed for you. Do not use the medication in larger amounts or for longer than recommended by your doctor.

nicotine comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

To use the patches:

Choose a different place on your body to wear the patch each time you put on a new one. Do not use the same skin area twice within 7 days.

Apply the patch to clean, dry, and hairless skin on the outer part of your upper arm or on your chest. Remove the patch after 24 hours and replace it with a new one.

If you are using Nicotrol patches, apply a new patch each morning and remove it at bedtime. Do not wear the patch while you are sleeping. If you are using Nicoderm CQ, you may wear the patch for 16 or 24 hours. If you crave cigarettes when you wake up, you may wear the patch for 24 hours. Do not wear the patch at night if you have vivid dreams or trouble sleeping.

To use the chewing gum or oral lozenges:

Place a piece of gum or a lozenge in your mouth.

Chew the gum slowly several times and stop chewing when you notice a tingling sensation or a peppery taste in the mouth. Park the gum between your cheek and gum and leave it there until the taste or tinging sensation is almost gone. Then slowly chew a few more times until the taste or sensation returns. Park the gum again in a different place in your mouth. Chewing too much or too quickly can cause too much nicotine to be released from the gum and you may have side effects such as nausea, hiccups, or stomach problems. Remove the gum after 30 minutes, or when the taste or tingle no longer return when you chew the gum.

Allow the lozenge to dissolve slowly without chewing or swallowing. You may notice a warm or tingling sensation in your mouth. Move the lozenge from one side of your mouth to the other while it is dissolving.

Do not eat or drink for 15 minutes before using the gum or lozenge and while the medicine is in your mouth.

To use the nasal spray:

Blow nose if it is not clear. Tilt head back slightly. Insert the tip of bottle into your nostril as far as comfortable. Spray once in each nostril. Do not sniff, swallow, or inhale while spraying. If your nose runs, gently sniff to keep the medicine in. Wait 2 or 3 minutes before blowing your nose. Do not use more of the medication than is directed.

Recap the bottle after each use. If you don t use the nasal spray for 24 hours, prime the pump by spraying several sprays into a tissue 1, then throw the tissue away.

Do not get nicotine spray into your eyes or mouth or on your skin. If this does occur, rinse the area with water.

To use the inhaler:

Inhale deeply or puff in short breaths. As you inhale through the mouthpiece, nicotine turns into a vapor and is absorbed into the mouth and throat. Nicotine in cartridges is used up after about 20 minutes of active puffing.

Keep used and unused nicotine patches or gum out of the reach of children and pets to prevent poisoning. Used bottles of nasal spray should be thrown away with their child-resistant caps in place.

Store nicotine products at room temperature away from moisture, heat, and direct sunlight.

What happens if I miss a dose.

Since nicotine is used as needed, you may not be on a dosing schedule. If you are using the medication regularly, use the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose.

Seek emergency medical attention if you think you have used too much of this medicine, or if anyone has accidentally swallowed it.

Overdose symptoms may include nausea; vomiting; diarrhea; stomach pain; cold sweat; headache; dizziness; problems with hearing or vision; confusion; uneven heartbeats; chest pain; seizures; and death.

What should I avoid.

Do not smoke while you are using nicotine. Stop smoking as soon as your treatment begins. Smoking while using this medication can be dangerous.

Nicotine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using nicotine and call your doctor at once if you have any of these serious side effects:

seizures; or

chest pain or uneven heartbeats.

Less serious nicotine side effects may include:

dizziness;

belching or hiccups;

stomach upset or nausea;

mouth or throat soreness;

dry or watering mouth;

watering eyes;

headache;

runny or stuffy nose when using the nasal spray ;

white patches or sores inside your mouth or on your lips when using the inhaler ;

constipation;

sneezing and coughing;

changes in taste; or

redness, itching, or burning where the patch is worn.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects in more detail What other drugs will affect nicotine.

Before using nicotine, tell your doctor if you are using any of the following drugs:

imipramine Tofranil ;

oxazepam Serax ;

propranolol Inderal, labetalol Normodyne, Trandate, or prazosin Minipress ;

theophylline Theo-Dur, Theochron, Theolair ;

pentazocine Talwin, or

insulin.

This list is not complete and there may be other drugs that can interact with nicotine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information.

Your pharmacist can provide more information about nicotine.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. Multum is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Dec 28, 2015 Nicotine patches are applied directly to the skin. They are applied once a day, usually at the same time each day. Nicotine patches come in various.

Abstract. Objective To determine the efficacy of 16 hour nicotine patches among pregnant smokers, with the dose individually adjusted according to saliva cotinine.

Nicotine Use for Smoking Cessation

This is a corrected version of the handout that appeared in print.

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education Web site.

Information from Your Family Doctor

Am Fam Physician. 2001 Jun 1;63 11 :2251-2252.

When you are ready to quit smoking, you may want to use nicotine replacement therapy to help you give up cigarettes. The cost of nicotine replacement therapy is about the same or less than the cost of cigarettes.

The nicotine patch, gum, nasal spray and inhaler are all forms of nicotine replacement therapy. All forms of nicotine replacement can help lessen your urge to smoke. This means you have less craving for nicotine when you stop smoking. You may still feel a craving to smoke, but don t smoke while using the patch, gum, nasal spray or inhaler.Who should use nicotine replacement therapy.

Almost every smoker can benefit from using nicotine replacement therapy. If you are pregnant or if you have heart or blood vessel problems, your doctor will be careful about giving you the nicotine patch or gum.How do I know what strength is right for me.Patch

Most smokers should start using a full-strength patch 15 to 22 mg of nicotine every day for 4 weeks and then a weaker patch 5 to 14 mg of nicotine for another 4 weeks.Gum

Many smokers should start using the 2-mg dose. However, you may want to start with 4-mg gum if you:

Smoke more than 20 cigarettes a day.

Smoke as soon as you wake up in the morning.

Have severe withdrawal symptoms when you don t smoke.

Have tried to quit on a lower dose and failed.

If you are a very light smoker less than 10 to 15 cigarettes a day or have health problems, your doctor can help you select the right dose.Should I use the nicotine patch, gum, nasal spray or inhaler.

Any of these treatments can help once you are ready to quit. The choice is up to you. Some people don t like the taste of the gum or don t like chewing in public. They prefer the patch. Other people have been unable to quit on the patch and want to try the gum. Some people prefer to use a nasal spray and some prefer the inhaler. Using the nicotine patch, gum, nasal spray or inhaler almost doubles your chances of quitting. Here is some information to help you decide which one is right for you.Nicotine PatchDirections for use

At the start of each day, place a new patch on a part of your body between the neck and the waist. Put the patch on a new spot each day to lessen skin irritation.Treatment period

The patch is usually used for up to 8 weeks.Side effects

Some people who use the patch get a rash on their body where the patch is placed. Skin rashes are usually mild and easily treated. Moving the patch to another area of the body helps.

If you have any side effects from the patch, be sure to tell your doctor right away.How to get the patch

You can buy the patch without a doctor s prescription. To be safe, carefully read and follow the directions inside the package. You can talk to your doctor about how to use it and how long to use it.Nicotine GumDirections for use

The gum must be chewed in a special way to make it work. Chew it slowly until you notice a peppery taste. Then stop chewing and move the nicotine gum between your cheek and your gum. Each piece of nicotine gum should be kept in your mouth for about 30 minutes.Treatment period

A regular schedule at least one piece of nicotine gum every 1 to 2 hours for 1 to 3 months may give the best results. Some people don t chew enough pieces of gum a day and or they don t chew the gum for 8 weeks. They might not get the most benefit from nicotine gum.Side effects

Some people have mild side effects such as hiccups, upset stomach or sore jaws. Most of these side effects go away if the gum is used correctly.

If you have any side effects from the gum, be sure to tell your doctor right away.How to get nicotine gum

You can buy the gum without a doctor s prescription. To be safe, carefully read and follow the directions inside the package. Also, you can talk to your doctor about how to use it and how long to use it.Nicotine Nasal nose SprayDirections for use

Apply one spray in each nostril. Use the spray one to two times each hour while you are awake. Use the spray at least 8 times a day. Don t use it more than 40 times a day.Side Effects

The nasal spray may cause nasal irritation, diarrhea and a fast heart rate. If you have hay fever or sinus infection, ask your doctor about using one of the other forms of nicotine replacement therapy.

If you have any side effects from the nasal spray, be sure to tell your doctor right away.How to get the nasal spray

You can only get the nasal spray with a doctor s prescription. To be safe, carefully read and follow the directions inside the package. corrected Nicotine InhalerDirections for use

Inhale from a cartridge when you have a desire for a cigarette. Use no more than 16 cartridges a day for up to 12 weeks.Side Effects

You might have irritation of throat and mouth when you first start to use the inhaler. It might make you cough. You should get over this after a while.

If you have any side effects from the inhaler, be sure to tell your doctor right away.How to get the inhaler

You can only get the nicotine inhaler with a doctor s prescription. To be safe, carefully read and follow directions inside the package.

This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact

afpserv aafp.org for copyright questions and/or permission requests.

Am Fam Physician. 2001 Jun 1;63 11 :2118-2129.

to the editor: I would like to commend the authors of the article, Acute and Post-traumatic Stress Disorder After Spontaneous Abortion. 1 I try to remain aware of the possibility of psychologic morbidity following spontaneous abortion but, admittedly, I had never considered the diagnosis of post-traumatic stress disorder PTSD. As noted, there has not been much written about this subject, and I wonder if it is because the diagnosis is uncommon or underappreciated.

I agree that more investigation is needed to determine the incidence of and the most effective treatment for PTSD following spontaneous abortion. The authors state that as many as 10 percent of women may have acute stress disorder and up to 1 percent may have PTSD after spontaneous abortion, rates they derive from anecdotal evidence. 1 Do the authors encounter this constellation of symptoms very often. The only article2 the authors cite that discusses the incidence of PTSD and spontaneous abortion found just one case of PTSD. This one case was in a study population different than the population with the more common first-trimester miscarriage; these were women who experienced a perinatal death between 16 weeks gestation and seven days following delivery.

Correctly classifying patients who are having difficulties following a miscarriage may not be easy. Most studies describing the psychologic morbidity associated with miscarriage focus on depression, grief, bereavement and anxiety. The methods used to estimate prevalence vary widely because different terms and methods are used for the diagnosis, including the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. DSM-IV, Hamilton Anxiety Scale, Hospital Anxiety and Depression Scale, Perinatal Grief Scale and many others. Unless the patient has a classic PTSD feature like vivid dreams, hallucinations or flashbacks, many features of PTSD overlap with the diagnostic criteria for depression or anxiety. Alternatively, physicians or researchers in the past may also have misdiagnosed cases of PTSD as depression, anxiety or a mixed depression-anxiety.

Finally, regardless of the diagnosis, physicians need to be on the lookout for psychologic problems following miscarriage, sometimes proactively, and help the patient cope. The article1 discusses only the critical incident stressdebriefing process as treatment Other forms of psychotherapy and even hypnotherapy may be helpful. In addition, some pharmacologic treatments antidepressants and anxiolytics have been studied in the treatment of PTSD. I mention this to make two points: 1 physicians need to recognize the psychologic complications of miscarriage and do something to help their patients and 2 whether the diagnosis is clearly PTSD or not, one can offer psychotherapy and possibly medication. For persons who seem to have more depressive-type symptoms, antidepressants may be prescribed, while anxiolytics may be more helpful for those with more hypervigilant, anxious features.REFERENCES

1. Bowles SV,

James LC,

Solursh DS,

Yancey MK,

Epperly TD,

Folen RA,

et al.

Acute and post-traumatic stress disorder after spontaneous abortion. Am Fam Physician.

2000;89–96.

2. Salvesen KA,

Oyen L,

Schmidt N,

Malt UF,

EikNes SH.

Comparison of long-term psychological responses of women after pregnancy termination due to fetal anomalies and after perinatal loss. Ultrasound Obstet Gynecol.

1997;–5.

to the editor: The authors of Acute and Post-traumatic Stress Disorder After Spontaneous Abortion 1 make a meaningful contribution to the family practice literature by pointing out the association between significant stressors, such as spontaneous abortion, and traumatic stress disorders.

In December 1999, the U. S. Food and Drug Administration FDA approved labeling for sertraline Zoloft in the treatment of post-traumatic stress disorder PTSD. Brief information about the approval can be found on the FDA s Web site:

A body of literature exists supporting the use of serotonergic antidepressants, including tricyclic antidepressants and selective serotonin reuptake inhibitors SSRIs, for the treatment of patients with post-traumatic stress disorder PTSD. 2

Although only anecdotal in acute stress disorder, I have found low-dose serotonergic antidepressants e.g., low-dose SSRIs of benefit for the anxiety-type, hyperarousal component of this disorder. I find this no different from the use of SSRIs in the treatment of patients with generalized anxiety disorder. However, it is important to note that low doses are often sufficient to produce antianxiety effects; whereas, higher doses are usually necessary for antidepressant effects.

While family physicians may choose to counsel patients themselves or refer patients for counseling for these indications, many family physicians have experience and are comfortable with these classes of pharmacotherapeutic agents. Therefore, I thought this worth mentioning.

Of course, in the circumstance of the postabortion patient, issues related to medications and subsequent pregnancy planning would also be a pertinent issue for the physician and the patient to discuss.REFERENCES

2. Sutherland SM,

Davidson JR.

Pharmacotherapy for post-traumatic stress disorder. Psychiatr Clin North Am.

1994;9–23.

in reply: Thank you for your observations and kind words regarding our article.1 You have raised some good points that were not addressed because of the limited focus of our article. The diagnosis for acute stress disorder2 ASD and post-traumatic stress disorder3 PTSD has been around for a relatively short time compared with depression, anxiety or pathologic grieving the latter is not a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. DSM-IV. 3 This is reflected in the limited writings on spontaneous abortion and negative emotional effects following this event.

We believe that the newness of this diagnosis, limited training and the lack of literature contribute to physicians overlooking this diagnosis when dealing with the aftereffects of spontaneous abortion. Additionally, we believe there is now a greater focus on psychologic issues in maternity care, which should increase research and literature in this area. In our own experiences in the departments of family practice, obstetrics-gynecology and behavioral medicine, we have observed these cases; however, as suggested, PTSD is rare while ASD is more likely observed in family practice or obstetrics-gynecology settings. Patients with PTSD are more likely to be referred for behavioral therapy, depending on the staff s level of awareness of this condition following spontaneous abortion. As has been aptly pointed out, psychotherapy and pharmacotherapy in this population may be of some benefit; however, we believe that in this subpopulation, pharmacotherapy may be of little benefit.

The concern with pharmacotherapy is the perceived risk these medications have on subsequent pregnancies. While a small percentage of subsequent pregnancies will end in another miscarriage, a woman taking a regular prescription medication often may assume that the medication had some role in the miscarriage or continue to harbor some increased apprehension about other untoward teratogenic effects if the pregnancy continues beyond the first trimester. Thus, most women prefer not to take a medication, if possible, when they begin attempting a subsequent pregnancy. Our focus in the article1 was to highlight the fact that when ASD is discovered, early preventive measures may reduce the traumatic experience and may prevent or reduce the symptomatology of PTSD. A psychotherapy referral may be in order if, after a brief intervention, the patient exhibits no symptomatic or limited relief.REFERENCES

2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3d ed. Washington D.C.: American Psychiatric Association, 1980.

3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington D.C.: American Psychiatric Association, 1994.

Nicotine is the primary ingredient in tobacco products. Nicotine in medical products is used to aid in smoking cessation. Using a controlled amount helps reduce.

Nicotine Patch Directions for use. At the start of each day, place a new patch on a part of your body between the neck and the waist. Put the patch on a new spot each.
Sep 09, 2014 A nicotine patch sticks to your skin and slowly releases nicotine into your bloodstream.