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Paroxetine Gum: A Case Study

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1. Nicotine transdermal patch should be applied 21 mg/24h x 6 weeks, 14 mg /24h x 2 weeks, 7mg/24h x2 weeks to a dry, hairless area on upper arms and rotate site. It works to deliver a sustained release of nicotine topically over 24h, and then gradually decrease this to cushion the effects of withdrawal and cravings associated with trying to quit smoking. It is best to remove the patch 2 hours before exercising as it can cause increased nicotine absorption through the skin. [5] 2. Nicotine polacrilex gum can be used when needed for breakthrough withdrawal and craving symptoms. It offers partial nicotine release so patients can decide when they want extra nicotine on top of their baseline release. Gum should be chewed once or twice and parked between teeth and gum for 1 minute, this should be continued …show more content…

Paroxetine 20mg should be continued once daily for depression. The patient should be advised to continue this therapy even though he is feeling better. Paroxetine is a selective serotonin reuptake inhibitor, causing there to be more serotonin in the synapse making the patient feel better. [7] 4. B-complex can be continued once daily for the general well being and to energize the patient. 5. Patient should be advised to not drink any acidic beverages (fruit juices, caffeine, alcohol or soft drinks) 15 minutes before and during the time when they are chewing the nicotine replacement gum. Acidic drinks lower the pH in the mouth causing a decreased absorption of the nicotine through the buccal system. [6] 6. Cigarette smoking induces the enzymes CYP1A2, which has an effect to increase the clearance of some drugs amongst which is caffeine. Patient KS should cut down his content from 4-5 coffees a day to 2 cups of coffee a day as the metabolism of caffeine will decrease once the patient quits smoking and he could experience signs of toxicity such as irritability and insomnia. Exercise and eat low caloric meals to prevent weight gain side effects of smoking cessation.

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