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  • Image not available. Tobacco is the number 1 preventable cause of death in the United States.
  • Image not available. Between 12 and 16 million Americans report current heavy alcohol use or alcohol abuse.
  • Image not available. Pharmacogenomics studies have identified genotypic and functional phenotypic variants that either serve to protect patients or predispose them toward alcohol dependence.
  • Image not available. Alcohol is a central nervous system depressant that shares many pharmacologic properties with the nonbenzodiazepine sedative hypnotics.
  • Image not available. The metabolism of alcohol is considered to follow zero-order pharmacokinetics, and this has important implications for the time course in which alcohol can exert its effects.
  • Image not available. Benzodiazepines are the treatment of choice for alcohol withdrawal.
  • Image not available.Disulfiram, naltrexone, and acamprosate are FDA-approved drug therapies for the treatment of alcohol dependence. The clinical utility of these agents to improve sustained abstinence remains controversial. Relapse is common.
  • Image not available. More than three quarters of smokers are nicotine dependent. Tobacco dependence is a chronic condition that requires repeated interventions.
  • Image not available. Use of nicotine replacement therapy along with behavioral counseling doubles cessation rates.
  • Image not available.Bupropion and varenicline are efficacious alone and in combination with nicotine replacement therapy for smoking cessation.
  • Image not available. Special precautions are associated with the use of varenicline for smoking cessation.
  • Image not available. Caffeine's pharmacologic actions are similar to those of other stimulant drugs. As such, abstinence from caffeine induces a distinct withdrawal syndrome that includes headache, drowsiness, and fatigue.

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Upon completion of the chapter, the reader will be able to:

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  • 1. List the adverse health effects brought about by the use/abuse of alcohol, nicotine, and caffeine.
  • 2. Recommend specific drugs and dosing regimens for preventing withdrawal from alcohol.
  • 3. Make evidence-based recommendations for helping people to stop smoking.
  • 4. Assess a patient’s intake of caffeine and determine if caffeinism is present based on presence/absence of specific signs and symptoms.
  • 5. Evaluate the role of naltrexone and disulfiram as long-term treatments for alcohol dependence.
  • 6. Select an appropriate product to be used as nicotine replacement therapy in a given patient, considering cost, convenience, efficacy, and side effects.
  • 7. Explain the role of counseling and other support therapy in an overall program to help people quit smoking.
  • 8. Explain the effects of alcohol at different concentrations in the blood.
  • 9. Identify risk factors that might predispose a person to alcoholism.
  • 10. Calculate the amount of alcohol present in given volumes of the different alcoholic beverages.
  • 11. State the economic burden imposed on our society by the abuse of alcohol, nicotine, and caffeine.
  • 12. Compare and contrast the five first-line pharmacotherapies that reliably increase long-term smoking abstinence rates.
  • 13. Recommend a starting dose and duration of treatment for a patient choosing to use varenicline as a smoking deterrent.
  • 14. Determine if a patient is suffering from caffeine withdrawal, given a specific set of signs and symptoms.

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Caffeinism:Caffeinism is the term coined to describe the clinical syndrome produced by acute or chronic overuse of caffeine.

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Euphoria: A mood state characterized by an exaggerated, superficial sense of well-being, characterized by extreme happiness, ...

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