Addiction Medicine Certificate Course by Muktaa Charitable Foundation Course Material by Dr Narayan Perumal Lecture conducted at Aga Khan Palace More material on Fullnasha.com

1. {
Thank You For Not
Smoking
Dr Narayan Nay Perumal
MBBS PGDCR MPH
Dr Mahajan Clinic
Olito Multi Speciality
CLEAN ROOM
#ExBox
http://drnay.in/

2. Why Not BAN Cigarettes?

3. What is the ribbon color
for Lung Cancer?

4. Lung cancer kills more people than breast, colon, and prostate
cancers combined. It is single most common cause of all deaths,
after heart disease.

5. Why spend on
Anti-Smoking
Ads?

6. If we ban today, then?

10. What is making Tobacco
so potent and powerful?

11. Triune System of Brain

17. Cigarettes are anti-depressants…

20. How to get them to stop

21. Be Encouraging

22. First Smoke? Brands they tried? New
Cigarettes – ICE BREAKERS

23. Everybody LIES
Family Counselling-PVT-Family
Descision

24. Help them set a Quit Date

25. Have Realistic Timelines
- Everyone wants to Binge their last
day

26. Ask them to inform
everyone

28. Tell them what to expect

30. Tell them what to do
instead

32. Tell them the pro’s of
quitting

34. Inform about Quit Apps

36. Your Prescription

37. Nicotine Replacement
Therapy (NRT)

38. NRT Precautions
Patients
- Recent Myocardial Infarction, arrhythmia, angina
- Pregnancy
- Lactation
- Temporomandibular joint disease (gums or lozenges)
- Adolescents

39. NRT can cause acid reflux, nausea – Always
prescribe Antacids SOS

40. Watch for Nicotine Patch
hypersensitivity – Ask to switch sites to
avoid local irritation

41. - Patients with no history of depression
- Doubles the chance of quitting successfully
- Can be used with NRT

43. Bupropion Dose
- 150 mg at morning for 3 days
- 150 mg BD (7-12 weeks)

44. Bupropion Side Effects
Pregnancy Category C – only if indicated (attempt non-drug
treatment first)
Bupropion Precautions
Dry mouth, Insomnia, Tremor, Rash

46. Varenicline

48. Starter Pack

49. Maintenance Pack

50. Varencline Precautions
- Pregnancy C (Attempt non drug treatment first)
Can cause
- Nausea
- Sleep disturbance (insomnia, abnormal dreams)
- Constipation
- Flatulence
- Vomiting

51. Additive Treatments

52. Topiramate
Anticonvulsant – Mood Stabilizer - Anti-craving Property
Prevents rebound cravings for other substances including food
Other uses of Topiramate – Personality Disorders, Bipolar Disorder,
Alcoholism, migraine, essential tremors, OCD, hypertension
Precautions – Causes Visual Disturbances, avoid in OCP,
contraindicated in pregnancy (cleft palate), rebound seizures

53. Buspirone
Anti-anxiolytic, with no withdrawal, no physical dependence
Works in Generalized Anxiety Disorder, hypoactive sexual desire
disorder (HSDD), irritability, agitation, aggression,
Precautions with MAO inhibitors, severe renal or hepatic
compromisation

54. Antioxidants, Vitamin C

55. Palliative Treat Symptoms
Constipation
Tingling Numbness
Lacrimation
And everything that patient is newly discovering

56. QUIT BUT NOW WHAT?

57. Get out of the routine –
“Comfort Zone”

58. Workout, Gyms, Marathons work by
giving “Runner’s High”

59. Person is vulnerable when -
Hungy, Angry, Lonely, Tired
(HALT) – Say halt, don’t do it.

60. Yoga, Relaxation, Meditation,
Flower Therapy, Massage therapy,
Animal Assisted Therapy

61. Get a Glass Piggy Bank, put
your smoke money in it

62. Encourage Life-Style
Changes

63. Volunteer in Anti-Smoking
Campaigns

64. E-Cigarettes And Vaping

65. Problem with Vaping
- Incorrect Dosing of Nicotine
- Inappropriate dosing with illicit substances
- No Regulations on Manufacturing and Sales
Control on the device and additives
- No enough studies on the flavoring solvents
- Gateway Drug

66. Thank You For Not Smoking

67. Dr. Narayan Nay Perumal
+91 9967536664
+91 8369750392
drnarayanperumal@gmail.com