I recommend using a Chantix starter pack to be taken as directed and then being seen for a recheck in 28 days. Other drug treatments listed below can be used in combination with Chantix.
These patches are worn daily (24 hours), and it is recommended that they are removed before showering or bathing, and a new patch is placed on afterwards. Patch sites need to be rotated daily.My usual recommendation is to put a patch on the left anterior shoulder, then left anterior chest, then right anterior chest, then the right anterior shoulder, and then repeat the cycle. The goal is to get the patient to stop smoking at this point.
I am recommending that when the patient still has a craving, they make sure they haven't eaten or had anything to drink in the last 15 minutes, and then chew the nicotine gum until the flavor is present and a tingling is noted in your mouth, and hopefully the desire to smoke is reduced.When this occurs, a patient should place the gum between the cheek and gum on the right or left side of their mouth, and then when the flavor wanes, re-chew it until the flavor comes back, and then place it again between the cheek and gum again. This is very similar to people who chew tobacco, and it is placed in the same area.This is often referred to as "park and chew," and eventually, like any gum, the nicotine gum will lose its flavor. At that point, you can assume that the gum is no longer releasing enough nicotine and dispose of it. It is recommended that the patient not eat or drink for at least 15 minutes afterward.However, summer dehydration can be a problem, and I recommend that the patient temporarily take the gum out of their month, drink water or fluids that they want to drink, and then reinsert the gum for nicotine therapy.
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