New Hope for Motivated Quitters

Most smokers trying to stop need some help from medication. Apart from the nicotine patch, the mainstay in recent years has been bupropion, which was originally used extensively as an antidepressant (Wellbutin® for depression, Zyban® for help quitting smoking). A recent issue of the Journal of the American Medical Association has published three clinical studies of varenicline, a new drug being developed by Pfizer Inc.

In the first two studies, varenicline was compared with bupropion and placebo for 12 weeks, with 40 to 52 weeks of non-drug follow-up. Varenicline was roughly twice as likely as bupropion to help people quit for at least the last 4 weeks of the 12 weeks’ treatment, and bupropion was twice as likely as placebo to achieve this. During the follow-up periods (weeks 12 through 40) smoking abstinence persisted for 22.5% with varenicline, compared with roughly 15% on bupropion and 10% on placebo. The third study examined the effect of varenicline given for an additional 12 weeks after the original 12, as maintenance therapy. Results were similar to those in the other studies.

About 30% of participants in these studies reported nausea with varenicline, significantly more than with bupropion or placebo. At first sight these results may not seem as wonderful as one might have hoped. But they do show effectiveness in a condition that’s notoriously difficult to influence, and the longer follow-up results are quite good. We are glad that FDA has approved this drug, so that smokers have another weapon in their war with the weed.

Comments

[B Kehke]

Female, 84 yrs old. Has had skin eruptions on arms and legs, puss and itching for past few years. . Recent dark blue coloring on ankle area Doctor says it's probably thin, dry skin. Patient not satisfied, would like further opinions.

[Heather RN]

2-3 years is a very long time to endure a skin condition causing itching and pus without having it assessed and treated. We can appreciate that the patient is not satisfied, but it is never possible to offer opinions without an examination and investigations and/or tests being carried out. As this is not possible over the Internet we would urge the patient to be assessed and investigated by a dermatologist (skin specialist) as only when there is a diagnosis can appropriate treatment be started.
The bleeding may possibly be caused by scratching. Skin bumps and itching with pus formation possibly indicate some type of skin infection. Aging reduces the capacity of the skin to moisturize itself, so the skin becomes dry. Dry skin is one of the major causes of itchiness in aging skin: the pattern can vary considerably from person to person. What's more, signs and symptoms of dry skin depend on age, health status, where on the body it occurs, the amount of time spent outdoors, and the cause of the problem. Other causes of itchy skin often require the attention of a dermatologist. Elderly skin is sometimes more sensitive to clothing fabrics (especially wool), soaps and detergents, and other items encountered in everyday living. Identification of the sensitizing agents and limiting exposure to them may reduce the itchiness. Allergies to a host of indoor and outdoor agents may cause itching. Some medications cause itchiness as a side effect. Severe itching as well as itching that does not respond to moisturizing should be evaluated by a dermatologist.
Also, as people age, the skin becomes thinner and fat padding under the skin is lost. Thus, blood vessels are less protected from injury. An injury inflicted by mild trauma - for example, bumping against a table or being hit by a tennis ball - may result in a substantial bruise. In some instances, bruising may be an indication of an underlying condition. Bruises that appear for no apparent reason may indicate a bleeding disorder. Anti-clotting medications may cause bleeding under the skin. To help prevent these knocks, extra protection should be worn on limbs, especially when outside, gardening etc. Good eyesight can also help prevent bumping into objects.
These related links may be of interest:
http://www.chic.org.uk/chicmco/feelingunwell/skinandscalp.htm
http://www.cnn.com/HEALTH/library/HQ/00355.html
http://www.medicinenet.com/bruises/article.htm

[Richard Cutts]

International nursing agency offering permanent and temporary job placements for nurses in various countries like USA, UK, Australia, New Zealand, Ireland, etc. The agency also helps nurses with visa processing, relocation support and professional advice for nurses worldwide.