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Re: smoking cessation in pregnancyFrom: Arthurfree@aol.comThu Nov 13 13:21:07 1997
<< At Mon, 10 Nov 1997, Roger Klam wrote: > >Does anyone use nicotine patches during pregnancy in those patients >wanting to stop smoking?
Michael Wolpman replied:
>Yes, at least you are eliminating the CO to the fetus though other risks You are truly improving the oxygen carrying capacity of hemoglobin, but the amount of nicotine one gets from the patches is often significantly more than harvested from the cigarettes themselves. Nicotine is a fairly efficient vasoconstrictor and there are cases reported where patients have caused a heart attack by smoking with a patch on - simply too much coronary constriction for their native disease. Perhaps one could use it (in pregnancy) with caution at the lowest doses but I still believe there is a difference between patient induced morbidity and iatrogenic misadventure. I do prefer the former if one has to have one or the other. Adequate counseling, advice, motivation, and support are the most crucial things to help anyone quit smoking, and usually are not accomplished well. Prescriptive aids I usually reserve for someone who has failed with adequate counseling and who is well motivated. A lot of docs tend to use the prescription instead of adequate education with predictably dismal results. By the way, is elvis a middle name, a nom de plume, or a fantasy life? ;-) Arthur Freeland Warrensburg Missouri
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