Nicotine patch in lung transplant

[Makati2008]

So today I admitted a patient with history of lung transplant that restarted smoking for about two months. I put her in, did her basic orders , started her on a nicotine patch.

I was advised by our fellow that was inappropriate but really couldn't give me an explanation why? Could someone here advise me why this is inappropriate therapy?

Thanks,
Makati

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[Mad Jack]

I'm actually quite curious to their logic as well. Transplanted lungs aren't exactly easy to come by, and smoking will certainly wreck them by substantially reducing ciliary beat frequency. But this isn't an effect of the nicotine itself, but the smoke deposition with the lungs. A nicotine patch won't impair his lung function, nor will it cause any great physiological disturbances.

Someone really needs to have the, "You will die, and you will die very quickly, if you don't stop smoking. These lungs aren't the same as the lungs you were born with. Smoking could kill you in months, rather than taking a lifetime." conversation with him. And he needs a good smoking cessation counselor. Can't see any reason to not give him the patch, but I'm not a physician yet and haven't a clue what they might be aiming for aside from forcing him to go cold turkey, which will send him right back to the gas station for a new pack the second he walks out the door.

 

[Makati2008]

I'm actually quite curious to their logic as well. Transplanted lungs aren't exactly easy to come by, and smoking will certainly wreck them by substantially reducing ciliary beat frequency. But this isn't an effect of the nicotine itself, but the smoke deposition with the lungs. A nicotine patch won't impair his lung function, nor will it cause any great physiological disturbances.

Someone really needs to have the, "You will die, and you will die very quickly, if you don't stop smoking. These lungs aren't the same as the lungs you were born with. Smoking could kill you in months, rather than taking a lifetime." conversation with him. And he needs a good smoking cessation counselor. Can't see any reason to not give him the patch, but I'm not a physician yet and haven't a clue what they might be aiming for aside from forcing him to go cold turkey, which will send him right back to the gas station for a new pack the second he walks out the door.

I am assuming it's fine. The fellow doesn't care for EM docs so I wonder if he was just finding something to complain about.

 

[jdh71]

So today I admitted a patient with history of lung transplant that restarted smoking for about two months. I put her in, did her basic orders , started her on a nicotine patch.

I was advised by our fellow that was inappropriate but really couldn't give me an explanation why? Could someone here advise me why this is inappropriate therapy?

Thanks,
Makati

the fellow is full of ****