Supplemental Online Lesson

Lesson S19: PreAnesthetic Assessment of the Heavy Smoker

Registration Fee: $15.00
2.0 AMA PRA Category 1 Credits^TM
available until July 31, 2012

Review Date: May, 2011

REGISTRATION INFORMATION FOR SUPPLEMENTAL LESSONS:

Click on the link below to download and print the course material and post-test exam.  Register for the exam to enter your responses to receive CME credit.  There are ten questions in the examination and you must achieve a score of 80% or better to earn CME credit.  Following successful completion, your certificate will be immediately available online.  In addition, a historical record of  completed CME courses is maintained online in an individualized profile.  This includes copies of course certificates which can be printed at any time.

The registration fee for this course is $15.00

Physicians are provided with two opportunities to successfully complete the exam presented here. 

Software Requirements: Adobe Acrobat Reader and any standard Internet Browser.

Strict regulation has led to a reduction in smoking in the United States while it has increased in many other countries. Major health issues associated with smoking were addressed at a global conference held in Uruguay in November, 2010. Nicotine remains the most addictive abused substance today with far-reaching health consequences. Smoking interferes with the responsiveness of the respiratory tract creating perioperative risks. Anesthesiologists should be knowledgeable about the smoking epidemic and be cognizant of steps that are essential for safe outcome in all patients.

CASE HISTORY

A 63 year old man presented for a total knee replacement. He was obese (BMI 42.1) with a history of hypertension controlled intermittently with amlodipine and hydrochlorothiazide. On admission, his blood sugar was 178mg/dl, although he reported that he had never been diagnosed with diabetes despite a family history. Other medications included acetaminophen. He reluctantly admitted that he smoked one pack of cigarettes daily since he was a teenager, sometimes more on weekends. He has a productive morning cough. Previous surgery consisted of cataract lens replacement and colonoscopy.

LEARNING OBJECTIVES

At the end of this activity, the participant should be able to:

1. Appreciate the addictiveness of tobacco
2. List the adverse effects of tobacco on the respiratory tract
3. Cite the frequency of tobacco use worldwide
4. Explain the cardiovascular effects of tobacco use
5. Outline how tobacco is cultivated
6. Describe the metabolism of nicotine
7. Briefly outline the history of tobacco use
8. List the components of tobacco smoke
9. Identify carcinogens in tobacco smoke
10. Prepare an anesthetic plan for the smoker, emphasizing potential complications

TARGET AUDIENCE:  Anesthesiologists

Accreditation Statement

Mount Sinai School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation: The Mount Sinai School of Medicine designates each educational activity for a maximum of 2 AMA PRA Category 1 Credits^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

It is the policy of Mount Sinai School of Medicine to ensure objectivity, balance, independence, and scientific rigor in all CME-sponsored educational activities. All faculty participating in the planning or implementation of a sponsored activity are expected to disclose to the audience any relevant financial relationships and to assist in resolving any conflict of interest that may arise from the relationship. Presenters must also make a meaningful disclosure to the audience of their discussions of unlabeled or unapproved drugs or devices.

Disclosures

The author, the reviewer, and the editor have no relation-ships with pharmaceutical companies or manufacturers of products to disclose. This educational activity may contain discussion of published and/or investigational uses of agents for the treatment of disease. Some uses of these agents have not been approved by the FDA. Please refer to the official prescribing information for each product for approved indications, contraindications, and warnings.

CONTACT INFORMATION

Questions regarding course content may be directed to Dr. Elizabeth Frost: ElzFrost@aol.com.

If you require technical assistance with completing this course, please contact Continuing Education Online Customer Service at 718-648-8080 or send e-mail to ceo.contact7@proceo.com.

CALL FOR WRITERS

If you would like to write a CME lesson in Anesthesiology News, please send an e-mail to Elizabeth A.M. Frost, MD, at ElzFrost@aol.com