Drug Interaction Due To Smoking

Drug Interaction Due To Smoking

Theophylline (Aminophylline, Deriphyllin, Theolong, Theomac)

This is a frequently prescribed bronchodilator to relieve and prevent symptoms of asthma, chronic bronchitis, and emphysema. In smokers, the drug is more rapidly eliminated from the body than in non-smokers, and thus its level in the blood decreases faster, reducing the duration of action. Some heavy smokers may require as much as one and a half to two time the maintenance dose of theophylline. It may take six months to three years to return to normal after smoking is stopped

Propranolol (Inderal Corbeta), Metoprolol (Metolar, Betaloc)

These drugs belongs to the class of beta-blocking agents which are used to control high blood pressure, angina pectoris (severe chest pain), cardiac arrhythmias, migraine headaches, and to improve the chances of survival of the patient after a heart attack. In smokers the drug is cleared faster from the body than in non-smokers, and thus, there is a reduced level of the drug in the blood, resulting in inadequate therapeutic effect.

Pentazocine (Fortwin, Pentawin, Sosegon)

Pentazocine is a pain reliever and is required in larger doses by smokers because of its increased rate of metabolism.

Phenothiazines like chlorpromazine (Largactil), trifluoperazine (Trinicalm, Lacalm), thioridazine (Melleril) are required in larger than usual doses in smokers as compared to non-smokers due to their increased rate of metabolism. The same is true for tricyclic antidepressant drugs like imipramine (Depsonil, Antidep, Tencodep), desipramine (Norpramine), amitriptyline (Sarotena), trimipramine (Surmontil), and doxepin (Spectra).

Sedatives

Sleep-producing and anxiety-relieving agents are affected by smoking. Heavy smokers are known to show markedly diminished effects of drugs such as diazepam (Valium, Calmpose), chlordiazepoxide (Librium), lorazepam (Larpose), and oxazepam (Serepax).

Heparin (Beparine)

This drug prevents the clotting of blood and is important in treating conditions like thromboembolic disease, in which clotted blood fragments threaten to block blood vessels. In smokers the heparin level in the blood decreases 50% more rapidly than in non-smokers.

Frusemide (Lasix, Salinex)

This is a drug used in hypertension and edema, and shows lesser effects amongst smokers.

Vitamins

Smoking has been shown to lower the blood level of the indispensable vitamin B12 (cyanocobalamin) by causing increased urinary excretion. Smokers also metabolise vitamin C faster than non-smokers and thus require about 40% additional dose of the vitamin.

Oral Contraceptives

Women who use oral contraceptives are strongly advised not to smoke. Cigarette smoking Increases the risk of such serious cardiovascular side effects of oral contraceptives such as stroke, heart attack, and sudden blockage of blood vessels (thromboembolism). The risk increases with age and the number of cigarettes smoked per day, and is more marked in women above 35 years of age and those who smoke more than 25 cigarettes a day.

Cessation of Smoking

The relative ineffectiveness of the drugs described above, must be understood in the right Perspective. If you are a smoker and suffer from high blood pressure, heart disease, asthma, or any mental disorder, and taking any of the above drugs, make sure that the adjustment of dosages is done in a proper way.

Only when faced with serious health problems do smokers think seriously of quitting smoking. They are advised to make a serious effort to stop smoking before their problems get out of hand.

There are two treatments which can help smokers quit smoking.

Nicotine Replacement

Nicotine Patch: It is applied over skin and releases nicotine at a rate of 7 to 10 mg in 24 hours. It is employed for about 8 weeks. Nicotine gum containing 2mg and 4 mg per piece is also available in some countries. A nicotine gum preparation (Nulife) containing 1 to 3 mg nicotine is also available.

Drug

Bupropion (Smoquit SR): This antidepressant drug is found to be helpful. Its continuous release form having 150 to 300 mg drug is used once a day and is helpful in quite a number of cases. It can be used along with nicotine patch.

By: Franchis

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