Drugs and smoking.
Generally, one should keep in mind that if a smoker takes a drug that is metabolized primarily by the CYP 1A2 system, an increased dose may be required. The patient should be closely monitored if he or she is taking several medications that may inhibit or induce the CYP 1A2 isoenzyme. Hepatic enzyme metabolism does not completely explain the effects of smoking on drugs, however, because smokers may have different physiologic responses to pain and sedation that depend on changes in plasma protein binding and in the rate and efficacy of subcutaneous absorption. Most of the few sex/gender-analyzed pharmacokinetic studies in smokers occurred after 1995. It appears that the 1993 changes at the National Institutes of Health and the Food and Drug Administration regarding inclusion of women in clinical trials enabled these examinations to take place. Because smokers--who make up nearly a quarter of the U.S. adult population--tend to consume more medications than nonsmokers, this social habit should be considered one of the most important to impact on drug metabolism in both sexes.
College of Pharmacy, University of Iowa, 115 S Grand, Room 118, Building PHAR, Iowa City, IA 52242, USA.
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D019388:Cytochrome P-450 CYP1A2 / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D010599:Pharmacokinetics; D012727:Sex Characteristics; D012907:Smoking / Q000378:metabolism*; D016540:Smoking Cessation
D019388:Cytochrome P-450 CYP1A2