Drug interactions and smoking: raising awareness for acute and critical care providers.
Because the prevalence of smoking in the United States remains significantly high, it is important to determine a patient's smoking status and perform a complete medication history to assess for potential drug interactions with smoking. Tobacco smoke can increase the hepatic metabolism and can oppose the pharmacologic effects of certain drugs. This article reviews the clinically significant drug interactions, resulting primarily from the induction of cytochrome P450 enzymes by tobacco smoke, of which all acute and critical care providers need to be aware when making therapeutic decisions and recommendations.
Kroon
Lisa A
LA
Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, 521 Parnassus Avenue, San Francisco, CA 94143, USA. lkroon@itsa.ucsf.edu
D000208:Acute Disease; D000319:Adrenergic beta-Antagonists / Q000378:metabolism; D000701:Analgesics, Opioid / Q000378:metabolism; D000889:Anti-Arrhythmia Agents / Q000378:metabolism; D000893:Anti-Inflammatory Agents / Q000378:metabolism; D000925:Anticoagulants / Q000378:metabolism; D002110:Caffeine / Q000378:metabolism; D003422:Critical Care / Q000379:methods; D019388:Cytochrome P-450 CYP1A2 / Q000378:metabolism; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism; D004347:Drug Interactions; D016903:Drug Monitoring; D004351:Drug Resistance; D006801:Humans; D008099:Liver / Q000378:metabolism; D008657:Metabolic Clearance Rate; D024802:Nurse's Role; D009730:Nursing Assessment; D015995:Prevalence; D011619:Psychotropic Drugs / Q000378:metabolism; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology / Q000378:metabolism*; D013806:Theophylline / Q000378:metabolism; D014481:United States / Q000453:epidemiology
D000319:Adrenergic beta-Antagonists; D000701:Analgesics, Opioid; D000889:Anti-Arrhythmia Agents; D000893:Anti-Inflammatory Agents; D000925:Anticoagulants; D011619:Psychotropic Drugs; D002110:Caffeine; D003577:Cytochrome P-450 Enzyme System; D013806:Theophylline; D019388:Cytochrome P-450 CYP1A2