Treating patients with respiratory disease who smoke.
The high prevalence of cigarette smoking in patients with respiratory disease puts them at risk of developing clinically important drug interactions. Cigarette smoking reduces the therapeutic response to certain drugs such as theophyllines through the induction of hepatic cytochrome P450 isoenzymes. Smokers with asthma and patients with COPD have reduced sensitivity to corticosteroids, possibly due to non-eosinophilic airway inflammation, altered glucocorticoid receptor activity or reduced histone deacetylase activity. Although all smokers should be encouraged to stop smoking, there is limited information on the influence of smoking cessation on the therapeutic and anti-inflammatory effects of a number of the drugs used in the treatment of respiratory disease.
Braganza
Georgina
G
Department of Respiratory Medicine, Division of Immunology, Infection & Inflammation, University of Glasgow, Glasgow, UK.
Chaudhuri
Rekha
R
Thomson
Neil C
NC
D000305:Adrenal Cortex Hormones / Q000493:pharmacokinetics; D000318:Adrenergic beta-Agonists / Q000493:pharmacokinetics; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics; D016587:Antimutagenic Agents / Q000493:pharmacokinetics; D001993:Bronchodilator Agents / Q000493:pharmacokinetics; D019388:Cytochrome P-450 CYP1A2 / Q000378:metabolism; D004347:Drug Interactions; D004351:Drug Resistance; D006801:Humans; D020024:Leukotriene Antagonists / Q000493:pharmacokinetics; D008099:Liver / Q000201:enzymology; D008171:Lung Diseases / Q000188:drug therapy*; D055118:Medication Adherence; D010726:Phosphodiesterase Inhibitors / Q000493:pharmacokinetics; D012907:Smoking / Q000009:adverse effects*; D013806:Theophylline / Q000493:pharmacokinetics
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D000900:Anti-Bacterial Agents; D016587:Antimutagenic Agents; D001993:Bronchodilator Agents; D020024:Leukotriene Antagonists; D010726:Phosphodiesterase Inhibitors; D013806:Theophylline; D019388:Cytochrome P-450 CYP1A2