Drugs Interaction With Smoking: Literature Review

Harmful effect of smoking on human health is a common theme in medical lit­erature. However, drugs interaction with smoking is of the same importance. Ciga­rette smoking alters the pharmacokinet­ics and pharmacodynamics of medicines. Polycyclic aromatic hydrocarbons of ciga­rette smoke are not only carcinogens but also increase the activity of cytochrome P450 isoenzymes such as CYP1A1, CYP1A2, CYP2B6 and possibly CYP2E1. Most of the drugs are substrates of CYP1A2, therefore smoking can gradually speed up their metabolism. Components of smoke can interact with the vast majority of medicines but the interactions of clinical importance are with antipsychotic drugs, antidepressant drugs, benzodiazepines, opioid drugs, antiplatelet drugs, anticoagu­lants, p-adrenoceptor antagonists, com­bined oral contraceptives, insulin, antican­cer drugs and medicines used to treat rheu­matoid arthritis. When the treatment ap­plied is not efficacious, it is necessary to rule out the effect of intensive and long - lasting smoking. There are no current systemic recommendations how to assess and control drugs interaction with smok­ing. Nevertheless, it is important to un­derstand and estimate the mechanisms of this interaction in a daily practice of a doc tor re gard less of his spe cial ity to choose drugs and doses properly and to achieve therapeutical goals. The literature review on drugs and smoking interaction goes below