KC dentists discuss the concerns of smoking and drug metabolism with their patients.
Smokers are warned there is a higher potential for dry sockets than there is for nonsmokers.
Literature reports some drugs interact with cigarette smoking.
Theophylline present in tea leaves, or produced synthetically is used in medicine especially as a bronchodilator, to relieve or prevent symptoms of asthma and bronchospasm, associated with chronic bronchitis and emphysema.
This smooth muscle relaxant has contraindications to not be used where there is hypertension, cardiac disease, liver disease, renal disease, or concurrent treatment with other xanthines that may prohibit its use.
Xanthine derivatives are agents that resemble natural occurring xanthines such as caffeine, theobromine and methyl-xanthines. These are plant alkaloids and components of coffee, tea and chocolate.
Chronic smoking causes on many occasions the problems requiring broncho-dilation.
Theophylline is eliminated more quickly in smokers than non-smokers.
With faster elimination of theophylline from the body, it becomes difficult to relieve or prevent symptoms of asthma and bronchospasm.
Cigarettes also induce an increase of the isoenzyme CYP, responsible for metabolism of theophylline.
As a result of hepatic induction of CYP, serum concentrations of theophylline have been shown to be reduced in smokers.
Patients with insulin dependent diabetes who smoke heavily, may require a heavier dose of insulin than nonsmokers.
Propoxyphene, a pain reliever, has been found to be less effective in heavy smokers than nonsmokers.
Propanolol is a prescription drug that treats hypertension, angina(chest pain), irregular heartbeat, migraine headaches, tremors, lowers risk of repeated heart attacks, anxiety and panic attacks.
Propanolol followed by heavy smoking, significantly decreased cardiac output, significantly increased blood pressure and peripheral resistance of blood flow.
Anti-anxiety agents such as diazepam showed that drowsiness was less likely to occur in smokers than nonsmokers.
Smoking probably acts by producing arousel of the central nervous system instead of the desired effect drowsiness.
Acceleration of the metabolism reduces concentrations of the drug in the blood stream.
The correlation between women older than 35 smoking 15 cigarettes daily on oral contraceptives is very complex.
Oral contraceptives in this age group may place the woman at an increased risk of myocardial infarction.
Smoking and drug metabolism is a concern in the dental office where doses of prescription drugs should be monitored closely.
From the Diary of my enlightenment,
A.L. Clark, D.D.S. http://dentist4you.biz
Reference: Drug Information Handbook For Dentistry 14th Edition by Lexi-Comp