Nicotine Addiction: Pharmacologic Interactions

Cigarette smoking may interact with a variety of other drugs (Table 375-2). Cigarette smoking induces the cytochrome P450 system, which may alter the metabolic clearance of drugs such as theophylline. This may result in inadequate serum levels in smokers as outpatients when the dosage is established in the hospital under nonsmoking conditions. Correspondingly, serum levels may rise when smokers are hospitalized and not allowed to smoke. Smokers may also have higher first-pass clearance for drugs such as lidocaine, and the stimulant effects of nicotine may reduce the effect of benzodiazepines or beta blockers.

Nicotine Addiction

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Revision date: July 4, 2011
Last revised: by Andrew G. Epstein, M.D.