Utjecaj alkohola i duhanskog dima na metabolizam lijekova

master's thesis

• Title (english): Effects of alcohol and tobacco smoke on drug metabolism
• Author: Nikolina Radan
• Mentor: Monika Barbarić (mentor)
• Committee member: Monika Barbarić (predsjednik povjerenstva)
• Committee member: Cvijeta Jakobušić Brala (član povjerenstva)
• Committee member: Ana Karković Marković (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of medicinal chemistry); Zagreb
• Defense date and country: 2024-06-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Nikotin i alkohol, uz kofein, predstavljaju globalno najčešće konzumirane psihoaktivne supstance. Upravo zbog
lake dostupnosti i široke primjene ovih supstanci, ovim diplomskim radom obrađene su klinički značajne
farmakokinetičke i farmakodinamičke interakcije etanola i duhanskog dima s lijekovima.
Alkohol svojim utjecajem na metabolizam stupa u farmakokinetičke interakcije s brojnim lijekovima poput
široko primjenjivanog OTC analgetika – paracetamola što može rezultirati porastom rizika hepatotoksičnosti lijeka.
Također je potrebno izbjegavati kombinacije etanola s određenim lijekova poput metronidazola, izoniazida i
cefalosporina jer takve interakcije mogu rezultirati razvojem „rekcije slične disulfiramu“ koja je popraćena brojnim
nuspojavama. Posebnu pozornost treba obratiti prilikom istovremene primjene alkohola i benzodiazepina, barbiturata,
opioida i antidepresiva zbog pojačanog depresornog učinka na CNS.
Farmakodinamičke interakcije duhanskog dima i lijekova uglavnom su posljedica djelovanja nikotina. Iako su
manje zastupljene od farmakokinetičkih interakcija, potreban je oprez prilikom istovremene konzumacije duhana i nekih
lijekova poput opioida i benzodiazepina. Većina interakcija farmakokinetičke je prirode, a uglavnom su uzrokovane
indukcijom enzima PAH-ovima. Kombinacije duhanskog dima s opiodima, antidepresivima, antikoagulansima,
antipsihoticima, kofeinom, teofilinom dovode do ubrzanog metabolizma i smanjenih učinaka takvih lijekova, stoga je
često potrebna prilagodba doze lijekova tijekom njihove uporabe te nakon prestanka terapije.

Abstract (english)

Nicotine and alcohol, along with caffeine, represent the most commonly consumed psychoactive substances
globally. Due to easy availability and wide use of these substances, this graduation thesis deals with clinically significant
pharmacokinetic and pharmacodynamic drug interactions with ethanol and tobacco smoke.
Alcohol causes pharmacokinetic interactions by affecting metabolism of numerous drugs such as the widely
applicable OTC analgesic - paracetamol, which can cause increased risk in hepatotoxicity of the drug. It is also necessary
to avoid combinations of ethanol with certain medications such as metronidazole, isoniazid and cephalosporins because
such interactions can result in the development of a "disulfiram-like reaction" which is accompanied by numerous side
effects. Special attention is required while using alcohol alongside with benzodiazepines, barbiturates, opioids and
antidepressants owing to the increased depressant effect on the CNS.
Pharmacodynamic drug interactions with tobacco smoke are largely due to nicotine. Although they are less
common than pharmacokinetic interactions, caution is required when using tobacco and some medications, at the same
time, such as opioids and benzodiazepines. Most of the interactions are of a pharmacokinetic nature, and are mainly
caused by the induction of enzymes by PAHs. Combinations of tobacco smoke with opioids, antidepressants,
anticoagulants, antipsychotics, caffeine, theophylline can lead to an accelerated metabolism and reduced effects of such
drugs, so it is often necessary to adjust the dose of these medications during therapy and after stopping the use of these
drugs.

• Keywords: alkohol; etanol; lijek; interakcija; duhanski dim; pušenje; nikotin; metabolizam; biotransformacija
• Keywords (english): alcohol; ethanol; drug; interaction; tobacco smoke; smoking; nicotine; metabolism; biotransformation
• Language: croatian
• URN:NBN: urn:nbn:hr:163:148352
• Study programme: Title: Pharmacy - integrated undergraduate and graduate - university study; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: sveučilišni magistar farmacije (sveučilišni magistar farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-07-26 11:26:59