Pharmacokinetic Drug Interactions with Tobacco, Cannabinoids and Smoking Cessation Products

Anderson, Gail D.; Chan, Lingtak Neander

doi:10.1007/s40262-016-0400-9

Cited by 126 publications

(118 citation statements)

References 130 publications

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“…This could explain why our results for these drugs may differ from the others. Another explanation that cannot be excluded is reduced cigarette smoking during pregnancy, which would also result in decreased CYP1A2 activity 19. Unfortunately, information on smoking habits was not available in our dataset.…”

Section: Discussionmentioning

confidence: 97%

Treatment With Antipsychotics in Pregnancy: Changes in Drug Disposition

Westin

Brekke

Molden

et al. 2017

Clin Pharma and Therapeutics

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Although pregnancy is known to cause changes in drug pharmacokinetics, little is known about its impact on serum levels of antipsychotics. In this study we retrospectively assessed 201 routine serum antipsychotic therapeutic drug monitoring concentration measurements obtained from a total of 110 pregnancies in 103 women, and 512 measurements from the same women before and after pregnancy. Serum concentrations in the third trimester were significantly lower than baseline for quetiapine (−76%; confidence interval (CI), −83%, −66%; P < 0.001) and aripiprazole (−52%; CI, −62%, −39%; P < 0.001), but not for olanzapine (−9%; CI, −28%, +14%; P = 0.40). For the remaining antipsychotics (perphenazine, haloperidol, ziprasidone, risperidone, and clozapine), our dataset was limited, but it indicates that concentrations may decline at least for perphenazine and possibly also for haloperidol. Even though the clinical consequence of the serum concentrations decline remains to be elucidated, our results warrant close clinical monitoring throughout pregnancy, preferentially supported by therapeutic drug monitoring.

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Section: Discussionmentioning

confidence: 97%

Treatment With Antipsychotics in Pregnancy: Changes in Drug Disposition

Westin

Brekke

Molden

et al. 2017

Clin Pharma and Therapeutics

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“…Furthermore, within distinct ethnic groups, smoking tobacco has been implicated as an independent risk factor for the development and progression of CKD [49,57,58]. From a pharmacology perspective, tobacco smoke induces several hepatic drug metabolizing enzyme isoforms such as CYP1A1, CYP1A2, and CYP2E1 [59,60], and therefore may have an effect on pharmacokinetic profiles. CYP modulation is not just limited to tobacco use, as marijuana consumption is also implicated in altering CYP activity.…”

Section: Smoking Statusmentioning

confidence: 99%

Update and trends on pharmacokinetic studies in patients with impaired renal function: practical insight into application of the FDA and EMA guidelines

Paglialunga

Offman

Ichhpurani

et al. 2017

Expert Review of Clinical Pharmacology

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Introduction: The incidence of kidney dysfunction increases with age and is highly prevalent among patients with hypertension. Since many therapeutic compounds are primarily eliminated through the kidneys, impaired renal function can have negative consequences on drug disposition, efficacy and safety. Therefore, regulatory agencies such as the Food and Drug Administration (FDA) and European Medicines Agency (EMA) have issued detailed guidelines for new drug applications to determine posology requirements for patients with renal impairment. Areas covered: The current review highlights and contrasts agency requirements for pharmacokinetic renal impairment clinical studies. While many of the guidelines are similar among the two agencies, glomerular filtration rate (GFR) determination and reporting differ. Design considerations for a reduced, full or dialysis renal impairment study, as well as modifications to the FDA's draft guidance are discussed. Furthermore, scenarios where pharmacokinetic modelling analysis can benefit a drug development program are also reviewed. Moreover, practical solutions for patient recruitment challenges are addressed. Expert commentary: We summarize how 'one size does not fit all' for GFR assessment, and recommend when to use certain modalities. Finally, we highlight the need for the pharmaceutical industry to engage therapeutic experts to assist in protocol development for renal impairment studies, as these experts understand the nuances of this special population and recommended guidelines. ARTICLE HISTORY

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“…Although neither thc nor cbd are inducers of cyp enzymes, both are inhibitors of a number of those enzymes, most notably 3A4, the enzyme that has the largest number of commonly used medical drugs as substrates 22 . Smoked cannabis has been noted to induce cyp 1A2 24 .…”

Section: Cannabinoid Pharmacologymentioning

confidence: 99%

A User’s Guide to Cannabinoid Therapies in Oncology

Maida

Daeninck

2016

Current Oncology

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ABSTRACT"Cannabinoid" is the collective term for a group of chemical compounds that either are derived from the Cannabis plant, are synthetic analogues, or occur endogenously. Although cannabinoids interact mostly at the level of the currently recognized cannabinoid receptors, they might have cross reactivity, such as at opioid receptors.Patients with malignant disease represent a cohort within health care that have some of the greatest unmet needs despite the availability of a plethora of guideline-driven disease-modulating treatments and pain and symptom management options. Cannabinoid therapies are varied and versatile, and can be offered as pharmaceuticals (nabilone, dronabinol, and nabiximols), dried botanical material, and edible organic oils infused with cannabis extracts. Cannabinoid therapy regimens can be creative, involving combinations of all of the aforementioned modalities. Patients with malignant disease, at all points of their disease trajectory, could be candidates for cannabinoid therapies whether as monotherapies or as adjuvants.The most studied and established roles for cannabinoid therapies include pain, chemotherapy-induced nausea and vomiting, and anorexia. Moreover, given their breadth of activity, cannabinoids could be used to concurrently optimize the management of multiple symptoms, thereby reducing overall polypharmacy. The use of cannabinoid therapies could be effective in improving quality of life and possibly modifying malignancy by virtue of direct effects and in improving compliance or adherence with disease-modulating treatments such as chemotherapy and radiation therapy.

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Pharmacokinetic Drug Interactions with Tobacco, Cannabinoids and Smoking Cessation Products

Cited by 126 publications

References 130 publications

Treatment With Antipsychotics in Pregnancy: Changes in Drug Disposition

Treatment With Antipsychotics in Pregnancy: Changes in Drug Disposition

Update and trends on pharmacokinetic studies in patients with impaired renal function: practical insight into application of the FDA and EMA guidelines

A User’s Guide to Cannabinoid Therapies in Oncology

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