Рациональная фармакотерапия в кардиологии (Dec 2015)
DRUGS AND SMOKING
Abstract
Smoking is a well – known risk factor of many diseases. It influences the efficacy and safety of drug treatment by affecting the course of different physiological processes and modifying the metabolism of drugs. The number of researches showed decrease in efficacy of some cardiovascular drugs in smokers.Aim. To compare efficacy and safety of selective and non-selective beta–adrenoceptor blockers in smokers and nonsmokers with chronic ischemic disease.Material and Methods. Antianginal efficacy of drugs in patients of both groups was evaluated by burden tests on treadmill, effective doses of bisoprolol and propranolol were adjusted.Results. The result shows that smokers two times more often need prescription of double doses of drugs. Depressed antianginal activity of both beta-adrenoceptor blockers, especially of non-selective propranolol, in smokers was revealed. When evaluating the parameters of spirography, it was found that non-selective beta-adrenoceptor blocker propranol statistically significant decreases figures of bronchial passage, irrespective of the status of smoking. Moreover, with propranol treatment, bigger number of side effects is registered in both groups, demonstrating 30% more in smokers compared to nonsmokers.Conclusion. Smoking attenuates efficacy and safety of beta-blockers, especially these of non-selective ones.
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