PURPOSE The mechanisms for drug interactions with smoking and clinically significant pharmacokinetic and pharmacodynamic drug interactions with smoking are reviewed. SUMMARY Polycyclic aromatic hydrocarbons (PAHs) are some of the major lung carcinogens found in tobacco smoke. PAHs are potent inducers of the hepatic cytochrome P-450 (CYP) isoenzymes 1A1, 1A2, and, possibly, 2E1. After a person...

The effectiveness of, and increasing indications for, the use of inhaled corticosteroids in asthma of varying severity prompts important questions to be raised relating to safety and the possibility of adverse systemic steroid effects. This concern is not new and has already resulted in guidelines on the use of spacer devices for high dose inhaled steroids in order to decrease systemic absorpti...

Background: Chronic obstructive pulmonary disease (COPD) is a major health dilemma and cause of morbidity and mortality in either industrialized or developing countries and inhaled corticosteroids are widely used worldwide in these patients. In this systematic review, we aimed to analyze the effectiveness of these gents compared to placebo. Methods: Pubmed and Google Scholar literature search ...

TI significantly reduced HbA1c by20.8% (29.0 mmol/mol) from a baseline of 8.3% (66.8 mmol/mol) compared with TP 20.4% (24.6 mmol/mol) (treatment difference 20.4% [95% CI 20.57, 20.23]; P < 0.0001). More TI-treated subjects achieved an HbA1c £7.0% (53.0 mmol/mol) (38% vs. 19%; P = 0.002). Mean fasting plasma glucosewas similarly reduced in both groups. Postprandial hyperglycemia, based on 7-poin...

OBJECTIVE To compare the intrapatient variability of the pharmacokinetic and pharmacodynamic responses to inhaled regular insulin (INH) delivered via the Aerodose Insulin Inhaler with that of subcutaneously injected regular insulin (SC) in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS A total of 15 patients with type 2 diabetes (nonsmokers, 10 men, aged 47-77 years) received two ...

The cough reflex has been investigated in insulin dependent diabetic patients with and without autonomic neuropathy. The cough response to inhaled citric acid was determined in eight patients with diabetes who had severe autonomic neuropathy and compared with that in 10 who had no evidence of neuropathy. The patients with autonomic neuropathy had a higher median threshold for the cough response...

Airway smooth muscle (ASM) plays a key role in the development of airway hyperresponsiveness and remodeling in asthma, which may involve maturation of ASM cells to a hypercontractile phenotype. In vitro studies have indicated that long-term exposure of bovine tracheal smooth muscle (BTSM) to insulin induces a functional hypercontractile, hypoproliferative phenotype. Similarly, the extracellular...

INTRODUCTION Previous studies have shown that patients with diabetes mellitus appear to have a lower prevalence of acute lung injury. We assumed that insulin prescribed to patients with diabetes has an anti-inflammatory property and pulmonary administration of insulin might exert beneficial effects much more than intravenous administration. METHODS Twenty-eight mechanically ventilated rabbits...