Medication adjustments

Physical healing of the body and mind

Medication adjustments

Joel
Joel

July 19th, 2001, 9:39 pm #1

Often when people quit smoking they may find that medications that were adjusted for them while smoking may be altered in effectiveness once quitting. People on hypertensives, thyroid, depression, blood sugar drugs, and others may need to get re-evaluated for proper dosages once quitting.


The first few days quitting can be very difficult to determine, what is a "normal" withdrawal and what is a medication dosage issue. But once through the first few days, if a person who is on medications for medical disorders finds him or herself having physical symptoms that just seem out of the ordinary, he or she should speak to the doctor who has him or her on the medications. Point out to the doctor that you have recently quit smoking and started to notice the specific symptoms just after quitting and that they haven't improved over time. The doctor should know the medication and potential interaction that not smoking may be adjusting for and which way the dosing may need to altered.


Treating many conditions is a partnership between you and your physician. The doctor needs your input to effectiveness of any treatment, whether it be by physical measurements or by verbally communicating how you feel while under treatment. The treatment for one condition though is your primary responsibility. The condition--nicotine addiction. It is by no means a minor medical issue, it is in fact probably the greatest controlable health threat anyone will ever face. Afterall, what other lifestyle issues carry a 50% premature mortality rate? Not to mention all the other crippling side effects that go along with long-term smoking. The treatment for this condition is your primary responsibility. To effectively treat smoking for the rest of your life simply remember to never take another puff!



Joel




Related video:


Medication adjustments that may be necessary after smoking cessation
Last edited by Joel on July 26th, 2013, 5:25 pm, edited 2 times in total.
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Hal(Gold)
Hal(Gold)

July 21st, 2001, 3:56 am #2

Excellent information Joel. I read of a study in England where nicotine causes smokers who drink have to drink more to feel the alcohol impact on the body. I have found that at almost 8 months quit I can feel the effects after drinking half of a glass of scotch and soda. It used to take two glasses. The study also stated that because of this impact smokers face more problems with alcohol than non or ex smokers.
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John (Gold)
John (Gold)

November 22nd, 2001, 4:22 am #3

Joel, I ran across the below article today which I found fascinating. I hadn't realized that estrogen directly regulated dopamine production. I guess that quitters on estrogen replacement threapy may fit into your "medication adjustment" group should mood symptoms/depression persist beyond the normal psychological loss (your phases of death article) that often accompanies quitting. Am I correct?
Try this on: What do bupropion, nicotine, estrogen and cocaine all have in common? Answer - They all elevate dopamine output. Wild!
Estrogen, women and addiction
WASHINGTON, Nov. 19 (UPI) -- It's long been noted that women have a harder time quitting smoking than men. Now new research by a University of Michigan bio-psychologist suggests that estrogen makes the brain more susceptible to addiction.[/size]
Moreover, the effects persist even in the hormone's absence.
All "drugs of abuse," including opiates and nicotine, ultimately activate the "ascending dopamine system" and the brain's pleasure center, Jill Becker told United Press International. She is a visiting professor on a year's sabbatical at Emory University in Atlanta.
The pleasurable effects of increased dopamine, and the craving to repeat it, help create addiction.
When women develop a nicotine addiction, "they have estrogen on board." Because the brain is sensitized, the craving for nicotine would be more pronounced and would continue even when estrogen levels are low.
Some of Becker's earlier research had shown that estrogen supplementation in female rats rapidly increased both dopamine release in response to amphetamines and cocaine and behavior known to be associated with the drugs.
Becker later found that female rats who received estrogen as well as cocaine exhibited more signs of such "sensitization" than either female rats that did not receive estrogen or male rats.
Rats who are sensitized after repeated drug doses learn to self-administer cocaine faster and at lower doses than other animals. These behavioral changes persisted after the female rats, all of whose ovaries had been surgically removed, stopped receiving estrogen, Becker reported on Nov. 14 at the 2001 meeting of the Society for Neuroscience in San Diego.
"We know from other studies that sensitization to cocaine results in structural changes in the brain that persist for some time," Becker said.
How can these observations be tied in with evolutionary theory? For female rats, at least, estrogen's role in boosting dopamine is involved in their motivation for engaging in sexual behavior and their reproductive success.
"My lab has demonstrated that estrogen has rapid effects that boost the amount of dopamine released," Becker said. "These effects are evident in sexual behavior, as well as compulsive drug-seeking. Dopamine levels increase when a female rat is engaging in sexual behavior that she finds rewarding, and for female rats, not all sex is rewarding."
According to sociobiological theory, the reproductive goals of both sexes are the same -- both want to produce the greatest number of viable offspring. The strategies for achieving that goal, however, are different.
"Males can do that most effectively by inseminating a large number of females," Becker told UPI. "So it's more adaptive for them to be able to ejaculate as rapidly as possible. Their system is designed for that."
Females, on the other hand, have a relatively greater investment in the production of eggs. "And so what they want to do is make sure that every time they ovulate, they get pregnant in order to maximize their reproductive success."
Male rats apparently prefer intromission every 30 seconds, followed by rapid ejaculation, she said, while females prefer a slower pace, with one or two minutes between intromissions. This pace activates a series of synaptic pathways in the female's brain that triggers the release of prolactins necessary for successful pregnancy.
If a female rat "paces" her sexual behavior, she increases her chances of getting pregnant from 60 percent to 90 percent.
Becker and colleagues have found that estrogen increases the behaviors that females engage in to slow male rats down. "So, the effects of estrogen to enhance sexual motivation may underlie the effects of estrogen on drug sensitization and addiction," Becker said.
Although the evidence is strong that estrogen makes the brain of the human female more susceptible to certain forms of addiction, it is not clear whether this relates to human sexual practices and reproduction. When it comes to addiction, however, Becker warned that estrogen's effects are very rapid.
Normally, estrogen action at receptors in the hypothalamus and uterus takes hours to days to produce a behavioral or functional response, she told UPI. "This happens within seconds or minutes."
"This is important because the way we have been thinking about how estrogen and other steroid hormones act in the brain in terms of depression and other mental health problems may need to be revised as we begin to appreciate that these hormones are acting throughout the brain in ways that we haven't appreciated before," she said.
"The receptors that everyone is looking for, including me, once they are found will help us find new ways of dealing with not only drug abuse but other mental health problems such as depression, where women have a much higher incidence."
Becker warned that women -- especially younger women who may be experiencing major hormonal swings at just the same time in their lives when many of their peers are first experimenting with nicotine, cocaine and other addictive substances -- should be extremely cautious when it comes to drug use. Older women using hormone replacement therapy may also increase their vulnerability to drug addiction.
Copyright 2001 by United Press International.
All rights reserved.
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Joanne Gold
Joanne Gold

November 22nd, 2001, 9:44 am #4

Interesting observation, John! A brain chemical, serotonin, is known to fluctuate during a females monthly cycle due to hormonal changes. Many woman (I know I was and many others have posted the same) are concerned and more cautious during their early quit and notice more of a challenge during "that time". I know it took some getting used to for me. Since this is true, you may be right - those on estrogen therapy for other hormal conditions may want to consult their physician to make sure their levels are up to par upon smoking cessation.

Here is a little excerpt from AOL's health section on PMS and its possible causes:
".....Another cause may be fluctuations of serotonin, a brain chemical that affects mood states, especially depression."
Thanks for the information. Very interesting indeed.

Joanne
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CTinoco
CTinoco

August 17th, 2002, 4:33 pm #5

I AM VERY GRATEFUL FOR FREEDOM.....I HAVE BEEN WITHOUT A COMPUTER FOR DAYS....AND I MISSED READING AND POSTING, BUT THANK YOU GOD AND FREEDOM I AM NICOTINE FREE FOR 6 MONTHS 1WEEK AND 3 DAYS...JOEL...THANK YOU FOR THE INFORMATION YOU GIVE US .....
HUGS TO ALL,
CLAUDIA
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kiki
kiki

January 22nd, 2003, 11:58 pm #6

Thank you Joel- and the others new friends who have replied - to guide me on the right path. I just called my doctor and explained the situation and now will call my stomach doctor- who originally perscribed the medication for my reflux.Will also call my dentist for th throbbing gums. You guys are alright! Helping others to overcome this deadly habit of smoking.
Thank you
kiki
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Red Orris
Red Orris

May 14th, 2003, 9:02 pm #7

This is very important, I am on medications,
although it doesn't seem like there is a need
for adjusting my meds, it is so important
regardless, i believe to notify your doctor
about quitting smoking.

Thanks for re-posting this!

Sincerely
Red-Orris
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Red Orris
Red Orris

June 16th, 2003, 11:03 pm #8

Well, now just over a month later.

Infact my medications did need adjusting!

Just wanted to update!

Sincerely
Red-Orris
1month (s) 2week(s) 6 day(s) 11:35 hour (s) smoke-free,
1,256 cigarettes not smoked, $401.92 saved,
4day (s) 8:40 life saved
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BubblyDoodlebug Gold
BubblyDoodlebug Gold

June 17th, 2003, 1:59 am #9

I have had to have my meds adjusted. I found out it is very important to let your doctor know if you are being treated for not only Diabetes but other things as well that you are planning on quitting smoking that way when things do go awry the doctor will have a heads up on the situation. Don't wait to pass out on the toilet to get help either. Katherine
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ChangingDeidre
ChangingDeidre

July 10th, 2003, 12:51 pm #10

Your words are something I already know, but I still needed to be told.
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Coolmare2green
Coolmare2green

October 16th, 2003, 7:26 am #11

Hi Joel (or whomever else may have this info )---i have been reading up on withdrawal symptoms, and the possibility that the newly nic-free individual may need medication adjustments. thyroid was mentioned, and i'm assuming that would be hormone replacement therapy. i have been on thyroid hormone for years, and seem to suffer some pretty late onset symptoms. don't worry, i'm not asking for med advice-----i would just like to be pointed to the source of this info, so that when i see my endocrinologist next week, i'll be well informed-----especially in case he isn't.
Thanks
Mary
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Joel
Joel

October 16th, 2003, 8:13 am #12

Has Your Thyroid Been Checked?
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Coolmare2green
Coolmare2green

October 16th, 2003, 8:55 am #13

Thanks Joel--- will let you know the outcome.
Mary
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cherylmcc
cherylmcc

September 1st, 2004, 3:28 am #14

For Robs all puffed out.

Hope this helps, it helped me.

Cheryl - Free and Healing for Two Months, Thirty Days, 15 Hours and 57 Minutes, while extending my life expectancy 6 Days and 8 Hours, by avoiding the use of 1833 nicotine delivery devices that would have cost me $414.05.
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Kristen Goldx3
Kristen Goldx3

January 10th, 2006, 10:09 pm #15

This thread is important for anyone who is on a maintenance drug for long-term medical conditions. Please see your doctor if you have any issues or questions about your condition and if perhaps you might require a dosage adjustment based upon any symptoms you might have.

Kristen
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Mike851
Mike851

April 11th, 2006, 11:26 pm #16

Just as a sidenote...............As much improved as I have felt after quitting on 13th Feb, I decided to go to the Doctor's to get checked out..........He took my blood pressure and found it was high so I'm going back for a FULL medical after Easter including lung xray as I told him about my quit.

I'm a bit nervous about this, but I'm not going to bury my head in the sand and heaven knows what my blood pressure was like when I was smoking!!!


Mike W....No nicotine since 13th Feb
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Joel
Joel

December 8th, 2006, 3:36 am #17

Treating many conditions is a partnership between you and your physician. The doctor needs your input to effectiveness of any treatment, whether it be by physical measurements or by verbally communicating how you feel while under treatment. The treatment for one condition though is your primary responsibility. The condition--nicotine addiction. It is by no means a minor medical issue, it is in fact probably the greatest controlable health threat anyone will ever face. Afterall, what other lifestyle issues carry a 50% premature mortality rate? Not to mention all the other crippling side effects that go along with long-term smoking. The treatment for this condition is your primary responsibility. To effectively treat smoking for the rest of your life simply remember to never take another puff!

Joel
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John (Gold)
John (Gold)

September 22nd, 2007, 9:09 am #18


Clinical Review
Drug interactions with smoking
Am J Health Syst Pharm. 2007 September 15;64(18):1917-21.
Kroon LA.

Department of Clinical Pharmacy, School of Pharmacy, University of California San Francisco, 3333 California Street, Suite 420, Box 0613, San Francisco, CA 94118, USA. [url=mailto:kroonl@pharmacy.ucsf.edu]kroonl@pharmacy.ucsf.edu[/url]
Abstract

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 quits smoking, an important consideration is how quickly the induction of CYP1A2 dissipates. The primary pharmacokinetic interactions with smoking occur with drugs that are CYP1A2 substrates, such as caffeine, clozapine, fluvoxamine, olanzapine, tacrine, and theophylline. Inhaled insulin's pharmacokinetic profile is significantly affected, peaking faster and reaching higher concentrations in smokers compared with nonsmokers, achieving significantly faster onset and higher insulin levels. The primary pharmacodynamic drug interactions with smoking are hormonal contraceptives and inhaled corticosteroids. The most clinically significant interaction occurs with combined hormonal contraceptives. The use of hormonal contraceptives of any kind in women who are 35 years or older and smoke 15 or more cigarettes daily is considered contraindicated because of the increased risk of serious cardiovascular adverse effects. The efficacy of inhaled corticosteroids may be reduced in patients with asthma who smoke.

CONCLUSION: Numerous drug interactions exist with smoking. Therefore, smokers taking a medication that interacts with smoking may require higher dosages than nonsmokers. Conversely, upon smoking cessation, smokers may require a reduction in the dosage of an interacting medication.
http://www.ajhp.org/cgi/content/abstract/64/18/1917
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Joined: January 16th, 2003, 8:00 am

August 12th, 2008, 5:59 am #19

Zero Medical Advice Policy :


Zero Medical Advice Policy This site is not meant to replace the advice of any physician. Do not rely upon any information that you read here at Freedom (or that you obtain through posts, email or links) to replace consultations or advice received by qualified health professionals regarding your own specific situation. The information provided here at Freedom is intended as nicotine cessation educational material only and it should NEVER be construed as medical advice.

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Last edited by Sal GOLD.ffn on March 12th, 2009, 11:54 pm, edited 1 time in total.
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Joined: November 13th, 2008, 2:04 pm

March 12th, 2009, 9:58 pm #20

From above:

I saw a post up earlier asking when a person returns to "normal" after quitting. This string addresses the issue of what is "normal." "Normal" levels for certain people of certain neurotransmitters or hormones or other chemicals may not be what is normal or the right amount of these substances. That is why symptoms lasting longer than a few days should never be simply ignored or written off to longer term withdrawal. Prolonged symptoms should be medically evaluated to insure that the individual is indeed normal for various conditions.
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Joined: November 13th, 2008, 2:04 pm

August 5th, 2011, 11:12 am #21

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Joined: November 13th, 2008, 2:04 pm

August 5th, 2011, 11:13 am #22

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Joined: November 13th, 2008, 2:04 pm

October 24th, 2011, 4:45 pm #23

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Joined: November 13th, 2008, 2:04 pm

February 16th, 2012, 8:01 pm #24

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jbnc7227
jbnc7227

May 20th, 2012, 12:16 pm #25

I appreciate the very informative article regarding the relationship between addiction and estrogen..but I have a question:  As of today, I have been free of cigarettes/nicotine for 1 week.  I started smoking at 19 and quit at 44, so I have smoked for most of the years I have been alive. 

I had my normal period which ended 10 days ago, then suddenly, yesterday, I started.  I have never been irregular my whole life...in fact, I could have set a clock by my cycle. LOL  I just wonder if my body is reacting to nicotine withdrawal by starting my period like 20 days early, and if anyone else has experienced this.  Thanks!

p.s. This site is responsible for my best attempt at quitting ever.  This time, I am NTAP!
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