参考chapter 2不良反应

ChapterChapterpartWangDepartmentofPharmacology ChapterGradedDose-response--studyofthebiochemicalandphysiologicaleffectsofdrugsandtheirmechanismsofactionbiochemicalorexcitingorinhibitingEpinephrineAction=MolecularSpecificitySelectivityhighselectivity-lesslowselectivity-moreeeEffect=PhysiologicalClinicalCardiacSelectivitySelectivityP.GlandsBlooddrymouthmydriasispasmodicheartrate dysphorialowselectivity-more eClinicalUses Side CarcinogenesisToxicreaction毒性作用MutagenesistogenesisAfter WithdrawalreactionAllergicreaction反Idiosyncrasy ToxicreactionWithdrawalSideeffectAllergicreactionIdiosyncrasyMTC(Minimumtoxicityconcentration)MEC(Minimumeffectiveconcentration)AfterdrugP.anyresponsetodrugthatisnoxiousunintendedandthatoccursatdosesusedinmanforprophylaxis预防diagnosisortherapyofadisease,orforthemodificationofphysiologicalfunction（definitionbynotpreventableeventoccurringinthenormaltherapeuticuseofadruganyreactionthatisunexpected,undesirable,andoccursatdosesnormallyusedTypesTypesofAdverse1.Sideeffect副作 P.--occuratthetherapeuticdose,don’trelatetotherapeuticaim,areinherenteffectsofdrug,butnondeleterious2.Toxicreaction--noxiouseffectsinducedbyoverdosageofdrugsoraccumulationoflargeamountofdrugsToxicreactionoccuratusingasingledoseorlargeamountofdrugs, aydamagethefunctionsofcirculatorysystem,respiratorysystemandnervoussystemusuallyoccuratusin allamountofdrugsinalong aydamagehepatic,renal,bonemarrowandendocrinefunctions1957～1957～1962Japan：300Thalidomide(沙度利胺,反应停AdverseReactionphocomeliaPrematureBirth早产 Aftereffect--afterwithdrawalofthedrug,itsconcentrationisbelowthethreshold阈剂量,theeffectstillexistsWithdrawalreaction停药反应reboundreap.565－afterwithdrawalofthedrug,diseaseis--5.Allergicreaction p.32--resultsfromprevioussensitizationtoaparticularchemicalorto hatisstructurallysimilar6.Idiosyncrasyp.32－occurininheriteddeficiency 5&6:concentration BloBlopsurloglogQuantalGradedDose-effectcurveglucose-6-phosphatedehydrogenaseglucose-6-phosphatedehydrogenaseisacriticalantioxidant-adeficiencycanpredisposetosubsequenthemolysisoftheredbloodcelldon'tusein swithG6PD-deficiencysulfonamides磺胺类药物furantoins呋喃妥因,chloramphenicol氯霉素,largedosesofVitC维生素Cchloroquine氯喹primaquine伯氨喹ChapterGradedDose-responseRelationshipRelationshipbetweenDoseandlogDose-effectCurveSymmetriaalalGradedDose-responseCurvesParametersalEfficacy效能＝Emax umresponsethatadrugcanismuchgreaterclinicalimprotanceits Potencydoserequiredtoproducean isunimport theclinicaluseofdrugsaslongastherequireddosecanbegivenconvenientlylessdose,moreAssessmentofDiureticABCAssessmentofDiureticABCDp.Efficacy%alresponsuricNaexcretion(mmol/L/%alresponsforeffectfordoseLDDrugSafetyGradedDose-responseQuantalDose-responseKeyKey--s