药理学英文版教学课件：Chapter 4 Factors affecting the drug's effects

FactorsAffectingDrug’sResponsedrugbodyDrug.StructurePolar,pKaSolubilityDosageformProductNoAdministration

DosageRouteTime,IntervalDruginteractionRepeatuseWithdraw

PhysicalsexageweightMentalityIllnessHereditylivingcustomIndividualvariationPDPK(药代）PharmaceuticalFactorsBiologicalFactors●●§1PharmaceuticalFactors1.Theformofdrug:preparation(制剂)2.Drugqualityandbioavailability,counterfeitdrugs（假药）,nationalessentialdrugs（国家基本药物）3.Multipledruguseanddruginteraction（1）pharmacokineticdruginteraction：aspirin+comarinplasmaproteinbinding

bleeding；

theinductionorinhibitionofdrugmetabolismenzyme。（2）pharmacodynemicsdruginteraction：PhysiologicalantagonismandsynergismReceptorlevelantagonismandsynergism§2BiologicalFactorsChildrenThelessmetabolismMoresensitivetodrugsInterferethebodydevelopmentOldpeopleDecreasedorganfunctionIncreasedsensitivity1.AGE年龄（岁）肾小球滤过率心脏指数生活能力肾血流量最大呼吸能力功能（%）Womenaremoresensitivetodrugtoxicity;Differentresponsetodruginwomen’sspecialphysiologicalperiod.2.Gender(性别)Pharmaco-logicaleffectsnonspecificdrugeffectsNonspecificmedicaleffectNaturalrecoveryPlaceboeffectsTotaleffects3.Placeboeffects（安慰剂效应）Trustondoctors,psychologicaleffectsofattitudeandtreatmenttowardpatients.30%showeffectiveresults30%adversereaction4.DiseasesLiverorkidneydisease：PKDrugresponsechange：PDhepaticdiseaseenzymeproduction↓hypersensitivity

Plasmaproteinproduction↓drugmetabolism↓Plasmabinding↓→freedrug↑RenaldysfunctionPlasmaproteinloss↑Shoulddosage↓Biotransformationgeneticpolymorphism(遗传多样性）.Enzyme,Racialdifferences（种属差异）indrugresponse

5.Genetic(遗传)factors6.Chronopharmacology（时间药理学）

Glucocorticoidsinsulin7. VariationinresponseLongtimedrugusecanresult:Tolerance（耐受性）：theresponsesofbodytodrugsdecreased

Drugresistance（耐药性）：thesensitivityofpathogenorcance