医学factors affecting body's response to drugs

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1、FactorsAffectingBody'sResponsetoDrugsLinYuan(林原)Ph.D,Prof.DepartmentofPharmacology,DalianMedicalUniversity学习要点：基本要求：从机体与药物两方面考虑，都有那些主要因素影响药物的作用延伸要求：为什么用药要个体化？机体状态不同，药物的作用可能发生什么变化？例如，儿童器官功能尚未发育完全，老人及严重肝肾疾病患者肝肾功能下降，可导致药物作用的加强；是否有例外情况。学习方法：注意分析影响药物作用因素的共性与特征。药物的药理效应受到药物与机体

2、、药物及环境方面因素的影响。机体方面的因素有：年龄、性别、生理状态、精神因素、疾病、遗传因素等。药物方面的因素包括：如药物的剂型、剂量、给药途径、药物在体内的相互作用等。环境因素：影响机体生理与精神状态，进而影响遗传（“你的命运，你做主”）。主要考虑到药物与机体两方面的因素，才能够最大限度的发挥药物的治疗作用、减少不良反应，做到合理用药。SummaryofFactorsAffectingBody'sResponsetoDrugsIndividualfactors(physiological,pathologicalpsychologi

3、cal).DrugrelatedpropertiesIndividualfactorsIndividualvariationcanbecongenitaloracquired.（个体差异可以是先天性的也可以是后天获得的）Q–HowAgeaffectsdrugeffect?ChildrenChildrenareatthestageofdevelopingorgans,sotheabilityofdrughepaticmetabolismandrenalclearance（肾清除率）ofchildandarelowerthanthatad

4、ult.elderlyForelderly,theorganfunctions,e.g.,liverandkidneydecreased,resultingindrugbiotransformationinliveranddrugexcretioninkidneydeclinedgradually.PharmacologicalandadversereactionsofadrugforbothchildrenandelderlyareincreasedQ-WhetherGender(性别）AffectsdrugeffectInPrin

5、ciple,therearenoapparentdifferencesbetweenbothgendersresponsetodrugs.However,(a)inmenstruation（月经）,drugsaffectinguteruscontractionshouldbeavoidedtopreventfromoverbleeding;(b)inpregnancy,extremecarefulnessshouldbetakenforthesafetyofbothmotherandfetus;and(c)duringlactatio

6、n,attentionshouldbepaidtosomedrugsthatexcreteviathemilk.Q-WhetherPsychologicalstateaffectsdrugeffectPlaceboeffect:(a)Thebeneficialeffectinapatientfollowingaparticulartreatmentthatarisesfromthepatient'sexpectationsconcerningthetreatment(non-specificplaceboeffect)ratherth

7、andrugspecificpharmacologiceffects.Noceboeffect:unwanted(e.g.,previousfailureofdrugtherapy)Psychologicalfactorsnotonlyincludenon-specificplaceboeffectbutalsoincludePatient-DoctorInteraction(relationship)whichmayinfluencepatient’smoodandothersubjectiveandobjectiveeffects

8、controlledbyautonomicnervesandhormones.（精神因素不仅包括安慰剂效应，也包括医生与患者的关系）Q-Whataremajorpathologicfactorsaffectingdrug