Factors of Influencing Drug Effect

General View

Pharmaceutical factors: Physical and chemical

property of drug Drug preparation Methods of drug

administration Drug interaction

Biological factors: Physiological factors Psychological factors Genetic factors Pathological factors Body response changes

induced by long-term medication

Biorhythm living habit and

environment

Section 1Pharmaceutical Factors

Chapter 4

1. Physical and Chemical Property of Drug

Penicillin Nitroprusside Vitamin C

Light-avoiding infusion aparatus

2. Drug Preparation

Oral administration: tablet, capsule, oral liquor Injection: aqua, oils, emulsion New preparation:

– Controlled release formulation (CLF)

3. Drug Interaction Pharmacokinetics:

– absorption, distribution, metabolism, excretion

Pharmacodynamics: Synergism(协同作用 ): ＞ 1+1

addition(相加作用 ): =1+1

Antagonism(拮抗作用 ): 1+1<1

Incompatibility(配伍禁忌 ): β lactam + aminoglycoside

Section 2Biological Factors

Chapter 4

1. Physiological Factors

Age:– Children:– The aged:

Gender: Body weight (BW):

2. Genetic Factors Genetic polymorphism -Drug metabolism genotype

- Drug transporter genotype- Drug receptor genotype

Racial differences in drug response Idiocyncrasy

3. Pathological Factors

Liver disease Kidney disease Dystrophia （营养不良） Acid-base disturbance ……

4. Body Response Changes Induced by Long-term Medication

1. Tolerance: body → drug, pharmacodynamic tolerance and metabolic tolerance

– Acute tolerance (tachyphylaxis)– Brady-phylaxis– Cross tolerance

2. Drug resistance: pathogen, tumor cells → drug3. Dependence:

– Physiological dependence (physical dependence)– Psychological dependence

4. Withdrawal symptoms (withdrawal syndrome)– Rebound phenomenon

5. Living Habit and Environment Smoking: hepatic drug enzyme activity↑ Drinking wine or liquor: Alcohol enhances

hepatic drug enzyme activity; when acute and large amount administration, it makes the hepatic drug enzyme saturation.

Drinking tea: Tannic acid(鞣酸 ) influences drug absorption. Theophylline (茶碱 ) excites the central nervous system and heart, promotes diuresis.

Diet/food: component, quantity, time;

The end