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儿童的生理特点与成人相差很大,对药物的处理能力弱,加上药物的剂型、剂量、药物间的相互作用及不合理用药等因素。儿童比成人更易发生药物不良反应。(1)机体因素对发生ADR的影响。①吸收与分布:儿童的生理特点,对某些药物吸收的好,某些药物吸收的不好。②代谢与排泄:儿童因体内酶系统不完善,某些酶分泌不足或完全缺乏,代谢与排泄能力差。③药物的敏感性及自身稳定性机制:儿童的自身稳定性机制变化较大,尤其对药效或用药安全范围空的药物,易带来不良后果。(2)不合理用药对儿童的ADR的影响。(3)儿童用药的主要原则:重视儿童用药。减少ADR的发病率。考虑到多方面的因素。合理选用药物是我们医药人员的职责。 相似文献
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高血压病患者常需联合用药以增强疗效或抵消不良反应,但也可因药物相互作用而使药效减弱或出现毒副反应.药效动力学相互作用可表现为药效协同或拮抗作用,药代动力学相互作用则主要由于药物在吸收、分布、代谢和排泄方面的相互影响所致.本文主要对抗高血压病药与其他药物之间的相互作用机制及结果,临床给药策略进行综述. 相似文献
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食物对药物吸收代谢的影响 总被引:1,自引:0,他引:1
药物在机体内将受到各种因素的影响,其中饮食是不可忽视的影响因素,特别是口服药物进入机体后,可能首先在消化道与食物发生各种物理、化学反应,改变药物吸收、分布、代谢和排泄,从而影响药物治疗作用。食物主要影响药物的吸收和代谢两个环节[1],笔者就食物对药物吸收和代谢两方面的影响作一综述,以期为临床合理用药提供参考。 相似文献
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药物转运体在体内药物的吸收(absorption)、分布(distribution)、代谢(metabolism)及排泄(excretion)的过程(ADME)中发挥着关键的作用。转运体在各组织器官的不同分布以及其基因多态性,导致某些药物的吸收、分布、代谢和排泄过程产生明显的个体差异。随着药物基因组学的快速发展,关于转运体基因多态性的研究报道越来越多。本文对近年来人体主要药物转运体基因多态性在药动学和药效学中的影响研究进行综述。 相似文献
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食物对药物吸收代谢的影响 总被引:1,自引:1,他引:0
药物在机体内将受到各种因素的影响 ,其中饮食是不可忽视的影响因素 ,特别是口服药物进入机体后 ,可能首先在消化道与食物发生各种物理、化学反应 ,改变药物吸收、分布、代谢和排泄 ,从而影响药物治疗作用。食物主要影响药物的吸收和代谢两个环节[1],笔者就食物对药物吸收和代谢两方面的影响作一综述 ,以期为临床合理用药提供参考。1食物对药物吸收的影响[2~5]1.1食物与药物直接理化作用食物与药物发生理化作用从而影响药物的吸收 ,如牛奶或其它乳制品中的钙离子与四环素形成络合物 ,减少四环素的吸收 ;茶叶水中的鞣酸与铁制剂… 相似文献
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近年来中药注射剂在临床上应用广泛,与其他药物联合应用极为普遍,联合用药是否会产生细胞色素P450(CYP)酶介导的代谢性药物相互作用,从而影响疗效和用药安全,已越来越受到关注.本文就近年来中药注射剂对CYP酶影响的国内外研究进行了综述,按各亚型酶进行归类,归纳了中药注射剂对CYP各亚型酶的作用(诱导、抑制),以预测中药注射剂及与哪些药物联合应用时可能会产生潜在的代谢性药物相互作用,与哪些药物可安全联用,从而为临床安全合理用药及相关研究提供参考,保障患者用药安全有效,规避用药风险. 相似文献
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《中南药学》2017,(3):329-334
甘草对肝细胞色素P450(CYP450)酶活性具有诱导或抑制作用,对一些化学药物如氨茶碱、安替比林、丙米嗪、利多卡因、氯沙坦等的体内代谢产生影响,合用时使这些药物的药物代谢动力学发生改变,在临床应用过程中应注意。因此,需要进一步在人体内研究甘草提取物及其有效成分与其他药物的相互作用。从CYP450酶角度研究中药,有利于从分子水平探讨中药的作用机制或毒性机制,并有可能揭示中药之间或中药与西药产生相互作用的关系,防止临床配伍用药后的不良反应,从而提高中药临床应用的有效性与安全性,促进临床合理用药。本文综述了甘草对药物代谢酶以及化学药物体内代谢的影响。 相似文献
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Drug metabolism in pharmaceutical research has traditionally focused on the well-defined aspects of absorption, distribution,
metabolism and excretion, commonly-referred to ADME properties of a compound, particularly in the areas of metabolite identification,
identification of drug metabolizing enzymes (DMEs) and associated metabolic pathways, and reaction mechanisms. This traditional
emphasis was in part due to the limited scope of understanding and the unavailability of in vitro and in vivo tools with which to evaluate more complex properties and processes. However, advances over the past decade in separate but
related fields such as pharmacogenetics, pharmacogenomics and drug transporters, have dramatically shifted the drug metabolism
paradigm. For example, knowledge of the genetics and genomics of DMEs allows us to better understand and predict enzyme regulation
and its effects on exogenous (pharmacokinetics) and endogenous pathways as well as biochemical processes (pharmacology). Advances
in the transporter area have provided unprecedented insights into the role of transporter proteins in absorption, distribution,
metabolism and excretion of drugs and their consequences with respect to clinical drug–drug and drug–endogenous substance
interactions, toxicity and interindividual variability in pharmacokinetics. It is therefore essential that individuals involved
in modern pharmaceutical research embrace a fully integrated approach and understanding of drug metabolism as is currently
practiced. The intent of this review is to reexamine drug metabolism with respect to the traditional as well as current practices,
with particular emphasis on the critical aspects of integrating chemistry and biology in the interpretation and application
of metabolism data in pharmaceutical research. 相似文献
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Drug interactions can alter the pharmacokinetics and/or pharmacodynamics of a drug. In pharmacokinetic drug interactions, the concentrations of 1 or more drugs are altered by another. This change in concentration in a given drug may be due to changes in absorption, distribution, metabolism, or elimination. The pharmacodynamic interaction can lead to additive, synergistic, or antagonistic effects of a drug. Drug interaction studies are regularly conducted with conventional drugs (small molecules), but very few drug interaction studies have been performed with macromolecules (therapeutic proteins or monoclonal antibodies). This is mainly because most macromolecules are not metabolized by the cytochrome P450 system, and their mechanism of elimination is complex. However, it has been shown in several studies that interferons can have an impact on the cytochrome P450 system that may alter the pharmacokinetics and pharmacodynamics of a conventional drug when given with interferons. Therefore, it is important to evaluate the effect of other classes of macromolecules (cytokines, interleukins, monoclonal antibodies) on drug-metabolizing enzymes. It is also imperative that the effects of conventional drugs on the pharmacokinetics and pharmacodynamics of macromolecules be conducted. The present review encompasses several drug interaction studies that were conducted with macromolecules and highlights the impact of these studies on the pharmacokinetics and/or pharmacodynamics of the involved drugs. 相似文献
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《Drug metabolism reviews》2012,44(3):357-368
AbstractGut microbiota, one of the determinants of pharmacokinetics, has long been underestimated. It is now generally accepted that the gut microbiota plays an important role in drug metabolism during enterohepatic circulation either before drug absorption or through various microbial enzymatic reactions in the gut. In addition, some drugs are metabolized by the intestinal microbiota to specific metabolites that cannot be formed in the liver. More importantly, metabolizing drugs through the gut microbiota prior to absorption can alter the systemic bioavailability of certain drugs. Therefore, understanding intestinal flora-mediated drug metabolism is critical to interpreting changes in drug pharmacokinetics. Here, we summarize the effects of gut microbiota on drug pharmacokinetics, and propose that the influence of intestinal flora on pharmacokinetics should be organically related to the therapeutic effects and side effects of drugs. More importantly, we could rationally perform the strategy of intestinal microflora-mediated metabolism to design drugs. 相似文献
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Introduction: The absorption, distribution, metabolism, excretion and toxicity (ADME-tox) processes of drugs are of importance and require preclinical investigation intestine in addition to the liver. Various models have been developed for prediction of ADME-tox in the intestine. In this review, precision-cut intestinal slices (PCIS) are discussed and highlighted as model for ADME-tox studies.Areas covered: This review provides an overview of the applications and an update of the most recent research on PCIS as an ex vivo model to study the transport, metabolism and toxicology of drugs and other xenobiotics. The unique features of PCIS and the differences with other models as well as the translational aspects are also discussed.Expert opinion: PCIS are a simple, fast, and reliable ex vivo model for drug ADME-tox research. Therefore, PCIS are expected to become an indispensable link in the in vitro–ex vivo–in vivo extrapolation, and a bridge in translation of animal data to the human situation. In the future, this model may be helpful to study the effects of interorgan interactions, intestinal bacteria, excipients and drug formulations on the ADME-tox properties of drugs. The optimization of culture medium and the development of a (cryo)preservation technique require more research. 相似文献
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中西药相互作用的药代动力学机制研究进展 总被引:1,自引:0,他引:1
近年来,中西药联合应用日益增多,引起诸多药物相互作用和不良反应。药物代谢酶和转运体在药物的体内代谢和处置过程中发挥重要的作用,中西药联用不仅会改变药物的理化性质和人体的生理特性,而且可以调节药物代谢酶和转运体的表达和功能,进而产生药动学相互作用,引起药物疗效的改变。本文对中西药相互作用的药动学基础及其评价方法进行总结,旨在为中西药的联合应用和研究提供参考。 相似文献
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长期以来,由于肠道菌群本身的复杂性以及培养方法和分析技术的限制,肠道菌群在药物代谢和体内处置中的作用未得到应有的重视。近年来,随着技术的快速发展,围绕肠道菌群的大量研究将对肠道菌代谢和肠道菌-宿主共代谢的认识提高到前所未有的深度。肠道菌群不仅能够直接代谢许多药物,还通过宿主、菌群、药物之间复杂多维的相互作用间接改变药物代谢,从而影响个体对药物治疗的响应(效应、毒性、耐药性等)。肠道菌群结构及代谢功能受多种因素的影响。综述近期肠道菌群代谢药物研究领域的重要进展及研究趋势,以期推进精准治疗,促进药物发现及新的治疗策略的出现。 相似文献
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INTRODUCTION: Garlic supplements have received wide public attention because of their health-beneficial effects. Although these products are considered as innocuous, several case reports and studies have shown the capacity of individual garlic phytochemicals/supplements to interfere with drug pharmacokinetics. AREAS COVERED: This review covers recently published literature on garlic chemistry and composition, and provides a thorough review of published studies evaluating drug-garlic interactions. The authors illustrate the mechanisms underlying pharmacokinetic interactions, which could serve as important highlights in further research to explain results for drugs with narrow therapeutic indices or for drugs, utilizing multiple absorption, distribution and metabolism pathways. EXPERT OPINION: To increase the relevance of further research on safety and efficacy of garlic supplements and phytochemicals, their composition should be addressed before conducting in vitro or in vivo research. It is also strongly recommended to characterize in vitro formulation performance to assess the rate and extent of garlic phytochemical release in order to anticipate the in vivo impact on the pharmacokinetics of concomitantly consumed drugs. The main conclusion of this review is that the impact of garlic on different stages of pharmacokinetics, especially on drug absorption and metabolism, is drug specific and dependent on the type/quality of utilized supplement. 相似文献
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食物与药物之间的相互作用普遍存在,且作用机制也多种多样。目前,研究较多的是单个食物或食物中的某些营养成分通过调节药物转运体或代谢酶的功能从而影响药物的体内过程。食物对药物体内过程的影响包括吸收、分布、代谢、排泄四个方面,并且主要是调节其中参与的药物转运体和代谢酶的功能。转运体介导的食物对药物体内吸收的影响主要是通过调节肠上皮摄取型和外排型的转运体,从而影响药物的吸收;对分布的影响主要是通过调节体内一些屏障中的转运体;对代谢的影响主要是同时调节药物代谢酶和转运体;对排泄的影响是通过调节肾脏和肝脏胆汁排泄的药物转运体,从而影响药物的清除率。因此,转运体介导的食物与药物相互作用直接影响药物治疗的效果。 相似文献