浙江大学医学院：《药理学》课程教学资源（PPT讲稿）Factors Influencing Drug Effects

Chapter 4 Factors Influencing Drug Effects a Patient factors u Drug Factors

Chapter 4 Factors Influencing Drug Effects Patient Factors Drug Factors

Drug Patient Dosage regimen drugs, doses, intervals, duration Efficacy Adjustment adverse effects, concentrations Doctor

Drug Patient Doctor Efficacy, adverse effects, concentrations Adjustment Dosage regimen drugs, doses, intervals, duration

PRESCRIBED DOSE patient compliance medication errors ADMINISTERED DOSE rate and extent of absorption body size and composition distribution in body fluids binding in plasma and tissues rate of elimination physiological variables CONCENTRATION pathological factors AT LOCUS genetIc factors OF ACTION interaction with other drugs development of tolerance drug-receptor interaction functional state placebo effects INTENSITY OF EFFECT

Parta Patient Factors u 1. Physiological Factors 口11Age MiSS MET D Children D Sensitivity to drugs u Pharmacokinetic properties 口 Elderly 日 Sensitivity to drugs U Pharmacokinetic properties

Part A Patient Factors 1. Physiological Factors 1.1 Age Children Sensitivity to drugs Pharmacokinetic properties Elderly Sensitivity to drugs Pharmacokinetic properties

Infants Young adults Elderly Total body water(%) of body Fraction of ry tiss metabolism of drug Renal drug elimination

Parta Patient Factors 1。2 Body Weight a Volume of distribution 囗Fat/ skeletal muscles I lipid-soluble/water-soluble drugs

Part A Patient Factors 1.2 Body Weight Volume of distribution Fat / skeletal muscles lipid-soluble / water-soluble drugs

Parta Patient Factors 囗1.3Sex a Women 口 Pregnancy I- malformation and dysfunction of the fetuses 日 Lactation D- milk: effects on infants

Part A Patient Factors 1.3 Sex Women Pregnancy - malformation and dysfunction of the fetuses Lactation - milk: effects on infants

Parta Patient Factors 口14 Individualvariation(个体差异) o (1Sensitivity to drugs I Hypersensitivity I Hyposensitivity(tolerance) L (2)Abnormal responses to drugs I Idiosyncracy(genetic abnormality) a Allergy (immunological abnormality)

Part A Patient Factors 1.4 Individual variation (个体差异) (1) Sensitivity to drugs Hypersensitivity Hyposensitivity (tolerance) (2) Abnormal responses to drugs Idiosyncracy (genetic abnormality) Allergy (immunological abnormality)

Parta Patient Factors U 2. Psychological Factors 囗 Placebo effects B Placebo effects commonly are manifested as alteration of mood, other subjective effects, and objective effects that are under autonomic or voluntary control

Part A Patient Factors 2. Psychological Factors Placebo effects Placebo effects commonly are manifested as alteration of mood, other subjective effects, and objective effects that are under autonomic or voluntary control

Parta Patient Factors 03. Pathological Factors 囗 Heart diseases 口 Hepatic diseases 囗 Renal diseases d Gastrointestinal diseases d Malnutrition I Imbalances of acid-base or electrolytes

Part A Patient Factors 3. Pathological Factors Heart diseases Hepatic diseases Renal diseases Gastrointestinal diseases Malnutrition Imbalances of acid-base or electrolytes