关于人体药物反应个体差异的近代见解

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本文综述了有关人体药物反应个体差异的现代资料。目前一致认为:1.个体差异是有原因的,原因很多,但不外为环境条件和遗传因素,其中遗传因素起着决定性作用,环境因素一般只起次要作用;2.各种原因主要作用于药代动力学环节,引起同一剂量在不同个体血浆药物浓度的巨大差异,从而导致不同个体药物反应的不同;但它们也能改变药效动力过程,不过一般说来作用较小;3.为了获得药物的最大功效,必须切实注意药物剂量的个体化。药物反应个体差异(Individual variation)简称药理差异(Pharmacologic var-iability),是药理学中一个有重要理论和实际意义的问题。它是一种普遍的生物现象,不但存在于致病微生物和寄生虫以及实验动物中,也存在于正常和患病的人体中,故又称为生物差异(Biological variabitity)。这个名称包括了比药理差异多得多的其他内容,未免不够确切,但药理差异在生物界普遍存在的事实,似乎是无可怀疑的。有关这方面的资料曾于本世纪30年代初期和60年代中期分别作过总结。十多年来,由于生化药理学和临床药理学的发展以及药物微量分析技术的进步又在动物实验和临床研究方面积累了大量的实验资料,本文根据这些资料对人的个体差异问题进行比较系统的论述。因为参考资料比较多,文中所引用的以综述性的为主。 This article reviews modern information on individual differences in human drug response. Currently agreed that: 1. Individual differences for a reason, for many reasons, but nothing more than environmental conditions and genetic factors, of which genetic factors play a decisive role, environmental factors generally only play a secondary role; 2. The main role of various reasons In the pharmacokinetics section, there is a huge difference in plasma drug concentrations of the same dose in different individuals, leading to differences in the response of different individual drugs; however, they also change the pharmacodynamic process, but in general they are less effective. 3. In order to Obtain the maximum efficacy of the drug, we must pay attention to the individual dose of the drug. Drug variation Individual variation, referred to as Pharmacologic var-iability, is a problem of major theoretical and practical significance in pharmacology. It is a common biological phenomenon, which is not only found in pathogenic microorganisms and parasites, but also in experimental animals as well as in normal and diseased humans. It is also called biological variabity. The fact that the name includes much more than the differences in pharmacology is more or less exact, but the fact that pharmacological differences are ubiquitous in the world of biology appears to be beyond doubt. Information on this subject was summarized in the early 1930s and mid-1960s respectively. For more than a decade, due to the development of biochemical pharmacology and clinical pharmacology and the progress of drug microanalysis technology, a great deal of experimental data have been accumulated in animal experiments and clinical studies. Based on these data, The discussion. Because of more reference, the article cited in order to summarize the main.
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