临床药理学精品课件之药物相互作用英文课件.ppt

上传人:b****9 文档编号:333198 上传时间:2022-10-09 格式:PPT 页数:44 大小:537KB
下载 相关 举报
临床药理学精品课件之药物相互作用英文课件.ppt_第1页
第1页 / 共44页
临床药理学精品课件之药物相互作用英文课件.ppt_第2页
第2页 / 共44页
临床药理学精品课件之药物相互作用英文课件.ppt_第3页
第3页 / 共44页
临床药理学精品课件之药物相互作用英文课件.ppt_第4页
第4页 / 共44页
临床药理学精品课件之药物相互作用英文课件.ppt_第5页
第5页 / 共44页
点击查看更多>>
下载资源
资源描述

临床药理学精品课件之药物相互作用英文课件.ppt

《临床药理学精品课件之药物相互作用英文课件.ppt》由会员分享,可在线阅读,更多相关《临床药理学精品课件之药物相互作用英文课件.ppt(44页珍藏版)》请在冰豆网上搜索。

临床药理学精品课件之药物相互作用英文课件.ppt

DrugInteractions,2,Example,Ketoconazoleisanenzymeinhibitor,Terfenadine+ketoconazole:

Increasetheserumconcentrationofterfenadine,In1998,terfenadinewasremovedfrommarket.,3,Outline,Introduction-Definition-Drugslikelytobeinvolvedininteractions-OutcomesofdruginteractionsMechanismsofdruginteractions-Pharmacokineticinteractions-Pharmacodynamicinteractions-PharmaceuticalinteractionsHigh-riskclinicalsettings,联合用药(Concomitantdrugs),Concomitantdrugsaretwoormoredrugsusedorgivenatoralmostatthesametime(oneaftertheother,onthesameday,etc.).同时或在一定间隔时间内使用两种或两种以上的药物,称为联合用药(Concomitantdrugs)。

联合用药品种偏多,使药物相互作用的发生率增加,影响药物疗效或毒性增加。

因此在给病人用药时,应十分小心,应尽量减少用药种类,减少药物相互作用引起的药物不良反应。

2022/10/9,4,5,Introduction,Druginteractionmeansthemodificationoftheeffectofadrug(objectdrug)byconcurrentadministrationofotherdrugs(precipitatingdrug).Adruginteractioncanresultineitheranincreasedordecreasedeffectoftheobjectdrug.,E.g.,terfenadine+ketoconazole,objectdrug,precipitatingdrug,theobjectsdrugs(目标药物):

在联合用药中,药效发生变化的药物theprecipitatingdrugs(促发药物):

在联合用药中,引起其他药物发生变化的药物。

6,7,Drugslikelytobeinvolvedininteractions,Likelytobetheprecipitatingdrugs(促发药物)highlyproteinboundphenylbutazone,aspirin,sulfonamidesalterthemetabolismofotherdrugsenzymeinducersanticonvulsants,rifampicin,griseofulvinenzymeinhibitorsallopurinol,chloramphenicol,cimetidineaffectrenalclearanceofobjectdrugsdiuretics,probenecid,8,Likelytobetheobjectsdrugs(目标药物)asteepdose-responsecurvealowtherapeuticindexanticoagulants,anticonvulsants,2022/10/9,9,TypesofDrugInteractions,Addition:

作用强度等于单独用药的作用强度之和阿托品与氯丙嗪可引起胆碱能神经功能过度低下的中毒症状;氨基糖甙类抗生素与硫酸镁合用,可加强硫酸镁引起的呼吸麻痹。

Doseaddition:

A剂量(B剂量)=A剂量+B剂量Effectaddition:

AB联合用药强度=A作用强度+B作用强度Synergism:

联合用药的效果大于单独用药效应的总和镇静催眠药与抗精神病药合用的中枢抑制作用。

AB联合用药A效应+B效应,Potentiation:

指一种药物可使组织或受体对另一药物的敏感性增强排钾性利尿剂使心脏对洋地黄的敏感性增强,导致心率失常。

Antagonism:

一种药物部分或全部阻断另一药物的作用,合用时引起药效降低ChemicalPhysiologicalorfunctionalCompetitiveNoncompetitive,10,11,InconsequentialDesirableorbeneficialincreasetheeffectoftherapydecreasethesideeffectdecreasetolerancetreatmentcomplications-Adverse(022%)E.g.,terfenadine+ketoconazole,Outcomesofdruginteractions,12,MechanismsofDrugInteractions,Pharmacokineticinteractions(PK)-ADME:

Absorption,distribution,metabolism,elimination-AchangeinserumconcentrationandtheamountofdrugavailableatthesiteofactionPharmacodynamicinteractions(PD)-Moleculartarget,electrolytebalanceorthebioactivesystem-WithoutalterationsinpharmacokineticparametersPharmaceuticalinteractions-theprinciplestopreventpharmaceuticalinteractions,13,PKinteractions-Absorption,AlteringGItractpH-E.g.,salicylate+NaHCO3,14,Ketoconazole+Ranitidine,PiscitelliSetal.AntimicrobAgentsChemother1991;35:

1765-1771,15,PKinteractions-Absorption,ChelationForminganinsolublecomplexintheGItractTetracyclines,quinoloneantibiotics+ferroussulfate(Fe+2),antacids(Al+3,Ca+2,Mg+2),dairyproducts(Ca+2),16,PKinteractions-Absorption,17,PKinteractions-Absorption,AlterationinGImotilityIncreasemotility-metoclopramide,cisapride,domperidoneE.g.,paracetamol+metroclopramideDecreasemotility-anticholinergicdrugs(atropine,probanthine),chlorpromazine,diphenhydramine,18,PKinteractions-Absorption,Binding-bycholestyramineE.g.,warfarin+cholestyramine-bycharcoalE.g.,carbamazepine+charcoal,19,PKinteractions-Absorption,AdministrationwithfoodFormanydrugs,changetherateofabsorptionIndinavirfewerisabsorbedintosystemiccirculationtogetherwithhighfatmeal,AUCandCmaxdecreasedby80%Saquinavir-administrationwithhighfatmealincreasesAUCby57%,forlowFdrug,20,PKinteractions-Distribution,ProteinBindingInteractionsCompetitionbetweendrugsforplasmaortissueproteinbindingsitesWhendrugswithhighlyaffinityforthesameproteinareusedtogether,acompetitivedisplacementinteractionmayoccur,resultinginatransientincreaseinthefreeconcentrationofthedisplaceddrug.E.g.,warfarin+phenylbutazone,21,ProteinBindingInteractions,22,PKinteractions-Distribution,Tocauseaclinicallysignificanteffectif:

-highlyproteinbound(90%)-asmallvolumeofdistribution-anarrowtherapeuticindex-arapidonsetofaction,23,PKinteractions-Distribution,ProteinBindingInteractionsThedisplaceddrugs(theobjectdrugs)warfarin,phenytoin,tolbutamidethedisplacingdrugs(theprecipitantdrugs)phenylbutazone,sulfonamides,salicylates,chloralhydrate,24,PKinteractions-Metabolism,DRUG,+,25,PKinteractions-Metabolism,Enzymeinducer-adrugorsubstancethatincreasesthemetabolicactivityofanenzymeusuallybyincreasingtheamountofthatenzymeexpressedincells.,26,Inducersofenzymeactivity,27,PKinteractions-Metabolism,Outcomeofinduction:

ActiveDruginactive:

ResultinginalowerplasmaconcentrationandadecreasedeffectE.g.,PhenobarbitalandwarfarinDrugToxicmetabolites:

ResultinginanincreasedtoxiceffectE.g.,isoniazidacetyl

展开阅读全文
相关资源
猜你喜欢
相关搜索

当前位置:首页 > 工程科技 > 纺织轻工业

copyright@ 2008-2022 冰豆网网站版权所有

经营许可证编号:鄂ICP备2022015515号-1