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
