1. The basic performance of drug action The drug action refers to the initial action between the drug and the body cells, is the agent, is the molecular reaction mechanism, and has its specificity.Pharmacological effectIt is the result of drug action, the manifestation of body reaction, and has selectivity for different organs.
(1)Excitability: refers to the ability of the body to feel and respond to stimuli.Excitement (hyperactivity): to improve the original function of the body organs.Inhibition (paralysis) reduces the original function of body organs.The transition from overexcitement to exhaustion is another kind of inhibition.
(2) Excitators: increase excitability and function, such asNikethamiThe excited respiratory index makes breathing stronger.
(3) Inhibitors: reduce excitability and function. For example, morphine inhibits the respiratory center and weakens respiration.
2. Metabolic changes: exert effects by influencing metabolism, such asadrenalineIncrease blood sugar;Insulin lowers blood sugar.
3. Adaptive change: to prevent and cure diseases by enhancing or inhibiting the adaptability of the body to environmental changes, such as immune enhancers/suppressants.
4. Note:
(1) Drugs that can cause qualitative changes in cell morphology and function are noticed, such as causing canceration;
(2) Gene therapy can lead the body outGenetic defectSpecial functions that are not available from time to time.
(3) Strong specificity of drug action does not necessarily lead to highly selective pharmacological effects, and the two are not necessarily parallel.If atropine specifically blocks M-cholinergic receptor, the selectivity of pharmacological effect is not highblood vessel、smooth muscle、GlandsandCentral nervous systemBoth functions are affected, and some are excited and some are inhibited.The drugs with strong specificity and (or) high selectivity of effect have better application accuracy.
(4) Drugs with wide effectsside reactionMore.However, broad-spectrum drugs have advantages when multiple causes or diagnosis are unknown, such asBroad-spectrum antibioticBroad spectrum antiarrhythmic drugs, etc.
(5) Pharmacological effect and therapeutic effect are not synonymous. For example, drugs for coronary artery dilation may not all be anti coronary drugs, and anti coronary drugs may not all relieve angina pectoris, and sometimes produceAdverse reactionsThis is the duality of drug effects: drugs can both treat and cause diseases.
selectivity
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1. Selectivity: refers to that the drug only has obvious effect on some tissues and organs, but has little or no effect on other tissues and organs.
2. Factors related to selectivity:
(1) Differences in drug distribution;
(2) Difference in biochemical function of tissues: exert effects by interfering with a certain biochemical metabolic process of tissues;
(3) Differences in cell structure, such as penicillin throughSuppressor cellWall synthesis selectively killsGram positive bacteriaHuman and animal cells have no effect.
Clinical effect
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1. Therapeutic effect: It refers to any effect that meets the purpose of medication or achieves the effect of prevention and treatment.The purpose of treatment is divided into cause and symptomatic treatment.
(1) Treatment for causes (root cause): the purpose of medication is to eliminate the primary diseasePathogenic factor, cure the disease thoroughly.For example, antibiotics eliminate pathogenic bacteria in the body.
(2) Symptomatic treatment (symptomatic treatment): the purpose of medication is to improve symptoms.The symptomatic treatment can not eradicate the cause of disease, but it is essential for diseases with unknown diagnosis or causes that cannot be cured temporarily.In some critical cases, such as shock, high fever and severe pain, symptomatic treatment is more urgent than treatment due to causes.
2. Adverse reaction: any action that has nothing to do with the purpose of medication and causes discomfort is collectively referred to as adverse drug reaction.Characteristics: The inherent effects of drugs are predictable and difficult to avoid.Pharmacogenic disease: a few serious adverse reactions are difficult to recover, such asgentamicinDeafness, hydralazineLupus erythematosusEtc.
(1) Side effects: effects irrelevant to the treatment purpose (side effects) at the commonly used dose.It is not serious and difficult to avoid under the common dose.If atropine is used to relieve gastrointestinal spasm, it may cause dry mouth, palpitations, constipation and other side effects.
(2) Toxic reaction: harmful reaction occurs in large amount or accumulation or high body sensitivity, which is generally serious, predictable and avoidable.Divided into:
① Acute toxicity: excessive dose will damage circulation, respiration andNervous system function。
② Chronic toxicity: It accumulates too much and damages liver, kidney, bone marrow, endocrine and other functions.Carcinogenic, teratogenic and mutagenic reactions also belong to the category of chronic toxicity.
③ Teratogenesis: It affects the normal development of the embryo and causes teratogenesis, usually occurring in the first 20 days to 3 months of pregnancy.
④ Mutagenicity and carcinogenesis:MutagenicityRefers to drug useDNA moleculeThe sequence of base pairs in is changed (gene mutation). There is a limit to attempting to increase the dose or extend the course of treatment to achieve the therapeutic purpose, and overdose is very dangerous.
(3) Aftereffect: refers to the residual pharmacological effect when the blood concentration has dropped below the threshold concentration after drug withdrawal.If used for a long timeAdrenocortical hormoneAfter drug withdrawalAdrenal cortex hypofunctionIt is difficult to recover within several months.
(4) Drug withdrawal reaction: exacerbation of original disease after sudden drug withdrawal, also known as rebound reaction.If taking clonidine for a long time, the blood pressure will rise sharply the next day.[1]
