pharmacology

Name of medical and pharmaceutical discipline

open 92 homonymous entries

Collection

zero Useful+1

zero

This entry is made by Project of Compilation and Application of Scientific Terms in "Popular Science China" Encyclopedia to examine.

Pharmacology is a science that studies the interaction between drugs and the body and the mechanism of drug action, mainly including pharmacodynamics and pharmacokinetics. The former is to clarify the action and principle of drugs on the body, while the latter clarifies the process of absorption, distribution, biotransformation and excretion of drugs in the body, as well as the law of drug effect and blood drug concentration changes with time.^[1]

Chinese name: pharmacology
Foreign name: pharmacology

Pinyin: yào lǐ xué
Research object: poison

catalog

five clinical
six New drug pharmacology
seven Pharmacology of Traditional Chinese Medicine
eight Basic theory

task

Announce

edit

pharmacology

The discipline task of pharmacology is to clarify the role and mechanism of drugs, improve the quality of drugs, and improve drugs curative effect Provide theoretical basis for prevention and treatment of adverse reactions; Research and develop new drugs, discover new uses of drugs and provide experimental data for exploring cell physiological, biochemical and pathological processes. Pharmacological method is experimental, that is, under strictly controlled conditions, observe the action law of drugs on the body or its components and analyze their objective action principles. It has gradually developed in recent years Clinical pharmacology It focuses on clinical patients for research and service applied science Its task is to transform the basic theory of pharmacology into clinical medication technology, that is, to transform pharmacological effects into actual curative effects Basic Pharmacology Subsequent to. The main purpose of learning pharmacology is to understand the role of drugs Action mechanism And how to give full play to its clinical efficacy. It is necessary to integrate theory with practice to understand the causal relationship 。 Three tasks or categories of pharmacology:

First, pharmacology is a compulsory course in medical colleges and universities to guide clinical medication.

Second, evaluation Drug efficacy And what are the differences between the economy and other aspects.

Third, pharmacology is an important part of life science.

There are two aspects:

On the one hand, in addition to guiding clinical medication, drugs usually have tool drugs, which are further used for research and have a great role in promoting academic development;

On the other hand, drug research itself is an important part of life science. I think from the proportion of Nobel laureates, Nobel Prize More than 30% of the recipients are in pharmacology or drugs, which indicates that pharmacology plays an important role in life science. For example, the discovery of pharmacology in the 1950s and 1990s has greatly improved human beings and made great progress in science.

research contents

Announce

edit

Pharmacology is Basic Medicine It is a bridge discipline between clinical medicine, medicine and pharmacy. Clinical practice is carried out under the guidance of the theory of pharmacology science, and pharmacology theory is enriched on the basis of experimental research. In addition to respecting scientific laws, drug research and application should also comply with laws, regulations and relevant guiding principles to ensure people's life and health.

Pharmacological research includes:

1. Pharmacodynamics: pharmacodynamics for short. To study the effects of drugs on the body, including the effects, mechanisms and clinical applications of drugs.

2. Pharmacokinetics: Pharmacokinetics for short. To study the changes and laws of drugs under the action of the body, including the absorption, distribution, metabolism and excretion process of drugs in the body, especially the laws of changes of blood drug concentration with time, factors affecting drug efficacy, etc.^[2]

Development History

Announce

edit

Early experience accumulation

The Shennong Herbal Classic in the first century AD contained 365 kinds of drugs.

New Materia Medica of the Tang Dynasty is the first pharmacopoeia in China, containing 884 kinds of drugs.

Li Shizhen's in the Ming Dynasty《 Compendium of Materia Medica 》It is a scientific masterpiece, lasting 27 years, with 1.9 million words and 52 volumes, containing 1892 kinds of drugs prescription More than 11000 pieces and 1160 illustrations. Widely spread all over the world, it is a glorious page in the history of drug development.

Development of related disciplines

Extraction of active ingredients of natural drugs: such as morphine 、 quinine 、 atropine 、 Imidine 、 Strychnine 、 cocaine Etc. The progress of chemistry and physiology led to the birth of pharmacology. R. Buchheim founded the pharmacology discipline and became the first pharmacology professor in the world|

Pharmacology and related disciplines infiltrate, learn from and promote each other, and have derived many branches.

History

In ancient times, people learned from their life experience that some natural substances can treat diseases and injuries in order to survive, which is the origin of medicine. Many of these practical experiences have been passed down to the present, such as drinking alcohol to relieve pain, rhubarb catharsis, neem fruit to dispel insects, willow peel to reduce fever, etc. Later, in the struggle between religious superstition and evil Feudal monarch Drugs have also been developed in seeking pleasure and longevity. However, it is more about integrating the accumulation and spread of folk medical practical experience into herbal medicine, which is recorded in China, Egypt, Greece, India, etc., such as around the first century A.D《 Shennong's Herbal Classic 》And Ebers' Papyrus in Egypt. the ming dynasty

pharmacology

Li Shizhen's Compendium of Materia Medica (1596) has made great contributions to the history of drug development. It is a classic work of traditional medicine in China. The book has 52 volumes, about 1.9 million words, contains 1892 kinds of drugs, 1160 illustrations, and more than 11000 prescriptions. It is a must read book for the study of traditional Chinese medicine. There are seven languages in the world translation Spread. After the Renaissance in Western Europe (beginning in the 14th century), people's thinking began to get rid of religious constraints, believing that everything has its own reasons and can be understood as long as objective observation. Switzerland Paracelsus (1493-1541), a doctor, criticized ancient Greek Galen's idealistic theory of evil liquid ended the dark age of more than 1500 years in the history of medicine. Later, the British anatomist W Harvey (1578-1657) discovered the blood circulation and created a new era of experimental pharmacology.

The improvement of people's living standards requires more and better new drugs. The development of pharmaceutical science provides the theoretical basis and technical conditions for the development of new drugs. Market economic competition also promotes the rapid development of new drugs. The US Food and Drug Administration (FDA) has approved more than 20 new drugs for marketing every year in the past decade. China has introduced many new drugs in recent years, but it needs to speed up innovation. New drug development is a very strict and complex process. Although different drugs are different, pharmacological research is essential Key steps 。 All clinically effective drugs have corresponding pharmacological effects, but not all drugs with positive pharmacological effects are clinically effective drugs. For example, antihypertensive drugs can reduce blood pressure, but antihypertensive drugs are not all antihypertensive drugs, not necessarily good drugs that can reduce complications and prolong life. Therefore, the development and research of new drugs must have a process of gradual selection and elimination. In order to ensure the efficacy and safety of drugs for patients, the development of new drugs requires not only reliable scientific experimental results, but also laws and regulations on the approval and management of new drug production and marketing, providing legal protection for people's health and economic rights and interests of industry and commerce. New drug sources include natural products, semi synthetic and fully synthetic chemicals. In the past, the main method of drug selection was to rely on practical experience, but now it is possible to find close relatives of effective drugs according to the plant taxonomy for screening or from effective drugs Pharmaceutical chemistry The relationship between structure and pharmacological activity was inferred, and a series of products were directionally synthesized, and then pharmacological screening was carried out. In recent years, DNA gene recombination technology has been used to isolate and implant specific gene segments of DNA into rapidly growing bacteria or yeast cells for the internal disease resistant substances (protein components) of the body to obtain a large number of protein drugs needed. In addition, the chemical structure of existing drugs can be modified (semi synthetic) or the dosage form can be changed, and drugs with better efficacy, less toxicity or more convenient application can also be obtained.

The process of new drug research can be roughly divided into three steps, namely preclinical research, clinical research and after-sales research. Pre clinical studies include systematic pharmacological studies and acute and chronic toxicity observations on animals. For drugs with selective pharmacological effects, it is also necessary to determine the absorption, distribution, elimination and elimination process of the drug in animals before clinical trials. Pre clinical research is to find out the action spectrum and possible toxic reactions of refreshing drugs. After passing

The clinical trial can be conducted only after the preliminary approval of the drug management department. The purpose is to ensure drug safety. In the clinical study, we first observed the tolerance of new drugs in 10~30 normal adult volunteers to find out the safe dose. Then select patients with specific indications to be randomly divided into groups, set up a double control of known effective drugs and blank placebos (for acute and severe patients, the blank control that is harmful to the patient's health is not allowed), and try to use a double blind method (patients and medical staff cannot distinguish between treatment drugs or reference drugs) for observation, and then conduct statistical analysis of treatment results to objectively judge the efficacy. At the same time, it is also necessary to monitor the blood concentration and calculate the pharmacokinetic data (see Chapter 3 for details). Generally, the number of test cases should not be less than 300, and they can be expanded to more than three medical units for multi center cooperative research after being in one hospital. For those new drugs that need long-term medication, there should be an observation record of 50-100 patients cumulatively using drugs for half a year to one year. Therefore, after formulating indications, contraindications, dosage and course of treatment, and explaining the possible adverse reactions, the product can be put on the market only after being approved by the drug administration department.

Postmarketing survey refers to the social examination and evaluation of new drugs after they are launched into the market, focusing on understanding the adverse reactions and long-term efficacy (including invalid cases) after long-term use. Drugs can only rely on the vast number of users (doctors and patients) to make a correct historical evaluation.

status

Announce

edit

Definition of new drugs: drugs whose chemical structure, drug components or pharmacological effects are different from those of existing drugs. The process of new drug research can be roughly divided into three stages: preclinical research, clinical research and post marketing surveillance. Pre clinical research consists of two parts: pharmaceutical chemistry and pharmacology《 experimental animal Pharmacodynamics, pharmacokinetics and toxicology The purpose of the study is to ensure the safety, effectiveness and controllability of drug use. Preclinical pharmacological research is an insurmountable bridge stage in the whole new drug evaluation system engineering, and its conclusions are of great value for the transition of new drugs from experimental research to clinical application. The clinical research of new drugs is generally divided into four phases. Phase I clinical trial is a preliminary clinical pharmacology and human safety evaluation test conducted on normal adult volunteers, which is the initial stage of human trials of new drugs and provides scientific basis for subsequent research. Stage I open, 20~30 cases, groping dosage. Phase II clinical trial is randomized double blind The purpose of controlled clinical trials is to select the best clinical application scheme. Phase II: blind, random, ≥ 100 pairs. Phase III clinical trial is expanded before new drugs are approved for marketing and during trial production Multicenter clinical trial The purpose is to conduct social inspection on the effectiveness and safety of new drugs. Only after the new drug has passed the clinical trial in this phase can it be approved for production and marketing. Phase III: blind, random, ≥ 300 cases. The Phase IV clinical trial is the evaluation of the safety and effectiveness of the new drug under test that continues to be carried out in a large range of social groups after it is launched. The efficacy and adverse reactions are investigated under the condition of extensive and long-term use. This phase is of great significance for the final establishment of the clinical value of the new drug. Stage IV: open,>2000 cases.

clinical

Announce

edit

Clinical pharmacology and clinical pharmacy These two sister disciplines are newly emerging disciplines in the 1960s. Marginal discipline The infiltration between them is particularly prominent, so that medical workers are inseparable. Although both belong to the pharmaceutical category, each has its own research purpose and focus.

concept

Clinical pharmacology is a discipline that studies the interaction between drugs and human body. It is not only the final comprehensive stage of pharmacological research, but also a new branch of pharmacology. The main feature different from basic pharmacological research is that clinical pharmacological research is carried out in human body. Clinical pharmacological research is one of the most important contents in evaluating new drugs.

The early clinical pharmacology can be simply regarded as "testing with human body". For example, in the feudal society of our country, there was a record that "when you are sick, you drink medicine first". In 1747, Lind used lemon Orange Treat patients with Scurvy Examples of crew members. However, clinical pharmacology was formally proposed as a discipline from 1974. In 1974, Professor Gold of the United States held a lecture on clinical pharmacology at Cornell University, which ushered in a new era of clinical pharmacology. In the following 20 years, due to the development of chemical synthesis industry, the number of new drugs increased sharply.

Species difference (including the difference between human species and between human and animals) is an important content in clinical pharmacology. The species difference makes clinical pharmacology do not support the direct promotion of a drug that has passed animal experiments into clinical practice. Even between different races, because of the species difference, it is not suitable to directly use drugs on different races. For example, ephedrine can dilate pupils, white person The pupil dilation effect is the strongest, yellow race Second, there are almost no black people. In particular, the Thalidomide incident in West Germany in the 1960s made clinical pharmacology research really attract the attention of the relevant administrative departments and medical science circles in many countries, and therefore established its essential position in new drug research.

Main tasks of clinical pharmacological research in new drug evaluation

1. Observe the efficacy and side effects of new drugs on people, and study the transport and transformation laws of new drugs in human body. This kind of research can only be carried out in hospitals with advanced equipment under the guidance of experienced clinical pharmacologists after being approved by relevant national authorities. In recent years, the extensive application of mathematics, physics, chemistry and electronic technology has made pharmacodynamic evaluation (physiological indicators such as ECG, EEG breathing Etc; Biochemical indicators such as the change of camppg concentration) reach the microscopic level. Gas chromatography, High performance liquid chromatography The application of radioimmunoassay and other technologies has solved the problem of drug microanalysis that could not be solved in the past. Finally, a pharmacokinetic parameter of drugs has been calculated. This is how to measure Drug quality The standards and methods of. Neopharmaceutical Pharmacodynamics and Pharmacokinetics The evaluation went a step further. This task is mainly completed through Phase I to III clinical research.

2. It is a regular work of clinical pharmacological research to conduct long-term in-depth clinical observation on the efficacy and toxicity of new drugs. The main form of the fourth phase clinical study is to evaluate the long-term efficacy and adverse reactions of a drug in a group of patients in a purposeful, planned and organized way. E.g. USA diabetes From 1961 to 1966, the research group was able to cooperate with 12 universities to collect 1027 patients to observe and prevent vascular complications in the development of diabetes. It was found that the cardiovascular mortality rate of patients in the methamphetamide group was significantly higher than that of other drug groups, so the use of methamphetamide was stopped in 1969. Fda of the united states has a special drug use experience department responsible for collecting reports on side effects of new drugs on the market (including spontaneous reports from medical staff around the country). In China, many clinicians and Pharmacist The experience of drug use or sporadic reports of adverse drug reactions occasionally found. There is still a gap between such an organized and purposeful large-scale phase IV clinical research and developed countries.

Difference from related science

Main differences between clinical pharmacology and clinical pharmacy

（1） Research objects In recent years, China's work in these two fields has been carried out very actively. Because the research object is people, especially the evaluation of new drugs should take a cautious attitude.

（2） If the research scope of clinical pharmacology is purely new drug evaluation, it is undoubtedly the scope of clinical pharmacology. But the new use of the old medicine and the discussion of the mechanism of action of traditional Chinese medicine, such as rivanol in amniotic fluid during induction of labor prostaglandin Horizontal research; Tripterygium wilfordii treatment Rheumatoid arthritis Comparison of 17 hydroxycorticosteroids in urine; Old medicine Phenytoin sodium , Digoxin gentamicin In normal healthy people in China Pharmacokinetics The determination of parameters should be the content of clinical pharmacology. Because it is an evaluation of old drugs, the test does not need to be approved by the authority, but some tests are not thorough from the perspective of reporting. For example, no routine physical examination, necessary laboratory examination and diet control instructions are given for normal health.

（3） The discussion of clinical pharmacy centered on rational use of drugs is very enthusiastic, and the content is quite extensive. as prescription analysis; Summarize rational drug use; Pharmacists go deep into clinical practice and share the same medication scheme with doctors; Serve as medication consultation; Pharmacokinetic test, etc.

（4） The difference between the two is Pharmacokinetics In terms of experiments, it is generally believed that the main difference between clinical pharmacology and clinical pharmacy is that the former main test object is normal healthy people, and every drug marketed for systemic use should have pharmacokinetic data (hundreds of drugs abroad have made a comprehensive and partial pharmacokinetic analysis, which is still lacking in China). The test object of the latter is patients, especially those with poor liver and kidney functions. The tested drugs are mainly limited to a few drugs with low treatment index and nonlinear dynamic characteristics, and eliminate drugs with constant and dose related in vivo.

Main functions of clinical pharmacology staff

（1） The clinical pharmacology base of the Ministry of Health shall actively undertake the clinical pharmacology research of a drug, and be technically responsible for guiding and assisting local clinical hospitals to carry out and do a good job in clinical trials and verification of new drugs. It is also responsible for formulating clinical research plans, organizing clinical trials, and jointly completing clinical research tasks of new drugs approved by the Ministry of Health or the health departments and bureaus of provinces, autonomous regions, and municipalities directly under the Central Government with hospitals designated by the health departments and bureaus of provinces, autonomous regions, and municipalities directly under the Central Government. After the clinical research is completed, a scientific summary report shall be written and sent to the development unit, and a copy shall be submitted to the Ministry of Health and the health departments and bureaus of relevant provinces, autonomous regions and municipalities directly under the Central Government.

（2） Clinical re evaluation of the produced drugs. Each clinical pharmacology base should actively carry out the re evaluation of the marketed drugs of a certain type of drugs it undertakes. According to the plan of the Ministry of Health, and in combination with the actual situation of the unit, it should carry out social investigation, collect data, combine experimental research, analyze and adjust the drugs whose efficacy is uncertain, adverse reactions or other reasons endanger people's health, Make scientific conclusions. Put forward evaluation opinions to the Ministry of Health and the Department and Bureau of Health.

（3） Responsible for drafting the clinical trial indicators and evaluation principles of various drugs. Each clinical pharmacology base is responsible for drafting the requirements, contents and observation indicators of clinical trials and clinical validation of various drugs, and the principles of clinical evaluation, so that the clinical research of various drugs can meet the requirements of standardization.

（4） Guide clinical rational drug use Adverse drug reactions Monitor and improve the level of drug treatment. When carrying out clinical pharmacological research, each clinical base should accumulate experience in safe and effective use of new and old drugs, make scientific summary at any time, and carry out adverse drug reactions epidemiology And the investigation of drug abuse, and is responsible for guiding doctors to use drugs rationally.

（5） Provide training on clinical pharmacology for doctors conducting clinical research on new drugs Beijing Medical University 、 Shanghai Medical Sciences University 、 Zhongshan Medical Sciences University Doctors from the three clinical training bases of the Ministry of Health and doctors from hospitals designated by provinces, autonomous regions and municipalities directly under the Central Government to carry out clinical trials of new drugs shall hold training courses at least once a year, and small training courses may also be held in different specialties. Other clinical pharmacology bases can also gradually create conditions to open training courses for local clinical pharmacology backbone. Each base can carry out horizontal contact, exchange with each other, and gradually write a unified national clinical pharmacology handout, so as to continuously improve the training level and make efforts to build a clinical pharmacology team in China.

（6） Each clinical pharmacology base should actively carry out clinical pharmacology consultation, and qualified units should be open to the public. For drugs with a narrow treatment range, blood concentration monitoring should be carried out in the unit to provide scientific basis for clinical treatment, and every effort should be made to ensure safe and effective drug use. Information exchange between bases is an extremely important means to promote the development of clinical pharmacology.

（7） To undertake temporary tasks and temporary clinical pharmacological tasks assigned by the Ministry of Health and the Department of Health.

New drug pharmacology

Announce

edit

pharmacology

New drugs refer to drugs with different chemical structure, drug components or pharmacological effects from existing drugs. China's "Drug Administration Law" stipulates that: new drugs refer to drugs that have not been produced in China; Changes in dosage forms, administration routes, new indications or new compound preparations of drugs already produced also belong to the scope of new drugs.

The research and development of new drugs is a systematic project with high scientific and technological content, large investment, long cycle, high risk and high benefit. It is also a very strict and complex process, and each drug is different, so pharmacological research is an essential key step. It is of great significance to constantly discover and provide new drugs that are safe, efficient, adaptable to disease spectrum and controllable in quality for protecting people's health and developing the national economy.

New drugs generally go through innovation and development stages from discovery to production to clinical application. In the innovation stage, the effective components of the product should be formulated for synthesis or separation and purification, and screened on the pathological model, so as to find compounds with development value, namely lead compounds. Further study the structure-activity relationship of the lead compound, and carry out process research, preparation research, quality control, pharmacodynamic evaluation, safety evaluation, clinical pharmacological research, etc. according to the relevant provisions of the state on the approval of new drugs.

New drugs can be found through synthesis and screening under the guidance of practical experience or theory. The research process of new drugs can be roughly divided into preclinical research, clinical research and post marketing surveillance. The preclinical research mainly includes pharmaceutical chemistry research and pharmacology research. The former includes the pharmaceutical preparation process, physical and chemical properties and quality control standards, etc., while the latter is to conduct pharmacodynamics, pharmacokinetics and toxicology research on experimental animals that comply with the Regulations on the Administration of Experimental Animals. The clinical study is divided into four phases:

Phase I clinical trial is a preliminary pharmacology and human safety test conducted on 20 to 30 normal adult volunteers, which is the initial stage of human trials of new drugs and provides scientific basis for subsequent research.

Phase II clinical trial is a randomized double-blind controlled trial, with no less than 100 cases observed, mainly to make a preliminary evaluation on the effectiveness and safety of new drugs, and recommend clinical dosage.

Phase III clinical trial is an expanded multi center clinical trial before the approval of new drugs for marketing and during trial production. The number of observed cases is not less than 300, and the effectiveness and safety of new drugs are investigated socially; Only after the new drug has passed clinical trials can it be approved for production and marketing.

Phase IV clinical trial is the evaluation of the safety and effectiveness of new drugs that continues to be carried out in a large range of social groups after the drugs are marketed. It is also called after-sales research to investigate the efficacy and adverse reactions under the condition of long-term widespread use. This period is of great significance for the final determination of the clinical value of new drugs.

At present, the concept of phase 0 clinical trial is proposed in the R&D field. Phase 0 clinical trial is a study limited to the traditional Phase I clinical trial, which aims to evaluate the pharmacodynamic and pharmacokinetic characteristics of the tested drugs. It is characterized by low dose, short cycle, small number of subjects, and not for the purpose of drug efficacy evaluation. Its purpose is to evaluate the pharmacodynamics and pharmacokinetics of anti-tumor candidate drugs acting on target indicators and/or biomarkers.^[2]

Pharmacology of Traditional Chinese Medicine

Announce

edit

pharmacology

Traditional Chinese medicine pharmacology is a science that studies the influence of traditional Chinese medicine on various functions of the body and its principle of action with pharmacological methods under the guidance of the basic theory of traditional Chinese medicine. Key research and TCM Theory Relevant achievements of modern scientific research on traditional Chinese medicine, known through research and experiment Pharmacology of Traditional Chinese Medicine Overview of the study. The research purpose of traditional Chinese medicine pharmacology is mainly to enable medical workers to further understand the principle of traditional Chinese medicine in preventing and treating diseases, as well as the material basis of curative effect. yes Traditional Chinese Medicine An important component of a category. Its main tasks are as follows:

(2) The combination of traditional Chinese medicine theory and modern scientific research results will help promote the development of traditional Chinese medicine.

(3) With the method of experimental pharmacology, combined with the separation and extraction of the effective ingredients of traditional Chinese medicine, it can provide scientific experiment basis.

(4) Via Experimental Pharmacology Methods: To develop new Chinese herbal medicine with medicinal value, expand the source of medicine, and use old medicine newly.

A brief history of the development of traditional Chinese medicine and the main achievements of modern research: (1) Development of traditional Chinese medicine brief history The emergence and development of traditional Chinese medicine, the main works of materia medica, came into being and developed in the process of the vast number of working people struggling with nature. China's first monograph on pharmacology《 Shennong's Herbal Classic It is the summary of drug knowledge gained by the working people in the practice of natural struggle and production struggle. Ephedra for asthma, Changshan for malaria, neem for insect control, rhubarb for diarrhea, etc. are valuable scientific records.

With the development of human society, folk medicine has been widely used. During the Han and Jin Dynasties, Hua Tuo 、 Li Dangzhi 、 Wu Pu They have made great contributions to drugs. At the beginning of the sixth century, Liang. Tao Hongjing Collection of the then popular Records of Famous Doctors and Materia medica By, we have compiled《 Collection of Materia Medica 》730 kinds of medicines were collected, which not only increased the variety of medicines, but also created the natural classification of herbal medicines according to the natural sources of jade, grass, wood, insects, animals, fruits, vegetables, rice, etc., which has been followed by later generations of herbal medicines such as "Syndrome Herbal Medicine", "Compendium of Materia Medica", etc. It also has a column of "general medicine for all diseases", which is very convenient for dialectical medicine. In the book, a series of explanations are made on the season of picking herbs, storage, preservation, authenticity identification, processing methods, pharmaceutical specifications and medication methods, which play a role of connecting the past and the future in the history of pharmacy.

In the seventh century AD, there were nearly 30 kinds of books on materia medica. There were some overlaps in the compilation style and content, and there were also shortcomings in the treatment of syndromes and explanations, which needed to be sorted out and improved urgently. Therefore, Tang. Su Jing , Li Chu and more than 20 others New Materia Medica 844 kinds of drugs were collected, and the drawings of medicinal materials specimens from all over the country were collected. It was issued in 654 AD, also known as Tang Materia Medica It is the first pharmacopoeia issued by the government in China Newland Pharmacopoeia As early as 877, it can also be said that it is the earliest pharmacopoeia in the world, and it has a great impact at home and abroad.

During the Northern Song Dynasty, more attention was paid to sorting out and revising ancient medical books, and they were compiled successively "Detailed Prescription of Kaibao" And Kaibao Redefining Materia Medica. jiayou During the reign of Emperor Yu Xi, he was in charge of the compilation of Jiayou Buzhu Ben Cao, Su Song Compile and draw the "Book of Materia Medica", Tang Shenwei According to the two books and other medical prescriptions Category book , compiled into a large comprehensive pharmacology book《 Prepare emergency herbs for classics and history 》, received by the following dynasties skilled doctor Attention. In the Song Dynasty, the state sent people to revise it several times, and continued to issue the Grand View Materia Medica of Classics and History, and the Standby Materia Medica of Zhenghe's New Revision of Classics and History. Later generations collectively called the two books "Zhenglei Materia Medica". It is a medicine book that gathers the achievements of materia medica before the Song Dynasty, preserves the essence of many ancient classics, and retains the original appearance of early documents《 Compendium of Materia Medica 》The large herbal medicine, which had been popular before its appearance, was regarded as a model for the study of materia medica. Some of the ancient medical books cited in the book have been lost, but we can see their outlines from this book, so it not only has great practical value, but also has important historical literature significance.

Ming, Liu Wentai Was ordered to compile《 Summary of Herbal Products 》It is the second draft book prepared by the government after the New Draft. Later, Li Shizhen In view of the fact that a variety of materia medica works have been published in the five hundred years since "Zheng Lei Ben Cao", a large number of practical drugs have emerged, and the main functions of drugs are

There are new developments. In addition, he has accumulated rich practical experience in collecting, distinguishing, making and using drugs. He took "Zheng Lei Ben Cao" as the blueprint, and referred to nearly 800 books of classics and history; Through field investigation and research, the authenticity was identified and compiled into 52 volumes of Compendium of Materia Medica, which is divided into 16 parts, 62 categories, 1892 kinds of drugs, and 1120 drug pictures. It was carved in Jinling at the beginning of 1590. This book summarizes the achievements of Chinese materia medica before the 16th century. Over the past three hundred years since its publication, it has been reproduced many times in Britain, Japan virtue , French, Russian and other translations are famous at home and abroad and have far-reaching influence. After the publication of Compendium of Materia Medica, scholars in the Qing Dynasty wrote books related to it from different perspectives, such as adding and correcting errors《 Supplement to Compendium of Materia Medica 》, the abridged Self Abstract of the Outline of Materia Medica and the Compilation of Materia Medica, as well as the small clinical practical materia medica, the Compendium of Materia Medica, and the New Materia Medica. Especially worth mentioning is Wu Qixuan's Textual Research on Plant Names and Facts Based on the material objects, the author has carefully drawn the medicine drawings, which are clear and lifelike, and corrected the mistakes in the drawing of ancient Chinese materia medica. The "Long Edition" part extracts relevant records in the ancient Chinese materia medica and miscellaneous books of literature and history, which has great reference value and is generally valued by scholars at home and abroad.

After the liberation, the government was very concerned about the cause of traditional Chinese medicine, and successively issued TCM policies, established TCM research institutions, and opened TCM colleges and universities. With the vigorous development of the cause of traditional Chinese medicine, a large amount of data has been accumulated in the resource investigation, variety identification, chemical and pharmacological research, clinical observation, etc. of traditional Chinese medicine. center Ministry of Health The Pharmacopoeia of the People's Republic of China has been compiled and promulgated, which clearly stipulates the specifications, efficacy, indications, dosage, usage and quality control of traditional Chinese medicine. Many books on traditional Chinese medicine, such as Traditional Chinese Medicine, Identification of Traditional Chinese Medicine, Chemistry of Traditional Chinese Medicine, and Clinical Chinese Medicine, have made preliminary summaries from different aspects. It also published large-scale comprehensive medicine books, such as "Records of Traditional Chinese Medicine", "National Collection of Traditional Chinese Medicine" and "Dictionary of Traditional Chinese Medicine", which comprehensively and systematically summarized the achievements of traditional Chinese medicine research. The latter also extracted ancient herbal literature, which is an important reference book for studying traditional Chinese medicine.

(2) In recent years, the main achievements in pharmacological research of traditional Chinese medicine scientific method It has studied Chinese medicine for more than 80 years. In the early 1920s, Chinese scholars were the first to component Ephedrine, pseudoephedrine and ephedrine were systematically studied in chemistry and pharmacology. Because of the discovery of its specific pharmacological effect, its paper report not only shocked the domestic, but also attracted great attention abroad, and aroused the interest of scholars around the world in ephedrine and other traditional Chinese medicine research, making ephedrine an important drug worldwide. Due to the social unrest, war unrest, poor equipment and few personnel at that time, the research was slow and the results were few. The research on a single drug was mainly carried out, and there was no cooperation among chemistry, pharmacology and clinic. In terms of chemistry, it mainly focuses on corydalis, uncaria, ephedra Changshan 、 Self-defense And dozens of other medicinal materials. Pharmacology mainly studies dozens of medicinal materials, such as Ephedra, Coptis chinensis, Changshan, Corydalis yanhusuo, Agrimonia pilosa, etc. After liberation, the government attached great importance to the sorting, research and development of traditional Chinese medicine, put forward important instructions on inheriting, carrying forward, sorting out and improving traditional Chinese medicine, and established TCM research institutions and TCM hospitals at all levels from the central to local provinces and cities, so that the pharmacology and clinical research of traditional Chinese medicine entered a new stage, and the research scope developed from unilateral to compound, Research topics range from resource investigation to crude drug identification, processing, chemistry

pharmacology

From pharmacology to clinical practice, the variety of single medicine and the scope of research are unprecedented. For Yanhusuo, Fenfangji, Ginseng, Coptis chinensis Pueraria lobata 、 rhizome of chuanxiong 、 Salvia miltiorrhiza , panax notoginseng, fructus aurantii Fructus Aurantii , Ganoderma lucidum, zedoary chinese rhubarb 、 Artemisia annua 、 Greenwood fragrance , motherwort Trichosanthin And other researches are relatively in-depth, and also from the aspects of anti microbial, anti parasite , anti-tumor, antipyretic, analgesic, cardiotonic, diuretic, anti hypertension, anti arrhythmia, etc. Not only Traditional Chinese Medicine There are many researches, including many herbs, such as Andrographis paniculata 、 Sijiqing 、 Ilex pubescens 、 Dwarf tea 、 Felwort 、 Folium Rhododendri Daurici And has provided clinical application, greatly enriching the variety of drugs. To sum up the pharmacological studies of Chinese herbal medicine, some of them clarify the theory of Chinese medicine (such as promoting blood circulation and removing blood stasis, strengthening the body and tonifying the body), clarify the effective ingredients of some Chinese medicines (such as tetrahydropalmatine, artemisinin, ligustrazine, etc.), improve some dosage forms (such as Ganmao Granule, Shengmai Injection Liquid, etc.), and discover new uses of some drugs (such as Zhishi, Qingpi, Hecao Bud, etc.). However, the components of traditional Chinese medicine are complex, and its functions are also multifaceted. One component can never represent a single traditional Chinese medicine, and one function can not summarize all its functions. In this case, many problems of traditional Chinese medicine need to be further studied. The problem needs further study.

Basic theory

Announce

edit

Pharmacological effect

1. Drug action refers to the initial action between drugs and body cells, which is the agent and molecular reaction mechanism, and has its specificity.

2. The result of the pharmacological effect of drugs is the manifestation of the body reaction, which has its selectivity to different organs. The most basic pharmacological effects include excitation and inhibition.

3. The selectivity of pharmacological effects, that is, the specificity of pharmacological effects, is the range of effects caused by drugs. It is the basis for drug classification, as well as the basis for guiding drug use and formulating therapeutic dose in clinical medication. Drug selectivity is related to the chemical structure of the drug itself.

4. The drug action has duality.

(1) Therapeutic effect: It refers to the effect caused by drugs that conforms to the purpose of drug use.

(2) Adverse reactions: those reactions that do not meet the purpose of drug treatment and bring pain or harm to patients.

Therapeutic effect of drugs

1. Define the actions that meet the purpose of medication or achieve the prevention and control effect as Therapeutic effect 。

2. Classification According to the purpose of treatment:

(1) Treatment for causes: for Etiological treatment It is called cause based treatment, also called root cause treatment. The purpose of medication is to eliminate the primary pathogenic factors and completely cure the disease.

(2) Symptomatic treatment: the use of drugs to improve the symptoms of the disease, but can not eliminate the cause, called symptomatic treatment, also known as symptoms. The purpose of medication is to improve symptoms.

Adverse drug reactions

pharmacology

Any reaction that does not meet the purpose of drug treatment and brings pain or harm to patients is called adverse reaction. It is generally predictable and can recover automatically after drug withdrawal.

1. Side effects The side effects of drugs at the therapeutic dose that have nothing to do with the therapeutic purpose are generally not serious and are difficult to avoid.

2. Toxic reaction Serious adverse reactions caused by excessive dosage or time of medication and excessive accumulation of drugs in the body are generally serious, predictable and avoidable. Divided into:

(1) Acute toxicity: toxicity that occurs immediately after overdose in a short period of time.

(2) Chronic toxicity: the toxicity that gradually occurs due to the accumulation of long-term drugs in the body. Carcinogenic, teratogenic and mutagenic reactions also belong to the category of chronic toxicity.

3. Sequential effect refers to the residual biological effect when the blood concentration has dropped below the threshold concentration after drug withdrawal.

4. Drug withdrawal reaction The exacerbation of the original disease after sudden drug withdrawal is also called rebound reaction.

5. Allergic reaction (anaphylaxis) is an immunopathological reaction caused by drugs.

6. Heterogeneous reaction Some drugs cause specific adverse reactions in a few patients, which is a genetic biochemical defect.

7. Secondary reactions: small and good reactions caused by drug treatment, also known as therapeutic contradictions.

Dose effect relationship

Announce

edit

Dose concept

1. The minimum effective dose (threshold dose or threshold concentration) is the minimum dose required for efficacy.

2. The therapeutic dosage refers to the commonly used dosage of drugs, which is the effective dosage range commonly used in clinical practice, and generally between the minimum effective dosage and the maximum dosage.

3. The maximum dose that causes the maximum effect without poisoning (i.e. the limit of safe use of drugs).

4. The commonly used dose is larger than the threshold dose and smaller than the extreme dose. Generally, the amount of treatment should not exceed the extreme amount.

5. The minimum amount of poisoning exceeds the extreme amount, which has just caused mild poisoning.

6. The dose that half of the animals die from LD50.

reaction curve

pharmacology

1. Quantitative reaction The pharmacological effect shows a quantitative change of continuous increase and decrease, which can be expressed by number or quantity grading, such as blood pressure rise and fall smooth muscle Relaxation and contraction, etc.

(1) Potency intensity: The dosage required for a drug to reach a certain pharmacological effect reflects the affinity between the drug and the receptor. The smaller the value, the greater the intensity. It is usually expressed as the dose that produces 50% of the maximum effect, called the half effective dose (ED50).

(2) Efficacy: the ability of the drug to achieve the maximum pharmacological effect (increase the concentration or dose and the effect dose will not continue to rise), reflecting the internal activity of the drug.

(3) The meaning of maximum efficacy and effect intensity of drugs is completely different, and they are not parallel.

2. Pharmacological effect of qualitative reaction shows the change of reaction nature, which can only be expressed by all or none, positive or negative, such as death And survival, convulsion and non convulsion.

（3） The time effect relationship of drugs is called the time effect relationship of drugs. The time course of drugs can be divided into incubation period, duration period and residual period.

Drug safety evaluation

1. The ratio of half lethal dose and half effective dose (LD50/ED50) of the treatment index, the greater the ratio, the greater the relative safety, and vice versa. The drug effect and toxic reaction nature of this indicator are not clear, and this safety indicator is not reliable.

2. The safety range is the distance between ED95 and TD5. The greater the value, the safer it will be. The safety of drugs is related to the drug dose (or concentration).

3. Safety index LD5/ED954. Safety limit (LD1-ED99)/ED99.

Action mechanism Drug

Pharmacological effects can be produced by:

1. Change the physical and chemical properties of the cell surrounding environment.

2. Supplement various substances lacking in the body.

3. Affect neurotransmitters or hormones.

4. Acting on specific target receptors, enzymes, ion channels, carriers, nucleic acids, immune system and gene Etc.

5. The non-specific action of drugs is mainly related to their physical and chemical properties, and does not depend on the chemical structure. There is no specific action mechanism.

pharmacology

Receptor theory

（1） Concept and characteristics of receptors

1. Receptors are glycoproteins or lipoproteins, which exist in cell membranes Cytoplasm Or in the nucleus, the cell components that can identify some trace chemicals in the surrounding environment, combine with drugs, and can transmit information and cause effects.

2. The ligand can specifically bind to the receptor, including endogenous ligand and exogenous ligand.

3. Receptor characteristics: ① saturation; ② High sensitivity; ③ Reversibility; ① High affinity; ⑤ Diversity.

（2） Type of receptor

According to the characteristics of receptor protein structure, information transmission process, effect properties and receptor location, receptors are divided into four categories:

1. Ion channel receptor.

2. G-protein coupled receptor.

3. Tyrosine kinase receptor.

pharmacology

4. Intracellular receptors. （3） Drug receptor interaction

According to the affinity and intrinsic activity of drugs, drugs can be divided into agonists and antagonists.

1. Agonists can bind to and stimulate receptors to produce corresponding effects, and have affinity and intrinsic activity with receptors.

(1) Complete agonists: have strong affinity and intrinsic activity (α=1).

(2) Some agonists: they have strong affinity with receptors and weak intrinsic activity (α<1).

2. Antagonists can block the ligand of receptor activity and have strong affinity with the receptor, but have no intrinsic activity (α=0).

（1） Competitive antagonist : It can compete with agonists for the same receptor, and can reversibly bind to the receptor. The dose response curve shifts parallel to the right, and the slope and height (Emax) remain unchanged.

（2） Non competitive antagonists : Do not compete with agonists for the same receptor, or irreversibly bind with the receptor, the dose-response curve shifts to the right, the slope decreases, and the height (Emax) decreases.

（4） The second messenger of signal transduction after the interaction of drugs and receptors: after the ligand acts on the receptor, it can induce the production of some intracellular chemicals, which can be used as intracellular signals Transfer material It further transmits the signal to the downstream signal transduction protein, so it is called the second messenger.

The identified second messengers include: Cyclic adenosine phosphate （cAMP）、 Cyclic guanosine （cGMP）、 Phosphoinositol （IP3）、 Diacylglycerol (DG) and calcium ion 。

Pharmacokinetics

Pharmacokinetics, called pharmacokinetics for short, studies the process of drugs in vivo and the law of drug concentration changes with time. Although drugs may not be concentrated in target organs in vivo, their pharmacological effects are proportional to the drug plasma concentration after the distribution reaches balance. Doctors can use the pharmacokinetic laws to scientifically calculate the drug dose to reach the required blood concentration and master the strength and duration of the drug effect. In this way, better clinical efficacy can be achieved than by experience alone.

absorb

A few drugs similar to normal metabolites, such as 5-fluorouracil and methyldopa, are absorbed by the active transport of carriers in cells. This active transport mechanism is closely related to the drug distribution in vivo and renal excretion. Facilitated diffusion depends on the carrier concentration gradient transmembrane transport mode, such as glucose absorption, which is faster. Solid drugs cannot be absorbed. Tablets and capsules may be absorbed only after disintegration and dissolution in the gastrointestinal tract.

Drug oxidation process

Drug reduction process

The second step of biotransformation is binding. Most of the drugs that have undergone oxidation reaction are combined with glucuronic acid by glucuronosyltransferase of liver microsome. Some drugs can also combine with acetyl, glycine, sulfuric acid, etc. These binding reactions require the participation of donors, for example, uracil diphosphate is the donor of glucuronic acid.

nature

Announce

edit

Pharmacology is one of the subjects studying drugs, and it is a basic medical discipline that provides basic theories for clinical rational drug use and disease prevention. Pharmacological study of drugs and body (including pathogen ）The law and principle of interaction. Drugs refer to substances used to prevent and diagnose diseases. Theoretically, all chemical substances that can affect the physiological functions of body organs and (or) cell metabolic activities belong to the category of drugs, including

pharmacology

Including contraceptives and health pills. Pharmacology, on the one hand, studies how the cell function of the body changes under the influence of drugs; on the other hand, studies the process of drugs in the body, that is, how the body treats drugs. The former is called Pharmacokinetics (pharmacodynamics), short for pharmacodynamics; The latter is called Pharmacokinetics (pharmacokinesics) Pharmacokinetics. It can be seen that the main object of pharmacological research is the body, which belongs to the broad category of physiological science. It is closely related to the pharmaceutical science, such as pharmacognosy Pharmaceutical chemistry 、 Pharmaceutics , pharmacy and other disciplines have obvious differences. Pharmacology is based on physiology Biochemistry , pathology, etc., providing a theoretical basis for guiding rational drug use in clinical departments.