药物不良反应与药源性疾病e.ppt

Drug adverse reaction and drug-induced disease Department of Pharmacology Shantou University Medical College Yan-Qiong Zhou Drug adverse reaction common/normal application dosage→harmful and unexpected reaction Drug adverse reaction Side effect (副作用) toxic effect(毒性反应) Residual effect(后遗效应) dependence(依赖性) Idiosyncratic reaction/ Idiosyncrasy (特异质反应) allergic reaction/hypersensitive reaction (过敏反应/变态反应) Carcinogenesis, teratogenesis, mutagenesis(致癌、致畸和致突变反应) (not including Overdose; drug abuse; error treatment) Drug-induced disease drug-induced functional or structural damage of the body; clinical course Essence: result/sequel of the Drug adverse reaction Classify adverse reaction§drug dosage adverse reaction§peculiarity WHO;World Health Organization adverse reaction§drug dosage concerned with dosage (A-type reaction)：有些药物不良反应与剂量大小有直接关系，这类反应也称为A型反应。 dosage indifference (B-type reaction)：某些药物不良反应与药物剂量无关，称为B型不良反应。 A型与B型药物不良反应的特点 adverse reaction§peculiarity side effect(副作用) toxic effect(毒性作用) residual effect(后遗效应) dependence(依赖性) idiosyncratic reaction(特异质反应) allergic reaction(变态反应) carcinogenesis(致癌作用) teratogenesis(致畸作用) mutagenesis(致突变作用) adverse reaction classified by WHO side effect (副反应) adverse event (不良事件) adverse reaction (不良反应) unexpected adverse reaction (意外不良反应) signal(信号) Aetiology of drug adverse reaction and drug-induced disease congenital abnormality of patient reaction病人反应先天性异常 Acquired abnormity获得性异常 drug factor药物因素 drug interactions 药物相互作用 Indirect reaction间接反应 Congenital abnormality of patient reaction allergic/hypersensitive reaction Ⅰ、Ⅱ 、Ⅲ 、Ⅳ 、 autoimmune response genetic factor pharmacokinetics abnormality、pharmacodynamics abnormality、idiosyncrasy、 Inborn sensitivity age; cyesis/pregnancy Acquired abnormality Hepar affection kidney affection drug receptor abnormity Drug factor Overdosage、alter of bioavailability、incorrect administration route withdrawal symptom spatial isomerism Indirect reaction fetal anomaly tha