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    Factors Modifying Drug Actions

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    DAMBALE
    There are many factors that can modify how an individual responds to a drug, requiring dosage adjustments. These include body size, age, sex, genetics, disease states, and environmental influences. Drugs may have different effects and dosages needed between individuals, populations, or even the same person over time due to differences in factors like metabolism and physiology. Careful consideration of modifying factors is important for optimizing drug therapy for each patient.

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    Factors Modifying Drug Actions

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    DAMBALE
    523 views3 pages
    There are many factors that can modify how an individual responds to a drug, requiring dosage adjustments. These include body size, age, sex, genetics, disease states, and environmental influences. Drugs may have different effects and dosages needed between individuals, populations, or even the same person over time due to differences in factors like metabolism and physiology. Careful consideration of modifying factors is important for optimizing drug therapy for each patient.

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    There are many factors that can modify how an individual responds to a drug, requiring dosage adjustments. These include body size, age, sex, genetics, disease states, and environmental influences. Drugs may have different effects and dosages needed between individuals, populations, or even the same person over time due to differences in factors like metabolism and physiology. Careful consideration of modifying factors is important for optimizing drug therapy for each patient.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    523 views3 pages

    Factors Modifying Drug Actions

    Uploaded by

    DAMBALE
    There are many factors that can modify how an individual responds to a drug, requiring dosage adjustments. These include body size, age, sex, genetics, disease states, and environmental influences. Drugs may have different effects and dosages needed between individuals, populations, or even the same person over time due to differences in factors like metabolism and physiology. Careful consideration of modifying factors is important for optimizing drug therapy for each patient.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    Pharmacology Ms. Meenu Bhati (Asst.

    Prof at CBS)

    FACTORS MODIFYING DRUG ACTION


    Individual differ in degree and character of drug response and therefore the optimum
    dose of drug that produces therapeutic effect varies from person to person.
    • Responses variation to a Drug – (1) person to person; and (2) also same person
    on different occasions.
    • Factors modify drug action
    Quantitatively – action increased or decreased
    Qualitatively: Altered response – allergic reaction or
    idiosyncrasy
    1. Body Size:
    Influences the conc. of the drug attained at the site of action – obese/lean/children
    – Body weight (BW) and Body Surface area
    • Individual dose = BW (In kg.)/70* average adult dose
    • Individual dose = BSA (Mtr.)2/ 1.7*average adult dose.
    2. Age:
    • Young`s formula
    Child Dose= Age/Age+12* Adult dose
    Note: Infants & children are not small adults – physiological differences
    • Low g.f.r and tubular transport – Gentamicin and Penicillin
    • Low hepatic drug metabolizing systems in newborns – gray baby syndrome
    • Blood brain barrier (BBB) is more permeable – Kernicterus
    3. Sex:
    • Females have smaller body size – required doses are lower
    • Digoxin in Maintenance therapy of heart failure – mortality higher
    • Beta blockers, methyldopa, diuretics – sexual function interference in males
    • Gynaecomastia – Metoclopramide, chlorpromazine, ketoconazole etc.
    • Pregnancy – particularly 3rd trimester.
    4. Species and Race:
    • Species variation in drugs responses do exist
    • Some strains of rabbits – resistant to atropine
    Pharmacology Ms. Meenu Bhati (Asst. Prof at CBS)

    • Rat and mice are resistant to digitalis


    • Race – racial differences have been observed
    • Blacks require higher doses of atropine and ephedrine, while Mongols
    require lower doses
    • Africans – beta blockers are less effective
    5. Genetics:
    • It deals with genetic influences on drug action as well as on drughandling by
    the body. As the genomic technology has advanced, gene libraries and huge
    data bases (like 'pharmacogenetics and pharmacogenomics knowledge base',
    'Human genome variation database', etc.) have been created aiming at
    improving precision in drug therapy.
    • Pharmacogenetics: Use of genetic information to guide the choice of drug
    and dose on an individual basis – to identify individuals who are either
    more likely or less likely respond to a drug.
    • so far genetic abnormalities have been identified
    • Personalized medicine goal yet to achieve
    • G-6PD deficiency – Primaquine, chlroquin, quinine, dapsone, aspirin
    6. Route of administration:
    • Route of admini5tration governs the speed and intensity of drug response
    • Parenteral administration often resorted to for more rapid, more pronounced
    and more predictable drug action.
    7. Environmental factors:
    • Drug metabolism may get induced – exposure to insecticides, carcinogens,
    tobacco smoke and charcoal broiled meat etc.
    • Food interferes absorption of some drugs while enhances some drugs –
    ampicillin gets reduced griseofulvin gets enhanced
    • Hypnotics taken at night and in quiet.
    8. Psychological factors:
    • Efficacy of a drug can be affected by patient`s beliefs, attitudes and
    expectations particularly. CNS drugs more GA in nervous and anxious
    patients – alcohol and performance
    e.g-Placebo
    9. Pathological states:
    • Diseases can influence drug disposition – GIT diseases, Liver diseases,
    Kidney diseases, Congestive heart failure and Thyroid etc.
    Pharmacology Ms. Meenu Bhati (Asst. Prof at CBS)

    • GIT: Coeliac diseases – amoxicillin absorption decreased while Cephalexin


    and cotrimoxazole increased; Achlorohydria – Reduced aspirin absorption –
    NSAIDs aggravate peptic ulcer
    • Liver diseases: Liver disease (cirrhosis) influence drug action Increased
    bioavailability of drugs with high first pass metabolism.
    10. Tolerance:
    • Requirement of higher dose of a drug to produce a given response
    refractoriness
    e.g- sulfonylureas in type 2 diabetes and beta-2 agonists in bronchial
    asthma - adaptive biological phenomena.

    ***END***

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