论文部分内容阅读
治疗药物监测(Therapeutic Drug Monitor-ing,简称TDM)是近年来临床医学中发展较快领域之一,它的兴起是与现代科学技术如微量分析技术、临床药物动力学理论、电子计算机的发展密切相连的。它是通过测定血液中药物的浓度,根据药物动力学的原理,来调整给药方案,以期达到安全有效地使用药物的目的。 一、血药浓度与药理效应 药物经各种给药途径进入体内后,绝大部分随着血流到达作用部位或受体部位,当这些部位的药物浓度达到一定水平时,就产生应有的药理效应。药物在体内的分布是不均匀的,分布多的组织,不一定就是表现药理作用的部位。药物在组织中的分布,或在作用部位与受体的结合,是一种可逆的过程,并且处在平衡之中。由于血浆中药物浓度与组织中细胞外液中药物浓度相平衡,而细胞外液中的药物可以进入细胞与受体结合,并且药物浓度在它们之间存在着一定的比例关系,因此,血浆中药物浓度(简称血药浓度)可以间接地作为受体部位药物浓度的指标,这就是测定血药浓度来表示药效的依据。
Therapeutic Drug Monitor-ing (TDR) is one of the fastest-growing areas in clinical medicine in recent years. Its rise is closely related to modern science and technology such as micro-analysis technology, clinical pharmacokinetic theory, and the development of electronic computers connected. It is through the determination of the concentration of the drug in the blood, according to the principle of pharmacokinetics, to adjust the dosing regimen, in order to achieve the purpose of safe and effective use of drugs. First, the blood concentration and pharmacological effects Drugs by various routes of administration into the body, most of the blood flow to reach the site or receptor sites, when these parts of the drug concentration reaches a certain level, it should produce Pharmacological effects. The distribution of drugs in the body is uneven, distributed more tissue, not necessarily part of the performance of pharmacological effects. The distribution of a drug in a tissue, or its binding to a receptor at the site of action, is a reversible process and is in balance. Due to the concentration of drug in plasma and the concentration of drug in the extracellular fluid in the tissue balance, and the extracellular fluid drugs can enter the cell and receptor binding, and the concentration of the drug there is a certain proportion between them, therefore, plasma Drug concentration (referred to as plasma concentration) can indirectly as an indicator of drug concentration at the receptor site, which is measured by the blood concentration to indicate the basis of efficacy.