CAJ | 학술논문

人体对药物的反应存在巨大的个体差异,体重相近的两个人给予相同剂量的药物,他们各自的血浆药物浓度水平可能相差10倍以上.药物相互作用、药物与食物相互作用、性别、年龄、疾病状态(即肾脏和肝脏的功能)以及妊娠都可能引发药物反应的个体差异.遗传因素也可能起到了重要作用,因为每个个体对药物的反应具有高度可再现性.药物基因组学是研究遗传性及获得性基因变异对药物反应作用的一门学科.证实影响药物吸收、代谢以及作用(在受体水平时)的遗传机制,使个体化治疗成为可能,使药物疗效最优化,药物的毒性最小化.本研究将以华法林为例,综述华法林药物基因组学的研究现状,为临床合理用药提供依据.
인체대약물적반응존재거대적개체차이,체중상근적량개인급여상동제량적약물,타문각자적혈장약물농도수평가능상차10배이상.약물상호작용、약물여식물상호작용、성별、년령、질병상태(즉신장화간장적공능)이급임신도가능인발약물반응적개체차이.유전인소야가능기도료중요작용,인위매개개체대약물적반응구유고도가재현성.약물기인조학시연구유전성급획득성기인변이대약물반응작용적일문학과.증실영향약물흡수、대사이급작용(재수체수평시)적유전궤제,사개체화치료성위가능,사약물료효최우화,약물적독성최소화.본연구장이화법림위례,종술화법림약물기인조학적연구현상,위림상합리용약제공의거.
There is tremendous interindividual variability in the response to pharmacologic agents.Plasma drug levels can vary more than 10-fold when the same drug dose is administered to two individuals having approximately the same weight.Drug-drug interactions,drug-food interactions,sex,age,disease state (ie,renal and hepatic function) and pregnancy can all influence variability in drug responses between patients.Genetic factors are also likely to play a major role,since the individual response to a given pharmacologic agent is highly reproducible.Pharmacogenomics is the study of the role of inherited and acquired genetic variation on drug response.The identification of genetic factors that influence drug absorption,metabolism,and action at the receptor level should allow for individualized therapy.This could optimize drug efficacy and minimize toxicity profiles.This article will take warfarin as an example,to review the research status of warfarin pharmacogenomics,and to provide the basis for clinical rational use of drugs.