Why prescription drugs work differently for different people

May be owned by different people taking the same medicine Significantly different response At the same dose. While many get the desired effect, some get little or no benefit, while others have unwanted side effects.

As pharmacist who Study the safety and effectiveness of drugsI know this can happen for a number of reasons, such as individual differences, drug interactions, etc. inflammation..

Genetic difference

In the liver Cytochrome P450 A system that can metabolize or break down many drugs and remove them from the body.

A cell’s DNA, or genetic material, contains a blueprint for making these enzymes. Unfortunately, some people have a little mistake in their DNA. Polymorphism As a result, the enzyme also stops working.

Where these errors occur Appears in enzymatic substances. If they occur in parts of the enzyme that are not directly involved in breaking down the drug, they have little effect on how you metabolize the drug. Active site However, it can bind to the drug and impair its ability to break it down, after which Many drugs that circulate in the blood..When blood levels are high Beyond the therapeutic range of the drug, May cause serious side effects.

Some people have polymorphisms that tell the body to make two identical enzymes instead of just one. They are “Super metabolic apparatus“It breaks down the drug faster than usual and lowers the concentration of active drug in the body. If the concentration is below the therapeutic range, there may not be enough drug to achieve a beneficial effect.

Clinicians can test a patient’s DNA for these enzyme polymorphisms. If a known polymorphism is detected Change the dose Or, if a particular drug isn’t working as expected, or is likely to cause side effects, avoid the drug altogether.

Drug interaction

Genetic variation explains only part of the variation in drug response. Another factor to consider Drug interaction..

Some drugs block the active site of the liver Enzyme Cytochrome P450 is not reusable, preventing other drugs from binding to it and being metabolized. As the drug levels increase, the risk of side effects also increases. For example, the cardiac conditioning drug amiodarone may be blocked Metabolism of the anticoagulant warfarinThis results in very high warfarin levels and can cause life-threatening bleeding.

Conversely, the antiepileptic drugs phenytoin and carbamazepine Stimulates the production of more metabolic enzymes more than usual. Other drugs may be metabolized faster than normal and their beneficial effects may be lost.

inflammation

If the body is newly infected or injured Inflammatory reaction It brings about an increase in white blood cells and blood flow to the area to sterilize and repair the problem. Only lasts a short time..However, some people’s immune systems can also attack and lead to unaffected areas. Chronic inflammation Damage to tissues and joints, and even Risk of heart disease..

inflammation of New infection or chronic inflammatory disease Enzymes like cytochrome P450, such as rheumatoid arthritis and psoriasis, can also impair the ability of a drug to metabolize.

The liver is one of the main organs that, in addition to producing the enzyme cytochrome P450, produces a special protein called. Cytokines and interferons attend Immune response.. When the liver is busy making all of these proteins, it is unable to make many drug metabolizing enzymes, which reduces drug breakdown. When the infection clears or when the cause of the inflammation is blocked as follows: Anti-inflammatory drugBut the liver’s ability to metabolize drugs Back to normal.. it’s, Chronic infection or inflammation Their liver enzymes don’t clean them out as quickly as they normally do, so they may require lower doses of the drug. And it’s Inflammation is eliminatedThey may need to increase their dose to maintain the same desired effect as before.

One of the main ways to tell if the inflammation has increased is c-reactive protein (CRP) concentration. CRP does not directly cause inflammation, but the body produces more CRP due to inflammation. Therefore, high levels of CRP in the blood may indicate an underlying inflammation and then Increased suppression Drug metabolism.

Other factors affecting drug metabolism

Even if drug interactions are avoided and inflammation is removed, many other factors can affect how well the drug works.

Damage to the liver or kidneys It can reduce the way the drug is broken down and eventually excreted in the urine and bile.

The size of the body also affects the response to the drug. Drug levels in the body are determined by both the dose administered and the amount of fluid in the individual. Dosage of the same drug Small person It can cause higher blood levels than when given to a bigger person. That is why many drugs are given to children in lower doses than adults.

And finally, some people don’t either Has many receivers The receptors they have, or in their body, do not work well for the drugs to bind and produce their effects. It could be due to genetic variation or an underlying disorder. The average dose of the drug produces only a limited response in these patients.

Talk to a clinician

One of the reasons there are so many different drugs and doses for different diseases is that your response to the drug may not be the same as that of the average person. When starting a new treatment regimen it may need to be adjusted to the correct level, and this requires patience and cooperation between you and your clinician.

Identify the possibilities Drug interaction, Tell the pharmacist All prescriptions, over-the-counter medications, and dietary supplements that you take.

If you develop a new infection or disease that causes you inflammation, Dosage of other medicines you are currently taking May need to be reduced.. If you notice any new side effects, tell your clinician or pharmacist immediately.

If you have a severe chronic inflammatory disease such as Rheumatoid arthritis Where to start psoriasis and a powerful anti-inflammatory to glideTell your clinician or pharmacist if there are any other medicines you are taking Doesn’t work like before You can therefore adjust your dose.

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