Nekvindová J, Anzenbacher P
Palacky University, Faculty of Medicine and Dentistry, Institute of Pharmacology, Olomouc Czech Republic.
Ceska Slov Farm. 2007 Jul;56(4):165-73.
Drug side effects and toxicity and often the drug efficacy are highly dependent on drug metabolism determining the activation and/or elimination of the respective compound. In humans, cytochromes P450 are the most important drug metabolizing enzymes of the first phase of drug biotransformation. Their activity can vary due to interindividual genetic differences, but it can be changed also by inhibition or induction of the enzymes by their substrates or other compounds that are not only drugs themselves and/or drugs taken concomitantly. Often, influence on drug metabolism by compounds that occur in the environment, most remarkably in the food, is forgotten. Some commonly used herbs, fruits as well as e.g. alcohol may cause failure of the therapy up to serious alterations of the patient's health. This review presents a brief overview of potentially dangerous nutrition factors including herbs (incl. teas, infusions) that should be considered when indicating individual drug therapy. Examples include primarily grapefruits, pomelo, star fruit, pomegranates and some other fruits, St John's Wort (Hypericum perforatum), caffeine, as well as alcohol and cigarette smoking.
药物副作用和毒性以及药物疗效通常高度依赖于药物代谢,而药物代谢决定了相应化合物的活化和/或消除。在人类中,细胞色素P450是药物生物转化第一阶段最重要的药物代谢酶。其活性可能因个体间的遗传差异而有所不同,但也可能因酶被其底物或其他不仅本身是药物而且/或者同时服用的药物的抑制或诱导而发生变化。通常,环境中出现的化合物,尤其是食物中的化合物对药物代谢的影响被忽视了。一些常用的草药、水果以及例如酒精可能导致治疗失败,甚至严重损害患者健康。本综述简要概述了在制定个体化药物治疗方案时应考虑的潜在危险营养因素,包括草药(包括茶、浸剂)。主要例子包括葡萄柚、柚子、杨桃、石榴和其他一些水果、圣约翰草(贯叶连翘)、咖啡因,以及酒精和吸烟。