Soldin Offie P, Mattison Donald R
Departments of Medicine, Oncology and Physiology, Center for the Study of Sex Differences, Georgetown University Medical Center, Washington, DC, USA.
Clin Pharmacokinet. 2009;48(3):143-57. doi: 10.2165/00003088-200948030-00001.
Significant differences that exist between the sexes affect the prevalence, incidence and severity of a broad range of diseases and conditions. Men and women also differ in their response to drug treatment. It is therefore essential to understand these reactions in order to appropriately conduct risk assessment and to design safe and effective treatments. Even from that modest perspective, how and when we use drugs can result in unwanted and unexpected outcomes. This review summarizes the sex-based differences that impact on pharmacokinetics, and includes a general comparison of clinical pharmacology as it applies to men, women and pregnant women. Sex-related or pregnancy-induced changes in drug absorption, distribution, metabolism and elimination, when significant, may guide changes in dosage regimen or therapeutic monitoring to increase its effectiveness or reduce potential toxicity. Given those parameters, and our knowledge of sex differences, we can derive essentially all factors necessary for therapeutic optimization. Since this is a rapidly evolving area, it is essential for the practitioner to review drug prescribing information and recent literature in order to fully understand the impact of these differences on clinical therapeutics.
两性之间存在的显著差异会影响多种疾病和病症的患病率、发病率及严重程度。男性和女性对药物治疗的反应也有所不同。因此，了解这些反应对于合理进行风险评估以及设计安全有效的治疗方案至关重要。即便从这个适度的角度来看，我们使用药物的方式和时间也可能导致不良和意外的结果。本综述总结了影响药代动力学的性别差异，并对适用于男性、女性和孕妇的临床药理学进行了总体比较。药物吸收、分布、代谢和排泄方面与性别相关或妊娠引起的变化，若较为显著，可能会指导调整给药方案或治疗监测，以提高疗效或降低潜在毒性。鉴于这些参数以及我们对性别差异的了解，我们基本上可以得出治疗优化所需的所有因素。由于这是一个快速发展的领域，从业者必须查阅药物处方信息和最新文献，以便充分了解这些差异对临床治疗的影响。
