Idoipe Tomás A
Hospital Miguel Servet, Zaragoza.
Nutr Hosp. 1990 Mar-Apr;5(2):77-84.
Human malnutrition is a complex, multirelated problem. Malnutrition and drug kinetics interaction was never studied in depth, despite the fact that as with antibiotics, medication is more often administered to malnourished than normonourished individuals, because of a higher rate of infection among members of the former group. We have studied the physiological changes resulting from malnutrition, and possible variations such state may have on absorption, distribution, protein binding capacity, drug metabolism and excretion processes in the body, in relation to possible dosage changes. Further studies are required on the effects of malnutrition on drug pharmacokinetics, especially in relation to antibiotics. Such assessment must be performed on different population subsets and under different environmental conditions, so as to obtain improved knowledge on each drug's clinical pharmacokinetics, that coupled with a more sensible way of handling plasma levels and careful patient clinical evaluation will lead to more rational therapy.
人类营养不良是一个复杂的、多方面相关的问题。尽管与抗生素一样,由于营养不良人群的感染率较高,因此给营养不良者而非营养正常者用药更为常见,但营养不良与药物动力学之间的相互作用从未得到深入研究。我们已经研究了营养不良引起的生理变化,以及这种状态可能对身体的吸收、分布、蛋白质结合能力、药物代谢和排泄过程产生的可能变化,并探讨了与之相关的可能的剂量变化。关于营养不良对药物药代动力学的影响,尤其是对抗生素的影响,还需要进一步研究。这种评估必须在不同的人群亚组和不同的环境条件下进行,以便更好地了解每种药物的临床药代动力学,再结合更合理的血浆水平处理方法和仔细的患者临床评估,将有助于实现更合理的治疗。