Morrelli H F, Melmon K L
Calif Med. 1968 Nov;109(5):380-9.
Drug interactions are important causes of both unexpected toxic and therapeutic effects. Adverse reactions due to drug interaction are proportional to the number of drugs given and the duration of administration. Although drug interactions may be beneficial, they are most often recognized when they increase mortality or morbidity. The frequency of adverse drug interactions in clinical practice makes it mandatory for physicians to know the drugs and mechanisms involved.A drug may potentiate or antagonize the effects of another drug by direct chemical or physical combination, by altering gastrointestinal absorption, by influencing metabolism, transport, or renal clearance, by changing the activity of a drug at its receptor site, or by modifying the patient's response to the drug by a variety of means. This article stresses the importance of avoiding multible drug therapy. When such treatment is unavoidable, patients must be carefully observed for evidence of intensified or diminished drug effect. Only this permits the detection and prevention of untoward drug interactions.
药物相互作用是导致意外毒性和治疗效果的重要原因。药物相互作用引起的不良反应与给药数量和给药持续时间成正比。尽管药物相互作用可能有益，但它们最常被认识到的时候是在增加死亡率或发病率的时候。临床实践中药物不良反应相互作用的频率使得医生必须了解所涉及的药物和机制。一种药物可能通过直接化学或物理结合、改变胃肠道吸收、影响代谢、转运或肾脏清除、改变药物在其受体部位的活性，或通过多种方式改变患者对药物的反应，来增强或拮抗另一种药物的作用。本文强调避免多种药物治疗的重要性。当这种治疗不可避免时，必须仔细观察患者，以寻找药物效果增强或减弱的证据。只有这样才能检测和预防不良药物相互作用。
