Marchant B
Scand J Rheumatol Suppl. 1981;39:5-14. doi: 10.3109/03009748109095328.
It is well recognised that the clinical response to drug administration varies widely between individuals and that most of this variability is pharmacokinetic in origin. In general, variability arises because of inter-individual differences in rates of drug absorption, drug distribution and elimination, either by metabolism or excretion. Variability of drug response is also a consequence of a variety of drug interactions which may influence pharmacokinetic parameters. Among the many factors which are responsible for the variation in human drug response, age is relatively important. As a consequence of impaired metabolism and excretion the inter-individual variation in the kinetic of many drugs is much greater in the elderly. Also the degree of plasma-protein binding, in turn, influences the distribution, action, metabolism and renal excretion of drugs. Thus changes in plasma protein binding of drugs, e.g. in diseased states, may give rise to altered pharmacokinetic and possibly altered drug response. The above factors influencing variability in drug response are discussed with particular reference to examples of non-steroidal antiinflammatory drugs used in the treatment of rheumatic diseases.
众所周知，个体对药物给药的临床反应差异很大，而且这种差异大多源于药代动力学。一般来说，差异的产生是由于个体在药物吸收、分布以及通过代谢或排泄进行消除的速率方面存在个体间差异。药物反应的变异性也是多种药物相互作用的结果，这些相互作用可能会影响药代动力学参数。在导致人类药物反应差异的众多因素中，年龄相对较为重要。由于代谢和排泄功能受损，许多药物动力学的个体间差异在老年人中要大得多。此外，血浆蛋白结合程度反过来又会影响药物的分布、作用、代谢和肾排泄。因此，例如在疾病状态下药物血浆蛋白结合的变化可能会导致药代动力学改变，并可能改变药物反应。将结合用于治疗风湿性疾病的非甾体抗炎药的实例，对上述影响药物反应变异性的因素进行讨论。
