Naguib M, Magboul M M, Jaroudi R
Department of Anaesthesia, Faculty of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia.
Middle East J Anaesthesiol. 1997 Oct;14(3):127-83.
The frequency of adverse drug interactions increases disproportionately with the increase in the number of drugs given to patients. It was shown that 40% of patients given 16 drugs experienced an adverse drug interaction, compared with 5% of patients given fewer than 6 drugs. The magnitude of the drug interaction problem increases substantially in anesthetised patients because of: (i) the increased use of multiple drugs in the preoperative and intraoperative periods; and (ii) the growing population of geriatric patients who, in addition to having diminished drug metabolising capacity, are often prescribed multiplied medications for concomitant medical illness. Drug interactions with volatile and intravenous anesthetics can be divided into those that are pharmacokinetic and pharmacodynamic in nature. Pharmacokinetic interactions occur when the absorption, distribution, metabolism or excretion of a drug is altered by the coadministration of a second drug. Pharmacodynamic interactions involve a change in the pharmacological effect of a drug as a result of the action of second drug at receptor sites.
药物不良相互作用的发生率会随着给予患者药物数量的增加而不成比例地上升。研究表明，服用16种药物的患者中有40%发生了药物不良相互作用，而服用少于6种药物的患者中这一比例为5%。由于以下原因，麻醉患者中药物相互作用问题的严重程度大幅增加：（i）术前和术中多种药物的使用增加；（ii）老年患者群体不断扩大，这些患者除了药物代谢能力下降外，还常常因合并疾病而被开具多种药物。与挥发性和静脉麻醉药的药物相互作用可分为药代动力学和药效学两类。当一种药物的吸收、分布、代谢或排泄因同时使用另一种药物而改变时，就会发生药代动力学相互作用。药效学相互作用是指由于第二种药物作用于受体部位而导致一种药物的药理作用发生改变。
