1. Chapter 4 Factors Influencing Drug Effects § Patient Factors § Drug Factors

2. DrugPatient Doctor Efficacy, adverse effects, concentrations Adjustment Dosage regimen drugs, doses, intervals, duration

4. Part A Patient Factors §1. Physiological Factors §1.1 Age §Children § Sensitivity to drugs § Pharmacokinetic properties §Elderly § Sensitivity to drugs § Pharmacokinetic properties

6. Part A Patient Factors §1.2 Body Weight §Volume of distribution § Fat / skeletal muscles § lipid-soluble / water-soluble drugs

7. Part A Patient Factors §1.3 Sex §Women § Pregnancy § - malformation and dysfunction of the fetuses § Lactation § - milk: effects on infants

8. Part A Patient Factors §1.4 Individual variation ( 个体差异 ) §(1) Sensitivity to drugs § Hypersensitivity § Hyposensitivity (tolerance) §(2) Abnormal responses to drugs § Idiosyncracy (genetic abnormality) § Allergy (immunological abnormality)

9. Part A Patient Factors §2. Psychological Factors § Placebo effects § Placebo effects commonly are manifested as alteration of mood, other subjective effects, and objective effects that are under autonomic or voluntary control.

10. Part A Patient Factors §3.Pathological Factors §3. Pathological Factors § Heart diseases § Hepatic diseases § Renal diseases § Gastrointestinal diseases § Malnutrition § Imbalances of acid-base or electrolytes

12. Part A Patient Factors §4.Genetic Factors §4. Genetic Factors § Pharmacogenetics § abnormality of drug responses § example: tolerance of warfarin § abnormality of pharmacokinetic properties § example: fast- or slow acetylation

13. Part A Patient Factors §5.Chronobiological Factors §5. Chronobiological Factors §Circadian rhythms

14. Part A Patient Factors §6.Life Styles and Environment Factors §6. Life Styles and Environment Factors § Nutrition § Drinking & smoking § Environmental poisons

15. Part B Drug Factors §1. Physic-chemical properties of drugs §2. Dose forms §3. Administration §4. Multiple-drug therapy §5. Long-term drug therapy

16. Part B Drug Factors §1. Physic-chemical properties of drugs § Stability § Molecular size § Lipid- and water soluble § ……

17. Part B Drug Factors §2. Dose forms § slow release formulation § controlled release formulation § sustained release formulation § transdermal patch § inhalation

18. Part B Drug Factors §3. Administration § Doses § Routes oral § intramuscular injection § subcutaneous injection § intravenous injection or infusion § Administration time § Dosing intervals § Dosing duration

19. Part B Drug Factors §4. Multiple-drug therapy (drug combination) § Drug-drug interactions pharmacy § pharmacokinetics § pharmacodynamics § Drug effects in combination synergism § antagonism § potentiation § addition

21. Part B Drug Factors §5. Long-term drug therapy § Tolerance (tachyphylaxis) and resistance § Dependence § Withdrawal syndrome

22. 二、机体方面的因素 §Box 1 §Physical dependence （生理依赖性） § 生理（身体）依赖性是指大多数具有依赖性特 征的药物经过反复使用所造成的一种适应状态， 用药者一旦停药，将发生一系列生理功能紊乱， 称戒断综合征（ withdrawal syndrome ）。

23. 二、机体方面的因素 §Box 2 §Psychological dependence or psychic dependence （精神依赖性） § 精神依赖性是指使人产生一种对药物欣快感的渴 求，这种精神上不能自制的强烈欲望驱使滥用者 周期性或连续地用药。精神依赖性与身体依赖性 的主要不同点是前者在停药后不出现严重的戒断 症状。

24. 二、机体方面的因素 §Box 3 §Drug addiction （药物成瘾） § 药物成瘾是指强迫性、失去控制的用药行 为，是药物的精神依赖性和身体依赖性共 同造成的结果 §Drug addiction is a progressive and often fatal behavioural syndrome characterized by compulsive drug seeking and consumption despite serious negative consequences.