What are the influencing factors of drug effectiveness?

What are the influencing factors of drug effectiveness?

Factors Affecting Drug Efficacy‌ can be categorized into the following five classes, summarized based on clinical practice and research data:

‌1. Drug-Related Factors‌

‌Dosage Form Differences‌:
Oral formulations require gastrointestinal absorption (slower onset), while injectables enter the bloodstream directly (faster onset). Sustained-release tablets prolong drug duration.

‌Chemical Properties‌:
Lipophilic drugs (e.g., warfarin) absorb faster with high-fat diets, potentially altering blood concentrations.

‌2. Individual Variability‌

‌Metabolic Capacity‌:
Declining liver/kidney function in elderly patients may cause drug accumulation, whereas faster metabolism in children requires dose adjustments.

‌Genetic Polymorphism‌:
CYP2C9 genotype affects warfarin metabolism, necessitating personalized dosing.

‌3. Medication Adherence‌

‌Dosage & Duration‌:
Subtherapeutic antibiotic doses promote resistance, while overdoses (e.g., digoxin) may lead to toxicity.

‌Timing of Administration‌:
Fasting vs. postprandial intake impacts absorption (e.g., some antihypertensives require fasting).

‌4. Environmental & Dietary Factors‌

‌Dietary Interference‌:
Grapefruit juice inhibits CYP3A4 enzymes, increasing statin concentrations by 3–5 times.

‌Storage Conditions‌:
Insulin requires refrigeration (high temperatures cause degradation), as does botulinum toxin (heat-sensitive).

‌5. Drug-Drug Interactions‌

‌Contraindications‌:
Antacids reduce anticoagulant efficacy, while antibiotics diminish diuretic effects.
Note: Psychological states (e.g., placebo effect) and extreme environments (UV, heat) may indirectly influence efficacy.

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