General Principles Of Pharmacology:Individual differences
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Previous Page: Drug Transformation and Clinical
Considerations
Individual differences in metabolic rate depend on the nature of the drug itself. Thus, within the same population, steady-state plasma levels may reflect a 30-fold variation in the metabolism of one drug and only a 2-fold variation in the metabolism of another. Genetic factors that influence enzyme levels account for some of these differences. Succinylcholine, for example, is metabolized only half as rapidly in persons with genetically determined defects in pseudocholinesterase as in normals. Analogous pharmacogenetic differences are seen in the acetylation of isoniazid and the hydroxylation of warfarin.
Environmental factors also contribute to individual variations in drug metabolism. Cigarette smokers metabolize some drugs more rapidly than nonsmokers because of enzyme induction. Industrial workers exposed to some pesticides metabolize certain drugs more rapidly than nonexposed individuals. Such differences make it difficult to determine effective and safe doses of drugs that have narrow therapeutic indices.
Next Page: Age and Sex Differences
Previous Page: Drug Transformation and Clinical
Considerations
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