Drug—Cytokine Interactions

摘要: Although the term “drug—cytokine interaction” has only recently been coined (1),the recognition of an interaction between acute-phase response and hepatic drug metabolism appreciated in laboratory since at least 1966 (2), clinical medicine late 1970s (3, 4). The (5) to infection or injury, with its complex cascade cytokines, endocrine hormones, free oxygen radicals, arachidonic acid metabolites, catecholamines, reactive species, nitric oxide, can have multiple effects on pharmacokinetic pharmacodynamic properties many drugs. Disturbances disposition action be due physiologic changes, including alterations protein binding, expansion extracellular fluid volume, end-organ dysfunction (liver kidney), hemodynamic compromise, hypoxia, receptor availability responsiveness (6). Theoretically, all these changes could fall under a broad description interactions;” however, this chapter will address more commonly accepted, narrower focus potentially important cytokines (7), emphasis management patients infectious diseases.