解说临床药理学-个体化药物治疗与精准医学.pptVIP

* * Let’s begin by examining what medicine has looked like in the past. Think of it as trial-and-error medicine. A physician observes the patient’s condition through a physical exam, asks about medical history, and makes a “most likely” diagnosis based on the knowledge and evidence that is available. The physician then decides upon the treatment that he or she believes is most appropriate. Then the physician monitors the response to decide whether to stay the course or try an alternative. Trial-and-error medicine represents a vast improvement over what came before—largely the “guesswork” of the 19th and early 20th centuries. And it often works. * * Producing better medical products: Producing new classes of structural materials that are expected to bring about lighter, stronger, smarter, cheaper, cleaner, and more precise medical products * * * Hier sehen sie, dass ?hnlich gro?e unterschiede wie für Glibenclamid auch für die anderen Sulfonylharnstoffen, sowie für Nateglinid gezeigt werden konnten, die verschiedenen Studien kommen dabei zu sehr einheitlichen Ergebnisen. * RISPERIDONE: NO SIG DOSING DIFF FOR MULTIPLE DOSE DUE TO AN ACTIVE METABOLITE; FLUPENTIXOL, ZUCLOPENTHIXOL, AND PERAZINE ARE NOT FDA APPROVED FOR ANTIPSYCHOTIC USAGE. * HLA-B*1502 (7.4%)，HLA-B*3101（7.21%）。 * XRCC1 中国人群TPMT突变率为0.8%，TPMT*3C在汉族人群突变率为0.2%-6%，TPMT*3A为2.82%，TPMT*3B为2.82%，TPMT*2为0.15%。 * UGT1A1*6/ *6汉族人群突变率为9.37%，UGT1A1*1/ *6为15.62%。 中心 T1/2 (hr) 平均血浆浓度 (ng/ml/mg 日剂量) 口服清除率 (ml/min) CNS 副作用 (%) 1 4.5 ? 2.1 0.9 ? 0.4 1048? 1312 12% 2 6.9 ? 3.2 1.4 ? 0.4 1426 ? 896 16% 3 13.2 ?4 8.0 2.2 ? 0.5 764 ? 48 47% 抗心律失常药普罗帕酮多中心I期 三个试验中心分别计算所得数据 表型 T1/2 平均血浆浓度 (ng/ml/mg日剂量) 口服清除率 (ml/min) CNS 副作用 (%) EM 5.5 ? 2.1 1.1 ? 0.6 1115 ? 1238 14% PM 17.2 ?4 8.0 2.5 ? 0.5 264 ? 48 67% 三个试验中心合并并根据药物代谢酶表型分层计算所得数据 失败案例1：西布曲明 2010年10月30日，国家药监局（SFDA）发公布减肥药西布曲明因可能增加严重心血管风险而将之撤出市场，而国家SFDA直到美国FDA宣布将西布曲明撤出市场后才如法炮制，也因此倍受压力； 卫生部首席法律顾问×××表示，该事件不仅说明政府相关部门的监管××，严重××，而且还说明了药品不良反应监测的制度形同××； 我国药物基因组学创始人