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Metabolism is the process of changing the chemical structure of drugs in the human body. The main organ that can metabolize drugs in the human body is the liver, followed by the small intestine, kidney, lung, and brain tissue. For more details, please read Factors Affecting Pharmacokinetics of Drugs.
Genetic factors: It is genetic polymorphism. The oxidation and binding reactions determined by genetics show differences, and will change the efficacy or toxicity of drugs.
Environmental factors: Chemical substances in the environment can enhance or weaken the activity of liver drug enzymes, change the metabolic rate, and affect the strength and duration of drug action, including:
Enzyme induction: Some chemical substances can increase the activity of liver drug enzymes, thereby increasing the rate of drug metabolism and shortening the time of drug action. Chemical substances that have the effect of inducing liver drug enzymes are called liver drug enzyme inducers. After the drug is induced by the enzyme, the metabolism is accelerated and strengthened, resulting in a decrease in plasma drug concentration, thereby weakening the therapeutic effect. But for drugs that need to be activated in the human body, the therapeutic effect will be enhanced. For drugs that produce toxic metabolites, their toxicity will also be enhanced.
Enzyme inhibition: Some chemical substances can inhibit the activity of liver drug enzymes, thereby slowing down the rate of drug metabolism and prolonging the action time of drugs. Chemical substances that have inhibitory effects on liver drug enzymes are called liver drug enzyme inhibitors. For drugs that need to be activated in the body, after enzyme inhibition, the production of active metabolites is reduced, and the drug’s effect is weakened. For drugs that need to be inactivated in the body, after enzyme inhibition, the metabolism slows down, the effect will be enhanced, and some even lead to toxic reactions.
Physiological factors and nutritional status: different age, gender, day or night, diet and other factors can affect the activity of liver drug enzymes. 4. Pathological factors: The disease state can affect the activity of liver drug enzymes.