藥學(xué)英語課文翻譯 課后翻譯節(jié)選 中英雙語對照 第四版

1、本篇包括人衛(wèi)第四版Unit3B，Unit4A，5A，8A，10A，12AB13A等七篇課文Unit3TextBTheOtherSideofAntibiotics抗生素的另一面Antibioticshaveeliminatedorcontrolledsomanyinfectiousdiseasesthatvirtuallyeveryonehasbenefitedfromtheiruseatonetimeoranother.Evenwithoutsuchpersonalexperience,however,onewouldhavetobeisolatedindeedtobeunawareofthe

2、virtues,realandspeculative,ofthese“miracle”drugs1.TheAmericanpress,radio,andtelevisionhavedoneagoodjobofreportingthetrulyremarkablestoryofsuccessesinthechemicalwarongerms.WhOtsmore,anyshortcomingsontheirparthavebeenmorethanmadeupforbytheaggressivepublicrelationsactivityofthepharmaceuticalcompanieswh

3、ichmanufactureandsellantibiotics.抗生素可以消除或控制很多種感染疾病，以致幾乎每人生病時都習(xí)慣于使用它而受益，但是如果一個人沒有這樣的親身經(jīng)歷，他必定是離群索居才會不知道這些“特效藥物”或真實或推測的優(yōu)點。美國的出版物、電臺或電視臺用大量的篇幅報道了有關(guān)對細菌的化學(xué)戰(zhàn)中獲得的這些顯著功績。而它的缺點卻被生產(chǎn)和銷售抗生素的制藥公司通過公關(guān)活動掩藏了。Incomparison,theinadequaciesandpotentialdangersoftheseremarkabledrugsaremuchlesswidelyknown.Andthelackofsuchk

4、nowledgecanbebad,especiallyifitleadspatientstopressuretheirdoctorsintoprescribingantibioticswhensuchmedicationisntreallyneeded,orleadsthemtoswitchdoctorsuntiltheyfindonewhois,sotospeak,antibiotics-minded2.相比而言，使用這些藥物的危險性并不廣為人知。對這種知識的缺乏將更糟糕，特別是當(dāng)患者要求醫(yī)生開處方用抗生素而事實并不需要，或患者頻繁地更換醫(yī)生直至找到一個同意開抗生素處方的醫(yī)生。Because

5、thegoodsideoftheantibioticsstoryissoverywell-known,thereseemsmorepointheretoareviewofsomeoftheimmediateandlong-rangeproblemsthatcancomefromtodayscasualuseofthesedrugs.Itshouldbemadeclearinadvancethatcalamitiesfromtheuseofantibioticsarerareinrelationtotheenormousamountsofthedrugsadministered.Butthepo

6、tentialhazards,solittletouchedongenerally,doneedaclearstatement.因為抗生素的好的一面已廣為人知，今天抗生素的濫用導(dǎo)致短期或長期問題。我們預(yù)先應(yīng)該知道與抗生素的巨大的使用量相比,它產(chǎn)生危害的例子是少見的。但是，盡管十分少見，需要對這種潛在的危險作一個清楚的說明。Theantibioticsarenot,strictlyspeaking,exclusivelyprescriptiondrugs.Anumberofthemarepermittedinsuchover-the-counterproductsasnasalsprays,lo

7、zenges,troches,creams,andointments.Eveniftheseproductsdonoharmthereisnopointwhatsoeverinusingthem.Ifyouhaveaninfectionseriousenoughtowarrantthelaunchingofchemicalwarfare,youneedmuchbiggerdosesoftheantibioticsthananyofthenon-prescriptionproductsareallowedtocontain.嚴(yán)格來講，抗生素并不全是處方藥。許多抗生素被允許作為非處方藥（如鼻噴霧劑

8、、鍵劑、片劑、軟膏和乳膏）,盡管它們沒有危害，也不能隨意地使用。如果你患了嚴(yán)重的感染，你就得需要比非處方藥所允許最大劑量更大劑量的抗生素了。Over-the-counterproducts,however,accountforonlyasmallpercentageoftotalantibioticsproduction.Itistheprescriptiondosagesthatgivepeopletrouble.然而，非處方藥品只是整個抗生素類產(chǎn)品的一小部分，正是處方藥物給人類帶來了麻煩。Thesedrugsevenallowingforthediverseabilitiesofthema

9、nynarrow-spectrumonesandtheversatilityofthebroad-spectrumonearenotthecure-allstheyoftenarebilledasbeing.Therearewidegapsintheirabilitytomastercontagiousdiseases.Suchimportantinfectionsasmumps,measles,commoncolds,influenza,andinfectioushepatitisstillawaitconquest.Allarevirusinfectionsanddespiteintens

10、eefforts,verylittleprogresshasbeenmadeinchemotherapyagainstviruses.Onlysmallprogresshasbeenachievedagainstfungi.Manystrainsofbacteriaandfungiarenaturallyresistanttoallcurrentlyavailableantibioticsandotherchemotherapeuticdrugs.這些藥物一即使允許最大能力,很多窄譜抗生素和廣譜抗生素也并不是如宣傳的那樣治療百病。它們的能力與治療傳染性疾病間還存在很大的差距。如腮腺炎、麻疹、普

11、通感冒、流行性感冒和傳染性肝炎等嚴(yán)重感染性疾病仍有待解決。這些都是病毒感染，盡管做出了很大的努力，但是在抗病毒的化療藥物的研究上幾乎沒有什么進展?？拐婢幬锏难芯可现蝗〉靡稽c小成就。很多細菌和真菌對現(xiàn)有的抗生素和其他化療藥物具有耐藥性。Somemicroorganismsoriginallysensitivetotheactionofantibiotics,especiallystaphylococcus,havedevelopedresistantstrains.Thisacquiredresistanceimposesonthelongrangevalueofthedrugsaveryim

12、portantlimitation,whichisnotadequatelymetbythefrequentintroductionofnewantimicrobialagentstocombattheproblem.一些原來對抗生素敏感的細菌，特別是葡萄球菌現(xiàn)在也產(chǎn)生了耐藥性，這些獲得的耐藥性對藥物的長期使用產(chǎn)生重要的限制，頻繁引人新的抗菌藥物也不能完全解決這個問題。Ithasbeenprettywellestablishedthattheincreaseinstrainsofbacteriaresistanttoanantibioticcorrelatesdirectlywiththedu

13、rationandextentofuseofthatantibioticinagivenlocation.Inonehospitalasurveyshowedthat,beforeerythromycinhadbeenwidelyusedthere,allstrainsofstaphylococcitakenfrompatientsandpersonnelweresensitivetoitsaction.Whenthehospitalstartedextensiveuseoferythromycin,however,resistantstaphylococcusstrainsbegantoap

14、pear.現(xiàn)已經(jīng)確定，在一些地區(qū)，抗生素廣泛和長期的使用與細菌耐藥性增加有直接的相互關(guān)系。某醫(yī)院調(diào)查顯示，在紅霉素廣泛使用以前，所有從病人身上取出的葡萄球菌都對紅霉素敏感然而，自從醫(yī)院開始廣泛應(yīng)用紅霉素以來，耐藥葡萄球菌菌株開始出現(xiàn)。Thedevelopmentofbacterialresistancecanbeminimizedbyamorediscriminatinguseofantibiotics,andthepersontakingthedrugcanhelphere.Whenanantibioticmustbeused,thebestwaytopreventthedevelopmen

15、tofresistanceistowipeouttheinfectionasrapidlyandthoroughlyaspossible.Ideally,thisrequiresabactericidaldrug,whichdestroys,ratherthanabacteriostaticdrug,whichinhibits.Andthedrugmustbetakeninadequatedosageforaslongasisnecessarytoeradicatetheinfectioncompletely.Thedoctor,ofcourse,mustchoosethedrug,butpa

16、tientscanhelpbybeingsuretotakethefullcourseoftreatmentrecommendedbythedoctor,eventhoughsymptomsseemtodisappearbeforeallthepillsaregone.Inrareinstancestheemergenceofresistancecanbedelayedorreducedbycombinationsofantibiotics.Treatmentoftuberculosiswithstreptomycinaloneresultsinahighdegreeofresistance,

17、butifpara-aminosalicylicacidorisoniazidisusedwithstreptomycinthepossibilitythatthiscomplicationwillariseisgreatlyreduced.更有區(qū)別的應(yīng)用抗生素可以最大限度地抑制細菌耐藥性的發(fā)展，使用藥物的病人可對此有所幫助。當(dāng)必須使用一種抗生素時，最好的避免耐藥性方法就是盡快徹底地去除感染。這就需要用能殺死細菌的殺菌藥，而不是抑制細菌的抑菌藥。這種藥物必須使用一定劑量，并且一定的時間以完全根除這種感染。醫(yī)生當(dāng)然得選這種藥，但患者須遵醫(yī)囑、使用足夠的治療量，即使在藥物吃完以前癥狀似乎已經(jīng)消失。

18、少數(shù)情況下聯(lián)合用藥可以推遲或降低耐藥性的產(chǎn)生。用鏈霉素單獨治療結(jié)核病會導(dǎo)致高度的耐藥，但如果鏈霉素聯(lián)用對氨基水楊酸或異煙肼將大大降低耐藥性。Inhospitaltreatmentofsevereinfections,thesensitivityoftheinfectingorganismtoappropriateantibioticsisdeterminedinthelaboratorybeforetreatmentisstarted.Thisenablesthedoctortoselectthemosteffectivedrugordrugs;itdetermineswhetherthean

19、tibioticisbactericidalorbacteriostaticforthegermsathand;anditsuggeststheamountneededtodestroythegrowthofthebacteriacompletely.Ineitherhospitalorhome,asepticmeasurescanhelptoreducetheprevalenceofresistantstrainsofgermsbypreventingcrossinfectionandtheresultantspreadingoforganisms.在醫(yī)院治療嚴(yán)重感染時，感染菌對抗生素的敏感

20、性在治療前已在實驗室確定，這樣可以使醫(yī)生選擇最有效的藥物，可以決定使用抑菌還是殺菌的抗生素，并可對能完全破壞細菌生長所需的用量給出建議。無論在醫(yī)院或是在家里，無菌措施由于避免了交叉感染以及由此造成的生物體傳播，從而可以降低細菌耐藥菌株的廣泛流行。Everyoneoftheantibioticsispotentiallydangerousforsomepeople.Severalseriousreactionsmayresultfromtheiruse.Oneisasevere,sometimesfatal,shock-likeanaphylacticaction,whichmaystrikep

21、eoplewhohavebecomesensitizedtopenicillin.Anaphylacticreactionhappenslessfrequentlyandislessseverewhentheantibioticisgivenbymouth.Itismostapttooccurinpeoplewithahistoryofallergy,orarecordofsensitivitytopenicillin.Verysmallamountsofpenicillin,eventhetraceswhichgetintothemilkofcowsforafewdaysaftertheya

22、retreatedwiththeantibioticformastitis,maybesufficienttosensitize;hence,thestrongcampaignbyfoodanddrugofficialstokeepsuchmilkoffthemarket.對有些人來說任何一種抗生素都可能有潛在的危險。一些嚴(yán)重的反應(yīng)可能是由于它們的應(yīng)用產(chǎn)生的，其中之一就是嚴(yán)重的有時甚至是致死性的過敏性休克，對青霉素過敏的人使用青霉素將很危險?？诜股貙⑹惯^敏頻率降低或降低嚴(yán)重性。青霉素過敏或有過敏史者更容易發(fā)生。奶牛使用抗生素治療乳腺炎幾天后，其牛奶中帶入的極其少量甚至痕量的青霉素也可能足以

23、引起過敏。所以食品藥品監(jiān)督官員采取強有力的措施防止這種牛奶進人市場。Tominimizetheriskofanaphylacticshockinillnesseswhereinjectionsofpenicillinarethepreferredtreatment,acarefuldoctorwillquestionthepatientcarefullyaboutallergiesandpreviousreactions.Incaseofdoubtanotherantibioticwillbesubstituted,iffeasible,orotherprecautionarymeasures

24、willbetakenbeforetheinjectionisgiven.當(dāng)注射青霉素是首選治療方案時，為降低這種過敏性休克，謹(jǐn)慎的醫(yī)生會仔細詢問病人的過敏史及其反應(yīng)。如過敏史不清楚，醫(yī)生會用其他抗生素代替或注射前用其他方法檢查其是否過敏。Otheruntowardreactionstoantibioticsaregastrointestinaldisorderssuchassoremouth,cramps,diarrhea,oranalitchwhichoccurmostfrequentlyafteruseofthetetracyclinegroupbuthavealsobeenencoun

25、teredafteruseofpenicillinandstreptomycin.Thesereactionsmayresultfromsuppressionbytheantibioticofbacterianormallyfoundinthegastrointestinaltract.Withtheircompetitionremoved,antibiotic-resistantstaphylococciorfungi,whichalsoarenormallypresent,arefreetoflourishandcausewhatiscalledasuper-infection.Suchi

26、nfectionscanbeextremelydifficulttocure.其他抗生素不良反應(yīng)包括胃腸道不適，如口腔疼痛、痙攣、腹瀉、肛門瘙癢，這種情況在使用四環(huán)素類抗生素后經(jīng)常發(fā)生，在使用青霉素和鏈霉素后也會遇到。這些反應(yīng)可能是由于使用的抗生素抑制了正常的胃腸道菌群引起的。隨著這種競爭的消除，正常存在的葡萄球菌或真菌耐藥菌株自由繁殖并引起所謂的超感染，這種感染將更難治療。Afewantibioticshavesuchtoxiceffectsthattheirusefulnessisstrictlylimited.Theyincludestreptomycinanddihydro-strep

27、tomycin,whichsometimescausedeafness,andchloramphenicol,whichmayinjurethebonemarrow.Drugswithsuchseriouspotentialdangersastheseshouldbeusedonlyiflifeisthreatenedandnothingelsewillwork有些抗生素有毒性作用，使其應(yīng)用受到了嚴(yán)格的限制。這類抗生素包括會導(dǎo)致耳聾的鏈霉素和雙氫鏈霉素，以及會產(chǎn)生骨髓損傷的氯霉素。這些有嚴(yán)重危險的藥物只有在生命受到威脅或其他藥物無效時才使用。Allthepossibletroublesthat

28、canresultfromantibiotictreatmentshouldnotkeepanyonefromusingoneofthesedrugswhenitisclearlyindicated.Norshouldtheydiscouragecertainpreventiveusesofantibioticswhichhaveprovedextremelyvaluable.由于有些抗生素療效確切，因此使用抗生素所帶來的所有可能的麻煩也不能阻止任何人用任何一種抗生素，對于被證明是有效的抗生素，人們不會不鼓勵它們的使用。翻譯另一種發(fā)現(xiàn)新的抗生素的高難度方法是合理藥物設(shè)計，即利用有關(guān)分子結(jié)構(gòu)的知

29、識來進行全新的藥品設(shè)計或改進。Rationaldrugdesignisanothermoredifficultmethodofnewantibioticsdiscovery,thatistosay,designorimproveabrandnewdrugbyusingtheknowledgeofmolecularstructure.制藥工業(yè)在探索和開發(fā)新藥的同時還要對抗現(xiàn)有抗生素不斷増長的微生物耐藥性，這將是一條漫長的道路。Whenpharmaceuticalindustryexploresanddevelopsanewdrug,itfightsagainstthemicrobialresis

30、tancestoavailableantibioticsallthetime.Itisaverylongway.應(yīng)該大力鼓勵醫(yī)生、制藥業(yè)以及公眾態(tài)度的轉(zhuǎn)變。必須將抗生素視為一種應(yīng)被謹(jǐn)慎使用并且僅在真正必需時才使用的寶貴資源。Thechangeofdoctors,pharmaceuticalindustryandthepublicattitudesshouldbeencouragedgreatly.Theantibioticsmustbeviewedasapreciousresourceonlyusedcautiouslyinrealneeds.全世界都必須在醫(yī)學(xué)教育的初期就進行關(guān)于抗生素的審慎

31、使用及其耐藥危險的灌輸，并且，這種教育還應(yīng)貫穿于醫(yī)學(xué)工作者的整個醫(yī)療生涯。Thecautioususeofantibioticsandtheirhazardousresistancesshouldbepumpedintothemedicalstudentsduringtheirearlymedicaleducationthroughouttheworld.Whatsmore,thiseducationshouldpenetratethroughthemedicalworkerswholecareer.制藥工業(yè)必須停止推進非臨床使用抗生素的生產(chǎn)，并且，它應(yīng)該認(rèn)識到，它將從抗生素的合理使用中獲利，

32、因此，應(yīng)該對為此所作的各種嘗試提供財務(wù)援助。Pharmaceuticalindustrymuststopproducingthenon-clinicalantibiotics,anditmayrealizethatitwillbenefitalotfromrationaluseofantibiotics.Hence,itshouldofferfinancialaidstoalltheseattempts.Unit4TextATheScopeofPharmacology藥理學(xué)范疇Initsentirety,pharmacologyembracestheknowledgeofthehistory,

33、source,physicalandchemicalproperties,compounding,biochemicalandphysiologicaleffects,mechanismsofaction,absorption,distribution,biotransformationandexcretion,andtherapeuticandotherusesofdrugs.Sinceadrugisbroadlydefinedasanychemicalagentthataffectslivingprocesses,thesubjectofpharmacologyisobviouslyqui

34、teextensive.總體來說，藥理學(xué)包括藥物的以下諸方面內(nèi)容:歷史背景、來源、理化特性、合成、生化生理作用、作用機制、吸收、分布、生物轉(zhuǎn)化和排泄以及治療作用和其他作用。由于藥物被一般性定義為影響生命過程的化學(xué)物質(zhì)，因而藥理學(xué)范疇顯然是極其廣泛的。Forthephysicianandthemedicalstudent,however,thescopeofpharmacologyislessexpansivethanindicatedbytheabovedefinitions.Theclinicianisinterestedprimarilyindrugsthatareusefulinthep

35、revention,diagnosis,andtreatmentofhumandisease,orinthepreventionofpregnancy.Hisstudyofthepharmacologyofthesedrugscanbereasonablylimitedtothoseaspectsthatprovidethebasisfortheirrationalclinicaluse.Secondarily,thephysicianisalsoconcernedwithchemicalagentsthatarenotusedintherapybutarecommonlyresponsibl

36、eforhouseholdandindustrialpoisoningaswellasenvironmentalpollution.Hisstudyofthesesubstancesisjustifiablyrestrictedtothegeneralprinciplesofprevention,recognition,andtreatmentofsuchtoxicityorpollution.Finally,allphysiciansshareintheresponsibilitytohelpresolvethecontinuingsociologicalproblemoftheabuseo

37、fdrugs.然而，就醫(yī)生和醫(yī)學(xué)生生而言，藥理學(xué)范疇并沒有上述定義那么廣泛。臨床醫(yī)生的主要興趣在于藥物對人類疾病的預(yù)防、診斷及治療.或是在避孕方而所起的作用。因而他對這些藥物的藥理學(xué)研究不僅僅周限于某些方面，只要能為其合理的臨床用藥提供理論根據(jù)就行。其次，醫(yī)生也關(guān)注某些化學(xué)物質(zhì)，這些物質(zhì)雖然不用于治療，但通常與家庭中毒；工業(yè)中毒以及環(huán)境污染有關(guān)。醫(yī)生對這些物質(zhì)的研究當(dāng)然僅限于一般性了解。對這類中毒或汚污染的防范、診斷和治療。最后，所有醫(yī)生都應(yīng)責(zé)無旁貸地為解決藥品濫用所引起的社會問題而做出自己的努力。Abriefconsiderationofitsmajorsubjectareaswillfur

38、therclarifyhowthestudyofpharmacologyisbestapproachedfromthestandpointofthespecificrequirementsandinterestsofthemedicalstudentandpractitioner.Atonetime,itwasessentialforthephysiciantohaveabroadbotanicalknowledge,sincehehadtoselecttheproperplantsfromwhichtopreparehisowncrudemedicinalpreparations.Howev

39、er,fewerdrugsarenowobtainedfromnaturalsources,and,moreimportantly,mostofthesearehighlypurifiedorstandardizedanddifferlittlefromsyntheticchemicals.Hence,theinterestsoftheclinicianinpharmacognosyarecorrespondinglylimited.Nevertheless,scientificcuriosityshouldstimulatethephysiciantolearnsomethingofthes

40、ourcesofdrugs,andthisknowledgeoftenprovespracticallyusefulaswellasinteresting.Hewillfindthehistoryofdrugsofsimilarvalue.從醫(yī)學(xué)生和從業(yè)醫(yī)師的特別耑求和一般興趣的角度來看，什么才是藥理學(xué)學(xué)習(xí)的最佳途徑呢？只要對其主要學(xué)科領(lǐng)域稍加研究便可知曉。以前，醫(yī)師必須擁有廣泛的植物方而的知識，因為他得挑選適當(dāng)?shù)闹参?，且將其制備成簡單的藥物制劑。然而，現(xiàn)在的藥物已很少取自于天然植物，而且更為重要的是大多數(shù)天然藥物已被高度提純，且與合成的化學(xué)藥物無甚區(qū)別，所以，臨床醫(yī)生對生藥學(xué)的興趣也相應(yīng)減弱

41、。盡管如此，應(yīng)該激勵臨床醫(yī)生了解藥物的來源的科學(xué)好奇心，這方面知識往往被證明不但有趣，而且有用。他將會發(fā)現(xiàn)了解藥物的歷史同樣具有價值。Thepreparing,compounding,anddispensingofmedicinesatonetimelaywithintheprovinceofthephysician,butthisworkisnowdelegatedalmostcompletelytothepharmacist1.However,towriteintelligentprescriptionorders,thephysicianmusthavesomeknowledgeofth

42、ephysicalandchemicalpropertiesofdrugsandtheiravailabledosageforms,andhemusthaveabasicfamiliaritywiththepracticeofpharmacy.Whenthephysicianshirkshisresponsibilityinthisregard,heinvariablyfailstotranslatehisknowledgeofpharmacologyandmedicineintoprescriptionordersandmedicationbestsuitedfortheindividual

43、patient.藥物的制備、合成與銷售一度都是醫(yī)生的職責(zé)，但這項工作現(xiàn)在幾乎全歸藥師了。不過臨床醫(yī)師要想開出合理的處方，必須對藥物的理化性質(zhì)及其現(xiàn)有劑型有所了解,必須基本了解藥房業(yè)務(wù)。若臨床醫(yī)師逃避這方面責(zé)任，他肯定用不好藥理學(xué)及藥物知識，從而難以開出適合每位患者的最佳醫(yī)療處方。IPharmacokineticsdealswiththeabsorption,distribution,biotransformation,andexcretionofdrugs.Thesefactors,coupledwithdosage,determinetheconcentrationofadrugatitss

44、itesofactionand,hence,theintensityofitseffectsasafunctionoftime.Manybasicprinciplesofbiochemistryandenzymologyandthephysicalandchemicalprinciplesthatgoverntheactiveandpassivetransferandthedistributionofsubstancesacrossbiologicalmembranesarereadilyappliedtotheunderstandingofthisimportantaspectofpharm

45、acology2.藥物動力學(xué)涉及藥物的吸收、分布、生物轉(zhuǎn)化以及排泄等方面。這些因素再加上劑量便決定了藥物在其作用點的濃度，進而決定了其與時間成函數(shù)關(guān)系的藥效強度。在對藥理學(xué)這一重要方面的理解過程中，常常運用到許多有關(guān)生物化學(xué)和酶學(xué)方面的基本原理和物理化學(xué)方面的一些基本法則，而這些原理和法則決定著物質(zhì)在生物膜之間的主動和被動轉(zhuǎn)移及分布。Thestudyofthebiochemicalandphysiologicaleffectsofdrugsandtheirmechanismsofactionistermedaspharmacodynamics.Itisanexperimentalmedical

46、sciencethatdatesbackonlytothelaterhalfofthenineteenthcentury.Asaborderscience,pharmacodynamicsborrowsfreelyfromboththesubjectmatterandtheexperimentaltechniquesofphysiology,biochemistry,microbiology,immunology,genetics,andpathology.Itisuniquemainlyinthatattentionisfocusedonthecharacteristicsofdrugs.A

47、sthenameimplies,thesubjectisadynamicone.Thestudentwhoattemptsmerelytomemorizethepharmacodynamicpropertiesofdrugsisforegoingoneofthebestopportunitiesforcorrelatingtheentirefieldofpreclinicalmedicine.Forexample,theactionsandeffectsofthesalureticagentscanbefullyunderstoodonlyintermsofthebasicprinciples

48、ofrenalphysiologyandofthepathogenesisofedema.Conversely,nogreaterinsightintonormalandabnormalrenalphysiologycanbegainedthanbythestudyofthepharmacodynamicsofthesalureticagents.對藥物的生化生理作用及其作用機制的研究稱為藥效學(xué)。這是一門實驗醫(yī)學(xué)，其歷史僅可追溯到19世紀(jì)后半葉。作為邊緣學(xué)科，藥效學(xué)從生理學(xué)、生化學(xué)、微生物學(xué)、免疫學(xué)、遺傳學(xué)和病理學(xué)等諸多學(xué)科的主要理論和實驗技術(shù)中吸取了大量內(nèi)容。該學(xué)科的獨到之處主要在于其關(guān)注的

49、要點是藥物的特征。顧名思義，該科目屬于動態(tài)學(xué)科。學(xué)生如果僅僅打算死記硬背藥物的藥效學(xué)特性的話，那他將會喪失把整個臨床前期醫(yī)學(xué)連為體的這一最佳機會。例如:利鹽排泄劑的活性和效用只有在腎臟生理學(xué)和水腫發(fā)病機制的基本原理的基礎(chǔ)上才能完全理解。換句話說，只有通過對利鹽排泄劑的藥效學(xué)研究，才能最深人地了解腎臟生理學(xué)正常和異常兩方面情況。Anotherramificationofpharmacodynamicsisthecorrelationoftheactionsandeffectsofdrugswiththeirchemicalstructures.Suchstructure-activityrela

50、tionshipsareanintegrallinkintheanalysisofdrugaction,andexploitationoftheserelationshipsamongestablishedtherapeuticagentshasoftenledtothedevelopmentofbetterdrugs.However,thecorrelationofbiologicalactivitywithchemicalstructureisusuallyofinteresttothephysicianonlywhenitprovidesthebasisforsummarizingoth

51、erpharmacologicalinformation.藥效學(xué)的另一分支是研究藥物活性和效用與其化學(xué)結(jié)構(gòu)的相互關(guān)系。這種構(gòu)效關(guān)系是分析藥物作用不可或缺的部分，將這種關(guān)系應(yīng)用于現(xiàn)有的治療藥物中往往會促使藥品的更新?lián)Q代。然而，只有當(dāng)生物活性與化學(xué)結(jié)構(gòu)的關(guān)聯(lián)能夠為總結(jié)其他藥物學(xué)信息提供基礎(chǔ)時，臨床醫(yī)師才會對此產(chǎn)生興趣。Thephysicianisunderstandablyinterestedmainlyintheeffectsofdrugsinman.Thisemphasisonclinicalpharmacologyisjustified,sincetheeffectsofdrugsareof

52、tencharacterizedbysignificantinterspeciesvariation,andsincetheymaybefurthermodifiedbydisease.Inaddition,somedrugeffects,suchasthoseonmoodandbehavior,canbeadequatelystudiedonlyinman.However,thepharmacologicalevaluationofdrugsinmanmaybelimitedfortechnical,legal,andethicalreasons,andthechoiceofdrugsmus

53、tbebasedinpartontheirpharmacologicalevaluationinanimals.Consequently,someknowledgeofanimalpharmacologyandcomparativepharmacologyishelpfulindecidingtheextenttowhichclaimsforadrugbaseduponstudiesinanimalscanbereasonablyextrapolatedtoman3.臨床醫(yī)師的興趣主要集中于藥物對人體的療效。臨床藥理重視這一點是合理的，因為藥物的作用往往因種屬的明顯差異而大相徑庭，并可能由于疾

54、病的作用而發(fā)生進一步改而且有些藥物作用諸如對情緒和行為的作用只有通過人體才能得以充分研究，不過藥物對人體的藥理學(xué)評價可能因技術(shù)、法律及倫理道德方面的原因而受到限制，對藥物的選擇在一定程度上也只得以它們在動物身上所進行的藥理學(xué)評價為基礎(chǔ)。因此，動物藥理學(xué)和比較藥理學(xué)方面的知識有助于確定以動物實驗為基礎(chǔ)的某種新藥研制何時才可用于人體。Pharmacotherapeuticsdealswiththeuseofdrugsinthepreventionandtreatmentofdisease.Manydrugsstimulateordepressbiochemicalorphysiologicalfu

55、nctioninmaninasufficientlyreproduciblemannertoprovidereliefofsymptomsor,ideally,toalterfavorablythecourseofdisease.Conversely,chemicotherapeuticagentsareusefulintherapybecausetheyhaveonlyminimaleffectsonmanbutcandestroyoreliminateparasites.Whetheradrugisusefulfortherapyiscruciallydependentuponitsabi

56、litytoproduceitsdesiredeffectswithonlytolerableundesiredeffects.Thus,fromthestandpointofthephysicianinterestedinthetherapeuticusesofadrug,theselectivityofitseffectsisoneofitsmostimportantcharacteristics.Drugtherapyisrationallybaseduponthecorrelationoftheactionsandeffectsofdrugswiththephysiological,b

57、iochemical,microbiological,immunological,andbehavioralaspectsofdisease.Pharmacodynamicsprovidesoneofthebestopportunitiesforthiscorrelationduringthestudyofboththepreclinicalandtheclinicalmedicalsciences.藥物治療學(xué)涉及如何在疾病防治中使用藥物。許多藥物以強有力的可重現(xiàn)方式促進或抑制著人體的生理生化功能，進而使癥狀得以緩解或促使病程朝著令人滿意的方向轉(zhuǎn)變。相反，化療藥物的治病功能是因為其對人體作用很

58、小但卻能殺死或清除寄生生物。種藥物是否可以用于治療，關(guān)鍵取決于其能否產(chǎn)生預(yù)期的治療效果，同時其副作用在可容忍的范圍內(nèi)。這樣，從關(guān)注藥物療效的臨床醫(yī)師的觀點來看，藥物作用的選擇性便是其最重要特點之一。藥物的活性和療效與疾病諸方面生理、生化、微生物、免疫和行為的聯(lián)系理所當(dāng)然地成為藥物治療的基礎(chǔ)。藥效學(xué)便為臨床前期和臨床期醫(yī)學(xué)研究這種聯(lián)系提供了一個絕好的機會。Toxicologyisthataspectofpharmacologythatdealswiththeadverseeffectsofdrugs.Itisconcernednotonlywithdrugsusedintherapybutals

59、owiththemanyotherchemicalsthatmayberesponsibleforhousehold,environmental,orindustrialintoxication.Theadverseeffectsofthepharmacologicalagentsemployedintherapyareproperlyconsideredanintegralpartoftheirtotalpharmacology.Thetoxiceffectsofotherchemicalsaresuchanextensivesubjectthatthephysicianmustusuall

60、yconfinehisattentiontothegeneralprinciplesapplicabletotheprevention,recognition,andtreatmentofdrugpoisoningsofanycause.毒理學(xué)是研究藥物副作用的藥理學(xué)分支。它不僅涉及治療藥物，還涉及引起家庭、環(huán)境或工業(yè)中毒的許多其他化學(xué)物質(zhì)。治療性藥物的副作用應(yīng)被視為整個藥理學(xué)的一個組成部分。其他化學(xué)物質(zhì)的毒副作用范圍太廣，臨床醫(yī)師通常只能將注意力放在預(yù)防、確認(rèn)和處理各種藥物中毒的基本原則上。翻譯藥物作用于人體的科學(xué)叫藥理學(xué)，研究這門學(xué)問的科學(xué)家便是藥理學(xué)家。藥理學(xué)不是一門能夠獨立研究的科學(xué)，