藥學英語課文翻譯-課后翻譯節(jié)選-中英雙語對照-第四版

..本篇包括人衛(wèi)第四版Unit3B,Unit4A,5A,8A,10A,12AB,13A等七篇課文Unit3TextBTheOtherSideofAntibiotics抗生素的另一面Antibioticshaveeliminatedorcontrolledsomanyinfectiousdiseasesthatvirtuallyeveryonehasbenefitedfromtheiruseatonetimeoranother.Evenwithoutsuchpersonalexperience,however,onewouldhavetobeisolatedindeedtobeunawareofthevirtues,realandspeculative,ofthese"miracle"drugs1.TheAmericanpress,radio,andtelevisionhavedoneagoodjobofreportingthetrulyremarkablestoryofsuccessesinthechemicalwarongerms.What′smore,anyshortcomingsontheirparthavebeenmorethanmadeupforbytheaggressivepublicrelationsactivityofthepharmaceuticalcompanieswhichmanufactureandsellantibiotics.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.Andthelackofsuchknowledgecanbebad,especiallyifitleadspatientstopressuretheirdoctorsintoprescribingantibioticswhensuchmedicationisn’treallyneeded,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。Becausethegoodsideoftheantibioticsstoryissoverywell-known,thereseemsmorepointheretoareviewofsomeoftheimmediateandlong-rangeproblemsthatcancomefromtoday’scasualuseofthesedrugs.Itshouldbemadeclearinadvancethatcalamitiesfromtheuseofantibioticsarerareinrelationtotheenormousamountsofthedrugsadministered.Butthepotentialhazards,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致短期或長期問題。我們預先應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,lozenges,troches,creams,andointments.Eveniftheseproductsdonoharmthereisnopointwhatsoeverinusingthem.Ifyouhaveaninfectionseriousenoughtowarrantthelaunchingofchemicalwarfare,youneedmuchbiggerdosesoftheantibioticsthananyofthenon-prescriptionproductsareallowedtocontain.嚴格來講,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、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。Thesedrugs—evenallowingforthediverseabilitiesofthemanynarrow-spectrumonesandtheversatilityofthebroad-spectrumones—arenotthecure-allstheyoftenarebilledasbeing.Therearewidegapsintheirabilitytomastercontagiousdiseases.Suchimportantinfectionsasmumps,measles,commoncolds,influenza,andinfectioushepatitisstillawaitconquest.Allarevirusinfectionsanddespiteintenseefforts,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、普通感冒、流行性感冒和傳染性肝炎等嚴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.Thisacquiredresistanceimposesonthelongrangevalueofthedrugsaveryimportantlimitation,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。Ithasbeenprettywellestablishedthattheincreaseinstrainsofbacteriaresistanttoanantibioticcorrelatesdirectlywiththedurationandextentofuseofthatantibioticinagivenlocation.Inonehospitalasurveyshowedthat,beforeerythromycinhadbeenwidelyusedthere,allstrainsofstaphylococcitakenfrompatientsandpersonnelweresensitivetoitsaction.Whenthehospitalstartedextensiveuseoferythromycin,however,resistantstaphylococcusstrainsbegantoappear.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)院開始廣泛應用紅霉素以來,耐藥葡萄球菌菌株開始出現(xiàn)。Thedevelopmentofbacterialresistancecanbeminimizedbyamorediscriminatinguseofantibiotics,andthepersontakingthedrugcanhelphere.Whenanantibioticmustbeused,thebestwaytopreventthedevelopmentofresistanceistowipeouttheinfectionasrapidlyandthoroughlyaspossible.Ideally,thisrequiresabactericidaldrug,whichdestroys,ratherthanabacteriostaticdrug,whichinhibits.Andthedrugmustbetakeninadequatedosageforaslongasisnecessarytoeradicatetheinfectioncompletely.Thedoctor,ofcourse,mustchoosethedrug,butpatientscanhelpbybeingsuretotakethefullcourseoftreatmentrecommendedbythedoctor,eventhoughsymptomsseemtodisappearbeforeallthepillsaregone.Inrareinstancestheemergenceofresistancecanbedelayedorreducedbycombinationsofantibiotics.Treatmentoftuberculosiswithstreptomycinaloneresultsinahighdegreeofresistance,butifpara-aminosalicylicacidorisoniazidisusedwithstreptomycinthepossibilitythatthiscomplicationwillariseisgreatlyreduced.更有區(qū)別的應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。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;itdetermineswhethertheantibioticisbactericidalorbacteriostaticforthegermsathand;anditsuggeststheamountneededtodestroythegrowthofthebacteriacompletely.Ineitherhospitalorhome,asepticmeasurescanhelptoreducetheprevalenceofresistantstrainsofgermsbypreventingcrossinfectionandtheresultantspreadingoforganisms.在醫(yī)院治療嚴重感染時,感染菌對抗生素的敏感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,whichmaystrikepeoplewhohavebecomesensitizedtopenicillin.Anaphylacticreactionhappenslessfrequentlyandislessseverewhentheantibioticisgivenbymouth.Itismostapttooccurinpeoplewithahistoryofallergy,orarecordofsensitivitytopenicillin.Verysmallamountsofpenicillin,eventhetraceswhichgetintothemilkofcowsforafewdaysaftertheyaretreatedwiththeantibioticformastitis,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。一些嚴重的反應可能是由于它們的應用產(chǎn)生的,其中之一就是嚴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,orotherprecautionarymeasureswillbetakenbeforetheinjectionisgiven.當注射青霉素是首選治療方案時,為降低這種過敏性休克,謹慎的醫(yī)生會仔細詢問病人的過敏史及其反應。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。Otheruntowardreactionstoantibioticsaregastrointestinaldisorders—suchassoremouth,cramps,diarrhea,oranalitch—whichoccurmostfrequentlyafteruseofthetetracyclinegroupbuthavealsobeenencounteredafteruseofpenicillinandstreptomycin.Thesereactionsmayresultfromsuppressionbytheantibioticofbacterianormallyfoundinthegastrointestinaltract.Withtheircompetitionremoved,antibiotic-resistantstaphylococciorfungi,whichalsoarenormallypresent,arefreetoflourishandcausewhatiscalledasuper-infection.Suchinfectionscanbeextremelydifficulttocure.其他抗生素不良反應包括胃腸道不適,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-streptomycin,whichsometimescausedeafness,andchloramphenicol,whichmayinjurethebonemarrow.Drugswithsuchseriouspotentialdangersastheseshouldbeusedonlyiflifeisthreatenedandnothingelsewillwork有些抗生素有毒性作用,使其應用受到了嚴格的限制。這類抗生素包括會導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。Allthepossibletroublesthatcanresultfromantibiotictreatmentshouldnotkeepanyonefromusingoneofthesedrugswhenitisclearlyindicated.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1. 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)的知識來進行全新的藥品設(shè)計或改進。Rationaldrugdesignisanothermoredifficultmethodofnewantibioticsdiscovery,thatistosay,designorimproveabrandnewdrugbyusingtheknowledgeofmolecularstructure.2. 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,itfightsagainstthemicrobialresistancestoavailableantibioticsallthetime.Itisaverylongway.3. 應該大力鼓勵醫(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被謹慎使用并且僅在真正必需時才使用的寶貴資源。Thechangeofdoctors,pharmaceuticalindustryandthepublicattitudesshouldbeencouragedgreatly.Theantibioticsmustbeviewedasapreciousresourceonlyusedcautiouslyinrealneeds.4. 全世界都必須在醫(yī)學教育的初期就進行關(guān)于抗生素的審慎使用及其耐藥危險的灌輸,并且,這種教育還應貫穿于醫(yī)學工作者的整個醫(yī)療生涯。Thecautioususeofantibioticsandtheirhazardousresistancesshouldbepumpedintothemedicalstudentsduringtheirearlymedicaleducationthroughouttheworld.What'smore,thiseducationshouldpenetratethroughthemedicalworker'swholecareer.5. 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,它應該認識到,它將從抗生素的合理使用中獲利,因此,應該對為此所作的各種嘗試提供財務援助。Pharmaceuticalindustrymuststopproducingthenon-clinicalantibiotics,anditmayrealizethatitwillbenefitalotfromrationaluseofantibiotics.Hence,itshouldofferfinancialaidstoalltheseattempts.Unit4TextATheScopeofPharmacology藥理學范疇Initsentirety,pharmacologyembracestheknowledgeofthehistory,source,physicalandchemicalproperties,compounding,biochemicalandphysiologicaleffects,mechanismsofaction,absorption,distribution,biotransformationandexcretion,andtherapeuticandotherusesofdrugs.Sinceadrugisbroadlydefinedasanychemicalagentthataffectslivingprocesses,thesubjectofpharmacologyisobviouslyquiteextensive.總體來說,藥理學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物質(zhì),因而藥理學范疇顯然是極其廣泛的。Forthephysicianandthemedicalstudent,however,thescopeofpharmacologyislessexpansivethanindicatedbytheabovedefinitions.Theclinicianisinterestedprimarilyindrugsthatareusefulintheprevention,diagnosis,andtreatmentofhumandisease,orinthepreventionofpregnancy.Hisstudyofthepharmacologyofthesedrugscanbereasonablylimitedtothoseaspectsthatprovidethebasisfortheirrationalclinicaluse.Secondarily,thephysicianisalsoconcernedwithchemicalagentsthatarenotusedintherapybutarecommonlyresponsibleforhouseholdandindustrialpoisoningaswellasenvironmentalpollution.Hisstudyofthesesubstancesisjustifiablyrestrictedtothegeneralprinciplesofprevention,recognition,andtreatmentofsuchtoxicityorpollution.Finally,allphysiciansshareintheresponsibilitytohelpresolvethecontinuingsociologicalproblemoftheabuseofdrugs.然而,就醫(yī)生和醫(yī)學生生而言,藥理學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)生都應責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。Abriefconsiderationofitsmajorsubjectareaswillfurtherclarifyhowthestudyofpharmacologyisbestapproachedfromthestandpointofthespecificrequirementsandinterestsofthemedicalstudentandpractitioner.Atonetime,itwasessentialforthephysiciantohaveabroadbotanicalknowledge,sincehehadtoselecttheproperplantsfromwhichtopreparehisowncrudemedicinalpreparations.However,fewerdrugsarenowobtainedfromnaturalsources,and,moreimportantly,mostofthesearehighlypurifiedorstandardizedanddifferlittlefromsyntheticchemicals.Hence,theinterestsoftheclinicianinpharmacognosyarecorrespondinglylimited.Nevertheless,scientificcuriosityshouldstimulatethephysiciantolearnsomethingofthesourcesofdrugs,andthisknowledgeoftenprovespracticallyusefulaswellasinteresting.Hewillfindthehistoryofdrugsofsimilarvalue.從醫(yī)學生和從業(yè)醫(yī)師的特別耑求和一般興趣的角度來看,什么才是藥理學學習的最佳途徑呢？只要對其主要學科領(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?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,且與合成的化學藥物無甚區(qū)別,所以,臨床醫(yī)生對生藥學的興趣也相應減弱。盡管如此,應該激勵臨床醫(yī)生了解藥物的來源的科學好奇心,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,thephysicianmusthavesomeknowledgeofthephysicalandchemicalpropertiesofdrugsandtheiravailabledosageforms,andhemusthaveabasicfamiliaritywiththepracticeofpharmacy.Whenthephysicianshirkshisresponsibilityinthisregard,heinvariablyfailstotranslatehisknowledgeofpharmacologyandmedicineintoprescriptionordersandmedicationbestsuitedfortheindividualpatient.藥物的制備、合成與銷售一度都是醫(yī)生的職責,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。若臨床醫(yī)師逃避這方面責任,他肯定用不好藥理學及藥物知識,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,determinetheconcentrationofadrugatitssitesofactionand,hence,theintensityofitseffectsasafunctionoftime.Manybasicprinciplesofbiochemistryandenzymologyandthephysicalandchemicalprinciplesthatgoverntheactiveandpassivetransferandthedistributionofsubstancesacrossbiologicalmembranesarereadilyappliedtotheunderstandingofthisimportantaspectofpharmacology2.藥物動力學涉及藥物的吸收、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)生物化學和酶學方面的基本原理和物理化學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.Itisanexperimentalmedicalsciencethatdatesbackonlytothelaterhalfofthenineteenthcentury.Asaborderscience,pharmacodynamicsborrowsfreelyfromboththesubjectmatterandtheexperimentaltechniquesofphysiology,biochemistry,microbiology,immunology,genetics,andpathology.Itisuniquemainlyinthatattentionisfocusedonthecharacteristicsofdrugs.Asthenameimplies,thesubjectisadynamicone.Thestudentwhoattemptsmerelytomemorizethepharmacodynamicpropertiesofdrugsisforegoingoneofthebestopportunitiesforcorrelatingtheentirefieldofpreclinicalmedicine.Forexample,theactionsandeffectsofthesalureticagentscanbefullyunderstoodonlyintermsofthebasicprinciplesofrenalphysiologyandofthepathogenesisofedema.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。這是一門實驗醫(yī)學,其歷史僅可追溯到19世紀后半葉。作為邊緣學科,藥效學從生理學、生化學、微生物學、免疫學、遺傳學和病理學等諸多學科的主要理論和實驗技術(shù)中吸取了大量內(nèi)容。該學科的獨到之處主要在于其關(guān)注的要點是藥物的特征。顧名思義,該科目屬于動態(tài)學科。學生如果僅僅打算死記硬背藥物的藥效學特性的話,那他將會喪失把整個臨床前期醫(yī)學連為—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研究,才能最深人地了解腎臟生理學正常和異常兩方面情況。Anotherramificationofpharmacodynamicsisthecorrelationoftheactionsandeffectsofdrugswiththeirchemicalstructures.Suchstructure-activityrelationshipsareanintegrallinkintheanalysisofdrugaction,andexploitationoftheserelationshipsamongestablishedtherapeuticagentshasoftenledtothedevelopmentofbetterdrugs.However,thecorrelationofbiologicalactivitywithchemicalstructureisusuallyofinteresttothephysicianonlywhenitprovidesthebasisforsummarizingotherpharmacologicalinformation.藥效學的另一分支是研究藥物活性和效用與其化學結(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,只有當生物活性與化學結(jié)構(gòu)的關(guān)聯(lián)能夠為總結(jié)其他藥物學信息提供基礎(chǔ)時,臨床醫(yī)師才會對此產(chǎn)生興趣。Thephysicianisunderstandablyinterestedmainlyintheeffectsofdrugsinman.Thisemphasisonclinicalpharmacologyisjustified,sincetheeffectsofdrugsareoftencharacterizedbysignificantinterspeciesvariation,andsincetheymaybefurthermodifiedbydisease.Inaddition,somedrugeffects,suchasthoseonmoodandbehavior,canbeadequatelystudiedonlyinman.However,thepharmacologicalevaluationofdrugsinmanmaybelimitedfortechnical,legal,andethicalreasons,andthechoiceofdrugsmustbebasedinpartontheirpharmacologicalevaluationinanimals.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評價為基礎(chǔ)。因此,動物藥理學和比較藥理學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.Manydrugsstimulateordepressbiochemicalorphysiologicalfunctioninmaninasufficientlyreproduciblemannertoprovidereliefofsymptomsor,ideally,toalterfavorablythecourseofdisease.Conversely,chemicotherapeuticagentsareusefulintherapybecausetheyhaveonlyminimaleffectsonmanbutcandestroyoreliminateparasites.Whetheradrugisusefulfortherapyiscruciallydependentuponitsabilitytoproduceitsdesiredeffectswithonlytolerableundesiredeffects.Thus,fromthestandpointofthephysicianinterestedinthetherapeuticusesofadrug,theselectivityofitseffectsisoneofitsmostimportantcharacteristics.Drugtherapyisrationallybaseduponthecorrelationoftheactionsandeffectsofdrugswiththephysiological,biochemical,microbiological,immunological,andbehavioralaspectsofdisease.Pharmacodynamicsprovidesoneofthebestopportunitiesforthiscorrelationduringthestudyofboththepreclinicalandtheclinicalmedicalsciences.藥物治療學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小但卻能殺死或清除寄生生物?！N藥物是否可以用于治療,關(guān)鍵取決于其能否產(chǎn)生預期的治療效果,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)系理所當然地成為藥物治療的基礎(chǔ)。藥效學便為臨床前期和臨床期醫(yī)學研究這種聯(lián)系提供了一個絕好的機會。Toxicologyisthataspectofpharmacologythatdealswiththeadverseeffectsofdrugs.Itisconcernednotonlywithdrugsusedintherapybutalsowiththemanyotherchemicalsthatmayberesponsibleforhousehold,environmental,orindustrialintoxication.Theadverseeffectsofthepharmacologicalagentsemployedintherapyareproperlyconsideredanintegralpartoftheirtotalpharmacology.Thetoxiceffectsofotherchemicalsaresuchanextensivesubjectthatthephysicianmustusuallyconfinehisattentiontothegeneralprinciplesapplicabletotheprevention,recognition,andtreatmentofdrugpoisoningsofanycause.毒理學是研究藥物副作用的藥理學分支。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物質(zhì)。治療性藥物的副作用應被視為整個藥理學的一個組成部分。其他化學物質(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防、確認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叫藥理學,研究這門學問的科學家便是藥理學家。藥理學不是一門能夠獨立研究的科學,而是與其它學科緊密相關(guān)的。藥理學家不僅要了解人體內(nèi)進行的正常反應過程,還應懂得機體功能是怎樣受疾病影響的。Thescienceoftheeffectsofdrugsonthebodyiscalledpharmacology,andthescientistswhostudyitarepharmacologists.Pharmacologyisnotasciencethatcanbestudiedonitsown,butthatcloselyrelatedtootherbranchesofscience.Pharmacologistsshouldnotonlyunderstandthenormalprocessesthattakeplaceinthebody,butknowhowthefunctionsofthebodyareaffectedbydisease.醫(yī)生和醫(yī)學生對藥理學的理解和要求沒有其定義范疇那么廣泛。臨床醫(yī)生主要關(guān)心藥品藥理學所提供的合理臨床用藥的理論基礎(chǔ),他們的主要興趣在于藥物對人類疾病的預防、這段及治療,或者在避孕方面所起的作用。Forphysiciansandmedicalstudents,thescopeofpharmacologyisnotsoexpansiveasitscommondefinition.Theclinicianisinterestedprimarilyindragsthatareusefulintheprevention,diagnosis,andtreatmentofhumandisease,orinthepreventionofpregnancy.所有醫(yī)生都應該負起責任解決藥品濫用所引起的各種社會問題。藥物用得恰當,將是人類的一大福音,用得不當,則可能毀了人類。病人〔特別是老年病人經(jīng)常性使用一種以上治療藥物的話,往往會發(fā)生產(chǎn)生毒性的藥物相互作用。Allphysiciansshouldsharetheresponsibilitytoresolvekindsofsociologicalproblemscausedbytheabuseofdrugs.Properlyused,drugsaregreatblessingtomankind;improperlyused,theycoulddestroyhumanrace.Whenapatient,particularlytheelderlyisprescribedfrequentlytotakemorethanonetherapeuticagent,druginteractionsresultingintoxicitywilloccur.以前,醫(yī)師必須具備很廣泛的植物學知識,因為他要懂得挑選適當?shù)闹参锏哪芰图记?并將它們制備成簡單的草藥?，F(xiàn)在,由于大多數(shù)天然藥物被高度提純,且與合成的化學藥物無甚區(qū)別,所以臨床醫(yī)生對生藥學的興趣也相應減弱。Atonetime,itwasessentialforthephysiciantohavebroadbotanicalknowledge,becausetheyhadtopossesstheabilityandskilltoselectproperplantsfromwhichtopreparehisowncrudemedicinalpreparations.對藥物的生化生理作用及其活性機制的研究叫做藥效學,該學科的獨到之處主要在于其關(guān)注的要點是藥物的特征。藥效學作為一門邊緣學科,大量借鑒了生理學、生物化學、免疫學、病理學等學科的理論和實驗技術(shù)。Thestudyofbiochemicalandphysiologicaleffectsofdragsandtheirmechanismsofactionistermedaspharmacodynamics,whoseuniquenessliesmainlyinthatitsattentionisfocusedonthecharacteristicsofthedrug.Asabroaderscience,itborrowsfreelyfromboththetheoriesandexperimentaltechniquesofphysiology,biochemistry,immunology,andpathology.Unit8TextAWhatAnalyticalChemistsDo?分析化學家做什么？Analyticalchemistryisconcernedwiththechemicalcharacterizationofmatterandtheanswertotwoimportantquestions:whatisit<qualitative>andhowmuchisit<quantitative>.Chemicalsmakeupeverythingweuseorconsume,andknowledgeofthechemicalcompositionofmanysubstancesisimportantinourdailylives.Analyticalchemistryplaysanimportantroleinnearlyallaspectsofchemistry,forexample,agricultural,clinical,environmental,forensic,manufacturing,metallurgical,andpharmaceuticalchemistry.Thenitrogencontentofafertilizerdeterminesitsvalue.Foodsmustbeanalyzedforcontaminants<e.g.,pesticideresidues>andforessentialnutrients<e.g.vitamincontent>.Theairincitiesmustbeanalyzedforcarbonmonoxide.Bloodglucosemustbemonitoredindiabetics<and,infact,mostdiseases;arediagnosedbychemicalanalysis>.Thepresenceoftraceelementsfromgunpowderonamurderdefendant'shandwillproveagunwasfired.Thequalityofmanufacturedproductsoftendependsonproperchemicalproportions,andmeasurementoftheconstituentsisanecessarypartofqualitycontrol.Thecarboncontentofsteelwilldetermineitsquality.Thepurityofdrugswilldeterminetheirefficacy.分析化學是研究物質(zhì)的化學特征并能回答兩個重要問題:是什么<定性>以及有多少<定量>。我們所使用和消耗的一切都是由化學物質(zhì)組成的,所以日常生活中了解物質(zhì)的化學成分是非常重要的。分析化學幾乎在化學的各個領(lǐng)域都起著至關(guān)重要的作用,比如農(nóng)業(yè)、臨床、環(huán)境、法醫(yī)、制造業(yè)、冶金以及藥物化學?；瘜W肥料中氮的含量決定了其價值。對食物而言,必須分析其中的污染物<比如殺蟲劑殘留和必要的營養(yǎng)成分<如維生素含量>。對城市空氣而言,必須分析其中的一氧化碳含量。糖尿病患者需檢測血糖<事實上,大多數(shù)疾病都是通過化學分析來診斷的>。謀殺嫌疑犯手上火藥中痕量元素的存在可以證明手槍是開過火的。出廠產(chǎn)品的質(zhì)量取決于合適的化學成分比例,因此對組分的測定是質(zhì)量控制中必不可少的一個環(huán)節(jié)。鋼鐵中碳的含量決定其質(zhì)量,藥物的純度決定其療效。WhatisAnalyticalScience?什么是分析科學？Theabovedescriptionofanalyticalchemistryprovidesanoverviewofthedisciplineofanalyticalchemistry.Therehavebeenvariousattemptstomorespecificallydefinethediscipline.ThelateCharlesN.Reilleysaid:"Analyticalchemistryiswhatanalyticalchemistsdo"Thedisciplinehasexpandedbeyondtheboundsofjustchemistry,andmanyhaveadvocatedusingthenameanalyticalsciencetodescribethefield.ThistermisusedinaNationalScienceFoundationreportfromworkshopson"CurricularDevelopmentsintheAnalyticalSciences."Eventhistermfallsshortofrecognitionoftheroleofinstrumentationdevelopmentandapplication.Onesuggestionisthatweusethetermanalyticalscienceandtechnology.通過以上描述可以對分析化學這門學科有大致的了解,為更加明確地定義這門學科,人們也有過多種嘗試。已故的CharlesN.Reilley曾說過:"分析化學家從事的工作就是分析化學"。這門學科的發(fā)展已跨越了純化學的界限,許多人已提倡使用"分析科學"來描述該領(lǐng)域。在名為"分析科學的課程發(fā)展"的工作組所做的國家科學基金報告中已使用這一名詞。但是該名詞忽視了儀器發(fā)展和應用的作用,有人建議使用"分析科學和技術(shù)"這一名詞。TheFederationofEuropeanChemicalSocietiesheldacontesttodefineanalyticalchemistry,andthefollowingsuggestionbyK.Cammannwasselected.AnalyticalChemistryprovidesthemethodsandtoolsneededforinsightintoourmaterialworld…foransweringfourbasicquestionsaboutamaterialsample:What?Where?Howmuch?Whatarrangement,structureorform?歐洲化學會聯(lián)盟曾舉行了一次會議來定義分析化學,K.Cammann所提出的如下建議被采納：分析化學提供了洞察物質(zhì)世界所需要的方法和工具,它回答了關(guān)于某一物質(zhì)樣品的四個基本問題：?是什么？?在哪里？?有多少？?是何種排列、結(jié)構(gòu)或形態(tài)？TheDivisionofAnalyticalChemistryoftheAmericanChemicalSocietyprovidesacomprehensivedefinitionofanalyticalchemistry,whichmaybefoundontheirwebsite.Itisreproducedinmostparthere:AnalyticalChemistryseekseverimprovedmeansofmeasuringthechemicalcompositionofnaturalandartificialmaterials.Thetechniquesofthisscienceareusedtoidentifythesubstanceswhichmaybepresentinamaterialandtodeterminetheexactamountsoftheidentifiedsubstance.美國化學會的"分析化學分類"為分析化學提供了一個全面的定義,可以在其網(wǎng)站査到,此處摘錄部分內(nèi)容：分析化學探索不斷改進的方法,用以檢測天然和人造材料的化學組成。此種科學的技術(shù)手段用來鑒別可能存在于一種材料中的物質(zhì)以及測定給定物質(zhì)的準確含量。Analyticalchemistsworktoimprovethereliabilityofexistingtechniquestomeetthedemandsforbetterchemicalmeasurementswhichariseconstantlyinoursociety.Theyadoptprovenmethodologiestonewkindsofmaterialsortoanswernewquestionsabouttheircompositionandtheirreactivitymechanisms.Theycarryoutresearchtodiscovercompletelynewprinciplesofmeasurementandareattheforefrontoftheutilizationofmajordiscoveries,suchaslasersandmicrochipdevicesforpracticalpurposes.Theireffortsservetheneedsofmanyfields:分析化學家致力于提高已有技術(shù)的可靠性以更好地滿足社會中頻繁出現(xiàn)的化學檢測的需求。他們將已證實的方法學應用于新型材料,或回答關(guān)于其組成及反應機制的新問題。他們開展研究,探索全新的檢測原理,站在了將激光和微芯片等重大發(fā)現(xiàn)應用于實際用途的最前沿。他們的努力滿足了許多領(lǐng)域的需求：Inmedicine,analyticalchemistryisthebasisforclinicallaborat