藥物分類
藥物分類,或稱藥物類別是藥物的某種分類方式,這種方式可以基於相似的化學結構、或相同的作用機制(如可與同一生物靶標結合)、或相似的作用模式,或用於治療相似的疾病。[1][2]
藥物可從多種角度進行分類,在主流的藥物分類系統中,以上四種分類模式形成了一種層次結構。例如,貝特類藥物具有相似的化學結構(兩親性羧酸),具有相同的作用機制(PPAR激動劑)和相同的作用方式(降低血液中的甘油三酯),均可用於預防和治療相同的疾病(動脈粥樣硬化)。[3][4]然而,並非所有PPAR激動劑都是貝特類藥物,並非所有降甘油三酯藥物都是PPAR激動劑,並非所有治療動脈粥樣硬化藥物均是降甘油三酯藥物。
藥物類別通常由原型藥物定義,原型藥物是該分類中的典型藥物且通常為首個成藥化合物,開發同類型的其他同藥物通常參考原型藥物或與之比較。[5][6] 如抗瘧疾藥物的原型藥物是氯喹,非甾體抗炎藥物的原型藥物是阿司匹林。[7][8]
按綜合系統分類
[編輯]- 解剖治療化學分類系統(Anatomical Therapeutic Chemical Classification System,ATC)是最廣泛使用的藥物分類系統。可結合器官系統、治療屬性、藥理學屬性和化學屬性進行分類。[9][10][11]
- 醫學系統命名法(Systematized Nomenclature of Medicine,SNOMED):其中部分規則也可用於藥物分類。[12][13]
按化學性質
[編輯]藥物可基於化學性質進行分類,如根據藥化學結構分類。基於化學結構進行分類的藥物類別包括:
按作用機制
[編輯]可基於藥理學按作用機制對藥物進行分類,作用機制通常依據生物學靶標的種類進行分類。分子作用機制相同的一類藥物,可調節特定的生物靶標活性。[21]作用機制還包括針對生物靶標的活性類型,如對於受體而言,這些活性包括:激動劑、拮抗劑、反向激動劑或調節劑。酶的靶向機制包括激活劑和抑制劑。離子通道調節劑包括開放劑和阻滯劑。以下是基於特定作用機制的藥物類別示例:
按作用方式
[編輯]按作用方式分類是基於生物學的角度出發,並根據藥物引起的解剖學或藥物引起的功能改變進行分類。基於常用的作用方式定義的藥物類別包括:
按臨床用途
[編輯]藥物分類還可從醫學臨床用途角度出發,根據藥物用於治療的病理學進行分類。
合併分類
[編輯]某些藥物類別會兼顧多種分類標準以滿足實際的分類需要。如非甾體類抗炎藥(Nonsteroidal anti-inflammatory durg,NSAID)就是其中一例。[59]歷史上對於抗炎藥的定義,除了非甾體抗炎藥,還包括皮質類固醇藥物即甾體類抗炎藥物。在非甾體抗炎藥這個類別出現之前的十年間,甾體類皮質類固醇類抗炎藥一直是抗炎藥物中的主流。[60]由於1950年代皮質類固醇藥物的不良反應事件,非甾體抗炎藥這種新型抗炎藥物迅速在臨床領域開展應用。 [59]因此,非甾體抗炎藥的藥物類別由作用機制——抗炎,與其化學結構——非甾體一起組成了新的藥物分類。
按其他系統分類
[編輯]其他藥物分類系統,如基於藥物的溶解度和胃腸道滲透性,對藥物進行分類的生物藥劑學分類系統(Biopharmaceutics Classification System,BCS)。[62]
![](http://upload.wikimedia.org/wikipedia/commons/thumb/a/a9/Biopharmaceutics_Classification_System_%28BCS%29.jpg/300px-Biopharmaceutics_Classification_System_%28BCS%29.jpg)
按生物藥劑學分類系統(BCS分類)可以將藥物基於不同的溶解性和滲透性,分為四類:[62]
按法律法規分類
[編輯]- 對於加拿大的法律分類,可參閱對於加拿大的法律分類和《受管制藥物和物質法》[63]。
- 對於英國法律分類,可參閱《英國濫用藥物法中的管制藥物》。[64]
- 對於美國法律的藥物分類,可參閱《受管制物質法案》。[65]
- 由於妊娠期的特殊性,不同司法管轄區使用不同的系統進行藥物的懷孕分級。[66]
參見
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外部連結
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