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How to identify drug antagonism: What to do when the drug's effect is lower than expected?
In pharmacology, the addition effect refers to the combined effect of the two drugs equals the sum of the independent action of the two drugs.This concept stems from drug synergy and has been studied and discussed by scientists over the past century.
The addition effect usually occurs when two similar drugs are used simultaneously, with the goal of achieving equal efficacy and reducing specific adverse reactions of a single drug.
For example, a combination of aspirin, paracetamol and caffeine can be used to relieve pain from stress headaches or migraines.When the combined effect of the drug is lower than the sum of independent effects, it is called antagonism, in which case these drugs are rarely prescribed together.
In the study of synergistic effects of drugs and chemical substances, the fields of medicine and pharmacology have proposed models such as Loewe additiveness and Bliss independence, which can be used to measure the effect of drug combinations.These models not only help to evaluate the synergistic effects of drugs, but also identify antagonism.
Type of addition effect
The addition effect can occur between the corresponding or overlapping drugs and the independent drugs.
Corresponding or overlapping effects
Many similar drugs have additive effects due to similar treatment mechanisms.For example, calcium carbonate, magnesium and aluminum salts are antacids, and their mechanism of action is to neutralize the acid in the stomach.These antacids do not affect each other when used simultaneously and can therefore be considered to have an additive effect.
Independent function
When two drugs act on different pathways but ultimately achieve therapeutic effects, these drugs are called additive effects with independent effects.For example, both artemisinin and curcumin can produce antimalarial effects, and both of them each have an impact on parasites through different mechanisms.
The application of the additive effect is very important in clinical practice, especially in combination therapy, where these drugs act on different biological and biochemical pathways and produce additive effects.
Clinical significance
Synonymous detection
A typical use of the addition effect is to detect synergistic effects.It can be viewed as a baseline effect that detects whether there is a joint effect between drugs.The effect of a combination with synergistic effects will be greater than the addition effect.
Detection of antagonism
Similarly, the addition effect can also be used to detect antagonism.When the combined effect of the two drugs is lower than the additive effect, the pharmacist can confirm the existence of this antagonism.
Combination Therapy
The clinical use of combination therapy is most common.The combination of different drugs can not only enhance the efficacy, but also help expand the pathological scope of treatment. For example, the combination of beta-2 adrenaline receptor agonists and inhaled steroids can fight respiratory diseases such as asthma.
Optimal Dosage
Under reasonable drug combination, not only can the expected effect be achieved, but the adverse reactions and toxicity of various drugs can also be reduced, thereby improving the safety of treatment and patient compliance.
Adverse reactions
While drug combinations may lead to an additive effect, sharing drugs with similar effects may also lead to an increased risk of adverse reactions.For example, the combination of ACE inhibitors and potassium supplements may lead to hyperkalemia, and such conditions should be considered with caution.
In short, understanding the additive effect and its possible antagonism is not only crucial for pharmacists and medical professionals, but also for the safe use of drugs in patients.
In the face of increasingly complex drug treatment, is it worth our deep thinking about how to identify the antagonistic effects of drugs to ensure the effectiveness of treatment and the safety of patients?
