药理药效

## Ps: 以{"text":[{"section_attr":段落类型, "section_text":"段落1"},{"section_attr":段落类型, "section_text":"段落2"}],"reference":["参考ID1","参考ID2"]} 格式标识，当段落中存在上角标时，以<medpper-reference>参考ID1</medpper-reference>标识，当连续出现上角标时，以<medpper-reference>参考ID1</medpper-reference><medpper-reference>,</medpper-reference><medpper-reference>参考ID2</medpper-reference>标识。段落类型：0代表正文类型，1代表标题类型。 ## 数据示例： ```json { "code": 200, "msg": "查询成功", "data": [ { "indication_desc": { "text": [ { "section_attr": 1, "section_text": "Pain, fever, and inflammation" }, { "section_attr": 0, "section_text": "Acetylsalicylic acid (ASA), in the regular tablet form (immediate-release), is indicated to relieve pain, fever, and inflammation associated with many conditions, including the flu, the common cold, neck and back pain, dysmenorrhea, headache, tooth pain, sprains, fractures, myositis, neuralgia, synovitis, arthritis, bursitis, burns, and various injuries. It is also used for symptomatic pain relief after surgical and dental procedures ." }, { "section_attr": 0, "section_text": "The extra strength formulation of acetylsalicylic acid is also indicated for the management migraine pain with photophobia (sensitivity to light) and phonophobia (sensitivity to sound)." }, { "section_attr": 1, "section_text": "Other indications" }, { "section_attr": 0, "section_text": "ASA is also indicated for various other purposes, due to its ability to inhibit platelet aggregation. These include:" }, { "section_attr": 0, "section_text": "Reducing the risk of cardiovascular death in suspected cases of myocardial infarction (MI) ." }, { "section_attr": 0, "section_text": "Reducing the risk of a first non-fatal myocardial infarction in patients, and for reducing the risk of morbidity and mortality in cases of unstable angina and in those who have had a prior myocardial infarction ." }, { "section_attr": 0, "section_text": "For reducing the risk of transient ischemic attacks (TIA) and to prevent atherothrombotic cerebral infarction (in conjunction with other treatments) ." }, { "section_attr": 0, "section_text": "For the prevention of thromboembolism after hip replacement surgery ." }, { "section_attr": 0, "section_text": "For decreasing platelet to platelet adhesion following carotid endarterectomy, aiding in the prevention of transient ischemic attacks (TIA) ." }, { "section_attr": 0, "section_text": "Used for patients undergoing hemodialysis with a silicone rubber arteriovenous cannula inserted to prevent thrombosis at the insertion site ." }, { "section_attr": 1, "section_text": "Important note regarding use of the extended-release formulation <medpper-reference>refe202107051418323906469193</medpper-reference>" }, { "section_attr": 0, "section_text": "In the setting of acute myocardial infarction, or before percutaneous interventions, the extended-release form of acetylsalicylic acid should not be used. Use immediate-release formulations in scenarios requiring rapid onset of action ,<medpper-reference>refe202107051418323906469193</medpper-reference>. The extended-release form is taken to decrease the incidence of mortality and myocardial infarction (MI) for individuals diagnosed with chronic coronary artery disease (CAD), including patients with previous myocardial infarction (MI) or unstable angina or with chronic stable angina. Additionally, the extended-release form is used to decrease the risk of death and recurrent episodes of stroke in patients with a history of stroke or TIA <medpper-reference>refe202107051418323906469193</medpper-reference>." } ], "reference": [ "refe202107051418323906469193" ] }, "pharmacodynamics_desc": { "text": [ { "section_attr": 1, "section_text": "Effects on pain and fever" }, { "section_attr": 0, "section_text": "Acetylsalicylic acid disrupts the production of prostaglandins throughout the body by targeting cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) ." }, { "section_attr": 1, "section_text": "Effects on platelet aggregation" }, { "section_attr": 0, "section_text": "The inhibition of platelet aggregation by ASA occurs because of its interference with thromboxane A2 in platelets, caused by COX-1 inhibition. Thromboxane A2 is an important lipid responsible for platelet aggregation, which can lead to clot formation and future risk of heart attack or stroke ." }, { "section_attr": 1, "section_text": "A note on cancer prevention" }, { "section_attr": 0, "section_text": "ASA has been studied in recent years to determine its effect on the prevention of various malignancies <medpper-reference>refe202107051418314675832720</medpper-reference>. In general, acetylsalicylic acid is involved in the interference of various cancer signaling pathways, sometimes inducing or upregulating tumor suppressor genes <medpper-reference>refe202107051418314675832720</medpper-reference><medpper-reference>,</medpper-reference><medpper-reference>refe202107051418318257683214</medpper-reference>. Results of various studies suggest that there are beneficial effects of long-term ASA use in the prevention of several types of cancer, including stomach, colorectal, pancreatic, and liver cancers <medpper-reference>refe202107051418316441756374</medpper-reference>. Research is ongoing." } ], "reference": [ "refe202107051418316441756374", "refe202107051418314675832720", "refe202107051418318257683214" ] }, "mechanism_action": { "text": [ { "section_attr": 0, "section_text": "Acetylsalicylic acid (ASA) blocks prostaglandin synthesis. It is non-selective for COX-1 and COX-2 enzymes . Platelet aggregation can result in clots and harmful venous and arterial thromboembolism, leading to conditions such as pulmonary embolism and stroke." }, { "section_attr": 0, "section_text": "It is important to note that there is 60% homology between the protein structures of COX-1 and COX-2. ASA binds to serine 516 residue on the active site of COX-2 in the same fashion as its binding to the serine 530 residue located on the active site of COX-1. The active site of COX-2 is, however, slightly larger than the active site of COX-1, so that arachidonic acid (which later becomes prostaglandins) manages to bypass the aspirin molecule inactivating COX-2 <medpper-reference>refe202107051418307321280400</medpper-reference><medpper-reference>,</medpper-reference><medpper-reference>refe202107051418309127119322</medpper-reference>. ASA, therefore, exerts more action on the COX-1 receptor rather than on the COX-2 receptor <medpper-reference>refe202107051418312739161520</medpper-reference>. A higher dose of acetylsalicylic acid is required for COX-2 inhibition <medpper-reference>refe202107051418314675832720</medpper-reference>." } ], "reference": [ "refe202107051418312739161520", "refe202107051418307321280400", "refe202107051418309127119322", "refe202107051418314675832720" ] }, "drug_absorption": { "text": [ { "section_attr": 0, "section_text": "Absorption is generally rapid and complete following oral administration but absorption may be variable depending on the route, dosage form, and other factors including but not limited to the rate of tablet dissolution, gastric contents, gastric emptying time, and gastric pH ." }, { "section_attr": 1, "section_text": "Detailed absorption information" }, { "section_attr": 0, "section_text": "When ingested orally, acetylsalicylic acid is rapidly absorbed in both the stomach and proximal small intestine. The non-ionized acetylsalicylic acid passes through the stomach lining by passive diffusion. Ideal absorption of salicylate in the stomach occurs in the pH range of 2.15 - 4.10. Intestinal absorption of acetylsalicylic acid occurs at a much faster rate. At least half of the ingested dose is hydrolyzed to salicylic acid in the first-hour post-ingestion by esterases found in the gastrointestinal tract. Peak plasma salicylate concentrations occur between 1-2 hours post-administration ." } ], "reference": [] }, "volume_distribution": { "text": [ { "section_attr": 0, "section_text": "This drug is distributed to body tissues shortly after administration. It is known to cross the placenta. The plasma contains high levels of salicylate, as well as tissues such as spinal, peritoneal and synovial fluids, saliva and milk. The kidney, liver, heart, and lungs are also found to be rich in salicylate concentration after dosing. Low concentrations of salicylate are usually low, and minimal concentrations are found in feces, bile, and sweat ." } ], "reference": [] }, "protein_binding": { "text": [ { "section_attr": 0, "section_text": "50% to 90% of a normal therapeutic concentration salicylate (a main metabolite of acetylsalicylic acid ) binds plasma proteins, particularly albumin, while acetylsalicylic acid itself binds negligibly . Acetylsalicylic acid has the ability to bind to and acetylate many proteins, hormones, DNA, platelets, and hemoglobin ." } ], "reference": [] }, "drug_metabolism": { "text": [ { "section_attr": 0, "section_text": "Acetylsalicylic acid is hydrolyzed in the plasma to salicylic acid. Plasma concentrations of aspirin following after administration of the extended-release form are mostly undetectable 4-8 hours after ingestion of a single dose. Salicylic acid was measured at 24 hours following a single dose of extended-release acetylsalicylic acid <medpper-reference>refe202107051418323906469193</medpper-reference>." }, { "section_attr": 0, "section_text": "Salicylate is mainly metabolized in the liver, although other tissues may also be involved in this process . The major metabolites of acetylsalicylic acid are salicylic acid, salicyluric acid, the ether or phenolic glucuronide and the ester or acyl glucuronide. A small portion is converted to gentisic acid and other hydroxybenzoic acids ." }, { "section_attr": 1, "section_text": "Hover over products below to view reaction partners" } ], "reference": [ "refe202107051418323906469193" ] }, "route_elimination": { "text": [ { "section_attr": 0, "section_text": "Excretion of salicylates occurs mainly through the kidney, by the processes of glomerular filtration and tubular excretion, in the form of free salicylic acid, salicyluric acid, and, additionally, phenolic and acyl glucuronides ." }, { "section_attr": 0, "section_text": "Salicylate can be found in the urine soon after administration, however, the entire dose takes about 48 hours to be completely eliminated. The rate of salicylate is often variable, ranging from 10% to 85% in the urine, and heavily depends on urinary pH. Acidic urine generally aids in reabsorption of salicylate by the renal tubules, while alkaline urine increases excretion ." }, { "section_attr": 0, "section_text": "After the administration of a typical 325mg dose, the elimination of ASA is found to follow first order kinetics in a linear fashion. At high concentrations, the elimination half-life increases ." } ], "reference": [] }, "half_life": { "text": [ { "section_attr": 0, "section_text": "The half-life of ASA in the circulation ranges from 13 - 19 minutes. Blood concentrations drop rapidly after complete absorption. The half-life of the salicylate ranges between 3.5 and 4.5 hours ." } ], "reference": [] }, "drug_clearance": { "text": [ { "section_attr": 0, "section_text": "The clearance rate of acetylsalicylic acid is extremely variable, depending on several factors . The extended-release tablet should not be administered to patients with eGFR of less than 10 mL/min <medpper-reference>refe202107051418323906469193</medpper-reference>." } ], "reference": [ "refe202107051418323906469193" ] }, "drug_toxicity": { "text": [ { "section_attr": 1, "section_text": "Lethal doses" }, { "section_attr": 0, "section_text": "Acute oral LD50 values have been reported as over 1.0 g/kg in humans, cats, and dogs, 0.92 g/kg - 1.48 g/kg in albino rats, 1.19 g/kg in guinea pigs, 1.1 g/kg in mice, and 1.8 g/kg in rabbit models ." }, { "section_attr": 1, "section_text": "Acute toxicity" }, { "section_attr": 0, "section_text": "Salicylate toxicity is a problem that may develop with both acute and chronic salicylate exposure <medpper-reference>refe202107051418300007369801</medpper-reference>.Multiple organ systems may be affected by salicylate toxicity, including the central nervous system, the pulmonary system, and the gastrointestinal system. Severe bleeding may occur. In the majority of cases, patients suffering from salicylate toxicity are volume-depleted at the time of presentation for medical attention. Fluid resuscitation should occur immediately and volume status should be monitored closely. Disruptions in acid-base balance are frequent in ASA toxicity <medpper-reference>refe202107051418300007369801</medpper-reference>." }, { "section_attr": 0, "section_text": "The acute toxicity of acetylsalicylic in animals has been widely studied. The signs of poisoning in rats from lethal doses are mild to severe gastroenteritis, hepatitis, nephritis, pulmonary edema, encephalopathy, shock and some toxic effects on other organs and tissues. Mortality has been observed following convulsions or cardiovascular shock. An important differentiating property between various animal species is the ability to vomit toxic doses. Humans, cats and dogs have this ability, but rodents or rabbits do not ." }, { "section_attr": 1, "section_text": "Chronic toxicity and carcinogenesis" }, { "section_attr": 0, "section_text": "Chronic ASA toxicity is frequently accompanied by atypical clinical presentations that may be similar to diabetic ketoacidosis, delirium, cerebrovascular accident (CVA), myocardial infarction (MI) or cardiac failure. Plasma salicylate concentrations should be measured if salicylate intoxication is suspected, even if there no documentation available to suggest ASA was ingested. In older age, nephrotoxicity from salicylates increases, and the risk of upper gastrointestinal hemorrhage is increased, with higher rates of mortality <medpper-reference>refe202107051418301833551319</medpper-reference>. It is also important to note that ASA toxicity may occur even with close to normal serum concentrations. Prevention of chronic ASA includes the administration of smallest possible doses, avoidance of concurrent use of salicylate drugs, and therapeutic drug monitoring. Renal function should be regularly monitored and screening for gastrointestinal bleeding should be done at regular intervals <medpper-reference>refe202107051418301833551319</medpper-reference>." }, { "section_attr": 0, "section_text": "Chronic toxicity studies were performed in rodents. ASA was administered at doses measured to be 2 to 20 times the maximum tolerated clinical dose to mice for up to one year. Negative dose-related effects were seen. These include decreased mean survival time, decreased number of births and progeny reaching an appropriate age for weaning. No evidence of carcinogenesis was found in 1-year studies . At daily doses of 0.24 g/kg/day given for 100 days to albino rats, ASA led to signs to excessive thirst, aciduria, diuresis, drowsiness, hyperreflexia, piloerection, changes in respiration, tachycardia, followed by soft stools, epistaxis, sialorrhea, dacryorrhea and mortality during hypothermic coma in the second study month ." }, { "section_attr": 1, "section_text": "Use in pregnancy and lactation" }, { "section_attr": 0, "section_text": "While teratogenic effects were observed in animals nearly lethal doses, no evidence suggests that this drug is teratogenic in humans . It is advisable, however, to avoid ASA use the first and second trimester of pregnancy, unless it is clearly required. If acetylsalicylic acid containing drugs are ingested by a patient attempting to conceive, or during the first and second trimester of pregnancy, the lowest possible dose at the shortest possible duration should be taken . This drug is contraindicated in the 3rd trimester of pregnancy ." } ], "reference": [ "refe202107051418300007369801", "refe202107051418301833551319" ] } } ] } ```

药理药效

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