Biotransformation of drugs depends on several internal and external factors. These factors influence the activity of some enzyme (i.e., cytochrome P450) that directly are involved in drug metabolism. The factors include:
- activation of enzymes. Some drugs act as enzyme inducers and activate the biotransformation of another drug. As a result, when these drugs are taken together, the level of biotransformation increases;
- inhibition of enzymes. Some drugs suppress the activity of metabolizing enzymes decreasing the biotransformation rate. This process leads to the accumulation of the drug in the blood increasing its half-life and inducing toxic effects.
- genetic variations. Some genetic differences may lead to different metabolizing rates and may significantly contribute to drug biotransformation.
- toxins and environmental pollutants. Some external substances (i.e., alcohol and smoke) may induce enzyme activity and increase the rate of drug metabolism.
- age and sex. The rate of biotransformation significantly depends on the basic metabolism linked to age and sex. For example, high doses of some drugs may be toxic for children and old people.
- nutrition. Amounts of minerals and vitamins consumed may affect the biotransformation as these ions and molecules are directly involved in the metabolic processes.
- pathological conditions. Numerous chronic and acute disorders (i.e., hepatitis and cirrhosis) affect drug metabolism that mainly occurs in the liver.
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