. .

. . *, ,
. . **, ,
. . *
* . . . ,
** ,

, , . ( ), ( , . . ).

- , () - , , (), (), () [1].

() , . , , , [2, 3]. , , 1045% () [46].

, , , , , , - (), , , , , . . () [79]. , .

, [1012].

XX , . , ().

. (, , /, ) , .

, , , , , / , , , , . [13]. .

, , , ?, , , . , , I , -450, , - [14].

, [15]. , , , , .

450

60% CYP3A4, . . . CYP3A4, , , [1618].

, .

• (extensivemetabolism, EM) , , . .
• (poormetabolism, PM) , , ( - ) ( - ) . , . , , . : , .
• , , (ultraextensivemetabolism, UM) , , ( - ) ( - ) . . , [10].

450 , , . 450 2C9 (CYP2C9) , XP-3174. , CYP2C9*2 CYP2C9*3 ( ) CYP2C9 - , [19].

-

, 450, P- (-gp). , - , . , [20]. , -. , . . 26 3435 (3435), ABCB1 ( MDR1), , - [2123]. , ABCB1 2 , - [24]. ABCB1 .

- . , , [25, 26]; , , ; , , [27, 28].

- . ABCB1 (-). - , - , -2, -4, γ [29]. , - . , , , - , [3032]. ABCB1 , . , -.

, -, -. - , , , , , , [33].

, , / - (.) [34].

-, . , , - [35].

- , (), , .

, . (, , ), (, ) (, ) [36].

. , PREVENT, ALLHAT, VALUE [37].

, [38, 39].

, () () , [40]. , ~20% , , [41]. , , .

, 65%. ( 612 ) (½ 40 ), 24 [42]. ( , .) (, ) [43, 44]. [4547].

, . . . , , , , . A. D. Baindridge ., 24 5 67%, [44, 48].

, P450 (CYP)3 . CYP3A CYP3A4 CYP3A5. CYP3A [49].

, -. , 3435 ABCB1 -. [5052]. , ABCB1 , , , [53].

, ABCB1. , -, -, , , [54, 55]. , , 3435 ABCB1 ( , n = 28), , ( , n = 55, , n = 20), 57% 13% ( = 0,0001) 0,25 /. , . 62% 84% , 0,25 /. DIG, , , ABCB1 , , . , ABCB1 - 3435. (, , ) C3435T ABCB1 , , .

, , . , , , , . 450 . , 450, P-. , , , .

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