How does your body process medicine? - Céline Valéry

4,587,327 views ・ 2017-05-15

TED-Ed


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翻译人员: Cherry Zhou 校对人员: Lipeng Chen
00:07
Have you ever wondered what happens to a painkiller, like ibuprofen,
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你可曾想过一片止痛药如布洛芬,
00:10
after you swallow it?
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被你吞下以后会发生什么事情吗?
00:11
Medicine that slides down your throat can help treat a headache,
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你吞下的药物可以治疗头痛,
00:14
a sore back,
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背疼,
00:16
or a throbbing sprained ankle.
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或者还在隐隐作痛扭伤了的踝关节。
00:17
But how does it get where it needs to go in the first place?
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但它是怎样在第一时间 就到达它需要前往的地方呢?
00:20
The answer is that it hitches a ride in your circulatory blood stream,
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答案就是它会搭上你血液循环的便车,
00:24
cycling through your body in a race to do its job
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在它被身体器官和能够中和
00:27
before it's snared by organs and molecules designed to neutralize
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和驱除外来物质的特定分子捕捉到之前,
00:31
and expel foreign substances.
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在你身体里流通的时候赶紧去完成它的工作。
00:33
This process starts in your digestive system.
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这个过程发生在你的消化系统中。
00:36
Say you swallow an ibuprofen tablet for a sore ankle.
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设想你关节疼痛,因此你吞下了一枚布洛芬片。
00:40
Within minutes, the tablet starts disintegrating in the acidic fluids
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几分钟内,药片开始在 你胃部的酸性液体中分解。
00:44
of your stomach.
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00:45
The dissolved ibuprofen travels into the small intestine
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溶解了的布洛芬片会来到小肠,
00:48
and then across the intestinal wall into a network of blood vessels.
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然后穿过小肠璧进入血管网络。
00:53
These blood vessels feed into a vein,
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这些血管会汇入静脉,
00:56
which carries the blood, and anything in it, to the liver.
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静脉会运送血液和血液中含有的任何物质到肝脏。
00:59
The next step is to make it through the liver.
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下一步就是让它通过肝脏。
01:02
As the blood and the drug molecules in it travel through liver blood vessels,
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血液和药物分子流经肝脏血管的时候,
01:07
enzymes attempt to react with the ibuprofen molecules
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酶会跟布洛芬分子发生反应。
01:11
to neutralize them.
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来中和它们。
01:13
The damaged ibuprofen molecules, called metabolites,
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被破坏的布洛芬分子,亦称代谢物,
01:16
may no longer be effective as painkillers.
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或许不能再起到止痛片的作用了。
01:19
At this stage, most of the ibuprofen makes it through the liver unscathed.
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在这一阶段,绝大多数布洛芬会让自己 在免受伤害的情况下穿过肝脏。
01:24
It continues its journey out of the liver,
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离开肝脏之后它继续自己的旅程,
01:26
through veins,
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流经静脉,
01:27
into the body's circulatory system.
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进入人体的循环系统。
01:30
Half an hour after you swallow the pill,
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在你吞下药片的半小时后,
01:32
some of the dose has already made it into the circulatory blood stream.
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部分剂量已经参与到血液循环过程。
01:36
This blood loop travels through every limb and organ,
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这种血液循环会流经四肢和人体器官,
01:39
including the heart, brain, kidneys, and back through the liver.
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包括心脏、大脑和肾脏,然后回到肝脏。
01:44
When ibuprofen molecules encounter a location
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当布洛芬分子遇到一个地方
01:47
where the body's pain response is in full swing,
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正发出身体疼痛的强烈信号,
01:50
they bind to specific target molecules that are a part of that reaction.
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它们会跟能引起化学反应的特定靶分子结合。
01:54
Painkillers, like ibuprofen, block the production of compounds
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止痛片像布洛芬会限制化合物的产生,
01:57
that help the body transmit pain signals.
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这些化合物会帮助人体传递疼痛信号。
02:00
As more drug molecules accumulate,
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药物分子积聚得越多,
02:02
the pain-cancelling affect increases,
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减轻疼痛的效果就越显著,
02:05
reaching a maximum within about one or two hours.
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大概在一至两小时内会达到最大值。
02:09
Then the body starts efficiently eliminating ibuprofen,
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然后身体开始高效消除布洛芬,
02:11
with the blood dose decreasing by half every two hours on average.
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平均每两个小时血液中的药物剂量就会减半。
02:16
When the ibuprofen molecules detach from their targets,
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当布洛芬分子从靶分子中分离出来,
02:19
the systemic blood stream carries them away again.
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血液循环系统会再次把它们运载出去。
02:22
Back in the liver, another small fraction of the total amount of the drug
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回到肝脏,而药物中的另一小部分
02:26
gets transformed into metabolites,
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会转化为代谢物,
02:29
which are eventually filtered out by the kidneys in the urine.
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这些代谢物最终会被肾脏过滤掉而后变成尿液。
02:32
The loop from liver to body to kidneys continues at a rate
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从肝脏到人体再到肾脏的血液循环速率
02:35
of about one blood cycle per minute,
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大概是每分钟一次,
02:38
with a little more of the drug neutralized and filtered out in each cycle.
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每次循环就会有更多的药物被中和和过滤掉。
02:42
These basic steps are the same for any drug that you take orally,
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无论你口服什么药物, 这些基本步骤都是会发生的,
02:45
but the speed of the process
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只是过程的速率
02:47
and the amount of medicine that makes it into your blood stream
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和进入你血液循环的药物剂量
02:50
varies based on drug,
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会因药物种类,
02:51
person,
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不同的人,
02:52
and how it gets into the body.
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以及如何进入人体体内而有所差异。
02:54
The dosing instructions on medicine labels can help,
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药物标签上的剂量介绍能给你提供帮助,
02:57
but they're averages based on a sample population
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但它们只是取了样本人口的平均值,
03:00
that doesn't represent every consumer.
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并不代表每一位消费者。
03:02
And getting the dose right is important.
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而摄取正确的剂量是很重要的。
03:05
If it's too low, the medicine won't do its job.
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如果剂量太低,药物起不了作用。
03:07
If it's too high, the drug and its metabolites can be toxic.
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如果剂量太高,药物产生的代谢物可能会有毒性。
03:12
That's true of any drug.
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这是对任何药物都适用的道理。
03:14
One of the hardest groups of patients to get the right dosage for are children.
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最难摄取到正确剂量的群体之一就是儿童。
03:18
That's because how they process medicine changes quickly, as do their bodies.
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因为他们的身体处理药物的过程变化得太快了。
03:22
For instance, the level of liver enzymes that neutralize medication
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例如中和药物的肝脏酶水平,
03:26
highly fluctuates during infancy and childhood.
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在婴儿和儿童时期波动起伏很大。
03:29
And that's just one of many complicating factors.
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而这只是众多复杂因素中的一种。
03:32
Genetics,
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遗传、
03:33
age,
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年龄、
03:34
diet,
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03:34
disease,
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饮食
疾病、
03:35
and even pregnancy influence the body's efficiency of processing medicine.
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甚至是怀孕期都会影响身体处理药物的效率。
03:40
Some day, routine DNA tests may be able to dial in the precise dose of medicine
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或许有一天常规的DNA测试可以 根据你肝脏功能效率和其他因素
03:45
personalized to your liver efficiency and other factors,
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测量药物的精确剂量。
03:49
but in the meantime,
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但与此同时,
03:50
your best bet is reading the label
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你最好的选择就是阅读药物标签,
03:52
or consulting your doctor or pharmacist,
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或者咨询你的医生或者药剂师,
03:54
and taking the recommended amounts with the recommended timing.
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然后在建议的时间内服用推荐剂量。
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