Gender, determining factors

The determination of an acceptable dose for humans involves the application of uncertainty factors to reflect the fact that, unlike the experimental animal, there is wide variability and susceptibility of response in the genetically diverse human population. Variations in gender, age, hormonal and disease status can affect the response to a chemical. In order to minimise any potential risks, uncertainty factors are applied to the NOAEL to arrive at a reduced exposure that is considered tolerable - namely the acceptable daily intake or ADI. These are usually tenfold for variations in susceptibility amongst the human population (the intra-species factor) and tenfold for the potential... 

When sufficient evidence is available to determine that the patient has real seizures and is at risk for another seizure, pharmacotherapy is usually started (Fig. 27-2). The patient should be in agreement with the plan, be willing to take the medication, and be able to monitor seizure frequency and adverse drug effects in some way. Design of an appropriate pharmacotherapeutic plan is based on the patient s seizure type, the common adverse-effect profile of possible AEDs, and economic factors (e.g., cost of the drug, insurance formulary, and ability to pay). Other patient factors such as gender, concomitant drugs, age, and lifestyle also need to be considered. 

The size of the body is another factor that determines cardiac output. Healthy young men have a cardiac output of about 5.5 to 6.0 1/min the cardiac output in women averages 4.5 to 5.0 1/min. This difference does not involve gender per se, but rather the mass of body tissue that must be perfused with blood. Cardiac index normalizes cardiac output for body size and is calculated by the cardiac output per square meter of body surface... 

Another factor that affected the direction of change in family income was its place on the economic ladder. The closer a family was V to poverty the more likely they were to see their income rise. Whereas, 45% of families at the top of the economic ladder, those with income-to-poverty ratios of more than 4.0, experienced income decreases in 1994. While age, gender, and race play a significant role in determining one s place on the economic ladder, these factors are 00) not good predictors of a rise or fall in income. The only population for which one of these factors was significant was the elderly, whose incomes tended to be fairly stable. 

If you are exposed to substances such as disulfoton, many factors will determine whether harmful health effects will occur and what the type and severity of those health effects will be. These factors include the dose (how much), the duration (how long), the route or pathway by which you are exposed (breathing, eating, drinking, or skin contact), the other chemicals to which you are exposed, and your individual characteristics such as age, gender, nutritional status, family traits, life-style, and state of health. 

Interspecies and interindividual variability in drug metabolism is influenced by both genetic and environmental factors. The basal rate of drug metabolism in a particular individual is determined primarily by genetic constitution, but also varies with age, gender, and environmental factors such as diet, disease states, and concurrent use of other drugs. 

The mechanisms for these interactions are not well defined, although numerous hypotheses have been advanced. It should be noted at the outset that attempts to determine the relationship between depression and altered immune function are confounded by the multiplicity of factors known to be associated with both and that may alter the interrelationship. Examples include age, gender, sleep status, the likelihood that depression represents a complex of disease states with varying involvement of the immune system, and the frequent presence of other psychiatric or physical disorders which can affect both psychological status and immune function. A detailed review of this topic has been published (hwin, 2001). Indeed, it has been pointed out by Irwdn that current data suggest immune changes in MDD specifically correlated with the disorder are also seen with stress and other psychiatric disorders, suggesting some common characteristic(s) shared by these problems (hwin, 2001). 

Schlienger et al. conducted a retrospective case control study from 1992-1997 to investigate if NSAIDs had the same cardiovascular benefit in prevention of AMIs.[154] A total of 3,319 cases with first time AMIs were determined and matched with 13, 139 controls based on age, gender, and practice and calendar time. After adjustment for other risk factors hke smoking, BMI, HRT and aspirin, there was a trend towards increased risk of AMI in NSAID users. The higher doses of NSAIDs were associated with significantly increased risk of MI as much as doubled. The authors concluded that NSAIDs was associated with an increased risk of AMI and no cardioprotection was observed with use of NSAIDs. 

Many commonly measured pharmacokinetic values can be used as biomarkers of exposure. Examples include parent compound or metabolites in exhaled breath, blood, or urine and macromolecular adducts or their degradation products that appear in urine. To make quantitative assessments of the relationship of such markers to prior exposures, it is necessary to determine the rate of formation and removal (clearance) of the marker. From this information it is possible to predict the steady-state concentrations of the marker following various exposure scenarios. In addition, with information on the rate of formation and removal of a marker and knowledge of the factors that influence those rates (such as gender, dose, repeated exposures, route of exposure, rate of exposure), a mathematical model that describes the concentration of the marker under different exposure conditions can be developed. While the concentration of the marker cannot be used to identify a unique exposure scenario, the marker can indicate the types of exposure regimens that would produce the measured level of the biomarker. 

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