75:. Different drugs have different therapeutic windows, and different people will have different MECs and MTCs for a given drug. If someone has a very low MTC for a drug, they are likely to experience adverse effects at drug concentrations lower than what it would take to produce the same adverse effects in the general populace; thus, the individual will experience significant toxicity at a dose that is otherwise considered "normal" for the average person. This individual will be considered "intolerant" to that drug.
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Drugs in systemic circulation have a certain concentration in the blood, which serves as a surrogate marker for how much drug will be delivered throughout the body (how much drug the rest of the body will "see"). There exists a minimum concentration of drug within the blood that will give rise to the
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the drug from their system. Thus, the drug will accumulate within the blood to higher-than-expected concentrations, reaching a MTC at a dose that would otherwise be considered normal for the average person. In other words, in a person that is intolerant to a medication, it is possible for a dose of
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of a medication, generally at therapeutic or subtherapeutic doses. Conversely, a patient is said to be "tolerating" a drug when they can tolerate its adverse effects. Some instances of drug intolerance are known to result from genetic variations in
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There is also an aspect of drug intolerance that is subjective. Just as different people have different pain tolerances, so too do people have different tolerances for dealing with the adverse effects from their medications. For example, while
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10 mg to "feel" like a dose of 100 mg, resulting in an overdose—a "normal" dose can be a "toxic" dose in these individuals, leading to clinically significant effects.
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superfamily. While most individuals will possess the effective metabolizing machinery, a person with a defect will have a difficult time trying to
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Backes, James; Ruisinger, Janelle; Gibson, Cheryl; Moriarty, Patrick (2017). "Statin-associated muscle symptoms--Managing the highly intolerant".
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338:"Safety of codeine during breastfeeding: fatal morphine poisoning in the breastfed neonate of a mother prescribed codeine"
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289:"Aspirin-exacerbated respiratory disease: Prevalence, diagnosis, treatment, and considerations for the future"
71:(minimum toxic concentration, MTC). The difference between these two values is generally referred to as the
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102:) process. For example, a patient could possess a genetic defect in a drug metabolizing enzyme in the
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There are a variety of factors that can affect the MTC, which is often the subject of clinical
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due to the unpleasantness of the constipation even if it brings them significant pain relief.
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may be tolerable to some individuals, other people may stop taking an
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can be caused to a breastfed newborn baby due to normal use of
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is responsible for the intolerance. Symptoms include chronic
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Madadi P, Koren G, Cairns J, et al. (January 2007).
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Jennedy, Joshua; Stoner, Ashley; Borrish, Larry (2016).
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Inability to tolerate the adverse effects of a drug
82:. Variations in MTC can occur at any point in the
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142:Aspirin-exacerbated respiratory disease
37:refers to an inability to tolerate the
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450:Förster U, Olze H (April 2008). "".
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53:Venn Diagram for Drug Intolerance
259:(drug hypersensitivity syndrome)
188:Muscle pain or weakness due to
65:minimum effective concentration
417:Journal of Clinical Lipidology
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63:intended therapeutic effect (
127:Examples of drug sensitivity
117:opioid-induced constipation
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429:10.1016/j.jacl.2017.01.006
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464:10.1007/s00106-008-1701-6
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153:) after a normal dose of
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19:Not to be confused with
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227:gastrointestinal ulcers
135:after a normal dose of
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392:|...}}
369:(Retracted, see
247:Adverse drug reaction
197:Analgesic intolerance
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293:Am J Rhinol Allergy
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73:therapeutic window
69:adverse drug event
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342:Can Fam Physician
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35:drug sensitivity
31:Drug intolerance
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149:(possibly also
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219:nasal polyps
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92:distribution
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21:Drug allergy
348:(1): 33–5.
486:Categories
274:References
231:angioedema
203:analgesics
96:metabolism
88:absorption
398:retracted
390:retracted
235:urticaria
179:poisoning
166:poisoning
100:excretion
472:18389300
437:28391891
383:33599627
364:17872605
323:28124651
241:See also
133:Tinnitus
355:1952551
314:5108840
192:therapy
183:codeine
170:codeine
137:aspirin
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233:, and
223:asthma
207:NSAIDs
190:statin
177:Fatal
164:Fatal
121:opioid
98:, and
394:with
217:with
108:clear
468:PMID
433:PMID
379:PMID
360:PMID
319:PMID
84:ADME
460:doi
452:HNO
425:doi
371:doi
350:PMC
309:PMC
301:doi
33:or
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