Synergist (pharmacology)

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A synergist (from the Greek συνεργεῖν synergeín , 'to work together') is the term used in pharmacology to refer to active substances that mutually reinforce their effect. This can affect both desirable and undesirable ( side effects ) effects. One differentiates

  • Synergists with an additive effect , where the effect corresponds to the sum of the individual effects, and
  • Synergists with a superadditive effect , in which the overall effect of both substances is stronger than a summation ( potentiation ).

In the Anglo-American language area, on the other hand, usually only the superadditive form is understood as synergism, while pure summation effects are referred to as "additive effect". Substances that reduce the effect of a drug are called antagonists .

Mechanisms

The following mechanisms can be involved in the creation of synergistic effects:

  • Improvement of absorption or bioavailability ( bioenhancer ; for example, loperamide lowers the motility of the small intestine and thus increases the absorption of many active substances absorbed in the small intestine)
  • Displacement of the binding to plasma proteins , as a result of which the unbound and thus actually effective proportion of the active ingredient is increased
  • Binding to the same receptors (e.g. two ACE inhibitors )
  • Effect on the same system, but at different points of attack (for example two different antibiotics such as a penicillin and an aminoglycoside : penicillins damage the cell wall of gram-positive bacteria and improve the penetration of the aminoglycoside)
  • Preventing or delaying the breakdown in the body (for example, the antibiotic ciprofloxacin inhibits the metabolism of theophylline )
  • Delay in excretion (for example, probenecid delays the tubular secretion of penicillins in the kidney, thus prolonging their effect)

Individual evidence

  1. ↑ Claudia Dellas: Pharmacology crash course: revision course with incorporation of the most important examination facts . Elsevier, Urban & Fischer, 2011, ISBN 9783437431821 , p. 8.
  2. ↑ David E. Golan, Armen H. Tashjian, Ehrin J. Armstrong: Principles of Pharmacology: The Pathophysiologic Basis of Drug Therapy . Lippincott Williams & Wilkins, 2011, ISBN 9781608312702 , p. 719.
  3. ↑ Kathy Moscou, Karen Snipe: Pharmacology for Pharmacy Technicians . Elsevier Health Sciences, 2012, ISBN 9780323085786 , p. 56.
  4. ↑ Kathy Moscou, Karen Snipe: Pharmacology for Pharmacy Technicians . Elsevier Health Sciences, 2012, ISBN 9780323085786 , p. 57.
  5. ↑ KD Tripathi: Essentials of Medical Pharmacology G - Reference, Information and Interdisciplinary Subjects Series . JP Medical Ltd, 2013, ISBN 9789350259375 , p. 698.
  6. ↑ a b K. D. Tripathi: Essentials of Medical Pharmacology G - Reference, Information and Interdisciplinary Subjects Series . JP Medical Ltd, 2013, ISBN 9789350259375 , p. 931.