Integratori, farmaci e terza et

Prof. Renato Bernardini Direttore Scuola di Specializzazione in Tossicologia Medica FACOLTA' DI MEDICINA & CHIRURGIA UNIVERSITA' DEGLI STUDI DI CATANIA

FEDERAZIONE MEDICO-SPORTIVA ITALIANA, PATTI-TINDARI (ME) 25-26 OTTOBRE 2002

Integratori, farmaci e terza et

z Linvecchiamento associato ad un danno delle z z z z
molecole e delle cellule Lattivit fisica pu rallentare alcuni di questi fenomeni Lapporto di integratori utile durante laging Alcuni farmaci possono aiutare a prevenire i fenomeni correlati allinvecchiamento pi direttamente connessi con lattivit fisica (anomalie muscolo-scheletriche, cardiovascolari, cerebrali, etc.) muscoloLa cinetica delle molecole nellanziano diversa rispetto agli standard farmacologici teorici

Free radical formation and removal systems

Damaged DNA is removed by specific endogenous defense systems

Free radicals impair the immune response against cancer cells

Immune system Neuroendocrine system

HOMEOSTASIS

Free radicals effects may be neutralized by endogenous antioxydative systems or by exogenous supplement of antioxidant agents
Scavenger molecule systems may be endogenously recruited as a consequence of excessive free radical formation Antioxidant pharmacological activity has been shown for an array of naturally occurring molecules Combination of self defenses with antioxidant administration may significantly decrease detrimental effects of free radicals in aging and chronic degenerative diseases Prevention of free radical-related damage of the immune system radicalmay improve immune competence Improvement of the immune response has been shown beneficial either in slowering cancer growth and, in addition, maintaining addition, satisfactory body homeostasis

SOME ENDOGENOUS ANTIOXYDANT SYSTEMS

Aptoglobin restrains lipoperoxyde formation Ascorbic acid neutralizes superoxyde, perhydroxyde superoxyde, Bilirubin Protects albumin bound NEFA Carotenoids restraints lipoperoxyde formation Catalase H2O2 to water and oxygen Ceruloplasmin restrains hydroxyde and lipoperoxyde formation Glucose Hydroxide blockade Glutathione blocks O2 singlet, superoxyde, hydroxyde, acylperoxyde singlet, superoxyde, hydroxyde, SOD dismutates superoxyde to H peroxyde and oxygen Tocoferols Block of peroxydes, restrain lipoperoxyde formation peroxydes, Transferrin neutralizes Fe++-dependent radical formation Uric acid restrains lipoperoxyde formation Zinc, Selenium, other oligoelements, participate in enzymatic Zinc, Selenium, oligoelements, reactions for oxidation

Plants are a source of antioxydant agents

Aloe (Aloe vera) alkylphtalates, acemannan alkylphtalates, Garlic (Allium sativum) diallylsulphide sativum) Grapes resveratrol Hypericum (Hypericum perforatum) naphtodianthrones, perforatum) naphtodianthrones,
hypericin

Lemon (Citrus limonium) flavonons, flavons, glycosides limonium) flavonons, flavons, Licorice (Glycirrhiza glabra) polyphenols Olive oil omega-3 FA omegaOrange (Citrus sinensis) flavonons, flavons, glycosides sinensis) flavonons, flavons, Peanuts (Arachis hypogaea) phytosterols hypogaea) Soy (Glycine max) genistein, bioflavonoids ) genistein, max Spinach (Spinacia oleracea) NAO oleracea) Tomato (Solanum lycopersicum) lycopene lycopersicum) Wheat (Triticum vulgare) polyphenols, quinones (in the germ) germ) vulgare) polyphenols,

Farmaci e Anziani
Ipoglicemizzanti Diuretici Ace-inibitori e altri Aceantipertensivi FANS Cardiotonici Antiulcera Trofici (creatina, citicolina, citicolina, carnitina, vitamine) carnitina, Ormoni Anti-depressivi AntiAnti-Parkinson, anti-Alzheimer Anti-Parkinson, antiVaccini

DESIGN ED OTTIMIZZAZIONE DEI REGIMI POSOLOGICI

I
(biodisponibilit, escrezione biodisponibilit, urinaria di farmaco immutato, legame alle proteine plasmatiche, plasmatiche, clearance, volume di distribuzione, emivita, tempo di raggiungimento clearance, emivita, del picco plasmatico, picco plasmatico) variano in dipendenza plasmatico, plasmatico)

parametri

farmacocinetici

di et, sesso, razza, etc.

Individualizzazione del dosaggio

Farmaci ed integratori con cinetiche diverse nelle varie et (1980-2000) (1980z z z z z z z z z z z z z

Antibiotici, antivirali <clearance Neonato Triazolobenzodiazepine <clear, >emivita Anziano clear, >emivita Valsartan > emivita Anziano Acido Valproico <plasmaproteine Anziano Tolbutamide <plasmaproteine Anziano Teofillina <plasmaprot Neo, Anz, Grav Anz, Teofillina >clearance Bam, Fum Bam, Prednisolone <plasprot, clear, VAD Anz, Obe plasprot, clear, Anz, Propranololo = emivita Anz, Fum Anz, Chinidina > emivita Anziano Risperidone >emivita Anziano Creatina >emivita Anziano Sildenafil <clearance Anziano