藥物分類

藥物分類，或稱藥物類別是藥物的某種分類方式，這種方式可以基於相似的化學結構、或相同的作用機制（如可與同一生物靶標結合）、或相似的作用模式，或用於治療相似的疾病。^[1][2]

藥物可從多種角度進行分類，在主流的藥物分類系統中，以上四種分類模式形成了一種層次結構。例如，貝特類藥物（英語：Fibrate）具有相似的化學結構（兩親性羧酸），具有相同的作用機制（PPAR激動劑（英語：PPAR agonist））和相同的作用方式（降低血液中的甘油三酯），均可用於預防和治療相同的疾病（動脈粥樣硬化）。^[3][4]然而，並非所有PPAR激動劑都是貝特類藥物，並非所有降甘油三酯藥物都是PPAR激動劑，並非所有治療動脈粥樣硬化藥物均是降甘油三酯藥物。

藥物類別通常由原型藥物（英語：Prototype drug）定義，原型藥物是該分類中的典型藥物且通常為首個成藥化合物，開發同類型的其他同藥物通常參考原型藥物或與之比較。^[5][6] 如抗瘧疾藥物的原型藥物是氯喹，非甾體抗炎藥物的原型藥物是阿司匹林。^[7][8]

按綜合系統分類

• 解剖治療化學分類系統（Anatomical Therapeutic Chemical Classification System，ATC）是最廣泛使用的藥物分類系統。可結合器官系統、治療屬性、藥理學屬性和化學屬性進行分類。^[9][10][11]
• 醫學系統命名法（英語：Systematized Nomenclature of Medicine）（Systematized Nomenclature of Medicine，SNOMED）：其中部分規則也可用於藥物分類。^[12][13]

按化學性質

藥物可基於化學性質進行分類，如根據藥化學結構分類。基於化學結構進行分類的藥物類別包括：

• 苯二氮䓬類^[14]
• 強心苷^[15]
• 貝特類藥物（英語：Fibrate）^[16]
• 甾體^[17]
• 噻嗪類利尿劑^[18]
• 曲坦類藥物（英語：Triptan）^[19]
• Β-內酰胺抗生素^[20]

按作用機制

可基於藥理學按作用機制對藥物進行分類，作用機制通常依據生物學靶標的種類進行分類。分子作用機制相同的一類藥物，可調節特定的生物靶標活性。^[21]作用機制還包括針對生物靶標的活性類型，如對於受體而言，這些活性包括：激動劑、拮抗劑、反向激動劑或調節劑（英語：Selective receptor modulator）。酶的靶向機制包括激活劑和抑制劑。離子通道調節劑包括開放劑和阻滯劑（英語：Channel blocker）。以下是基於特定作用機制的藥物類別示例：

• 5-alpha-還原酶抑制劑（英語：5-alpha-reductase inhibitor）^[22]
• ACE抑制劑^[23]
• Alpha-腎上腺素受體激動劑（英語：Alpha-adrenergic agonist）^[24]
• 血管緊張素II受體拮抗劑^[25]
• β受體阻滯劑^[26]
• 膽鹼能（英語：Cholinergic）^[27]
• 多巴胺能（英語：Dopaminergic）^[28]
• 氨基丁酸能（英語：GABAergic）^[29]
• 腸促胰島素擬似物^[30]
• 非甾體抗炎藥 − 環氧合酶抑制劑^[31]
• 質子泵抑制劑^[32]
• 腎素抑制劑^[33]
• 選擇性糖皮質激素受體調節劑（英語：Selective glucocorticoid receptor modulator）^[34]
• 血清素能^[35]
• 他汀類藥物 – 羥甲基戊二酸單酰輔酶A還原酶抑制劑^[36]

按作用方式

按作用方式分類是基於生物學的角度出發，並根據藥物引起的解剖學或藥物引起的功能改變進行分類。基於常用的作用方式定義的藥物類別包括：

• 抗真菌藥^[37]
• 抗微生物劑^[38]
• 抗血栓藥物（英語：Antithrombotic）^[39]
• 支氣管擴張藥^[40]
• 變時性藥物（英語：Chronotrope）（正向或負向）^[41]
• 解充血藥（英語：Decongestant）^[42]
• 利尿劑或抗利尿劑（英語：Antidiuretic）^[43]
• 強心劑（英語：Inotrope）（正向或負向）^[44]

按臨床用途

藥物分類還可從醫學臨床用途角度出發，根據藥物用於治療的病理學進行分類。

• 鎮痛藥^[45]
• 抗生素^[46]
• 抗癌藥^[47]
• 抗凝劑^[48]
• 抗抑鬱藥^[49]
• 降糖藥^[50]
• 抗癲癇藥（英語：Antiepileptic）^[51]
• 抗精神病藥^[52]
• 解痙藥^[53]
• 抗病毒藥^[54]
• 心血管藥物^[55]
• 鎮定劑^[56]
• 鎮靜劑^[57]
• 興奮劑^[58]

合併分類

某些藥物類別會兼顧多種分類標準以滿足實際的分類需要。如非甾體類抗炎藥（Nonsteroidal anti-inflammatory durg，NSAID）就是其中一例。^[59]歷史上對於抗炎藥的定義，除了非甾體抗炎藥，還包括皮質類固醇藥物即甾體類抗炎藥物。在非甾體抗炎藥這個類別出現之前的十年間，甾體類皮質類固醇類抗炎藥一直是抗炎藥物中的主流。^[60]由於1950年代皮質類固醇藥物的不良反應事件，非甾體抗炎藥這種新型抗炎藥物迅速在臨床領域開展應用。 ^[59]因此，非甾體抗炎藥的藥物類別由作用機制——抗炎，與其化學結構——非甾體一起組成了新的藥物分類。

• 緩解疾病的抗風濕藥（英語：Disease-modifying antirheumatic drug）（DMARD）^[61]
• 非甾體類抗炎藥（NSAID）^[59]

按其他系統分類

其他藥物分類系統，如基於藥物的溶解度和胃腸道滲透性，對藥物進行分類的生物藥劑學分類系統（英語：Biopharmaceutics Classification System）（Biopharmaceutics Classification System，BCS）。^[62]

BCS分類

按生物藥劑學分類系統（BCS分類）可以將藥物基於不同的溶解性和滲透性，分為四類：^[62]

• I類 - 高滲透性（英語：intestinal permeability），高溶解度
• II類 - 高滲透性，低溶解度
• III類 - 低滲透性，高溶解度
• IV類 - 低滲透性，低溶解度

按法律法規分類

• 對於加拿大的法律分類，可參閱對於加拿大的法律分類和《受管制藥物和物質法》^[63]。
• 對於英國法律分類，可參閱《英國濫用藥物法中的管制藥物（英語：Drugs controlled by the UK Misuse of Drugs Act）》。^[64]
• 對於美國法律的藥物分類，可參閱《受管制物質法案》。^[65]
• 由於妊娠期的特殊性，不同司法管轄區使用不同的系統進行藥物的懷孕分級。^[66]

參見

• 生藥學
• 臨床前研究（英語：Preclinical development）
• 臨床研究
• 臨床研究分期

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