药物分类

药物分类，或称药物类别是药物的某种分类方式，这种方式可以基于相似的化学结构、或相同的作用机制（如可与同一生物靶标结合）、或相似的作用模式，或用于治疗相似的疾病。^[1][2]

药物可从多种角度进行分类，在主流的药物分类系统中，以上四种分类模式形成了一种层次结构。例如，贝特类药物（英语：Fibrate）具有相似的化学结构（两亲性羧酸），具有相同的作用机制（PPAR激动剂（英语：PPAR agonist））和相同的作用方式（降低血液中的甘油三酯），均可用于预防和治疗相同的疾病（动脉粥样硬化）。^[3][4]然而，并非所有PPAR激动剂都是贝特类药物，并非所有降甘油三酯药物都是PPAR激动剂，并非所有治疗动脉粥样硬化药物均是降甘油三酯药物。

药物类别通常由原型药物（英语：Prototype drug）定义，原型药物是该分类中的典型药物且通常为首个成药化合物，开发同类型的其他同药物通常参考原型药物或与之比较。^[5][6] 如抗疟疾药物的原型药物是氯喹，非甾体抗炎药物的原型药物是阿司匹林。^[7][8]

8 sources

按综合系统分类

• 解剖治疗化学分类系统（Anatomical Therapeutic Chemical Classification System，ATC）是最广泛使用的药物分类系统。可结合器官系统、治疗属性、药理学属性和化学属性进行分类。^[9][10][11]
• 医学系统命名法（英语：Systematized Nomenclature of Medicine）（Systematized Nomenclature of Medicine，SNOMED）：其中部分规则也可用于药物分类。^[12][13]

5 sources

按化学性质

药物可基于化学性质进行分类，如根据药化学结构分类。基于化学结构进行分类的药物类别包括：

• 苯二氮䓬类^[14]
• 强心苷^[15]
• 贝特类药物（英语：Fibrate）^[16]
• 甾体^[17]
• 噻嗪类利尿剂^[18]
• 曲坦类药物（英语：Triptan）^[19]
• Β-内酰胺抗生素^[20]

7 sources

按作用机制

可基于药理学按作用机制对药物进行分类，作用机制通常依据生物学靶标的种类进行分类。分子作用机制相同的一类药物，可调节特定的生物靶标活性。^[21]作用机制还包括针对生物靶标的活性类型，如对于受体而言，这些活性包括：激动剂、拮抗剂、反向激动剂或调节剂（英语：Selective receptor modulator）。酶的靶向机制包括激活剂和抑制剂。离子通道调节剂包括开放剂和阻滞剂（英语：Channel blocker）。以下是基于特定作用机制的药物类别示例：

• 5-alpha-还原酶抑制剂（英语：5-alpha-reductase inhibitor）^[22]
• ACE抑制剂^[23]
• Alpha-肾上腺素受体激动剂（英语：Alpha-adrenergic agonist）^[24]
• 血管紧张素II受体拮抗剂^[25]
• β受体阻滞剂^[26]
• 胆碱能（英语：Cholinergic）^[27]
• 多巴胺能（英语：Dopaminergic）^[28]
• 氨基丁酸能（英语：GABAergic）^[29]
• 肠促胰岛素拟似物^[30]
• 非甾体抗炎药 − 环氧合酶抑制剂^[31]
• 质子泵抑制剂^[32]
• 肾素抑制剂^[33]
• 选择性糖皮质激素受体调节剂（英语：Selective glucocorticoid receptor modulator）^[34]
• 血清素能^[35]
• 他汀类药物 – 羟甲基戊二酸单酰辅酶A还原酶抑制剂^[36]

16 sources

按作用方式

按作用方式分类是基于生物学的角度出发，并根据药物引起的解剖学或药物引起的功能改变进行分类。基于常用的作用方式定义的药物类别包括：

• 抗真菌药^[37]
• 抗微生物剂^[38]
• 抗血栓药物（英语：Antithrombotic）^[39]
• 支气管扩张药^[40]
• 变时性药物（英语：Chronotrope）（正向或负向）^[41]
• 解充血药（英语：Decongestant）^[42]
• 利尿剂或抗利尿剂（英语：Antidiuretic）^[43]
• 强心剂（英语：Inotrope）（正向或负向）^[44]

8 sources

按临床用途

药物分类还可从医学临床用途角度出发，根据药物用于治疗的病理学进行分类。

• 镇痛药^[45]
• 抗生素^[46]
• 抗癌药^[47]
• 抗凝剂^[48]
• 抗抑郁药^[49]
• 降糖药^[50]
• 抗癫痫药（英语：Antiepileptic）^[51]
• 抗精神病药^[52]
• 解痉药^[53]
• 抗病毒药^[54]
• 心血管药物^[55]
• 镇定剂^[56]
• 镇静剂^[57]
• 兴奋剂^[58]

14 sources

合并分类

某些药物类别会兼顾多种分类标准以满足实际的分类需要。如非甾体类抗炎药（Nonsteroidal anti-inflammatory durg，NSAID）就是其中一例。^[59]历史上对于抗炎药的定义，除了非甾体抗炎药，还包括皮质类固醇药物即甾体类抗炎药物。在非甾体抗炎药这个类别出现之前的十年间，甾体类皮质类固醇类抗炎药一直是抗炎药物中的主流。^[60]由于1950年代皮质类固醇药物的不良反应事件，非甾体抗炎药这种新型抗炎药物迅速在临床领域开展应用。 ^[59]因此，非甾体抗炎药的药物类别由作用机制——抗炎，与其化学结构——非甾体一起组成了新的药物分类。

• 缓解疾病的抗风湿药（英语：Disease-modifying antirheumatic drug）（DMARD）^[61]
• 非甾体类抗炎药（NSAID）^[59]

3 sources

按其他系统分类

其他药物分类系统，如基于药物的溶解度和胃肠道渗透性，对药物进行分类的生物药剂学分类系统（英语：Biopharmaceutics Classification System）（Biopharmaceutics Classification System，BCS）。^[62]

BCS分类

按生物药剂学分类系统（BCS分类）可以将药物基于不同的溶解性和渗透性，分为四类：^[62]

• I类 - 高渗透性（英语：intestinal permeability），高溶解度
• II类 - 高渗透性，低溶解度
• III类 - 低渗透性，高溶解度
• IV类 - 低渗透性，低溶解度

1 sources

按法律法规分类

• 对于加拿大的法律分类，可参阅对于加拿大的法律分类和《受管制药物和物质法》^[63]。
• 对于英国法律分类，可参阅《英国滥用药物法中的管制药物（英语：Drugs controlled by the UK Misuse of Drugs Act）》。^[64]
• 对于美国法律的药物分类，可参阅《受管制物质法案》。^[65]
• 由于妊娠期的特殊性，不同司法管辖区使用不同的系统进行药物的怀孕分级。^[66]

4 sources

参见

• 生药学
• 临床前研究（英语：Preclinical development）
• 临床研究
• 临床研究分期

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外部链接

• Drug names and classes. PubMed Health. United States National Library of Medicine. [2015-11-07]. （原始内容存档于2014-03-23）.
• Information by Drug Class. Drug Safety and Availability. United States Food and Drug Administration. [2015-11-07]. （原始内容存档于2017-01-20）.
• Drug Classes. A drug may be classified by the chemical type of the active ingredient or by the way it is used to treat a particular condition. Each drug can be classified into one or more drug classes. [2023-06-14]. （原始内容存档于2011-09-02）.