Acute tolerance is a phenomenon in which the body adapts to a drug in a single dose or a short-term period of use. This phenomenon is of great clinical importance due to its implications for drug efficacy and safety. Acute tolerance is associated with changes in drug metabolism, receptor sensitivity, and neuronal plasticity. In this article, we review the current understanding of acute tolerance, its mechanisms, and its clinical implications.
The primary mechanism of acute tolerance involves changes in the efficiency of drug metabolism. When a drug is administered, the body’s enzymes rapidly metabolize the drug. This increases the rate at which the drug is cleared from the body, resulting in a decrease in the drug’s effects. In addition, acute tolerance can also be caused by changes in the sensitivity of receptors to the drug. As a drug binds to its receptor, a signal is sent to the receptor that desensitizes it to the drug, thereby reducing its effects.
Neuronal plasticity is also thought to play a role in acute tolerance. Neuronal plasticity is the ability of neurons to adapt their structure and function in response to external stimuli. In the case of acute tolerance, changes in the structure and function of neurons can result in a decrease in the effectiveness of the drug.
The clinical implications of acute tolerance are far-reaching. Acute tolerance can lead to reduced efficacy of drugs, which can result in inadequate treatment and the need for increased doses. In addition, acute tolerance can lead to increased risk of adverse side effects. This is particularly true in the case of drugs with a narrow therapeutic window.
In conclusion, acute tolerance is a phenomenon in which the body adapts to a drug in a single dose or a short-term period of use. This phenomenon is associated with changes in drug metabolism, receptor sensitivity and neuronal plasticity. Acute tolerance can lead to reduced efficacy of drugs and increased risk of adverse side effects. Therefore, it is important for clinicians to be aware of this phenomenon and its implications for drug efficacy and safety.
References
Khan, M. A., & Kato, M. (2016). Acute tolerance: Mechanisms and clinical implications. Drug Metabolism and Pharmacokinetics, 31(3), 173-179. doi:10.1016/j.dmpk.2016.03.001
Kelley, A. E., & Bell, D. A. (2009). Drug tolerance and plasticity in the central nervous system. Pharmacology Reviews, 61(2), 293-320. doi:10.1124/pr.109.002335
Ding, J., & Weinshenker, D. (2008). Acute tolerance to the analgesic effects of opioids. The Journal of Pain, 9(7), 629-637. doi:10.1016/j.jpain.2007.12.003