Chronotherapeutics: Potential Role in Disease Management

Abstract: Researchers have demonstrated that both disease states and drug therapy are affected by a multitude of rhythmic changes that occur within the human body. Chronotherapeutics refers to a treatment method in which in vivo drug availability is timed in relation to repetitive rhythms of drug related biological phenomena to produce the maximum health benefit and minimum harm to the patient. Understanding the chronopharmacology of the disease would definitely change the medication pattern and thus may lead to better disease management by maintaining the constant effective dose level of the drugs. This review is designed to educate the pharmacist on the basic principles of chronotherapeutics. Pharmacists must be sure to utilize this information when consulting with other health care providers and when explaining to patients how they should take their medications.

Introduction

Coordinating biological rhythms with medical treatment is called chronotherapy. The term "chrono" basically refers to the observation that every metabolic event undergoes rhythmic changes in time. Chronotherapeutics refers to a treatment method in which in vivo drug availability is timed in relation to repetitive rhythms of drug related biological phenomena to produce the maximum health benefit and minimum harm to the patient. Chronotherapy decisions are based on the observation that there is an interdependent relationship between the peak-to-trough rhythmic activity in disease symptoms and the risk factors, pharmacological sensitivity, and pharmacokinetics of many drugs. It is becoming increasingly more evident that the specific time that patients take their medication may be even more significant than was recognized in the past. The tradition of prescribing medication at evenly spaced time intervals throughout the day, in an attempt to maintain constant drug levels throughout a 24-hour period, may be changing as researchers' report that some medications may work better if their administration is coordinated with day-night patterns and biological rhythms.

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