ｃｈｒｏｎｏｐｈａｒｍａｃｏｄｙｎａｍｉｃｓとＤＤＳ

Abstract

The understanding of periodic and predictable changes in drug effects is a goal of chronopharmacology. To better understand chronopharmacologic rhythms, chronopharmacokinetics, chronesthesy (chronopharmacodynamics) and chronergy are the essential concepts. Both chronopharmacokinetic and chronopharmacodynamic circadian changes are known in many drugs. The role of circadian changes in hepatic cytochrome P-450 isozymes and activities were explained as one of the important chronopharmacodynamic mechanism. The other example of chronesthesy was circadian variation of blood pressure in a patient after subarachnoid hemorrhage. The desynchronization of blood pressure circadian rhythm observed in this patient suggested the importrance of synchronization in the treatment of severely affected neurological disorders, and thus the importance of chronotherapy. Rational chronotherapy for the optimization of drug administration timing is possible when considering all these basic concepts. The programmable-in-time pumps as device for clocking intravenous infusion and the sustained-release drug form would be useful from the practical point of view. Further widespread diffusion of chronopharmacological knowledge in clinical medicine is indispensable for optimization of drug administration timing.