Biorhythms (cont.)
Can drug therapy be matched to the "body clock?"
The time of day also can affect the way our bodies respond to medical
therapy, especially drug therapy. Investigators working in a special area of
chronobiology, called chronotherapeutics or chronotherapy, are studying these effects. Their goal
is to come up with new medications, or improve existing ones, that make the most
of what we know about how the body clock works.
Already there is evidence that taking medication "by the
clock" helps the drugs work better and reduces their side effects. Currently,
some doctors are prescribing nighttime administration of medication for patients
with ulcer disease or asthma (which worsen at night), rheumatoid arthritis
(which worsens
in the early morning hours), and high cholesterol levels (most of the body's
cholesterol production occurs at night). For patients with osteoarthritis, which
worsens in the afternoon and evening, some doctors are prescribing midday
medication.
Drugs that may be given "by the clock" include corticosteroids,
nonsteroidal
antiinflammatory drugs (NSAIDs), antihistamines, theophyllines, and anticancer
drugs.
These lists are growing as chronobiology, chronotherapy, and the
diagnostic and treatment methods derived from them are slowly accepted by the
medical community. However, the broad acceptance of chronobiology in medicine is
expected to take (excuse the expression) time.
Chronobiology: marking time, making progress
Although chronobiology is not new to medical science, it's still in the
process of being accepted by the medical community. That's because most doctors
are not taught about chronobiology - in fact, they are taught something that
seems to contradict it!
What are doctors taught?
Homeostasis - the concept that body functions are in
a constant "steady state" throughout the day and night, and that the goal of
treatment is restoring or maintaining this "steady state." Even the treatment
itself may have this goal, for example, a prescribed drug is given in a way
("every 4 hours") that theoretically will ensure a steady level of it in the patient's bloodstream. Obviously, this view contrasts sharply with diagnosing
and treating illness chronobiologically - "by the clock."
Fortunately, although chronobiology is not yet taught in medical schools,
doctors are increasingly taking biologic rhythms into account in diagnosing and
treating illness. They are recognizing that whereas homeostatic mechanisms keep
the body functioning continuously on a moment-to-moment basis (for example, by
maintaining breathing and heartbeat), biologic rhythms program the body "in
advance" for coping with its predictably changing needs, such as varying energy
requirements, during specific time cycles.
The time is coming, medical experts say, when chronobiology, and particularly
the body clock, will play a vital role in many areas of medical practice. In
some of those areas, as we've seen, that time is now.
If you are taking medication for a medical condition, consider keeping a
record of the timing and intensity of your symptoms for a few days and showing
it to your doctor; he or she may want to adjust your therapy to align more with
your body clock. Who knows, maybe now is your time to get more into the rhythm
of life!
References:
The right time? Chronopharmacology - a new science.
Nursing RSA Verpleging.
1992;7:23-27. Pharmacology.
Smolensky MH, D'Alonzo GE. Medical chronobiology: concepts and applications.
Am Rev Respir Dis.1993;147:S2-S 19.
Time of day medicine dose is taken may boost its
efficacy, cut toxicity. JAMA. 1996;275:1 143-1 144. Medical News & Perspectives.
American Heart Association; "Know the Facts, Get the Stats 2007."
Centers for Disease Control, National Center for Health Statistics;
"Allergies/Hay Fever."
Centers for Disease Control, National Center for Health Statistics; "Asthma."
Last Editorial Review: 12/29/2008
- Chemotherapy - Explains chemotherapy, a drug treatment to kill cancer cells. Article includes descriptions, uses, and side effects, and care support.
- Rheumatoid Arthritis - Learn more about rheumatoid arthritis, an autoimmune disease that causes chronic joint inflammation, which has symptoms that include stiffness, fever, muscle and joint aches, loss of appetite, and fatigue. Treatment of rheumatoid arthritis incorporates the use of first-line drugs (aspirin and corticosteroids for pain and inflammation) and second-line drugs (methotrexate and hydroxychloroquine to prevent joint destruction and promote remission).
- Radiation Therapy -
Latest Medical News
Interactive Slideshows