Clinical Chronopharmacology and Chronotherapy of Asthma

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Abstract

As a result of endogenous biological rhythms both desired and undesired effects of a therapeutic agent vary as a function of the time at which it is given in the 24 h scale among other periods. Emphasis will be given here to circadian (≃24 h) chronopharmacology and chronotherapy. A better understanding of these pre-dictable changes can be reached by using several new concepts (Reinberg 1976). Chronopharmacokinetics (or chronokinetics, Reinberg 1976, Sturtevant 1976) means circadian changes of parameters and curve patterns used to characterize the pharmacokinetics of an agent. Chronesthesy (Reinberg 1976) indicates circadian changes in the susceptibility of target biosystems to an agent and involves receptors, cells, tissues, organs and organ systems. The chronergy (Reinberg 1976) of an agent designates its overall effects on the organism as a result of both its chronokinetics and the chronesthesy of target biosystems. Circadian changes in desired effects are usually namend chronoeffectiveness while time dependent changes in undesired effects are described as chronotolerance.