Clinica Medica, Azienda Ospedaliera-Universitaria, Ferrara, Italy.
Eur J Intern Med. 2013 Dec;24(8):698-706. doi: 10.1016/j.ejim.2013.03.019. Epub 2013 Apr 21.
Chronobiology is devoted to the study of biological rhythms. It is possible that a given medication may be therapeutic and safe when administered at some time, but subtherapeutic or poorly tolerated at another.
We focused on some classes of drugs, widely used by the internists, performing a PubMed search with the single drugs associated with the MeSH terms "Chronotherapy", "Circadian rhythm", and "Chronobiology, phenomena". Among the studies found, we considered only those provided with discrete numerosity or clearly stated methodological characteristics.
The results of available studies were given, along with a series of short take-home messages at the end of each mini-chapter devoted to: antihypertensives, statins, anticoagulants, analgesics, drugs for acid-related disorders, and anti-asthmatic drugs. In particular, evidence of morning vs. evening administration, when applicable, was given for each medication.
Adequate evidence seems to support that at least ACE-inhibitors or angiotensin receptor blockers, simvastatin, corticosteroids (slow-release formulation) for arthritic patients, and ranitidine should preferably be administered in the evening. Morning dosing could be better for proton pump inhibitors, whereas time of administration is not crucial for asthma inhalation drugs. Studies are available for other drugs, but not so strong enough to draw definite conclusions. For now, we need prospective intervention trials specifically designed to investigate the long-term effects of a temporal approach to medical therapy. However, since switching to morning-evening administration or vice versa is simple and inexpensive, in some cases it could be considered, remembering that, in any case, adherence remains the crucial point.
时间生物学致力于研究生物节律。某种药物在某个时间给药可能具有治疗作用且安全，但在另一个时间给药可能疗效不佳或耐受性差。
我们专注于一些内科医生广泛使用的药物类别，使用与 MeSH 术语“时间治疗学”、“昼夜节律”和“时间生物学现象”相关的单一药物对 PubMed 进行搜索。在所找到的研究中，我们只考虑了那些提供离散数量或明确说明方法特征的研究。
给出了现有研究的结果，并在每个迷你章节的末尾提供了一系列简短的要点，这些章节分别涉及：抗高血压药、他汀类药物、抗凝剂、镇痛药、酸相关疾病药物和抗哮喘药物。特别是，对于每种药物，当适用时，给出了早晨与晚上给药的证据。
似乎有足够的证据支持至少 ACE 抑制剂或血管紧张素受体阻滞剂、辛伐他汀、关节炎患者的皮质类固醇（缓释制剂）和雷尼替丁最好在晚上给药。质子泵抑制剂早晨给药可能更好，而给药时间对于哮喘吸入药物并不重要。对于其他药物也有研究，但还不够有力，无法得出明确的结论。目前，我们需要专门设计的前瞻性干预试验来研究时间治疗方法对医学治疗的长期影响。然而，由于切换到早晚给药或反之亦然既简单又便宜，在某些情况下可以考虑，记住，在任何情况下，坚持都是关键。
