Department of Biomedical Engineering, Cockrell School of Engineering, The University of Texas at Austin, Austin, Texas, USA.
Department of Internal Medicine, Division of Cardiology, McGovern School of Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
Chronobiol Int. 2024 Nov;41(11):1365-1376. doi: 10.1080/07420528.2024.2414878. Epub 2024 Oct 21.
Chronotherapy is the timing of medications to circadian rhythms to optimize beneficial and minimize adverse outcomes. We reviewed the US Online Prescribers' Digital Reference for the specified administration schedule of medications prescribed to manage coronary heart disease (CHD) and its major risk factors. For arterial hypertension, dosing of terazosin and guanfacine is recommended in the evening and thiazide, thiazide-like, and sulfonamide diuretics morning; Verapamil (Verelan®) morning, its "PM" formulation evening, and long-acting diltiazem (Cardizem® LA), per clinical goal, morning or evening. Most hyperlipidemia medications are recommended in the evening. Many hyperglycemia medications are intended for morning ingestion, but, when indicated, some may be prescribed in unequal doses or intervals. For obesity, administration of appetite suppressant psychostimulants and sympathomimetics is stipulated for morning ingestion. Sleep insufficiency medications are to be taken before bedtime. For tobacco dependence, transdermal nicotine patch application is recommended in the morning, and bupropion early, but not late, during the wake span. For alcohol dependence, disulfiram is intended for morning ingestion. For thromboembolism prophylaxis, factor Xa inhibitor rivaroxaban is recommended at dinner and low-dose acetylsalicylic acid before bedtime. Medications for angina pectoris and edema of congestive heart failure are stipulated for morning administration. Overall, >200 medications prescribed to manage CHD and its risk factors qualify as chronotherapies.
时间治疗学是指根据生理节律调整药物给药时间，以优化疗效和减少不良反应。我们查阅了美国在线处方者数字参考资料，以了解用于治疗冠心病（CHD）及其主要危险因素的处方药物的特定给药时间表。对于动脉高血压，推荐在晚上给予特拉唑嗪和胍法辛，而噻嗪类、噻嗪类似物和磺胺类利尿剂则在早上服用；维拉帕米（Verelan®）在早上服用，其“PM”制剂在晚上服用，而长效二氢吡啶类钙通道阻滞剂（Cardizem® LA）则根据临床目标，在早上或晚上服用。大多数降脂药物都建议在晚上服用。许多治疗高血糖的药物都建议在早上服用，但在需要时，有些药物可能会以不等剂量或间隔时间进行处方。对于肥胖症，规定在早上服用食欲抑制剂和拟交感神经药。睡眠不足药物应在睡前服用。对于烟草依赖，建议在早上使用透皮尼古丁贴片，以及在清醒期的早期（但不是晚期）使用安非他酮。对于酒精依赖，双硫仑用于早上服用。对于血栓栓塞预防，建议在晚餐时使用因子 Xa 抑制剂利伐沙班，在睡前服用低剂量乙酰水杨酸。用于心绞痛和充血性心力衰竭水肿的药物规定在早上给药。总体而言，用于治疗 CHD 及其危险因素的 200 多种药物都属于时间治疗学。
