时间药理学和时间治疗学

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The effect of bioperiodicity on the absorption of medicine
药物吸收与机体节律性的关系 9时与21时口服氨茶碱的血药浓度 比较，尽管AUC和t1/2相同，但9时的 tmax短；Cmax高
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时间药理学和时间治疗学
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The effect of bioperiodicity on the distribution of medicine
肝脏酶的活性具有昼夜节律性 ❖ 肝脏酶活性低时，药物代谢慢，作用维
持时间长 ❖ 肝脏酶活性高时，药物代谢快，作用维
持时间短 肾上腺皮质激素的昼夜节律性也会影响药 物代谢(晨后高午后低)
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时间药理学和时间治疗学
ຫໍສະໝຸດ Baidu
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The effect of bioperiodicity on the excretion of medicine
corresponds to 10 A.M. and 2 P.M., the alkaline tide after meals.
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时间药理学和时间治疗学
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The effect of bioperiodicity
on the pharmacodynamics
❖ 胆固醇合成酶系统夜间合成增加；
时间药理学 与
临床合理用药
CHRONOPHARMACOLOGY AND
RATIONAL MEDICATION
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时间药理学和时间治疗学
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时间药理学 Chronopharmacology
研究药物的体内过程和药物效应与机体 生物周期的相互关系
生物周期性(bioperiodicity)
机体的功能状态随时间推移所呈现的规 律性变化，包括近日节律 (昼夜节律circadian rhythm)和近年节律(circannual rhythm)
The rhythm of the acid and base flow of the urine ❖The most acid at 2:00 A.M. (pH 5.0 to 6.8) ❖The most alkaline at 2:00 P.M. (pH 7.0 to 8.5) ❖Two times a day the urine should be alkaline
9时与21时口服地西泮的血药浓度比较： 9时的Cmax高；tmax短 ➢ 禁食状态下给药仍然存在这种差异 ➢在静脉注射给药时，仍然表现出这种差异
提示：这种变化与血浆蛋白含量的节律 变化有关(地西泮的血浆蛋白结合率为99％)
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时间药理学和时间治疗学
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The effect of bioperiodicity on the metabolism of medicine
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时间药理学和时间治疗学
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The revolving circling movement of time which can be compared to the circadian rhythms that regulate the behaviour, physiology and function of living organisms at many biochemical levels.
❖ 甲基戊二酰辅酶A还原酶抑制剂可抑制 胆固醇的合成，药物效应也体现出相应 的昼夜节律；
❖ 黎明前肾上腺素和cAMP浓度低下，哮 喘发作加重；晚饭后一次给予茶碱缓释 剂，可明显减轻哮喘的夜间发作
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时间药理学和时间治疗学
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影响药物作用的时间因素
Chronopharmacokinetics
Chronopharmacodynamics
E=F(, C, S)
E：药效及毒性作用的强度
：常数
：药物的内在活性
C：作用部位的药物浓度
S：机体对药物的反应性
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时间药理学和时间治疗学
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时间药理学和时间治疗学
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Effective treatment must work with the body’s clocks not against them. The evidence suggests the treatment of disease could be improved by giving drugs at carefully selected times of the day.
Chronopharmacology aims at achieving optimum drug effect and minimum adverse effect without altering the functioning of the drug in the body.
Modern chronopharmacology investigates drug effects as a function of biological timing.
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时间药理学和时间治疗学
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The distinguish on the effect of drug while using in different time
The same disease, same medicine, same dose, take in different time of a day, there are different effect and toxicity. The degree of the difference may be twofold, or even decades times.
The daily patterns of hormone release result in different body temperatures, pulse and blood pressure depending on the time of the day. This can be applied to the understanding and treatment of disease.