[医药卫生]时间药理学和时间治疗学.ppt

时间药理学与临床合理用药;时间药理学Chronopharmacology;The distinguish on the effect of drug while using in different time; 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. 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. ; 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. ;影响药物作用的时间因素;The effect of bioperiodicity on the absorption of medicine;The effect of bioperiodicity on the distribution of medicine;The effect of bioperiodicity on the metabolism of medicine;The effect of bioperiodicity on the excretion of medicine;The effect of bioperiodicity on the pharmacodynamics;时间药理学对临床药物治疗的指导作用;抗高血压药物对血压昼夜节律的影响 ?受体阻断药和?受体阻断药对血压的昼夜节律无明显影响 ?、?受体阻断药拉贝洛尔，每日三次给药时，可降低24小时的收缩压；如每日6时一次给药时，可减弱血压昼夜节律的振幅 硝苯地平可抑制血压的昼夜节律 维拉帕米可抑制心率的昼夜节律;药物代谢的节律性与哮喘治疗 特布他林8时5 mg和20时10 mg，或 茶碱8时250 mg和20时500 mg， 均可使血药浓度维持相对恒定;肾上腺皮质激素的昼夜节律性 与药物治疗 血浆糖皮质激素的峰值为7~8时，此时的激素水平增加对促皮质激素释放的抑制程度最弱 肾上腺皮质功能亢进时，丧失糖皮质激素和ACTH的昼夜节律性 下丘脑—边缘系统病变时，丧失糖皮质激素的昼夜节律性;Bioperiodicity vs antitumour chemotherapy 肿瘤细胞对化疗药物的敏感性具有周期节律性 人正常骨髓细胞增值高峰在8时~16时 恶性淋巴瘤的增值高峰在0时~4时;The circadian rhythm of toxic reaction(1) 两种化疗时间患者发生恶心、呕吐程度比较 用药时间 0度 Ⅰ度 Ⅱ度 Ⅲ度 Ⅳ度 日间 1 2 7 6 4 晚间 5 4 9 2 0