The Chronopharmacology of Cardiovascular Medications

Lemmer, Björn

doi:10.1016/b978-0-08-034135-4.50009-5

Cited by 31 publications

(4 citation statements)

References 55 publications

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“…25 The cause or mechanism of these time-dependent phenomena has yet to be sufficiently clarified. 25 The cause or mechanism of these time-dependent phenomena has yet to be sufficiently clarified.…”

Section: Figmentioning

confidence: 99%

“…There is mounting evidence demonstrating time-dependent fluctuations in the pharmacokinetics and pharmacodynamics of cardiovascular agents. 25 The cause or mechanism of these time-dependent phenomena has yet to be sufficiently clarified. Nagayama et al 26 have suggested that the daily fluctuation in the sedative effect of chlorpromazine may be ascribed not to the daily fluctuation in the levels of absorption, distribution, metabolism or excretion of this drug, but rather to the daily fluctuation at the level of amine receptor activity in the brain.…”

Section: Figmentioning

confidence: 99%

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Ginkgo Biloba Extract Attenuates The Development Of Hypertension In Deoxycorticosterone Acetate‐Salt Hypertensive Rats

Umegaki

Shinozuka

Watarai

et al. 2000

Clin Exp Pharma Physio

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1. We examined the effects of Ginkgo biloba extract (GBE) on the development of hypertension, platelet activation and renal dysfunction in deoxycorticosterone acetate (DOCA)-salt hypertensive rats. Both DOCA-salt hypertensive rats and normotensive rats were fed a 2% GBE diet for 20 days. Blood pressure (BP) was measured by two methods, namely by the tail-cuff and telemetry methods. 2. Development of hypertension was attenuated in rats fed a 2% GBE diet. In addition, an increase in heart weight, an indicator of sustained high BP, was inhibited significantly by feeding of the GBE diet. 3. Decreases in 5-hydroxytryptamine content in platelets, a marker of platelet activation in vivo associated with hypertension, were also prevented by feeding of the GBE diet. Ginkgo biloba extract itself did not inhibit ADP- and collagen-induced platelet aggregation examined in vitro. Feeding of the GBE diet tended to inhibit increases in plasma urea nitrogen due to hypertension. 4. The telemetry study demonstrated that BP and heart rate (HR) showed a clear circadian rhythm and the antihypertensive effect of GBE was prominent in the daytime, a resting period for rats. This anti-hypertensive effect of GBE was not detected in normotensive rats. In contrast, the inhibitory effect of GBE on HR was independent of time and was observed in both normotensive and hypertensive rats. 5. These results indicate that GBE has an anti-hypertensive and bradycardiac action, which are time dependent and independent, respectively. Thus, it appears that the chronopharmacological action of GBE may be ascribed not to pharmacokinetic factors, but rather to a circadian susceptibility rhythm to GBE in DOCA-salt hypertensive rats.

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Section: Figmentioning

confidence: 99%

Section: Figmentioning

confidence: 99%

Ginkgo Biloba Extract Attenuates The Development Of Hypertension In Deoxycorticosterone Acetate‐Salt Hypertensive Rats

Umegaki

Shinozuka

Watarai

et al. 2000

Clin Exp Pharma Physio

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“…One explanation may be that patients overcome drug-induced sedation or lethargy when they are aroused and challenged to perform a task in the laboratory (as previously noted with the ACE inhibitor enalapril; Olajide & Lader, 1985). Moreover, the effects of antihypertensive medications on psychomotor functioning may be found to be dependent on circadian cycles (Lemmer, 1986). For example, nonhuman primates have shown maximal decreases in ambulatory activity around the time of day that the second daily dose of drug was administered (Turkkan, Allen, & Hienz, 1992; Turkkan, Hienz, Allen, & Bezold, 1992).…”

Section: Laboratory Versus Field Assessments and Time-of-day Effectsmentioning

confidence: 99%

Antihypertensive pharmacotherapy side effects: Behavioral measurement and quality-of-life issues in clinical trials.

Turkkan¹

1993

Experimental and Clinical Psychopharmacology

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Large numbers of hypertensive patients drop out of antihypertensive pharmacotherapy annually, thereby increasing their health risks from elevated blood pressure. Many studies show that adverse side effects (a large number related to behavioral functioning) are pivotal in discouraging patients from continuing with medication regimens. Multidimensional quality-of-life assessment batteries in clinical trials have begun to incorporate objective measures of behavioral functioning in addition to the more typical self-report assessments of symptoms and mood states. This article addresses several experimental design and methodology issues resulting from the use of behavioral assessment procedures in the context of antihypertensive quality-of-life trials, including (a) objective vs. subjective assessments of side effects, (b) time course of side effects after medication onset, (c) practice and placebo effects, and (d) laboratory vs. field assessments. This research aims to aid physicians in selecting optimal treatments among equieffective antihypertensive agents and in assessing the necessary trade-offs between treatment of disease and the creation of new symptoms. Patients in turn can be educated about the extent and duration of likely impairments once they begin treatment.

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“…Circadian rhythm has been shown in the cardiovascular functions such asblood pressure, blood flow to various organs, cardiac output and heart rate (Euler et a1 1955;Koneko et a1 1968;Smolensky et a1 1976), and time-dependent changes in the pharmacokinetics of several cardiovascular drugs have also been reported (Lemmer 1990;Rao & Rambhau 1993, 1995. Because of these circadian changes in the functioning of the cardiovascular system and the reported chronokinetics of drugs used in cardiovascular disorders the chronokinetics of pentoxifylline assume importance.…”

mentioning

confidence: 99%

Circadian Variations in the Pharmacokinetics of Pentoxifylline in Man

Poondru

Rao

et al. 1998

Journal of Pharmacy and Pharmacology

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Optimization of therapy by chronopharmacology requires knowledge of rhythmic manifestations of disease activity and chronopharmacokinetic data of the drugs prescribed. Rhythmic functioning of the cardiovascular system in healthy and diseased subjects is manifested as circadian rhythms in blood pressure, cardiac output, heart rate, etc. The disposition of several cardiovascular drugs in man has been reported to be time-dependent. This study reports the effect of time of administration on the disposition of pentoxifylline. Twelve healthy volunteers were treated with 400 mg pentoxifylline orally at 0100, 0700, 1300 and 1900 h in a randomized crossover Latin-square design with a wash-out period of one week. Serum samples were analysed for unchanged pentoxifylline by HPLC. Pharmacokinetic parameters were calculated using a model-independent method. The mean values of various pharmacokinetic parameters after drug treatment at these times were, respectively: maximum plasma concentration (Cmax) 485+/-174, 646+/-175, 735+/-271 and 781+/-217 ng mL(-1); time to reach the maximum plasma concentration (Tmax) 1.90+/-0.39, 1.66+/-0.4, 1.31+/-0.41 and 1.32+/-0.44 h, mean residence time (MRT) 3.8+/-0.8, 2.9+/-0.5, 2.9+/-0.4 and 2.7+/-0.3 h, elimination half-life (t1/2) 1.93+/-0.86, 1.23+/-0.3, 1.39+/-0.3 and 1.23+/-0.18 h and volume of distribution at steady state (VdSS/f) 11991+/-4862, 8823+/-3484, 8275+/-2357 and 7063+/-1950 mL kg(-1). The mean Cmax value was significantly (P < 0.05) lower after drug administration at 0100 h than after other time-points whereas mean Tmax, MRT, VdSS/f and t1/2 values were significantly (P < 0.05) higher. These variations might be because of time-dependent changes in absorption and biliary excretion of pentoxifylline and should be borne in mind when designing sustained action dosage forms for the drug.

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The Chronopharmacology of Cardiovascular Medications

Cited by 31 publications

References 55 publications

Ginkgo Biloba Extract Attenuates The Development Of Hypertension In Deoxycorticosterone Acetate‐Salt Hypertensive Rats

Ginkgo Biloba Extract Attenuates The Development Of Hypertension In Deoxycorticosterone Acetate‐Salt Hypertensive Rats

Antihypertensive pharmacotherapy side effects: Behavioral measurement and quality-of-life issues in clinical trials.

Circadian Variations in the Pharmacokinetics of Pentoxifylline in Man

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