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CONTENTS
Introduction Definitions
Scope
Classification
Introduction:
Homeostasis
Non-cyclical change Non-linear pharmacokinetics
Definitions:
Chronopharmacokinetics Biological rhythm The Period (T) The Acrophase () The Amplitude (A) The Mesor (M) The Frequency (F)
Circadian rhythms:
- Exogenous rhythms Ex: Sleep wake cycles, blood pressure, pulse rate, metabolic, gastro intestinal rhythms - Endogenous rhythms Ex: ACTH output, corticosteroid output, . circulating neutrophils , circulating eosinophils , rapid eye movement
Scope:
Control the time of administration Variations in plasma drug level as a function of time of day. Mechanism responsible for the time dependent variation.
Classification
Gastric acid secretion pH Motility Gastric emptying time longer for evening meal tmax Gastrointestinal blood flow
NSAIDs Indomethacin and Ketoprofen better absorption in the morning and greater bioavailability. 3. Paracetamol extent of absorption is less at night
2.
Blood flow to organs - Sympathetic and parasympathetic systems - Diurnal increases and nocturnal decreases in blood flow Plasma protein binding
Enzyme activity - brain, kidney, and liver. Ex: -Hydrocortisol cortisol - cytochrome CYP3A activity Hepatic blood flow - Indocyanine green (ICG) clearance
Temporal variation in oxidase activity of the liver Temporal variation in conjugation Parcetamol
Capacity limited metabolism - decreases hepatic clearance in case of Phenytoin. Enzyme induction - Carbamazepine hepatic clearance Decreased hepatic blood flow - Propranalol hepatic clearance
Contraindications: Mono oxygenase activities male and female rats Liver microsomal testosterone hydroxylase
Ex: The rhythmicity in urinary pH modifies drug ionization Acidic drugs are excreted faster after evening administration Ex: Sodium salicylate and Sulfasymazine
Maxima during the dark period (02.00 05.00 am hours) Minima during the light period (14.00 17.00 pm hours)
The timing of exposure to light The length of exposure Intensity and wavelength of light
Other factors:
Physical activity Music Administration of the neurohormone melatonin Feeding schedules Temperature Pharmacology Sexual stimuli Stress
Applications:
Asthma - Nocturnal worsening of asthma is a serious clinical problem - Evening Theophylline and -agonist bronchiodilator
early morning
Antibiotics Aminoglycosides, Antihypertensive drugs Propranolol, Nifedipine Anti epileptic drugs - Valporic acid Anti cancer drugs Cyclosporine, Methotrexate NSAIDs Ketoprofen, Indomethacin
Difference between species rhodents and humans Harmful to rhodents/experimental animal Large number of animals
REFERENCE:
Time dependent pharmacokinetics by Rene H. Levy, Department of pharmaceutics BG-20, University of Washington, Seattle, Washington, U.S.A, pp. 115-127. Pharmacology, 6th edition, by H.P. Rang, M.M. Dale, J.M. Ritter and R.J. Flower, pg no. (98-126). Time dependent pharmacokinetics - recent developments by Rene H. Levy and C.R. Banfield University of Washington, Seattle, Washington. Pg no. (178-186). Applied Biopharmaceuticals & Pharmacokinetecs (5th edition) by Leon Shargel, page240-242
Drug disposition & pharmacokinetics Stephen H. Curry, 122 page. Daily Variationsin Ceftriaxone Pharmacokinetics in Rats. Antimicrob. Agent and chemother. M. Rebuelto, L. Ambros, and M. Rubio.2003. Clinical Concepts and Applications, 2nd addition, by Rowlend and Towzer, pp (256-262). www.pubmed.com www. Sciencedirect. com Bruguerolle B, Lemmer B.1993. Recent advances in chronopharmacokinetics: methodological problems. Life Sci. 52:1809-24.