Biorhythm and drugs

The bad news: Biorhythm calculations are about as meaningful as coffee grounds. The good: The biological rhythm exists. In the course of its evolution, man has developed an internal clock that over the span one day sees itself as switching between light and dark.

Our inner clock

For thousands of years, the sun-set day-night rhythm has become established in the genes; Each cell contains such "clock genes" that control the daily routine of bodily functions. Temperature, pulse, pain sensation, mental and physical performance, activity of kidneys, liver and digestive system, almost all processes in the body tick in time with these ancient biological timers.

Although there are the well-known Morgenmuffel and early risers, but despite individual deviations in the day-night rhythm: by nature completely "nocturnal" are the fewest people. Most night workers fight against their internal clock. The constant divergence between biological rest periods and forced activity means that night workers and shift workers are more likely to suffer from depression, gastrointestinal and cardiovascular problems.

But now and then, "night work" has its positive side too: most children are born at night - provided they are left.

Nature runs slowly

Allowing the inner clock to run free by removing external influences, such as the alternation of light and dark and social compulsion, tends to slow down and settle on a 25-hour day. The daily rhythm is therefore called "circadian" (from "circa" and "this", the day).

Scientists have now also found out where the "central clock" of humans sits: it is a rice grain-sized organ in the brain, which is connected by nerve tracts that are different from the optic nerves, with the eyes. Therefore, blind people also live in the day-night rhythm. Only when their eye nerves are completely absent, perhaps due to an operation, they lose the sense of time.

Diseases also follow a certain daily rhythm. Most heart attacks happen in the morning between eight and twelve o'clock, rheumatism suffer usually in the morning most under rigidity and pain. And the dentist is best in the afternoon. On the one hand, the sensation of pain is weakest around 3 pm, on the other hand local painkillers and narcotics have the longest effect at this time.

Save medication, reduce side effects

Exactly these cycles try chronopharmacologists (chronos = time) to explore more closely, in order to achieve the best possible effect of drugs or to reduce the side effects.

For example, Björn Lemmer, Professor of Pharmacology and Toxicology, says: "Not only does the right amount of the right substance have to reach the right target organ, this also has to happen at the right time, " a classic example is the active substance theophylline against asthma. "Here, a drug was approved that saves patients three times a day, only twice a day, a weaker dose in the morning and a stronger one in the evening, or just a heavy evening dose because asthma attacks are more likely to occur at night than during the day . "

An example of how the right time improves efficacy and tolerability are pain relieving medications that are prescribed for rheumatism. If the person takes the drug in the evening, they can tolerate it better and at the same time the drug is available when they need it most, namely in the morning. The inclusion of the biological rhythm in treatment may not cure a disease faster or better, but it can at least make life easier for the patient.

A question of time

For some drugs, it has now been scientifically proven whether their effectiveness follows the biological rhythm and, if so, when they work best or are best tolerated. Individual deviations from the average daily rhythm need not be considered. However, it has not yet been researched whether people whose work rhythm deviates greatly from the biological rhythm, eg. As shift workers, stewardesses, pilots, other rules apply. Taking in the evening

  • Mequitazine, a specific antihistamine for allergies
  • H2-blockers, such as cimetidine, famotidine and ranitidine, for the reduction of gastric acidity in gastric and intestinal ulcers
  • Statins, such as simvastatin and lovastatin, for lowering cholesterol
  • Anti-pain and anti-inflammatory agents called NSAIDs, such as acetylsalicylic acid, ibuprofen and ketoprofen
  • Theophylline, salbutamol and prednisone in asthma, usually requiring a smaller dose in the morning

Taking in the morning

  • The beta-adrenergic blocker propranolol in angina pectoris
  • Proton pump inhibitors, such as omeprazole, which also reduce gastric acid, but act differently than H2 receptor inhibitors. They are prescribed for gastric and duodenal ulcers as well as for chronic heartburn
  • Glucocorticoids in rheumatism

Taking in the afternoon

  • Local painkillers and anesthetics
  • Hepatitis B vaccination
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