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Aspects of chronopharmacology and chronotherapy in children
A Reinberg1, M Smolensky, G Labrecque
1CNRS UA581, Paris, France.
Insights
Chronopharmacology research in children is limited, especially for infants. Exploring biological rhythms in pediatric medicine can improve drug effectiveness and reduce side effects.
Area of Science:
- Pediatric Pharmacology
- Chronobiology
Background:
- Current pediatric chronopharmacology studies primarily focus on children aged 6-15 years.
- Limited data exists for newborns and infants, and infradian rhythms (yearly cycles) remain unexplored in older children.
Purpose of the Study:
- To highlight the limitations in current pediatric chronopharmacology research.
- To emphasize the potential benefits of exploring broader biological rhythms in pediatric drug administration.
Main Methods:
- Review of existing pediatric chronopharmacology literature.
- Identification of knowledge gaps regarding age-specific and infradian rhythm research.
Main Results:
- Existing studies on phenytoin, theophylline, orciprenaline, ipratropium bromide, corticosteroids, and anticancer agents show time-dependent effects.
- Chronopharmacological approaches offer more precise characterization of drug pharmacokinetics and pharmacodynamics compared to conventional methods.
Conclusions:
- Chronopharmacology in pediatrics has the potential to significantly enhance therapeutic outcomes.
- Appropriate timing of medication based on biological rhythms can optimize drug efficacy and minimize adverse effects in children.
Abstract:
Pediatric studies involving chronopharmacology until now have been limited mainly to investigation of circadian patterns in children of 6 to 15 years. This means that: a. data on newborns and even on infants of one year or younger are not available, and b. other bioperiodicities, such as those of one year (infradian rhythms), have not yet been explored in older children. Biological time-related changes have been documented for phenytoin and theophylline with regard to their pharmacokinetics and for orciprenaline, ipratropium bromide, corticosteroids and anticancerous agents with regard to their effectiveness. Despite the small number of investigations performed to date, results indicate that: a. more comprehensive and precise characterization of pharmacokinetic and pharmacodynamic phenomena can be achieved by a chronopharmacological approach than the conventional one and, b. better therapeutics can be achieved using chronopharmacological facts since an appropriate timing of medicines with regard to biological rhythms is likely to enhance desired and/or reduce undesired effects.