A recent study has found that a very common surgery sedative, when taken at the wrong time, can increase the risk of heart damage in patients in non-cardiac surgery.
“My lab and I have been studying chronotherapy, or how the time of day affects disease development and treatment effectiveness, for many years. In our recently published research, we found that using a particular sedative at night can increase the risk for heart damage,” co-author Tobias Eckle at the University of Colorado Anschutz Medical Campus said, reported Inverse.
The sedative in question is midazolam – “the most common sedative used in surgical procedures worldwide,” Eckle said, and added “currently, there are no guidelines regarding when midazolam should be administered.”
Chronotherapy is premised on the concept that like all bodily functions, drugs also are influenced by the 24-hour day-night cycle, called the circadian rhythm.
“This means that the specific proteins a drug is designed to modify can react differently to the medication over the course of a 24-hour time period,” Eckle explained.
Some examples elucidated by the researcher include over-the-counter acid reflux drug, omeprazole, and blood pressure medications that are said to be most effective when taken before bedtime or in the evening, respectively.
“Considering that the top 10 highest-grossing drugs in the U.S. help only between 1 in 25 and 1 in 4 of the people who take them, I believe that taking drug timing into account could help make treatments more effective and help more people worldwide,” Eckle stated.
However, doctors seldom if ever consider the appropriate time of medicine administration while prescribing drugs. Eckle attributes this oversight to two factors.
First, physicians are not aware of chronotherapy and its benefits. In other words, they don’t know that some drugs can have greater efficacy when taken during a certain time of the day. Second, not enough research has been conducted in this field for various drugs to know the best time for their administration.
As a result, the general timing of morning or evening is prescribed by the doctors for medication.
Besides being ineffective, taking some drugs at the wrong time can also prove to be dangerous.
The study, published in the journal Frontiers in Cardiovascular Medicine, “analyzed data from 50 medical institutions for the occurrence of heart damage during surgical procedures from 2014 to 2019, we found that taking midazolam during overnight surgeries may increase the odds of heart damage in healthy patients by over threefold,” Eckle said.
However, further research is needed in the field to reap the benefits of chronotherapy.
“More research is needed to determine the best times to administer treatments for different diseases. Taking the time of day into account might require reformulating some medications that last for more than a 24-hour time period in the body,” Eckle concluded.