The chronotherapy of corticosteroids: practical application of chronobiologic findings to nursing.

In this paper evidence is presented pointing to the significance of when to treat along with why, what, and how much. Because of the circadian organization of the pituitary-adrenal axis, the long-term management of steroid-dependent patients must recognize and take into consideration the advantages of chronotherapy with corticosteroids. Thus, when corticosteroids are administered either daily or on alternate days, adrenal suppression and possibly growth disturbance can be minimized by timing to the circadian crest in adrenocortical function. As more findings are accumulated from ongoing and planned investigations, it can be expected that in the near future chronotherapeutics will become established in the practice of clinical and hospital nursing.