Theophylline A “State of the Art” Review
Theophylline A “State of the Art” Review
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茶碱“最先进”评论
DOI：
10.1002/j.1875-9114.1983.tb04531.x
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发表时间：
1983
期刊：
影响因子：
--
通讯作者：
M. Weinberger
中科院分区：
文献类型：
--
作者：
L. Hendeles;M. Weinberger
茶碱是一种支气管扩张剂和呼吸兴奋剂，可有效治疗急性和慢性哮喘、Cheyne-Stokes呼吸和新生儿呼吸暂停/心动过缓发作。它也被用作治疗充血性心力衰竭和急性肺水肿的辅助药物，但在慢性不可逆气道阻塞患者中尚未确定疗效。茶碱的获益和风险与血清浓度直接相关，血清浓度是个体患者中药物剂量和消除特征的函数。当用于治疗急性症状时，需要基于平均分布容积的初始负荷剂量以快速获得最大支气管扩张作用。由于消除的患者间差异较大，必须通过定期监测血清茶碱浓度来指导持续治疗的恒定静脉输注速率，直至稳态血清浓度达到10-20 μg/ml的治疗范围。静脉、口服或直肠溶液和普通无包衣片剂适用于急性治疗，而可靠吸收的缓释制剂为慢性哮喘的管理提供了治疗优势，特别是在快速消除的患者中。长期治疗的剂量是通过从允许几乎完全接受药物的低剂量开始，然后逐渐增加，如果耐受的话，以三天为间隔，直到达到平均年龄特异性剂量。随后根据血清浓度测量值调整给药方案。大多数临床实验室现在测量茶碱，并且已经开发了更新的系统，以合理的成本在几分钟内提供紧急结果。在茶碱中毒的情况下，药物必须迅速清除，以防止危及生命的毒性。当血清浓度超过60 μg/ml时，即使没有明显的毒性体征，也可能需要进行血液灌流透析。
Theophylline is a bronchodllator and respiratory stimulant that is effective in the treatment of acute and chronic asthma, Cheyne‐Stokes respirations, and apnea/bradycardia episodes in newborns. It is also used as an adjunct in the treatment of congestive heart failure and acute pulmonary edema, but it has no established efficacy in patients with chronic irreversible airways obstruction. Benefits and risks from theophylline relate directly to serum concentration, which is a function of both dose and elimination characteristics of the drug in an individual patient. When used to treat acute symptoms, an initial loading dose based on a mean volume of distribution is required to rapidly obtain maximum bronchodilator effect. Because of large interpatient differences in elimination, constant intravenous infusion rates for continued therapy must be guided by monitoring serum theophylline concentration at intervals until a steady‐state serum concentration is reached within the 10–20 μg/ml therapeutic range. Intravenous, oral or rectal solutions and plain uncoated tablets are appropriate for acute therapy, while reliably absorbed slow‐release formulations offer therapeutic advantages for the management of chronic asthma, particularty in patients with rapid elimination. Dosage for long‐term therapy is determined by starting with low doses that allow virtually complete acceptance of the medication followed by gradual increases, if tolerated, at three day intervals until mean age‐specific doses are reached. Subsequent adjustment in dosage regimens are then based upon serum concentration measurements. Most clinical laboratories now measure theophylline, and newer systems have been developed to provide emergency results within minutes at a reasonable cost. In cases of theophylline poisoning, the drug must be rapidly removed to prevent life‐threatening toxicity. When serum concentrations are in excess of 60 μg/ml charcoal hemoperfusion dialysis may be indicated, even in the absence of obvious signs of toxicity.
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DOI：
10.1164/arrd.1980.122.3.365
发表时间：
1980-09
期刊：
The American review of respiratory disease
影响因子：
--
作者：
T. Rossing;C. Fanta;D. H. Goldstein;J. Snapper;E. Mcfadden
通讯作者：
T. Rossing;C. Fanta;D. H. Goldstein;J. Snapper;E. Mcfadden
茶碱、特布他林和泼尼松对抗原诱导的支气管痉挛和介质释放的影响。
DOI：
10.1016/0091-6749(80)90040-8
发表时间：
1980
期刊：
The Journal of allergy and clinical immunology
影响因子：
--
作者：
Martin,GL;Atkins,PC;Dunsky,EH;Zweiman,B
通讯作者：
Zweiman,B
DOI：
10.1056/nejm198209093071102
发表时间：
1982
期刊：
The New England journal of medicine
影响因子：
--
作者：
Berg,MJ;Berlinger,WG;Goldberg,MJ;Spector,R;Johnson,GF
通讯作者：
Johnson,GF
西咪替丁对正常志愿者茶碱清除率和半衰期的改变。
影响因子：
39.2
作者：
Reitberg,DP;Bernhard,H;Schentag,JJ
通讯作者：
Schentag,JJ