Poe R H, Utell M J
Pulmonary Unit, Highland Hospital, Rochester, NY.
Geriatrics. 1991 Apr;46(4):55-6, 61-5.
Theophylline's role in the treatment of airway obstruction has been challenged, yet it remains a useful agent in the management of obstructive lung disease. It has a narrow therapeutic range and frequent side effects. Drug interactions are common, and variations in theophylline clearance among patients arise from individual differences in its absorption, metabolism, and elimination. Acute bronchospasm is best treated with inhaled sympathomimetic agents, but the nonbronchodilator effects of theophylline offer therapeutic benefits for the patient with non-reversible disease. When properly monitored by serum level determinations, theophylline may be used as an adjunct to aerosol therapy and corticosteroids in asthma. However, the patient with COPD may benefit the most from an empiric trial of the drug, using lower doses than were commonly employed in the past.
茶碱在气道阻塞治疗中的作用一直受到质疑，但其在阻塞性肺病管理中仍是一种有用的药物。它的治疗窗较窄且副作用频繁。药物相互作用很常见，患者之间茶碱清除率的差异源于其吸收、代谢和消除的个体差异。急性支气管痉挛最好用吸入性拟交感神经药治疗，但茶碱的非支气管扩张作用为患有不可逆疾病的患者提供了治疗益处。通过血清水平测定进行适当监测时，茶碱可作为哮喘气雾剂治疗和皮质类固醇治疗的辅助药物。然而，慢性阻塞性肺病患者可能从该药物的经验性试验中获益最大，使用的剂量低于过去常用剂量。
