Torrent J, Izquierdo I, Cabezas R, Jané F
School of Medicine, Autonomous University of Barcelona, Spain.
DICP. 1989 Feb;23(2):143-5. doi: 10.1177/106002808902300208.
Drugs influencing hepatic microsomal enzyme systems, such as isoniazid, may affect the elimination pattern of theophylline. The case reported here refers to an adult female patient with a history of chronic asthma and intestinal tuberculosis who, during isoniazid therapy, presented with theophylline plasma concentrations above the therapeutic range and developed toxic symptoms. The initial episode of theophylline toxicity occurred after one month of coadministering isoniazed 300 mg/d and theophylline 350 mg bid. The theophylline plasma concentration during this episode was 24.1 micrograms/mL and was associated with the typical symptoms of theophylline toxicity. Rechallenge with isoniazide 300 mg/d and theophylline 400 mg bid showed a progressive increase in trough morning theophylline plasma levels, reaching a toxic concentration of 25.1 micrograms/mL on day 55. After withdrawal of isoniazid, theophylline concentrations gradually declined, reaching 12.9 micrograms/mL in 35 days. Theophylline toxicity in this patient might have been induced by chronic administration of isoniazid.
影响肝微粒体酶系统的药物，如异烟肼，可能会影响茶碱的消除模式。本文报道的病例是一名成年女性患者，有慢性哮喘和肠结核病史，在接受异烟肼治疗期间，出现血浆茶碱浓度高于治疗范围并出现中毒症状。茶碱中毒的首次发作发生在同时服用异烟肼300mg/d和茶碱350mg bid一个月后。此次发作期间茶碱血浆浓度为24.1μg/mL，并伴有茶碱中毒的典型症状。再次同时服用异烟肼300mg/d和茶碱400mg bid后，晨间茶碱血浆谷浓度逐渐升高，在第55天达到中毒浓度25.1μg/mL。停用异烟肼后，茶碱浓度逐渐下降，35天后降至12.9μg/mL。该患者的茶碱中毒可能是由长期服用异烟肼引起的。
