Hosseini Seyedeh Maryam, Ajmal Muhammad, Shetty Ranjith
University of Arizona College of Medicine, USA.
Carondelet Medical Group, USA.
Case Rep Cardiol. 2021 Mar 27;2021:2806193. doi: 10.1155/2021/2806193. eCollection 2021.
Theophylline is a potent adenosine receptor antagonist with indirect adrenergic effects that can lead to arrhythmias and metabolic abnormalities such as hypokalemia. Therapeutic toxicity cases have declined over the years mainly due to decreased recommended therapeutic doses and overall decreased usage of this medication due to newer available COPD treatment options. We present a clinical case of symptomatic supraventricular tachycardia resistant to adenosine therapy in a patient with theophylline use. This case highlights the importance of comprehensive medication review in acute settings to aid in identifying the underlying etiologies and initiating prompt treatments. It also signifies the importance of reviewing chronic medications in each outpatient visits to ensure continued indication for their use and be able to change them to newer agents per guidelines whenever possible.
茶碱是一种强效的腺苷受体拮抗剂，具有间接的肾上腺素能效应，可导致心律失常和代谢异常，如低钾血症。多年来，治疗毒性病例有所下降，主要是因为推荐的治疗剂量降低，且由于有了更新的慢性阻塞性肺疾病（COPD）治疗选择，该药物的总体使用量减少。我们报告一例使用茶碱的患者出现对腺苷治疗耐药的症状性室上性心动过速的临床病例。该病例强调了在急性情况下进行全面药物审查以帮助识别潜在病因并及时开展治疗的重要性。它还表明每次门诊就诊时审查慢性用药的重要性，以确保其使用仍有持续的指征，并能够根据指南尽可能将其更换为更新的药物。
