Aranda J V, Turmen T
Clin Perinatol. 1979 Mar;6(1):87-108.
Caffeine and theophylline are effective in the treatment of apnea in the newborn infant. Controlled studies of efficacy and comparative efficacy and studies of toxicity are visibly lacking. Both drugs exert their anti-apneic activity by stimulation of the respiratory center. Both drugs are eliminated from the baby slowly (caffeine even slower than theophylline) and doses should be adjusted accordingly. Neonates excrete caffeine largely unchanged and they methylate theophylline to caffeine significantly. Caffeine seems preferable to theophylline because of its wider therapeutic index, ease of administration (i.e., given once per day), lesser fluctuation in plasma concentration owing to longer half-life, potent central respirogenic effect, and fewer peripheral side effects. Areas of concern and feasible research have been discussed.
咖啡因和茶碱对治疗新生儿呼吸暂停有效。明显缺乏关于疗效、对比疗效的对照研究以及毒性研究。两种药物均通过刺激呼吸中枢发挥抗呼吸暂停作用。两种药物在婴儿体内清除缓慢（咖啡因比茶碱清除得更慢），因此剂量应相应调整。新生儿排泄的咖啡因大多未发生变化，且他们会将茶碱大量甲基化为咖啡因。由于咖啡因具有更宽的治疗指数、易于给药（即每天给药一次）、因半衰期较长血浆浓度波动较小、强大的中枢呼吸兴奋作用以及较少的外周副作用，所以咖啡因似乎比茶碱更可取。文中已讨论了关注领域和可行的研究。
