Uden D L, Wyatt R A, Zaske D E
Postgrad Med. 1984 Jun;75(8):247-56. doi: 10.1080/00325481.1984.11698651.
Theophylline has long been a cornerstone of bronchodilator therapy for asthma and chronic obstructive lung disease, but until recently its use carried the risk of serious, even fatal, toxicity. With recent advances in understanding of this drug's pharmacologic properties and pharmacokinetic characteristics, serious toxicity now can usually be avoided. The dosage requirements for theophylline demonstrate wide interpatient and intrapatient variation. Several factors responsible for this variation, most notably age, have been identified and used in definition of dosage guidelines for different patient groups. However, substantial variation still exists within these groups, necessitating measurement of serum concentration in selected patients. The measurements obtained are used to titrate the patient's dosage requirement in such a way as to maximize therapeutic response while minimizing risk of toxicity.
长期以来，茶碱一直是哮喘和慢性阻塞性肺疾病支气管扩张剂治疗的基石，但直到最近，其使用仍存在严重甚至致命毒性的风险。随着对该药物药理特性和药代动力学特征认识的最新进展，现在通常可以避免严重毒性。茶碱的剂量需求在患者之间和患者自身存在很大差异。已经确定了导致这种差异的几个因素，最显著的是年龄，并将其用于定义不同患者群体的剂量指南。然而，这些群体中仍然存在很大差异，因此需要对部分患者测量血清浓度。所获得的测量结果用于调整患者的剂量需求，以在将毒性风险降至最低的同时最大化治疗反应。
