Lam C, Ben-Zvi Z, Barnett S, Kattan M
Am J Dis Child. 1982 Apr;136(4):345-7. doi: 10.1001/archpedi.1982.03970400063016.
In two groups of patients, noncompliance with drug regimens resulted in misinterpretation of serum theophylline levels. All six chronic asthmatics in the first group, found in a retrospective review of 43 outpatient charts, had outpatient serum theophylline levels in the therapeutic range (10 to 20 microgram/mL) and at least a 7-microgram/mL greater inpatient theophylline level while receiving the same dosage. When hospitalized, four of these patients had serum theophylline levels in the toxic range (greater than 20 microgram/mL). In the second group four hospitalized patients had persistently low serum theophylline levels despite an adequate theophylline dose. When compliance was enforced, serum theophylline levels rose significantly. Compliance cannot be assumed in the outpatient with a serum theophylline level in the therapeutic range or in the hospitalized patient. Determination of serum theophylline level after supervised drug administration is recommended in inpatients requiring unusually high doses of theophylline or in those whose condition is poorly controlled despite having serum theophylline levels in the therapeutic range (10 to 20 microgram/mL).
在两组患者中，不遵守药物治疗方案导致了血清茶碱水平的误判。在对43份门诊病历的回顾性研究中发现，第一组的所有6名慢性哮喘患者门诊时血清茶碱水平处于治疗范围（10至20微克/毫升），且在接受相同剂量治疗时，住院期间的茶碱水平至少比门诊时高7微克/毫升。住院时，其中4名患者的血清茶碱水平处于中毒范围（大于20微克/毫升）。在第二组中，4名住院患者尽管茶碱剂量充足，但血清茶碱水平持续偏低。当强制要求患者遵守治疗方案时，血清茶碱水平显著上升。对于门诊时血清茶碱水平处于治疗范围的患者或住院患者，不能假定其遵守了治疗方案。对于需要异常高剂量茶碱的住院患者，或那些尽管血清茶碱水平处于治疗范围（10至20微克/毫升）但病情控制不佳的患者，建议在监督给药后测定血清茶碱水平。
