Zach M
Monatsschr Kinderheilkd. 1982 Sep;130(9):696-703.
Theophylline reduces asthmatic bronchial obstruction; this desired therapeutic action but also the occurrence of unpleasant and dangerous side effects depends directly on its tissue and serum concentration. An effective therapy therefore requires repeated determinations of this serum concentration. Safe dosage is complicated by complex pharmacokinetics such as considerable interindividual differences in distribution space and hepatic clearance. Children eliminate theophylline faster than adults; thus they require larger doses and demonstrate higher fluctuations of their serum levels. Various exo- and endogenous factors can alter the clearance rate and therefore have to be considered. Intravenous infusions of theophylline are the mainstay in the treatment of status asthmaticus. A flow chart of therapeutic actions is presented and supportive intensive care is described. In prophylactic oral therapy slow-release preparations are preferred. Optimal long-term medication is best initiated via stepwise increments of the daily dosage plus one or more final adjustments after the determination of the drug's serum concentration.
茶碱可减轻哮喘性支气管阻塞；这种预期的治疗作用以及不良和危险副作用的发生直接取决于其组织和血清浓度。因此，有效的治疗需要反复测定血清浓度。安全剂量因复杂的药代动力学而变得复杂，例如分布空间和肝脏清除率存在相当大的个体差异。儿童清除茶碱的速度比成人快；因此他们需要更大的剂量，并且血清水平波动更大。各种外源性和内源性因素可改变清除率，因此必须加以考虑。静脉输注茶碱是治疗哮喘持续状态的主要方法。本文给出了治疗措施流程图并描述了支持性重症监护。在预防性口服治疗中，优选缓释制剂。最佳的长期用药最好通过每日剂量逐步增加，以及在测定药物血清浓度后进行一次或多次最终调整来开始。
