Stanek E J, Melko G P, Charland S L
Department of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy and Science, PA, USA.
Ann Pharmacother. 1995 Apr;29(4):425-7. doi: 10.1177/106002809502900414.
Both theophylline and caffeine have been shown to antagonize adenosine and are associated with false-negative test results with dipyridamole-T1-201 imaging. This has led to recommendations for theophylline and caffeine abstinence for at least 24 hours prior to dipyridamole-T1-201 imaging. Because pentoxifylline and its metabolites are structurally similar to theophylline and caffeine, and pentoxifylline has adenosine antagonistic properties, one might presume that pentoxifylline may also attenuate the diagnostic yield of dipyridamole-T1-201 imaging. To the best of our knowledge, the pharmacodynamic interaction between pentoxifylline and dipyridamole and its effects on dipyridamole-T1-201 imaging in patients have never been studied adequately. However, a single study in 7 dogs does suggest that there may be no significant interaction. In addition, we must also consider the nonacute nature of the clinical use of pentoxifylline in peripheral vascular disease and the critical need for accurate dipyridamole-T1-201 imaging results and the cost associated with this procedure. Until such information is available in humans, it would be prudent to discontinue pentoxifylline, in addition to caffeinated foods, caffeine-containing drug products, and theophylline, at least 24 hours prior to dipyridamole-T1-201 imaging.
已证实氨茶碱和咖啡因均可拮抗腺苷，并且与双嘧达莫 - T1 - 201成像的假阴性检测结果相关。这导致了在双嘧达莫 - T1 - 201成像前至少24小时停用氨茶碱和咖啡因的建议。由于己酮可可碱及其代谢产物在结构上与氨茶碱和咖啡因相似，且己酮可可碱具有腺苷拮抗特性，因此有人可能推测己酮可可碱也可能降低双嘧达莫 - T1 - 201成像的诊断率。据我们所知，己酮可可碱与双嘧达莫之间的药效学相互作用及其对患者双嘧达莫 - T1 - 201成像的影响从未得到充分研究。然而，一项对7只狗的单一研究确实表明可能不存在显著相互作用。此外，我们还必须考虑己酮可可碱在周围血管疾病临床应用中的非急性性质，以及对准确的双嘧达莫 - T1 - 201成像结果的迫切需求和该检查相关的费用。在获得人体相关信息之前，除了含咖啡因的食物、含咖啡因的药品和氨茶碱外，在双嘧达莫 - T1 - 201成像前至少24小时停用己酮可可碱是谨慎的做法。
