Knutsen R, Bøhmer T, Falch J
Department of Internal Medicine, University of Oslo, Aker Hospital, Norway.
Scand J Clin Lab Invest. 1994 Apr;54(2):119-25. doi: 10.3109/00365519409086518.
Hypomagnesaemia in a woman treated with theophylline and albuterol because of recurrent asthmatic attacks prompted us to explore the effects of these drugs on the metabolism of magnesium, calcium, sodium and phosphate in such patients. Theophylline given intravenously to 10 females with recurrent asthmatic attacks increased total mean urinary excretion (mean +/- SEM, mmol 5 h-1) of Mg from 0.54 +/- 0.07 to 0.86 +/- 0.10; of Ca from 0.89 +/- 0.18 to 1.45 +/- 0.26; of Na from 22.9 +/- 7.5 to 49.4 +/- 9.5. Theophylline i.v. and an inhaled beta 2-agonist (albuterol) both increased the normal morning-till-noon serum concentration difference (mean +/- SEM, mmol l-1) in PO4 (from -0.13 +/- 0.04 to - 0.23 +/- 0.03 and -0.23 +/- 0.04, respectively) and reduced the normal increase in serum-K (from 0.25 +/- 0.07 to 0.06 +/- 0.08 and -0.13 +/- 0.09, respectively). Disproportional changes in serum and urinary levels of magnesium and calcium by theophylline i.v. is suggestive of Mg depletion of intracellular stores and a negative calcium balance. Theophylline, therefore, may exert adverse effects on the metabolism and urinary excretion of calcium and magnesium in subjects with recurrent asthmatic attacks.
一名因反复哮喘发作而接受茶碱和沙丁胺醇治疗的女性出现低镁血症，这促使我们探究这些药物对这类患者镁、钙、钠和磷酸盐代谢的影响。对10名反复哮喘发作的女性静脉注射茶碱后，镁的平均总尿排泄量（平均值±标准误，mmol 5 h⁻¹）从0.54±0.07增加到0.86±0.10；钙从0.89±0.18增加到1.45±0.26；钠从22.9±7.5增加到49.4±9.5。静脉注射茶碱和吸入β₂激动剂（沙丁胺醇）均增加了正常情况下上午至中午血清中磷酸根浓度差（平均值±标准误，mmol l⁻¹）（分别从-0.13±0.04增加到-0.23±0.03和-0.23±0.04），并降低了血清钾的正常升高幅度（分别从0.25±0.07降低到0.06±0.08和-0.13±0.09）。静脉注射茶碱导致血清和尿液中镁和钙水平的不成比例变化，提示细胞内储存的镁耗竭和钙负平衡。因此，茶碱可能对反复哮喘发作患者的钙和镁代谢及尿排泄产生不利影响。
