Pharmacist's Antidote | For autumn and winter asthma, use theophylline safely and effectively, you need to know these key points!

Autumn and winter are the peak seasons for respiratory diseases, and the number of outpatient visits increases sharply. Patients often complain of "coughing and asthma that keeps them awake all night", and doctors generally prescribe theophylline drugs to relieve symptoms. Theophylline drugs have the effects of bronchial dilation and anti-inflammatory, and are mainly used to treat asthma, including acute asthma attacks, control of chronic asthma, hormone-dependent and hormone-resistant asthma. However, its effective dose is close to the toxic dose, and the following points should be noted when using the drug.

Key point 1: It is generally not used alone and needs to be combined with other anti-asthma drugs

At present, the commonly used oral theophylline drugs in clinical practice are theophylline tablets and sustained-release tablets. Theophylline drugs are generally not used alone to treat asthma, but are often used in combination with hormones and β2 receptor agonists. Tablets have a short duration of action and are suitable for acute asthma attacks; sustained-release tablets are long-acting preparations and are suitable for the control of asthma, especially nocturnal asthma.

Key point 2: Drug interactions have a great impact

Theophylline drugs are mainly metabolized and eliminated by the liver. When taken with other drugs, their metabolism may be accelerated or slowed down. If necessary, they should be taken at intervals.

Point 3: Excessive frequency and excessive dosage of medication can lead to serious adverse consequences

Oral theophylline drugs have the characteristics of slow onset of action and close effective concentration to toxic concentration. Patients often suffer from poisoning reactions due to excessive frequency or excessive dosage. When the therapeutic concentration is too high, symptoms such as nausea, vomiting, irritability, and insomnia may occur. When the dosage exceeds the recommended dosage in the instructions, tachycardia, arrhythmia, and even fever, dehydration, convulsions, and in severe cases, death may occur.

Point 4: There are many factors that affect the effect of drugs

There are two main factors that affect the effect of theophylline drugs:

One is lifestyle habits, such as smoking, drinking, and consuming caffeinated food or drinks, which will increase the risk of poisoning.

1

Viral infection: Early application of antiviral drugs may be effective, which can control symptoms and shorten the course of the disease. Commonly used antiviral drugs include oral oseltamivir, intravenous acyclovir, ganciclovir, etc. If combined with bacterial infection, combined antibacterial drugs are needed.

2

Bacterial infection: Bacterial pneumonia requires standardized medication under the diagnosis and advice of professional doctors. Professional doctors will select appropriate antibacterial drugs based on the patient's clinical symptoms, the site of onset, and the results of blood tests and sputum bacterial culture. Do not choose medication at will, and do not stop taking medication at will.

3

Mycoplasma or Chlamydia infection: The clinically recommended antimicrobial drugs mainly include azithromycin, doxycycline, minocycline, levofloxacin and moxifloxacin. After standardized drug treatment, mycoplasma pneumonia generally has a good prognosis and a low mortality rate.

Acute diarrhea

constipate

Taking antibiotics

1

Age : In cases of chronic poisoning caused by long-term high-dose use of theophylline drugs, age is the most important risk factor. The older you are, the greater the chance of poisoning.

2

Concomitant diseases : Patients with peptic ulcer, uncontrolled convulsive disease, acute myocardial infarction with hypotension should not use theophylline drugs. Patients with liver and kidney dysfunction should inform their doctors to adjust the dosage or extend the interval between medications.

3

Pregnant and lactating women : Theophylline drugs can cross the placental barrier and increase the serum theophylline concentration of newborns to dangerous levels, so they must be monitored. Theophylline drugs can also be excreted with breast milk. Taking them by lactating women can cause infantile irritability or other adverse reactions, so pregnant women and lactating women should try to avoid using them. Theophylline sustained-release preparations cannot be broken, chewed or crushed before taking, and must be swallowed intact.