teofülliin

Teofülliin (also known as theophylline) is a methylxanthine compound used as a bronchodilator and respiratory stimulant. It is structurally related to caffeine and theobromine and has been used in the treatment of obstructive airway diseases, including asthma and chronic obstructive pulmonary disease (COPD), as well as historically for apnea of prematurity.

The pharmacological effects of teofülliin include nonselective inhibition of phosphodiesterase enzymes, antagonism of adenosine receptors and modest augmentation of catecholamine release, which together raise intracellular cyclic AMP and promote bronchodilation. Anti-inflammatory effects are limited compared with inhaled corticosteroids.

Teofülliin is administered orally or intravenously. It is well absorbed and extensively metabolized in the liver, primarily by cytochrome P450 1A2; its elimination half-life is variable and is influenced by age, smoking, comorbidities and concurrent medications. The drug has a narrow therapeutic index, and plasma concentration monitoring is commonly performed to balance efficacy and toxicity. Typical therapeutic ranges are often cited in the 5–15 mg/L band.

Adverse effects are dose-related and include gastrointestinal upset, insomnia, tremor, tachycardia, arrhythmias and central nervous system toxicity that can progress to seizures at high concentrations. Numerous drug interactions and factors such as smoking or liver disease can alter teofülliin clearance. Its clinical use has declined with the availability of more selective and better-tolerated inhaled therapies, but it remains an optional adjunct in selected patients.