THEOFILLINE

Teofilin is compound
methylxanthine who is
utilized for asthma cure, paru
obstruktif kronik's disease
(COPD; chronic bronchitis and
emfisema), and premature
apnea.

Teofilin's purpose on patient

with diseased paru obstruktif
kronik more controversial
since diseased it has different
pathophysiologic profile, even
umpteen patient shows
disease profile dashed with
by reversibel's breath
component circumscribed.
Breathing in ß2
selective agonis is
utilized as bronkodilator
on asthma patient.

Bronkodilator inhalasi is
selection cure for
PPOK'S patient with ß2
selective agonis or
reputed antikolinergik's
agent the line first.
Bronchodilatory's comment pass
through plain muscle relaxation at
lung for teofilin happens to pass
through many mechanisms which
is two dominate action
mechanism that constrains siklik
nukleotida phosphodiesterases
who increases intraseluler siklik
adenosine monophosphate
(cAMP) and guanosin cyclic
monophosphate (cGMP), and
reseptor adenosin's antagonism .
Besides bronchodilation, teofilin
increases kontraktilitas
diaphragm, increasing clearance
mukosiliar, and be given many
antiinflamasi's effects.
Terapeutik
and toxic
concentration

Terapeutik's gyration that generally

accepted for teofilin is 10 20 ug /
mL to asthma cure or PPOK, or 6 13
ug / mL to apnea's cures
premature.
Terapeutik's range(> 15 ug / mL)
severally patient will experience
demulcent side effect as coffein.
Effect that is evoked comprises
bellyful, puke, dyspepsia,
insomnia, ill at ease, and
headache. teofilin's concentration
exceeds 20 30 ug / mL can cause
various tachyarrhythmias
comprises takikardia sines. On
teofilin's concentration upon 40
ug / mL, serious sideways effect
one gets to threaten soul including
aritmia ventrikel (premature
kontraksi ventrikel, ventrikel
takikardia or fibrilasi) or catalepsy
gets to happen.
PARAMETERS CLINICAL MONITORING
Ekspirasi's volume forces up to 1 second
(FEV) shall measure periodic ala for asthma
patient, and flow's top monitoring meter get
routinely been done by patient.

Besides purpose FEV to monitor

bronkodilator's effect doctor , essay
spirometric another beneficent one for
patient with PPOK comprises vital's capacity
(VC), paru's totaled capacity (TLC), vital's
capacity forces (FVC), and ekspirasi up to 50
means % of ekspirasi's curves (FEF25 - 75% or
FEF50%).
Monitoring concentrates
teofilin's serum
mandatory is done on
patient that accept that
doctor. If patient
experiences clinical
phenomena or
phenomena who can
because of teofilin's bad
effect, teofilin's serum
concentration shall be
gotten at the time which
to remove induced's
doctor toxicity.
In order to get perfect
situation, volum is
teofilin's distribution (V
deep liter) shall be
known to account
content dose (LD in
milligram): LD = Css · v,
whereabouts Css is
concentrate teofilin
that desirable deep
milligram per liter. But,
this farmakokinetik's
parameter rare being
utilized.
S ehingga is dose tranships to base
volume average distribution is utilized
to account needed teofilin amount.
Since patient own volume, unique
possible distribution will be even
greater (one that beget dose too low) or
less (one that beget outsize dose) of
volume average distribution that is
utilized to account content dose,
desirable teofilin steady state
concentration won't be reached. In
consequence, still will be needed 3 5
halflives divides patients to reach
condition of steady state while accept
rates .
After dosed rejimen
efficacious teofilin was
established for patient,
teofilin's serum
concentration makes a
abode stable enough on
patient that accepts to be
damped down longterm.
BASIC is farmakokinetik's PARAMETER CLINICAL
Sometimes, teofilin increases to concentrate
serum on patient is more than that expected
after dose step-up for motive that
diidentifikasikan that can't, and
farmakokinetik nonlinear can watch.
Three available different form from teofilin.
Aminofilin is salt etilendiamina teofilin, and
aminofilin teofilin anhidrat contains around
85% while at aminofilin teofilin's hydrate
contains around 80%. Oxtriphylline is salt kolin
teofilin and teofilin contains around 65%.
Teofilin and aminofilin reserve for hypodermic
intravena and penggunakan oral.
Encouraged dose teofilin
or one of salt form is
gone upon on diseased
condition and condition
of while coincides on
patient who can regard
farmakokinetik teofilin.
farmakokinetik teofilin's
parameter that is utilized
to account dose is given
deep a part following for
specific patient profile.
STATE CONDITION IMPACT AND
DISEASE ON
Farmakokinetik teofilin AND dose

Baffled cardiacing to cause clearance teofilin

dwindling because blood flow decrease hepatik
secondary for output dikompromikan's heart. stasis
vena is blood at heart can also get contribution to
clearance teofilin's decrease . Patient is with
unsuccessful cardiac demulcent (Heart Association's
new york or NYHA IS i. class or II., have average
teofilin and bill time one par with 12 hours (range: 5 -
24
the time of day), meanwhile they what do moderate
fail weight heart (NYHA is III. class or IV.) or
pulmonale's cast has average teofilin's bill time 24
hours (50 - 50 hours).
If bases body weight
recommendation dose (mg / kg / d. or mg /
kg / the time of day) shall be utilized, body
weight ideal shall be utilized to account dose
for obesitas's patient.

Baby conduct to have bill time average

teofilin 25 hours 1 2 days afters comes into
the world, and 11 hours 3 30 postnatal
weeks. Children among age 1 9 year being
hastened by clearance teofilin's zooms beget
bills average 3,5 hours (range: 1,5 - 5 hours).
As children reaches puberty, clearance
teofilin and point half approachings adult
lifes . For lansia's patient gets age be more
than 65 years, severally studi points out that
clearance teofilin as as on temporary young
adult another investigation have found that
clearance teofilin slower and more long time
(averagely = 12 hours, range: 8 - 16 hours).
 SALVING INTERACTION
Cimetidine is given on superordinate dose(= 1000 mg
/ d.) base dose daily menurun some dose teofilin
clearance by 30 50%. Any other dose simetidin(= 800
mg / d.) given really or two times one teofilin's day
can down clearance 20% or less. Ciprofloxacin and
enoxacin, well antibiotic quinolone, and
troleandomycin, one macrolide antibiotic, also
downs ranging clearance teofilin 30 50%. Estrogen
and estrogen is oral's contraceptive that contains,
propranolol, metoprolol, mexiletine, propafenone,
pentoxifylline, ticlopidine, tacrine, thiabendazole,
disulfiram, nefazodone, interferon, zileuton, and
fluvoxamine can also down clearance teofilin by so
far.
Calcium channel resistor,
verapamil, and diltiazem,
was reported cause
clearance teofilin's
decrease by 15 25%.
Klaritromisin and
eritromisin, well antibiotic
macrolide, and
norfloksasin, quinolone's
antibiotic, can also reduce
clearance teofilin by this
as big as. On dose 600
mg / d. or up the stairs,
allopurinol was reported
to clearance teofilin's
decrease as big as 25%.
TERIMA KASIH