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HEPATITIS A
Author(s) -
I D Gust,
S M Feinstone
Publication year - 1977
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1977.tb99250.x
Subject(s) - citation , computer science , information retrieval , library science
inhibition of phosphodiesterase, the enzyme responsible for the metabolism of 3· 5 cyclic AMP. However, even this is in doubt,as some workers have found that tissue phosphodiesterase levels are normal afteradministrationof theophylline.6 An alternativepostulateis that some of the action of theophylline is due to the release of endogenous catecholamines. Now that theophylline is gaining acceptance as a treatment of apnoeasof prematurity,it may be wise to be cautious before recommending it for widespread use, as disasters have occurred in the newborn from the indiscriminate use of drugs such as chloromycetin, vitamin K and oxygen. The commonly seen side effects aretachycardiaand vomiting. While a slight tachycardiais not dangerous and is used as a clinical ndicator of a therapeuticblood level in centres with no facilities to monitor serum levelsof theophylline, vomiting on the other hand is dangerous in the prematureinfant. Less well known side effects of theophylline are the in-vitro reduction of platelet aggregation, interference in normal glycolysis, and diuresisinduced fluid and electrolyte disturbances. Xanthines, as well as alcohol(.with which theophylline is usually combined), are very irritant to the gastrointestinaltract, and theoretically this may lead to intestinal perforationand necrotizing enterocolitis. Otherreportedside effectsinclude inhibition of the physiological closure of the ductus arteriosus, and it is possible that vascular beds such as the retina may also be affected. The few clinical trials published so far involve very small numbers of patients and have all been uncontrolled. Many centres are waiting for more evidence of the effectiveness and safety of theophylline and are recommending its use only when other methods of controlling the apnoeic episodes, including CPAP, have failed. At this stage double blind, controlled trials are needed to establish the role of theophylline in this area, since in theprematureinfant it is important that if any drug has to be given we should at least know whether it is efficacious.