Budi Yanti,1 Menaldi Rasmin2
1SMF Pulmonologi dan Kedokteran Respirasi, Fakultas Kedokteran Universitas Syiah Kuala, RSUD Dr. Zainoel Abidin, Banda Aceh
2 Departemen Pulmonologi dan Kedokteran Respirasi Fakultas Kedokteran Universitas Indonesia, RSUP Persahabatan, Jakarta
Abstract
Theophylline has been used in the treatment of asthma and chronic obstructive pulmonary disease (COPD) for over 60 years and remains one of the most widely prescribed drugs for the treatment of airway diseases worldwide as it is inexpensive. The molecular mechanism of bronchodilatation is likely explained by PDE inhibition, resulting in an increase in cAMP by inhibition of PDE3 and PDE4 and in cyclic guanosine 3,5 monophosphate by inhibition of PDE5. Theophylline directly relaxes human airways smooth muscle in vitro and like β2-agonists, acts as a functional antagonist, preventing and reversing the effects of all bronchoconstrictor agonists. Aminophylline increases diaphragmatic contractility and reverses diaphragm fatigue. Theophylline may also have an additional effect on mucociliary clearance through a stimulatory effect on ciliary beat frequency and water transport across the airway epithelium. Theophylline gives direct relaxation of pulmonary arterial smooth muscle, which may be of clinical use in treating the pulmonary hypertension often associated with COPD and acute asthma. The variable clearance, narrow therapeutic index, and severity of toxic reactions of theophylline necessitate close attention to dosing routines and subsequent monitoring. (J Respir Indo. 2016; 36: 267-73)
Keywords: Asthma, COPD, Xantin