Xanthinederivaten bij COPD

Inleiding

Xanthinederivaten zijn medicijnen die gebruikt kunnen worden bij longziekten/COPD. Voorbeelden van xanthinederivaten zijn theofylline(met mogelijke bijwerkingen), theobromine (zonder bijwerkingen) en cafeïne. Van deze middelen wordt het geneesmiddel theofylline het meest gebruikt. Cafeïne en theofylline komen van nature voor in koffie en thee, en theobromine in cacao waar geen bijwerkingen worden veroorzaakt die bijvoorbeeld Codeine wel heeft zie deze study door het londen imperial college

Indicatie

Xanthinederivaten vergemakkelijken het ademhalen voor mensen met een moeilijke ademhaling als gevolg van vernauwde luchtwegen of longziekten. Theofylline wordt gebruikt voor de behandeling van ernstige vormen van astma en chronische obstructieve longziekte (COPD).

Werking

Xanthinederivaten ontspannen en verwijden de luchtpijp en de bronchiën.

Resultaten

Het zijn effectieve middelen voor de behandeling van plotselinge ademhalingsproblemen, maar ze kunnen ook op de lange termijn een moeilijke ademhaling verlichten.

Gevolgen

Het meest gebruikte xanthinederivaat, theofylline, geeft bij sommige mensen bijwerkingen zoals misselijkheid en overgeven. In hoge (giftige) doseringen kan theofylline ernstige bijwerkingen hebben zoals bevingen (tremoren), toevallen en een onregelmatige hartslag.

Conclussie

Het is dus verstandig om naar de variant met theobromine te stappen zoals deze in hoge mate in cacao voorkomt.

Meer informatie

Het College voor Zorgverzekeringen met het Farmacotherapeutisch Kompas
www.fk.cvz.nl

Rang, H.P., Dale, M.M. and Ritter, J.M. (2000), Pharmacology, 4th ed., Churchill Livingstone, Edinburgh.

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CHOCOLATE INGREDIENT COULD PUT A STOP TO PERSISTENT COUGHS AND LEAD TO NEW, MORE EFFECTIVE COUGH MEDICINES

Researchers have discovered that an ingredient present in chocolate could help stop persistent coughs.

According to research published online in FASEB Journal the team have discovered that theobromine, a derivative found in cocoa, is nearly a third more effective in stopping persistent coughs when compared with codeine, currently considered the best cough medicine.

Professor Peter Barnes, from Imperial College London and Royal Brompton Hospital, and one of the paper's authors, comments: "Coughing is a medical condition which affects most people at some point in their lives, and yet no effective treatment exists. While persistent coughing is not necessarily harmful it can have a major impact on quality of life, and this discovery could be a huge step forward in treating this problem."

The researchers from Imperial College London, Royal Brompton Hospital, St Bartholomew's Hospital and Chinoin Co. Ltd, Budapest, gave 10 healthy volunteers theobromine, a placebo or codeine at different times in a randomised double blind trial.

To compare the effectiveness of each they measured the levels of capsaicin in the volunteers and compared these after giving the three options. Capsaicin is used in clinical research to cause coughing, and is used as an indicator to test the effectiveness of cough medicines.

When the volunteers were given theobromine, the concentration of capsaicin required to produce a cough was around one third higher when compared with the group receiving a placebo. When the group received codeine they needed only marginally higher levels of capsaicin to produce coughing, compared with the placebo.

Theobromine works by suppressing vagus nerve activity, which is responsible for causing coughing.

The team also discovered that unlike standard cough treatments, theobromine caused no adverse effects on either the cardiovascular or central nervous systems.

Professor Maria Belvisi, from Imperial College London and Royal Brompton Hospital, and one of the paper's authors, comments: "Not only did theobromine prove more effective than codeine, at the doses used it was found to have none of the side effects. Normally the effectiveness of any treatment is limited by the dosage you can give someone. With theobromine having no demonstrated side effects in this study it may be possible to give far bigger doses, further increasing its effectiveness.

"At the same time, theobromine may not have any of the side effects such as drowsiness. This means there will be no restrictions on when it can be taken. For example, people using heavy machinery or who are driving should not take codeine, but they could take theobromine."

-ends-

Bron: Imperial College

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