Evidence supporting the use of: Methylxanthine (unspecified)
For the body system: Epinephrine

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Table of Contents

Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Methylxanthines, such as caffeine and theophylline, are well-studied stimulants that act as adenosine receptor antagonists and phosphodiesterase inhibitors. Their pharmacological effects include increased alertness, bronchodilation, and stimulation of the central nervous system. Regarding the "Epinephrine body system," methylxanthines have been shown to enhance the effects of endogenous catecholamines like epinephrine (adrenaline). This occurs because methylxanthines increase intracellular cyclic AMP by inhibiting phosphodiesterase, thereby potentiating the cellular responses mediated by epinephrine, such as increased heart rate, bronchodilation, and smooth muscle relaxation.

In acute medical settings, theophylline has been used to manage asthma and chronic obstructive pulmonary disease (COPD) because of its bronchodilatory effects, which are in part due to enhanced responsiveness to endogenous and exogenous epinephrine. Caffeine is also used neonatally to treat apnea of prematurity, where it stimulates respiratory drive partly via similar mechanisms.

Clinical research supports the use of methylxanthines as adjuncts in situations where the body’s catecholaminergic (epinephrine-mediated) responses need to be supported or enhanced. However, their use has become more limited due to the availability of safer, more targeted drugs. Nonetheless, the mechanistic basis for their interaction with the epinephrine system is well established in scientific literature, justifying a relatively high evidence score.

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