Skip to main content
NCBI home page
British Journal of Clinical Pharmacology logoLink to British Journal of Clinical Pharmacology
. 1983 Oct;16(4):405–411. doi: 10.1111/j.1365-2125.1983.tb02185.x

The effect of posture on the sympathoadrenal response to theophylline infusion.

J B Warren, C Turner, N Dalton, A Thomson, G M Cochrane, T J Clark
PMCID: PMC1428031  PMID: 6313028

Abstract

We studied the effect of posture on the sympathoadrenal response to intravenous theophylline in six normal subjects. On three separate occasions they received an intravenous infusion of either theophylline (6 mg/kg) while supine, theophylline (6 mg/kg) while standing or saline as placebo while standing. With the subjects standing theophylline caused tremor, a peak heart rate of 99 +/- 6 beats/min, and an elevation of plasma cyclic AMP from 9.3 +/- 0.7 to 15.1 +/- 1.7 nmol/1 (mean +/- s.e. mean). There was a small, but significant, elevation of plasma adrenaline, noradrenaline and glucose. The elevation in plasma catecholamines was insufficient to explain either the sympathomimetic effects of theophylline or the rise in plasma cyclic AMP. Theophylline had little or no effect with the subjects supine. The mean peak theophylline concentration following infusion was significantly higher with the subjects upright than when supine (18.3 c.f. 12.4 mg/l, P less than 0.025). However, adequate plasma levels of theophylline were obtained in all subjects when lying or supine. Analysis of individual data suggests that differences in plasma levels of theophylline are unlikely to account for the increased effects seen on standing. The mechanism of action of theophylline cannot be explained by increased secretion of catecholamines alone. Theophylline appears to amplify the increased sympathetic activity associated with standing and this is probably by phosphodiesterase inhibition.

Full text

PDF
405

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Atuk N. O., Blaydes M. C., Westervelt F. B., Jr, Wood J. E., Jr Effect of aminophylline on urinary excretion of epinephrine and norepinephrine in man. Circulation. 1967 Apr;35(4):745–753. doi: 10.1161/01.cir.35.4.745. [DOI] [PubMed] [Google Scholar]
  2. Aunis D., Mandel P., Miras-Portugal M. T., Coquillat G., Rohmer F., Warter J. M. Changes of human plasma dopamine-beta-hydroxylase activity after intravenous administration of theophylline. Br J Pharmacol. 1975 Mar;53(3):425–427. doi: 10.1111/j.1476-5381.1975.tb07380.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. BUTCHER R. W., SUTHERLAND E. W. Adenosine 3',5'-phosphate in biological materials. I. Purification and properties of cyclic 3',5'-nucleotide phosphodiesterase and use of this enzyme to characterize adenosine 3',5'-phosphate in human urine. J Biol Chem. 1962 Apr;237:1244–1250. [PubMed] [Google Scholar]
  4. Ball J. H., Kaminsky N. I., Hardman J. G., Broadus A. E., Sutherland E. W., Liddle G. W. Effects of catecholamines and adrenergic-blocking agents on plasma and urinary cyclic nucleotides in man. J Clin Invest. 1972 Aug;51(8):2124–2129. doi: 10.1172/JCI107019. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Brisson G. R., Malaisse-Lagae F., Malaisse W. J. The stimulus-secretion coupling of glucose-induced insulin release. VII. A proposed site of action for adenosine-3',5'-cyclic monophosphate. J Clin Invest. 1972 Feb;51(2):232–241. doi: 10.1172/JCI106808. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Campbell I. A., Middleton W. G., McHardy G. J., Shotter M. V., McKenzie R., Kay A. B. Interaction between isoprenaline and aminophylline in asthma. Thorax. 1977 Aug;32(4):424–428. doi: 10.1136/thx.32.4.424. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Cryer P. E. Isotope-derivative measurements of plasma norepinephrine and epinephrine in man. Diabetes. 1976 Nov;25(11):1071–1082. doi: 10.2337/diab.25.11.1071. [DOI] [PubMed] [Google Scholar]
  8. Estenne M., Yernault J. C., De Troyer A. Effects of parenteral aminophylline on lung mechanics in normal human. Am Rev Respir Dis. 1980 Jun;121(6):967–971. doi: 10.1164/arrd.1980.121.6.967. [DOI] [PubMed] [Google Scholar]
  9. Fitzgerald G. A., Barnes P., Hamilton C. A., Dollery C. T. Circulating adrenaline and blood pressure: the metabolic effects and kinetics of infused adrenaline in man. Eur J Clin Invest. 1980 Oct;10(5):401–406. doi: 10.1111/j.1365-2362.1980.tb00052.x. [DOI] [PubMed] [Google Scholar]
  10. Fredholm B. B., Sydbom A. Are the anti-allergic actions of theophylline due to antagonism at the adenosine receptor. Agents Actions. 1980 Apr;10(1 Pt 2):145–147. doi: 10.1007/BF02024198. [DOI] [PubMed] [Google Scholar]
  11. Handslip P. D., Dart A. M., Davies B. H. Intravenous salbutamol and aminophylline in asthma: a search for synergy. Thorax. 1981 Oct;36(10):741–744. doi: 10.1136/thx.36.10.741. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Higbee M. D., Kumar M., Galant S. P. Stimulation of endogenous catecholamine release by theophylline: a proposed additional mechanism of action for theophylline effects. J Allergy Clin Immunol. 1982 Nov;70(5):377–382. doi: 10.1016/0091-6749(82)90028-8. [DOI] [PubMed] [Google Scholar]
  13. Horrobin D. F., Manku M. S., Franks D. J., Hamet P. Theophylline and bronchospasm. N Engl J Med. 1977 Nov 24;297(21):1181–1181. doi: 10.1056/nejm197711242972118. [DOI] [PubMed] [Google Scholar]
  14. James G. W. The role of the adrenal glands and of alpha- and beta-adrenergic receptors in bronchodilatation of guinea-pig lungs in vivo. J Pharm Pharmacol. 1967 Dec;19(12):797–802. doi: 10.1111/j.2042-7158.1967.tb09546.x. [DOI] [PubMed] [Google Scholar]
  15. Leopold D., Handslip P. Additive interaction of aminophylline and salbutamol in asthma: an in vivo study using dose-response curves. J Int Med Res. 1979;7 (Suppl 1):52–55. [PubMed] [Google Scholar]
  16. Mitenko P. A., Ogilvie R. I. Rational intravenous doses of theophylline. N Engl J Med. 1973 Sep 20;289(12):600–603. doi: 10.1056/NEJM197309202891202. [DOI] [PubMed] [Google Scholar]
  17. Monie R. D., Rocchiccioli K. M., White J. P. Sustained release aminophylline in asthma and its interaction with rimiterol. Br J Clin Pharmacol. 1982 Jul;14(1):110–112. doi: 10.1111/j.1365-2125.1982.tb04945.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Peuler J. D., Johnson G. A. Simultaneous single isotope radioenzymatic assay of plasma norepinephrine, epinephrine and dopamine. Life Sci. 1977 Sep 1;21(5):625–636. doi: 10.1016/0024-3205(77)90070-4. [DOI] [PubMed] [Google Scholar]
  19. Piafsky K. M., Ogilvie R. I. Dosage of theophylline in bronchial asthma. N Engl J Med. 1975 Jun 5;292(23):1218–1222. doi: 10.1056/NEJM197506052922305. [DOI] [PubMed] [Google Scholar]
  20. Polson J. B., Krzanowski J. J., Goldman A. L., Szentivanyi A. Inhibition of human pulmonary phosphodiesterase activity by therapeutic levels of theophylline. Clin Exp Pharmacol Physiol. 1978 Sep-Oct;5(5):535–539. doi: 10.1111/j.1440-1681.1978.tb00707.x. [DOI] [PubMed] [Google Scholar]
  21. Riegelman S., Loo J. C., Rowland M. Shortcomings in pharmacokinetic analysis by conceiving the body to exhibit properties of a single compartment. J Pharm Sci. 1968 Jan;57(1):117–123. doi: 10.1002/jps.2600570123. [DOI] [PubMed] [Google Scholar]
  22. Robertson D., Frölich J. C., Carr R. K., Watson J. T., Hollifield J. W., Shand D. G., Oates J. A. Effects of caffeine on plasma renin activity, catecholamines and blood pressure. N Engl J Med. 1978 Jan 26;298(4):181–186. doi: 10.1056/NEJM197801262980403. [DOI] [PubMed] [Google Scholar]
  23. Senior R. M., Lefrak S. S., Korenblat P. E. Status asthmaticus. JAMA. 1975 Mar 24;231(12):1277–1279. [PubMed] [Google Scholar]
  24. Starr I., Gamble C. J., Margolies A., Donal J. S., Joseph N., Eagle E. A CLINICAL STUDY OF THE ACTION OF 10 COMMONLY USED DRUGS ON CARDIAC OUTPUT, WORK AND SIZE; ON RESPIRATION, ON METABOLIC RATE AND ON THE ELECTROCARDIOGRAM. J Clin Invest. 1937 Sep;16(5):799–823. doi: 10.1172/JCI100906. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Thompson W. O., Thompson P. K., Dailey M. E. THE EFFECT OF POSTURE UPON THE COMPOSITION AND VOLUME OF THE BLOOD IN MAN. J Clin Invest. 1928 Jun;5(4):573–604. doi: 10.1172/JCI100179. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Trembath P. W., Shaw J. Potentiation of isoprenaline-induced plasma cyclic AMP response by aminophylline in normal and asthmatic subjects. Br J Clin Pharmacol. 1978 Dec;6(6):499–503. doi: 10.1111/j.1365-2125.1978.tb00873.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Vandongen R., Davidson L., Beilin L. J., Barden A. E. Effect of beta-adrenergic receptor blockade with propranolol on the response of plasma catecholamines and renin activity to upright tilting in normal subjects. Br J Clin Pharmacol. 1981 Sep;12(3):369–374. doi: 10.1111/j.1365-2125.1981.tb01228.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Vinegar R., Truax J. F., Selph J. L., Welch R. M., White H. L., Ellis C. H. Potentiation of the anti-inflammatory and analgesic activity of aspirin by caffeine in the rat. Proc Soc Exp Biol Med. 1976 Mar;151(3):556–560. doi: 10.3181/00379727-151-39257. [DOI] [PubMed] [Google Scholar]
  29. Warren J. B., Dalton N. A comparison of the bronchodilator and vasopressor effects of exercise levels of adrenaline in man. Clin Sci (Lond) 1983 May;64(5):475–479. doi: 10.1042/cs0640475. [DOI] [PubMed] [Google Scholar]
  30. Waterfield R. L. The effects of posture on the circulating blood volume. J Physiol. 1931 Jun 6;72(1):110–120. doi: 10.1113/jphysiol.1931.sp002765. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Journal of Clinical Pharmacology are provided here courtesy of British Pharmacological Society

RESOURCES