Abstract
Twenty-four patients with reversible airflow obstruction under suboptimal control on conventional therapy entered a double-blind placebo-controlled trial of additional oral sustained release aminophylline. Assessment was by diary cards, twice daily PEFR, and weekly FEV1. Nineteen patients completed the trial satisfactorily. Eleven were improved subjectively by addition of aminophylline. The mean PEFR for all 19 patients rose from 232 1 min-1 SEM +/- 5, to 247 1 min-1 SEM +/- 4 (p less than 0.0001); nine individuals showed a statistically significant improvement in mean PEFR and 10 showed an improvement of greater than 200 ml in their FEV1. Improvement in PEFR on aminophylline was not at the expense of benefit from inhaled salbutamol. Unwanted effects of nausea, headache, and abdominal discomfort were recorded by 12 of the 24 patients entering the trial. Seventeen of the 19 patients completing the trial had plasma theophylline levels in the accepted therapeutic range of 10-20 mg 1(-1). The drug doses required to achieve these levels varied from 8.6-30.8 mg kg-1 24 hr-1 in the patients with no clinical or biochemical evidence of liver disease. Oral aminophylline can improve control of airflow obstruction in patients with moderately severe disease who are already receiving multiple medication, but side-effects often limit its use. The wide dose range required to achieve therapeutic plasma levels indicates that measurements of plasma theophylline are necessary for adequate interpretation of trials of theophylline compounds.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Jacobs M. H., Senior R. M., Kessler G. Clinical experience with theophylline. Relarionships between dosage, serum concentration, and toxicity. JAMA. 1976 May 3;235(18):1983–1986. doi: 10.1001/jama.235.18.1983. [DOI] [PubMed] [Google Scholar]
- Jenne J. W., Wyze M. S., Rood F. S., MacDonald F. M. Pharmacokinetics of theophylline. Application to adjustment of the clinical dose of aminophylline. Clin Pharmacol Ther. 1972 May-Jun;13(3):349–360. doi: 10.1002/cpt1972133349. [DOI] [PubMed] [Google Scholar]
- Jusko W. J., Koup J. R., Vance J. W., Schentag J. J., Kuritzky P. Intravenous theophylline therapy: nomogram guidelines. Ann Intern Med. 1977 Apr;86(4):400–404. doi: 10.7326/0003-4819-86-4-400. [DOI] [PubMed] [Google Scholar]
- McKenzie S. A., Edmunds A. T., Baillie E., Meek J. H. Clinical applications of serum theophylline measurement by high pressure liquid chromatography. Arch Dis Child. 1978 Apr;53(4):322–325. doi: 10.1136/adc.53.4.322. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 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]
- 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]
- TURNER-WARWICK M. Study of theophylline plasma levels after oral administration of new theophylline compounds. Br Med J. 1957 Jul 13;2(5036):67–69. doi: 10.1136/bmj.2.5036.67. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Trembath P. W., Boobis S. W., Richens A. Theophylline: biochemical pharmacology and pharmacokinetics. J Int Med Res. 1979;7 (Suppl 1):4–15. [PubMed] [Google Scholar]