PURPOSE: To determine if intravenous aminophylline adds any efficacy to nebulized albuterol and intravenously administered corticosteroid in children who hospitalized with mild to moderate asthma. METHOD: Subjects were children between the ages of 5 and 15 years admitted of acute asthma attack to Department of Pediatrics, Kyung Hee University Hospital. All patient received therapy with albuterol delivered with nebulization at 4-6 hour interval and intravenously adminstered methylprednisolone in standardized doses. Thirty patients were recruited to receive either an intravenous aminophylline(n=15) or not(n=15). The outcome variables were:duration of hospitalization, percent of predicted peak expiratory flow rates recorded at 12-hour intervals and side effects. When intravenously administered medications were discontinued, therapy continued with oral administration of theophylline. Twice daily assessments of clinical asthma symptoms were made by using a scoring system consisting of respiratory rate, wheeze and accessory muscle use. RESULTS: 1) There were no significant differences at study entry in age, sex, race, number of previous hospital admission, clinical symptom scores, or initial peak flow rates for the two groups. 2) Fifteen patients in the aminophylline group were hospitalized for an mean duration of 5.1+/-1.0 days, whereas 15 patients in the control group required 5.3+/-1.2 days. There were no significant differences between the two groups. 3) There was no differences in the absolute changes in their scores two scoring intervals(at 24 hours) between the two groups. 4) The two groups showed no differences in measurements of peak expiratory flow rates at any time interval and at the end of treatment. 5) The mean theophylline level for aminophylline group was 10.2+/-1.7micorgram/mL. 6) In the aminophylline group, 6 of 15 patients who entered the study experienced adverse effects consisting of nausea/vomiting, abdominal pain, and irritability. Five of 15 patients in the control group had an adverse effects. There were no significant differences between the two groups for incidence of adverse effects. 7) There were no significant differences between the two groups for amount of albuterol therapy required. CONCLUSION: When the combination of systemically administered corticosteroid and inhaled albuterol is used in hospitalized asthmatic children with mild to moderate asthma, addition of theophylline provided no additional benefit. Further study will be needed to evaluate if patients with more severe asthma exacerbation benefit for the use of intraveously administered aminophylline.
Abdominal Pain ; Administration, Oral ; Albuterol ; Aminophylline* ; Asthma* ; Child ; Continental Population Groups ; Hospitalization ; Humans ; Incidence ; Methylprednisolone ; Pediatrics ; Respiratory Rate ; Theophylline

AIMTo investigate the in vitro influencing factors on drug release from matrices with sodium alginate as the hydrophilic polymer.

METHODSSodium alginate hydrophilic matrix tablets were prepared by direct compression method with theopylline as a model drug. The in vitro influencing factors on drug release behavior from matrices were studied by investigating the swelling, water uptake and erosion characteristics of pure sodium alginate matrices.

RESULTSThe results showed that drug release rate and drug release mechanism were both related to the viscosity of sodium alginate used in matrices, pH values and ionic strength of dissolution media and rotation speeds.

CONCLUSIONSodium alginate can be tailor-made to suit the demands of applicants in sustained delivery systems as a good candidate of hydrophilic polymer.

Alginates ; administration & dosage ; chemistry ; Chemistry, Pharmaceutical ; Delayed-Action Preparations ; Drug Carriers ; Drug Delivery Systems ; Glucuronic Acid ; administration & dosage ; chemistry ; Hexuronic Acids ; administration & dosage ; chemistry ; Hydrogen-Ion Concentration ; Solubility ; Tablets ; Theophylline ; administration & dosage ; chemistry ; Viscosity

PURPOSE: The purpose of this study was to evaluate the effects of theophylline in preterm infants with apnea on glucose homeostasis and insulin values. METHOD: In this prospective study, level of glucose and insulin were measured from peripheral blood of 8 neonates(1,450+/-114gm, 31+/-2.1week), who were admitted from April 1, 1997 to July 30, 1997 in Neonatal Intensive Care Unit of Wonkwang University Hospital, for apnea of prematurity(> 20 sec with bradycardia and/or cyanosis) were given aminophylline intravenously. Blood samples were collected at pretreatment, posttreatment 2hours, 1-2days, 3-4days, 5-7days and posttreatment 48hours, and compare to those of the 8 control neonates(1,711+/-232gm, 32+/-1.7week). RESULTS: The results were as follows: 1) Plasma glucose values were significantly higher in the treatment group than those of the control group at 1-2days(104.67+/-20.39mg/dL vs 83.43+/-15.86mg/dL) and 3-4days(111.0+/-32.39mg/dL vs 79.25+/-14.03mg/dL)(p<0.05). 2) Plasma glucose values which were increased at 1-2days(104.67+/-20.39mg/dL)and 3-4days(111.0+-32.39mg/dL), were significantly higher than pretreatment values(66.33+/-31.19mg/ dL)(p<0.02), but were not increased to the level of hyperglycemia(> 125mg/dL). 3) The mean posttreatment glucose levels drawn at 48hours after discontinuation of theophylline was significantly decreased to the values of pretreatment values compared to those of the 1-2days and 3-4days(p<0.01). 4) Insulin concentrations were also increased insignificantly when blood glucose were increased in the treatment group compared with control group. CONCLUSION: In conclusion, intravenous administration of theophylline produces hyperglycemia significantly, including an increase in a serum insulin. But, clinically significant hyperglycemia(> 125mg/dL) was not noted. So, plasma glucose may not need to be monitored in preterm apneic infants receiving theophylline. But, further studies are need to elucidate the effect of theophylline considering the serum toxic level of theophylline.
Administration, Intravenous ; Aminophylline ; Apnea* ; Blood Glucose* ; Bradycardia ; Glucose ; Homeostasis ; Humans ; Hyperglycemia ; Infant ; Infant, Newborn ; Infant, Premature* ; Insulin* ; Intensive Care, Neonatal ; Plasma* ; Prospective Studies ; Theophylline

OBJECTIVETo observe the role of theophylline in relieving airway symptoms and inflammation in patients with mild asthma.

METHODSFifty-six patients with mild asthma were randomly divided into treatment group (n=41) receiving oral theophylline at daily dose of 4 to 6 mg/kg for 16 weeks and control group (15 cases) without medication other than beta2 antagonist, which was administered when necessary in both groups. Peripheral blood T-lymphocyte subsets (CD3(+), CD4(+), and CD8(+)) and pulmonary function (PEF(am) and PD(20)) before and at 8 and 16 weeks during treatment were measured.

RESULTSSignificant difference was observed in CD3+ and CD4(+) T-lymphocyte subsets after medication with theophylline (P<0.05) in the patients, and PEF(am) and PD(20) were also significantly different from those of the control group (P<0.05). Theophylline significantly improved the clinical symptom scores (P<0.05) and decreased the asthma attacks.

CONCLUSIONLow-dose oral theophylline may significantly relieving airway inflammation in patients with mild asthma.

Administration, Oral ; Adult ; Asthma ; drug therapy ; immunology ; physiopathology ; Bronchodilator Agents ; administration & dosage ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Respiratory Function Tests ; T-Lymphocyte Subsets ; drug effects ; immunology ; Theophylline ; administration & dosage ; therapeutic use ; Treatment Outcome

PURPOSE: Low-dose theophylline has anti-inflammatory effects. The aim of this study was to evaluate the effects of adding theophylline compared with increasing the dose of inhaled corticosteroid (ICS) on symptomatic asthma. MATERIALS AND METHODS: The associated literature was acquired through deliberate searching and selected based on the established inclusion criteria for publications. The extracted data were further analyzed by a meta-analysis RESULTS: Four randomized, controlled, parallel studies were selected. Addition of theophylline produced a greater increase of forced expiratory volume in one second as %predicted (FEV1pred) by 2.49% [95% confidence interval (CI) 1.99-3.00; z = 9.70; p < 0.001], compared with increasing the dose of ICS. There was no difference between the two treatments in terms of peak expiratory flow (PEF). CONCLUSION: Addition of theophylline to ICS has similar therapeutic effects on improving lung function as increasing the dose of ICS in the treatment of symptomatic asthma.
Adrenal Cortex Hormones/administration & dosage/*therapeutic use ; Anti-Asthmatic Agents/administration & dosage/*therapeutic use ; Asthma/*drug therapy ; Forced Expiratory Volume/drug effects ; Humans ; Randomized Controlled Trials as Topic ; Theophylline/*therapeutic use ; Treatment Outcome

Metabolic and electrolyte abnormalities, including hypokalemia, hyperglycemia and lactic acidosis, are associated with theophylline overdose. However, we report an unusual case of sinus tachycardia, lactic acidosis, hypokalemia and hyperglycemia associated with the usual theophylline dose in a patient with asthma. The theophylline dose was 200 mg orally twice daily. Three hours after administration of the third dose, the patient experienced palpitation. An electrocardiogram showed a sinus tachycardia. Arterial blood gas analysis revealed a mixed metabolic acidosis and respiratory alkalosis. Serum lactate level was 51 mmol/L (normal 0.7~2.1 mmol/L). Biochemistry results were sodium 136 mEq/L, chloride 99 mEq/L, potassium 1.9 mEq/L and glucose 204 mg/dL. Our case suggests that a possibility of theophylline-associated metabolic abnormalities should be considered when an asthmatic patient given the usual theophylline dose presents with lactic acidosis, hypokalemia and hyperglycemia of unknown etiology.
Acidosis, Lactic/*chemically induced ; Adult ; Asthma/drug therapy ; Bronchodilator Agents/administration & dosage/*adverse effects ; Case Report ; Female ; Human ; Hyperglycemia/chemically induced ; Hypokalemia/etiology ; Tachycardia, Sinus/chemically induced ; Theophylline/administration & dosage/*adverse effects

Acute Disease ; Asthma ; drug therapy ; Bronchodilator Agents ; administration & dosage ; adverse effects ; therapeutic use ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infusions, Intravenous ; Male ; Theophylline ; administration & dosage ; adverse effects ; analogs & derivatives ; therapeutic use ; Treatment Outcome

OBJECTIVETo evaluate the effect of traditional Chinese medicine preparations on bronchial hyperesponsiness (BHR)-induced cough.

METHODSixty patients with cough due to BHR (shown by positive bronchial provocation test) were randomly divided into Chinese medicine group (n = 30) and control group (n = 30) to receive Bufeishenqingre decoction twice a day and 100 mg theophylline sustained-release capsules twice a day for one month, respectively. The changes of the clinical symptoms were observed during the treatment and bronchial infrared imaging was performed before and after the treatment.

RESULTSThe symptoms of patients in the Chinese medicine group were more effectively alleviated than those of the control group (P < 0.05). The difference in the temperature between the bronchial lesions and the surrounding normal mucosa changed more obviously in the Chinese medicine group (P < 0.01).

CONCLUSIONBufeishenqingre decoction can relieve the symptoms and improve the abnormalities in infrared imaging of patients with BHR-induced cough.

Adult ; Bronchial Hyperreactivity ; complications ; drug therapy ; Bronchial Provocation Tests ; Bronchodilator Agents ; administration & dosage ; Cough ; drug therapy ; etiology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Theophylline ; administration & dosage ; Young Adult

Administration, Inhalation ; Adrenal Cortex Hormones ; pharmacology ; Asthma ; drug therapy ; metabolism ; Child ; Child, Preschool ; Drug Interactions ; Drug-Related Side Effects and Adverse Reactions ; Female ; Humans ; Male ; Theophylline ; pharmacokinetics ; pharmacology ; Treatment Outcome

To study the metabolite excretion of theophylline, a rapid and specific method by liquid chromatography with heated electrospray ionization tandem mass spectrometry (LC-HESI/MS/MS) method for simultaneous determination of theophylline, 1, 3-dimethyluric acid (1,3-DMU), 3-methylxanthine (3-MX) and 1-methyluric acid (1-MU) in human urine was developed using theophylline-d6 and 5-fluorouracil as internal standards. Selected reaction monitoring (SRM) with heated electrospray ionization (HESI) was used in the negative mode for mass spectrometric detection. After diluted with methanol and centrifuged, the analytes and ISs were separated on a XDB-Phenyl (150 mm x 4.6 mm, 5 microm) column with a mixture of water-methanol-formic acid (30 : 70 : 0.15) as mobile phase at a flow rate of 0.6 mL x min(-1). The linear calibration curves for theophylline, 1, 3-DMU, 3-MX and 1-MU were obtained in the concentration range of 1.0-250 microg x mL(-1), separately. The method herein described is effective and convenient, and can be used for determination of theophylline and its three metabolites. The results showed that urinary excretion ratio of theophylline, 1,3-DMU, 3-MX and 1-MU is approximately 1 : 3 : 1 : 2 in Chinese subjects, which is similar to the reported excretion pattern in Caucasian.
Administration, Oral ; Asian Continental Ancestry Group ; Calibration ; Chromatography, Liquid ; Delayed-Action Preparations ; metabolism ; Healthy Volunteers ; Humans ; Spectrometry, Mass, Electrospray Ionization ; Tablets ; Tandem Mass Spectrometry ; Theophylline ; metabolism ; urine ; Uric Acid ; analogs & derivatives ; urine ; Xanthines ; urine