Chest

Chest

Volume 95, Issue 5, May 1989, Pages 1028-1032
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Theophylline Disposition in Patients with COLD with and without Hypoxemia

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This study aimed to assess the effect of hypoxemia on theophylline disposition. Ten patients with a mean (± SEM) of 58 ± 3 years with COLD (PaO2 55 ± 1 mm Hg, PaCO2 46 ± 2 mm Hg, and pH of 7.39 ± 0.01) were hospitalized to have oxygen therapy. Before starting O2, they received intravenously, 4 mg/kg of theophylline over a 20-minute period; blood samples and urine were collected for six hours. The results suggested that hypoxia does not influence the disposition of theophylline or its metabolites.

Section snippets

Subjects

The selection of the patients was based on the following two criteria: (1) hypoxic patients requiring oxygen therapy; and (2) patients presenting no obvious cause, other than the disease itself, able to alter theophylline disposition. Ten patients (nine men and one woman) with COLD were selected for the study. Special care was taken to exclude patients older than 70 years old, or patients with cor pulmonale, congestive heart failure or hepatic disease. None of the patients exhibited acute

RESULTS

As shown in Table 1, patients presented severe hypoxia and a mild hypercapnia secondary to obstructive lung disease. These showed considerable reduction in both the FEV1 and the FVC, as well as in the FEV1/FVC percentage. After 48 hours of oxygen therapy, PaO2 increased significantly, while PaCO2 increased only slightly and the indices of ventilatory function showed no change at all.

Theophylline plasma concentrations showed a similar pattern before and after oxygen therapy in all subjects,

DISCUSSION

The results of this study showed that prior to oxygen therapy, theophylline clearance in our patients was not lower than that reported in healthy volunteers.27 The average value of theophylline clearance was not significantly decreased if the three exsmokers were excluded, eg, C1T = 0.90 ± 0.11 ml/min/kg. On the other hand, after oxygen therapy, the changes in PaO2 in our patients with COLD did not significantly alter the apparent systemic clearance of theophylline, and that was also true when

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    Supported by the Medical Research Council of Canada (grant MA-7834).

    Manuscript received July 6; revision accepted September 21.

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    Copyright © 1989 The American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.