Therapeutic theophylline levels in acute exacerbations of chronic obstructive pulmonary disease

INTRODUCTION

For the clinical effectivity of theophylline it is required to reach therapeutic levels. It was aimed to reveal serum theophylline level and effective intravenous (iv) döşe during acute attack in patients with chronic obstructive pulmonary disease (COPD).

METHODS

Patients with acute attack of COPD were classified to two groups according to the theophylline dose used (400 mg/day in Group 1, 600 mg/day in Group 2). Serum theophylline levels were measured at 0, 6, 12, 24, 72 hours. Subtherapeutic level was measured at emergency unit admission.

RESULTS

30 in both groups, totally 60 patients were included in the study. Subtherapeutic serum theophylline levels at acute attack when the limit was accepted as 8 μg/ml; were 60% in Group 1 and 57% in Group 2, 38% and 57% respectively, for 5 μg/ml. When the subtherapeutic level was accepted as 8 μg/ml; serum theophylline levels were 60% subtherapeutic, 34% therapeutic and 6% toxic. In Group 2, serum theophylline levels at hour 0, were 57% subtherapeutic, 40% therapeutic and 3% toxic.

Serum theophylline level at hour 6 was 10,48 μg/ml in Group 1 and 12,06 μg/ml in Group 2 (p=0.000). As serum theophylline levels significantly increase between hours 0 and 6 in Group 1, there was no difference for hours 12, 24, 72. A significant increase was detected between hours 0 and 6, 12, 24, 72. There was no difference between toxic levels of two groups after iv theophylline.

DISCUSSION AND CONCLUSION

Intravenous theophylline is effective with 600 mg/day dose in patients with COPD admitted to hospital because of an acute attack. Serum theophylline levels should routinely be controlled in order to avoid toxic effects in long-term use.