| Description |
Theophylline and its derivatives currently occupy a central role in the management of asthma and other forms of chronic obstructive lung disease. Unfortunately, theophylline has a relatively narrow therapeutic index. Inadequate bronchodilation is frequent with serum concenstrations less than 10 mcg/ml, whereas toxicity is often apparent with concentrations greater than 20 mcg/ml. A variety of toxic reactions, including gastrointestinal disturbances, cardiac arrhythmias, and central nervous system alterations occur with increasing frequency as serum concentrations rise progressively above 20 mcg/ml. In recent years, a number of factors have been shown to significantly alter plasma clearance and thereby alter theophylline serums concentrations. A limited number of studies and observations have suggested that macrolide antibiotics can also affect the serum concentrations of theophylline in patients on chronic theophylline therapy. Weinberger, et al in 1977 found a mean decrease in theophylline clearance of 50 percent during administration of troleandomycin. However, the studies reporting changes in theophylline disposition during administration of the macrolide antibiotic erythromycine, are of more clinical relevance since erythromicin , not troleandomycin , is commonly used at the present time for treatment of various infections. The purpose of this project was to conduct a controlled, prospective study to document whether there is significant change in the serum concentration of theophylline after erythromycin challenge in elderly patients with chronic obstructive lung disease. |
