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Intravenous Aminophylline in Patients With Cystic Fibrosis: Pharmacokinetics and Effect on Pulmonary Function

Intravenous Aminophylline in Patients With Cystic Fibrosis: Pharmacokinetics and Effect on... Abstract • Intravenous aminophylline was administered to ten patients with cystic fibrosis (CF) to determine if the medication would improve pulmonary function and to study theophylline pharmacokinetics. Intravenous normal saline was given on another day as a control. Thoracic gas volume and airway resistance, measured in a volume displacement body plethysmograph, and maximal expiratory flow-volume curves were performed before and after each infusion. No significant improvement was noted in pulmonary function after normal saline infusion. Following aminophylline infusion, significant improvement in thoracic gas volume, residual volume, specific airway conductance, and maximal expiratory flow at 60% of total lung capacity was noted. The pharmacokinetic analysis revealed a mean half-life of 4.7 hours, a total clearance of 91 mL/hr/kg, and a volume of distribution of 574 mL/kg. Intravenous aminophylline can acutely decrease airway obstruction in children with CF. (Am J Dis Child 134:1143-1148, 1980) References 1. Shapiro GG, Bamman J, Kanarek P, et al: The paradoxical effect of adrenergic and methylxanthine drugs in cystic fibrosis . Pediatrics 58:740-743, 1976. 2. Taussig LM, Kattwinkel J, Friedewald WT, et al: A new prognostic score and clinical evaluation system for cystic fibrosis. J Pediatr 82:380-390, 1973.Crossref 3. Barron R, Cotton E, Larsen G, et al: The prevalence of atopy in cystic fibrosis, abstracted . Am Rev Respir Dis 115 (pt (2) ):275, 1977. 4. Mead J: Volume displacement body plethysmograph for respiratory measurements in human subjects . J Appl Physiol 15:736-740, 1960. 5. DuBois AB, Botelho SY, Bedell GN, et al: A rapid plethysmographic method for measuring thoracic gas volume: A comparison with nitrogen washout method for measuring functional residual capacity in normal subjects . J Clin Invest 35:322-326, 1956.Crossref 6. DuBois AB, Botelho SY, Comroe JH: A new method for measuring airway resistance in man using a body plethysmograph: Values in normal subjects and patients with respiratory disease . J Clin Invest 35:327-335, 1956.Crossref 7. Polgar G, Promadhat V: Pulmonary Function Testing in Children: Techniques and Standards . Philadelphia, WB Saunders Co, 1971, chap 5 . 8. Weng TR, Levison H: Standards of pulmonary function in children . Am Rev Respir Dis 99:879-894, 1969. 9. DeMuth GR, Howatt WF, Hill B: V. Forced flow rates . Pediatrics 35:200-210, 1965. 10. Zapletal A, Motoyama EK, van de Woestijne KP, et al: Maximum expiratory flow-volume curves and airway conductance in children and adolescents . J Appl Physiol 26:308-316, 1969. 11. Steel RGD, Torrie JH: Principles and Procedures of Statistics . New York, McGraw-Hill Book Co, 1960, chap 7 , 21. 12. Weddle OH, Mason WD: Rapid determination of theophylline in human plasma by high-pressure liquid chromatography . J Pharm Sci 65:865-868, 1976.Crossref 13. Smolen VF: Theoretical and computational basis for drug bioavailability determinations using pharmacological data: I. General considerations and procedures . J Pharmacokinet Biopharm 4:337-353, 1976.Crossref 14. Szasz G: A kinetic photometric method for serum γ-glutamyl transpeptidase . Clin Chem 15:124-136, 1969. 15. Henry RJ, Chiamori N, Golub OJ, et al: Revised spectrophotometric methods for determination of glutamic-oxaloacetic transaminase, glutamic-pyruvic transaminase, and lactic dehydrogenase . Am J Clin Pathol 34:381-398, 1960. 16. West JR, Levin SM, di Sant'Agnese PA: Pulmonary function in cystic fibrosis of the pancreas . Pediatrics 13:155-164, 1954. 17. Gandevia B, Anderson C: The effect of a bronchodilator aerosol on ventilatory capacity in fibrocystic disease of the pancreas . Arch Dis Child 34:511-515, 1959.Crossref 18. Mellins RB, Levine OR, Ingram RH, et al: Obstructive disease of the airways in cystic fibrosis . Pediatrics 41:560-573, 1968. 19. Mearns MB: Simple tests of ventilatory capacity in children with cystic fibrosis . Arch Dis Child 43:528-539, 1968.Crossref 20. Lifshitz MI, Denning CR: Assessment of bronchospasm in patients with cystic fibrosis . Am Rev Respir Dis 99:399-405, 1969. 21. Phelan PD, Gracey M, Williams HE, et al: Ventilatory function in infants with cystic fibrosis . Arch Dis Child 44:393-400, 1969.Crossref 22. Featherby EA, Weng T, Levison H: The effect of isoproterenol on airway obstruction in cystic fibrosis . Can Med Assoc J 102:835-838, 1970. 23. Zapletal A, Motoyama EK, Gibson LE, et al: Pulmonary mechanics in asthma and cystic fibrosis . Pediatrics 48:64-72, 1971. 24. Chang N, Levison H: The effect of a nebulized bronchodilator administered with and without intermittent positive pressure breathing on ventilatory function in children with cystic fibrosis and asthma . Am Rev Respir Dis 106:867-872, 1972. 25. Landau LI, Phelan PD: The variable effect of a bronchodilating agent on pulmonary function in cystic fibrosis . J Pediatr 82:863-868, 1973.Crossref 26. Larsen GL, Barron RJ, Cotton EK, et al: A comparative study of atropine sulfate and isoproterenol hydrochloride in cystic fibrosis . Am Rev Respir Dis 119:399-407, 1979. 27. Cooper DM, Doron I, Mansell AL, et al: The relative sensitivity of closing volume in children with asthma and cystic fibrosis . Am Rev Respir Dis 109:519-524, 1974. 28. Woolcock AJ, Read J: Improvement in bronchial asthma not reflected in forced expiratory volume . Lancet 2:1323-1325, 1965.Crossref 29. Benatar SR, Konig P: Maximal expiratory flow and lung volume changes associated with exercise-induced asthma in children and the effect of breathing a low-density gas mixture . Clin Sci Mol Med 46:317-329, 1974. 30. Ramsdell JW, Tisi GM: Determination of bronchodilation in the clinical pulmonary function laboratory: Role of change in static lung volumes . Chest 76:622-628, 1979.Crossref 31. Allan JD, Moss AD, Wallwork JC, et al: Immediate hypersensitivity in patients with cystic fibrosis . Clin Allergy 5:255-261, 1975.Crossref 32. Warner JO, Taylor BW, Norman AP, et al: Association of cystic fibrosis with allergy . Arch Dis Child 51:507-511, 1976.Crossref 33. Mellis CM, Levison H: Bronchial reactivity in cystic fibrosis . Pediatrics 61:446-450, 1978. 34. Mitchell I, Corey M, Woenne R, et al: Bronchial hyperreactivity in cystic fibrosis and asthma . J Pediatr 93:744-748, 1978.Crossref 35. Nelson LA, Callerame ML, Schwartz RH: Aspergillosis and atopy in cystic fibrosis . Am Rev Respir Dis 120:863-873, 1979. 36. Piafsky KM, Ogilvie RI: Dosage of theophylline in bronchial asthma . N Engl J Med 292:1218-1222, 1975.Crossref 37. Maselli R, Casal GL, Ellis EF: Pharmacologic effects of intravenously administered aminophylline in asthmatic children . J Pediatr 76:777-782, 1970.Crossref 38. Ellis EF, Koysooko R, Levy G: Pharmacokinetics of theophylline in children with asthma . Pediatrics 58:542-547, 1976. 39. Gal P, Jusko WH, Yurchak AM, et al: Theophylline deposition in obesity . Clin Pharmacol Ther 23:438-444, 1978. 40. Kattwinkel J, Taussig LM, Statland BE, et al: The effects of age on alkaline phosphatase and other serologic liver function tests in normal subjects and patients with cystic fibrosis . J Pediatr 82:234-242, 1973.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Intravenous Aminophylline in Patients With Cystic Fibrosis: Pharmacokinetics and Effect on Pulmonary Function

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References (42)

Publisher
American Medical Association
Copyright
Copyright © 1980 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1980.02130240027009
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Abstract

Abstract • Intravenous aminophylline was administered to ten patients with cystic fibrosis (CF) to determine if the medication would improve pulmonary function and to study theophylline pharmacokinetics. Intravenous normal saline was given on another day as a control. Thoracic gas volume and airway resistance, measured in a volume displacement body plethysmograph, and maximal expiratory flow-volume curves were performed before and after each infusion. No significant improvement was noted in pulmonary function after normal saline infusion. Following aminophylline infusion, significant improvement in thoracic gas volume, residual volume, specific airway conductance, and maximal expiratory flow at 60% of total lung capacity was noted. The pharmacokinetic analysis revealed a mean half-life of 4.7 hours, a total clearance of 91 mL/hr/kg, and a volume of distribution of 574 mL/kg. Intravenous aminophylline can acutely decrease airway obstruction in children with CF. (Am J Dis Child 134:1143-1148, 1980) References 1. Shapiro GG, Bamman J, Kanarek P, et al: The paradoxical effect of adrenergic and methylxanthine drugs in cystic fibrosis . Pediatrics 58:740-743, 1976. 2. Taussig LM, Kattwinkel J, Friedewald WT, et al: A new prognostic score and clinical evaluation system for cystic fibrosis. J Pediatr 82:380-390, 1973.Crossref 3. Barron R, Cotton E, Larsen G, et al: The prevalence of atopy in cystic fibrosis, abstracted . Am Rev Respir Dis 115 (pt (2) ):275, 1977. 4. Mead J: Volume displacement body plethysmograph for respiratory measurements in human subjects . J Appl Physiol 15:736-740, 1960. 5. DuBois AB, Botelho SY, Bedell GN, et al: A rapid plethysmographic method for measuring thoracic gas volume: A comparison with nitrogen washout method for measuring functional residual capacity in normal subjects . J Clin Invest 35:322-326, 1956.Crossref 6. DuBois AB, Botelho SY, Comroe JH: A new method for measuring airway resistance in man using a body plethysmograph: Values in normal subjects and patients with respiratory disease . J Clin Invest 35:327-335, 1956.Crossref 7. Polgar G, Promadhat V: Pulmonary Function Testing in Children: Techniques and Standards . Philadelphia, WB Saunders Co, 1971, chap 5 . 8. Weng TR, Levison H: Standards of pulmonary function in children . Am Rev Respir Dis 99:879-894, 1969. 9. DeMuth GR, Howatt WF, Hill B: V. Forced flow rates . Pediatrics 35:200-210, 1965. 10. Zapletal A, Motoyama EK, van de Woestijne KP, et al: Maximum expiratory flow-volume curves and airway conductance in children and adolescents . J Appl Physiol 26:308-316, 1969. 11. Steel RGD, Torrie JH: Principles and Procedures of Statistics . New York, McGraw-Hill Book Co, 1960, chap 7 , 21. 12. Weddle OH, Mason WD: Rapid determination of theophylline in human plasma by high-pressure liquid chromatography . J Pharm Sci 65:865-868, 1976.Crossref 13. Smolen VF: Theoretical and computational basis for drug bioavailability determinations using pharmacological data: I. General considerations and procedures . J Pharmacokinet Biopharm 4:337-353, 1976.Crossref 14. Szasz G: A kinetic photometric method for serum γ-glutamyl transpeptidase . Clin Chem 15:124-136, 1969. 15. Henry RJ, Chiamori N, Golub OJ, et al: Revised spectrophotometric methods for determination of glutamic-oxaloacetic transaminase, glutamic-pyruvic transaminase, and lactic dehydrogenase . Am J Clin Pathol 34:381-398, 1960. 16. West JR, Levin SM, di Sant'Agnese PA: Pulmonary function in cystic fibrosis of the pancreas . Pediatrics 13:155-164, 1954. 17. Gandevia B, Anderson C: The effect of a bronchodilator aerosol on ventilatory capacity in fibrocystic disease of the pancreas . Arch Dis Child 34:511-515, 1959.Crossref 18. Mellins RB, Levine OR, Ingram RH, et al: Obstructive disease of the airways in cystic fibrosis . Pediatrics 41:560-573, 1968. 19. Mearns MB: Simple tests of ventilatory capacity in children with cystic fibrosis . Arch Dis Child 43:528-539, 1968.Crossref 20. Lifshitz MI, Denning CR: Assessment of bronchospasm in patients with cystic fibrosis . Am Rev Respir Dis 99:399-405, 1969. 21. Phelan PD, Gracey M, Williams HE, et al: Ventilatory function in infants with cystic fibrosis . Arch Dis Child 44:393-400, 1969.Crossref 22. Featherby EA, Weng T, Levison H: The effect of isoproterenol on airway obstruction in cystic fibrosis . Can Med Assoc J 102:835-838, 1970. 23. Zapletal A, Motoyama EK, Gibson LE, et al: Pulmonary mechanics in asthma and cystic fibrosis . Pediatrics 48:64-72, 1971. 24. Chang N, Levison H: The effect of a nebulized bronchodilator administered with and without intermittent positive pressure breathing on ventilatory function in children with cystic fibrosis and asthma . Am Rev Respir Dis 106:867-872, 1972. 25. Landau LI, Phelan PD: The variable effect of a bronchodilating agent on pulmonary function in cystic fibrosis . J Pediatr 82:863-868, 1973.Crossref 26. Larsen GL, Barron RJ, Cotton EK, et al: A comparative study of atropine sulfate and isoproterenol hydrochloride in cystic fibrosis . Am Rev Respir Dis 119:399-407, 1979. 27. Cooper DM, Doron I, Mansell AL, et al: The relative sensitivity of closing volume in children with asthma and cystic fibrosis . Am Rev Respir Dis 109:519-524, 1974. 28. Woolcock AJ, Read J: Improvement in bronchial asthma not reflected in forced expiratory volume . Lancet 2:1323-1325, 1965.Crossref 29. Benatar SR, Konig P: Maximal expiratory flow and lung volume changes associated with exercise-induced asthma in children and the effect of breathing a low-density gas mixture . Clin Sci Mol Med 46:317-329, 1974. 30. Ramsdell JW, Tisi GM: Determination of bronchodilation in the clinical pulmonary function laboratory: Role of change in static lung volumes . Chest 76:622-628, 1979.Crossref 31. Allan JD, Moss AD, Wallwork JC, et al: Immediate hypersensitivity in patients with cystic fibrosis . Clin Allergy 5:255-261, 1975.Crossref 32. Warner JO, Taylor BW, Norman AP, et al: Association of cystic fibrosis with allergy . Arch Dis Child 51:507-511, 1976.Crossref 33. Mellis CM, Levison H: Bronchial reactivity in cystic fibrosis . Pediatrics 61:446-450, 1978. 34. Mitchell I, Corey M, Woenne R, et al: Bronchial hyperreactivity in cystic fibrosis and asthma . J Pediatr 93:744-748, 1978.Crossref 35. Nelson LA, Callerame ML, Schwartz RH: Aspergillosis and atopy in cystic fibrosis . Am Rev Respir Dis 120:863-873, 1979. 36. Piafsky KM, Ogilvie RI: Dosage of theophylline in bronchial asthma . N Engl J Med 292:1218-1222, 1975.Crossref 37. Maselli R, Casal GL, Ellis EF: Pharmacologic effects of intravenously administered aminophylline in asthmatic children . J Pediatr 76:777-782, 1970.Crossref 38. Ellis EF, Koysooko R, Levy G: Pharmacokinetics of theophylline in children with asthma . Pediatrics 58:542-547, 1976. 39. Gal P, Jusko WH, Yurchak AM, et al: Theophylline deposition in obesity . Clin Pharmacol Ther 23:438-444, 1978. 40. Kattwinkel J, Taussig LM, Statland BE, et al: The effects of age on alkaline phosphatase and other serologic liver function tests in normal subjects and patients with cystic fibrosis . J Pediatr 82:234-242, 1973.Crossref

Journal

American Journal of Diseases of Children – American Medical Association

Published: Dec 1, 1980

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