Clinafloxacin-Theophylline Drug Interaction

1995 ◽  
Vol 29 (4) ◽  
pp. 378-380 ◽  
Author(s):  
Paul R Matuschka ◽  
Richard S Vissing
Keyword(s):  
Drug Interaction ◽  
Pharmacokinetic Interaction ◽  
Hepatic Metabolism ◽  
Chronic Obstructive ◽  
Serum Concentrations ◽  
Theophylline Concentration ◽  
Serum Theophylline Concentration ◽  
Serum Theophylline ◽  
Obstructive Pulmonary Disease ◽  
The Right

Objective: To report an apparent pharmacokinetic interaction between clinafloxacin and theophylline in a patient with chronic obstructive pulmonary disease (COPD). Case Summary: A patient with a history of COPD was admitted for a fracture of the right femoral neck. Admission medications included extended-release theophylline 400 mg bid. The initial serum theophylline concentration was 81.03 µmol/L (normal 55—110). A subsequent concentration was subtherapeutic (46.62 µmol/L) and the theophylline dosage was increased to 300 mg tid. Therapeutic steady-state concentrations were achieved. The patient later developed pneumonia and was enrolled in a study of nosocomial acquired pneumonia involving clinafloxacin versus ceftazidime. He was randomized to receive clinafloxacin 200 mg iv ql2h. After clinafloxacin therapy was initiated, the serum theophylline concentration increased into the toxic range (155.96 µmol/L). Theophylline administration was held for 2 doses and the dosage then reduced to 200 mg tid. Serum concentrations decreased to within the therapeutic range. Discussion: The fluoroquinolones have been shown to interact with the hepatic metabolism of theophylline and increase serum theophylline concentrations. The quinolone metabolite, 4-oxo-quinolone, inhibits the N-demethylation of theophylline, leading to a decrease in the clearance of theophylline. The resultant rise in theophylline concentrations corresponds with the decrease in clearance and possible toxicity. In our patient, careful monitoring of theophylline concentrations and dosage adjustments resulted in the restoration of therapeutic serum concentrations. Conclusions: The observation of this drug interaction between clinafloxacin and theophylline suggests a need for prudent monitoring of theophylline concentrations. Dosage adjustments may be warranted when this combination of medications is used. Such action may prevent significant toxicities and prolonged hospitalization. Further controlled clinical trials in healthy volunteers are needed to substantiate the interaction between clinafloxacin and theophylline.

Dose-Dependent Theophylline Elimination in an Adult

1983 ◽  
Vol 17 (3) ◽  
pp. 202-204 ◽  
Author(s):  
Richard J. Creger ◽  
William D. Ball ◽  
Michael F. Bahntge
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Infusion Rate ◽  
Chronic Obstructive ◽  
Serum Concentrations ◽  
Theophylline Clearance ◽  
Elimination Kinetics ◽  
Serum Theophylline ◽  
Obstructive Pulmonary Disease ◽  
Steady State Serum ◽  
Dose Dependent

A 69-year-old male patient with chronic obstructive pulmonary disease exhibited dose-dependent theophylline elimination. Steady-state serum theophylline concentrations, obtained at five different aminophylline infusion rates, ranged from 2.0 mg/L at an infusion rate of 36 mg/h to 10.1 mg/L at 76 mg/h. These serum concentrations were nonlinearly related to dose, with a Vmax of 89.04 mg/h and Km of 3.96 mg/L (r = 0.983, p < 0.005). Theophylline clearance fell from a high of 348 ml/kg/h to 145 ml/kg/h as the infusion rate was increased. Although theophylline elimination kinetics in adults are generally assumed to be linear, clinicians should be alert to the possibility of nonlinear theophylline elimination, as has been observed commonly in children.

Investigation of a Dosage Regimen for Intravenous Theophylline

1982 ◽  
Vol 16 (4) ◽  
pp. 301-305 ◽  
Author(s):  
Marshall C. Hughey ◽  
Richard L. Yost ◽  
J. Daniel Robinson ◽  
Eloise M. Harman
Keyword(s):  
Dosage Regimen ◽  
Serum Concentrations ◽  
Theophylline Concentration ◽  
Serum Theophylline Concentration ◽  
Serum Theophylline ◽  
Dosage Guidelines ◽  
The Mean

A study was designed to evaluate the validity of the dosage guidelines for theophylline recommended by Hendeles and Weinberger. A total of seven asthmatic smokers and non-smokers were entered and studied. Theophylline serum concentrations were determined prior to the start of therapy and at intervals following initiation of an infusion. The mean theophylline concentration attained for all subjects was 10 μg/ml, however, five of the six patients completing the study did not achieve the predicted serum theophylline concentration. Further study of higher dosage designed to achieve a concentration of 12 μg/ml is suggested.

Prevention of Apnea and Bradycardia in Low-Birthweight Infants

PEDIATRICS ◽  
1975 ◽  
Vol 55 (5) ◽  
pp. 589-594
Author(s):  
Daniel C. Shannon ◽  
Felicita Gotay ◽  
Israel M. Stein ◽  
Mark C. Rogers ◽  
I. David Todres ◽  
...  
Keyword(s):  
Low Birthweight ◽  
Serum Levels ◽  
Serum Concentrations ◽  
Theophylline Concentration ◽  
Serum Theophylline Concentration ◽  
Serum Theophylline ◽  
Recording Technique ◽  
Alarm Systems ◽  
On Line ◽  
Oral Doses

The efficacy of theophylline in preventing severe apnea was evaluated in 17 low-birthweight infants (mean weight, 1,400 gm). Apnea was detected and accurately quantified by 13-hour pneumogram recordings and correlated with serum theophylline levels. Nursing observations coupled with on-line alarm systems detected only 39% of severe apneic episodes as compared to the pneumogram recording technique. Theophylline in six hourly oral doses (1.5 to 4.0 mg/kg) yielded two-hour serum concentrations of 6.6 to 11.Oµg/ml which completely controlled apneic spells exceeding 20 seconds in duration and markedly reduced 10- 19-second apneic episodes and any resultant bradycardia. At these serum levels, toxicity was not observed. Therapy with theophylline should be instituted at a dose of 2 to 3 mg/kg every six hours and the optimum therapeutic dose should be individualized as determined by objective quantitation of apnea and serum theophylline concentration.

Management of Asthma—A Correction

PEDIATRICS ◽  
1982 ◽  
Vol 69 (5) ◽  
pp. 663-663
Author(s):  
Miles Weinberger
Keyword(s):  
Side Effects ◽  
Term Therapy ◽  
Serum Concentrations ◽  
Theophylline Concentration ◽  
Serum Theophylline Concentration ◽  
Short Term ◽  
Serum Theophylline ◽  
Short Term Therapy ◽  
Higher Doses ◽  
Optimal Effect

In the paper "Management of Asthma," table 1 presents the theophylline dose for short-term therapy of acute symptoms when serum concentrations will not be monitored.1 The data from which these recommendations were derived have subsequently been published.2 Unfortunately, it is now apparent that there is an error in the data of table 1. Safer dosage recommendations are presented in the Table. As stated in "Management of Asthma," even these doses may cause minor side effects in some patients, and higher doses may be needed for optimal effect in others but should be guided by measurement of serum theophylline concentration.

CONDITION OF HEMODYNAMICS IN THE PULMONARY CIRCULATION OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) CONCURRENT WITH METABOLIC SYNDROME WITH HYPERTROPHY AND ATROPHY OF THE MYOCARDIUM

2019 ◽  
Vol 72 (8) ◽  
pp. 1491-1493
Author(s):  
Viktor P. Boriak ◽  
Svitlana V. Shut’ ◽  
Tetiana A. Trybrat ◽  
Olena V. Filatova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Metabolic Syndrome ◽  
Right Ventricular ◽  
Pulmonary Disease ◽  
Pulmonary Circulation ◽  
Contractile Function ◽  
Ventricular Myocardium ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The Right

Introduction: In recent years, COPD is observed as not an isolated, but an associated pathology, in particular, concurrent with metabolic syndrome. The aim of the research is to identify the differences in changes of the rheopulmonography parameters (RPG) depending on the presence of hypertrophy or atrophy of the right ventricular myocardium in patients with COPD concurrent with metabolic syndrome.. Materials and methods: We studied changes in rheopulmonography (RPG) in 145 patients with chronic obstructive pulmonary disease (COPD) concurrent with metabolic syndrome. Results: We detected precapillary hypertension of the pulmonary circulation in patients with right ventricular myocardial hypertrophy: anacrotism serration; flattened peak of the systolic wave; decreased Vcp; high placement of incisura; horizontal course of catacrotism; decreased amplitude of the systolic wave (in this case, due to a greater increase in the resistance of the blood flow in the pulmonary vessels than the decreased impact volume of the right ventricle); prolonged Q-a (in this group of patients, it depends more on hypertension of the pulmonary circulation than on the reduction of contractile function of the myocardium). In atrophy of the right ventricular myocardium, the following changes in the RPG were revealed: decreased systolic wave at its dramatic rise; prolonged Q-a (in this case, due to the weakened heart contraction); Vmax reduction (it reflects the reduction of myocardial contractility); in hypertrophy of the myocardium, Vcp., unlike RPG, does not decrease, which is explained by the decrease in the pressure of the pulmonary circulation. Conclusions: We believe that these changes in RPG allow differentiating hypertrophy and right ventricular myocardial atrophy along with established diagnostic criteria, and can be used as markers for the diagnosis and treatment of COPD concurrent with metabolic syndrome.

The state of the cardiovascular system in occupational bronchitis and chronic obstructive pulmonary disease, not associated with the impact of harmful industrial factors

2021 ◽  
pp. 55-68
Author(s):  
Vyacheslav S. Lotkov ◽  
Anton Vladimirovich Glazistov ◽  
Antonina G. Baykova ◽  
Marina Yuryevna Vostroknutova ◽  
Natalia E. Lavrentieva
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cardiovascular System ◽  
Pulmonary Disease ◽  
Lung Diseases ◽  
Chronic Obstructive ◽  
External Respiration ◽  
Obstructive Pulmonary Disease ◽  
Occupational Lung Diseases ◽  
The Right ◽  
The Impact

The formation and progression of chronic dust bronchitis and chronic bronchitis of toxic-chemical etiology, chronic obstructive pulmonary disease is accompanied by an increase in the degree of ventilation disorders, echocardiographic signs of hypertrophy and dilatation of the right ventricle are formed, typical for chronic pulmonary heart disease. The progression of disturbances in the function of external respiration in dusty lung diseases leads to a decrease in myocardial contractility. The detection of hemodynamic disturbances at the early stages of the development of occupational lung diseases indicates the need for individual monitoring of the functional state of the cardiovascular system in the process of contact with industrial aerosols, especially in groups of workers with long-term exposure.

Non-Invasive Ventilation in Stable Chronic Obstructive Pulmonary Disease

2019 ◽  
Vol 15 (2) ◽  
pp. 120-132 ◽  
Author(s):  
Cosei Valentin-Caius ◽  
Borcea Corina-Ioana ◽  
Zaharie Ana-Maria ◽  
Mihaltan Florin-Dumitru ◽  
Deleanu Oana-Claudia
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Invasive Ventilation ◽  
Obstructive Pulmonary Disease ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Patient Reported ◽  
The Right

The benefit of non-invasive ventilation (NIV) in stable chronic obstructive pulmonary disease (COPD) remains controversial. However, there is increasingly more evidence of NIV efficiency, especially high-flow NIV. This review presents the old and the new evidence of NIV effectiveness in stable COPD, considering pathophysiological arguments for NIV in COPD. Guidelines, randomized controlled trials (RCTs) and crossover studies included in review and metaanalysis based on patient-reported outcomes (PROs) have been analyzed. The role of NIV in rehabilitation and in palliative care and the role of telemedicine in relation with NIV are still up for debate. Challenges in choosing the right device and the optimal mode of ventilation still exist. There are also discussions on the criteria for patient inclusion and on how to meet them. More studies are needed to determine the ideal candidate for chronic NIV and to explain all the benefits of using NIV.

Effect of intravenous furosemide on serum theophylline concentration

1981 ◽  
Vol 38 (9) ◽  
pp. 1345-1347
Author(s):  
Paul F. Conlon ◽  
Geoffrey R. Grambau ◽  
Cary E. Johnson ◽  
John G. Weg
Keyword(s):  
Theophylline Concentration ◽  
Serum Theophylline Concentration ◽  
Serum Theophylline

scholarly journals Interference of nail polish on the peripheral oxygen saturation in patients with lung problems during exercise

2012 ◽  
Vol 20 (6) ◽  
pp. 1169-1175
Author(s):  
Walkiria Shimoya-Bittencourt ◽  
Carlos Alberto de Castro Pereira ◽  
Solange Diccini ◽  
Ana Rita de Cássia Bettencourt
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Oxygen Saturation ◽  
Pulmonary Disease ◽  
Exercise Programme ◽  
Chronic Obstructive ◽  
Peripheral Oxygen Saturation ◽  
Obstructive Pulmonary Disease ◽  
Opposite Hand ◽  
Nail Polish ◽  
The Right

AIM: To assess the interference of nail polish on the reading of peripheral oxygen saturation in patients with chronic obstructive pulmonary disease on the step exercise. METHODS: In this study, there was the inclusion of patients with chronic obstructive pulmonary disease, current non-smokers, of both sexes. Four different colours of nail polish were used in the present study (base, light pink, red and brown), randomly distributed among the fingers of the right hand, with the corresponding fingers on the opposite hand being controls. Saturation was measured at rest, with and without the polish, and also during the 4th, 5th and 6th minutes of the exercise programme. RESULTS: The experimental universe included 42 patients with ages of 62.9±8.7 years. In the exercise considered, the red colour reduced it in the fourth minute of the exercise (p=0.047). In contrast, the brown colour reduced saturation at rest and also during the course of exercise (p=0.01). CONCLUSION: In patients with chronic obstructive pulmonary disease, the red and brown colours interfered with the reading of the peripheral oxygen saturation during exercise. This study is registered at the Brazilian Register of Clinical Trials (Registro Brasileiro de Ensaios Clínicos) under No. RBR-9vc722.

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