Adverse Reactions and Interactions with Theophylline

Skinner, Michael H.

doi:10.2165/00002018-199005040-00004

Cited by 20 publications

(5 citation statements)

References 110 publications

(79 reference statements)

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“…It has been shown that inspired hypoxia leads to a drop in MAP, which was present but nonsignificant in our study. Theophyllineinduced hypotension was nonsignificant in our study (45). Overall, PAP values are, however, lower than those reported before in male-anesthetized and awake Sprague-Dawley rats of similar age and weight (ϳ19 mmHg).…”

Section: Blood Pressurescontrasting

confidence: 81%

The combination of theophylline and endothelin receptor antagonism improves exercise performance of rats under simulated high altitude

Radiloff

Zhao

Boico

et al. 2012

Journal of Applied Physiology

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Decreased physical performance is a well-known consequence of rapid ascent to high altitude. Hypoxic pulmonary vasoconstriction (HPV) potentially limits cardiac output and systemic blood flow, thus preventing successful adaptation to rapid ascent. We hypothesized that pharmacological enhancement of the heart rate with theophylline, combined with reversal of HPV via endothelin blockade, could increase exercise performance at high altitude. Female Sprague-Dawley rats were treated with combinations of 1) theophylline, 2) the endothelin receptor antagonists sitaxsentan/ambrisentan, and/or 3) phosphodiesterase-5 inhibitor sildenafil and exposed to either a simulated high altitude (4,267 m) or 12% oxygen. Exercise capacity, peripheral blood flow, hemodynamics, and pulmonary leak were examined. Combination treatment with theophylline and endothelin blockade, but not with the respective single compounds, significantly prolonged run-to-fatigue time under simulated high altitude. No such efficacy was found when theophylline was combined with sildenafil. Neither theophylline nor sitaxsentan or their combination influenced breathing rates and hemoglobin oxygen saturation. Whereas under hypoxia, theophylline significantly increased muscular blood flow, and sitaxsentan increased tissue oxygenation, the combination improved both parameters but in a reduced manner. Under hypoxia, the combination treatment but not the single compounds significantly enhanced pulmonary arterial pressure compared with controls (13.1 ± 6.3 vs. 11.9 ± 5.2 mmHg), whereas mean arterial pressure remained unaffected. Pulmonary wet-to-dry weight ratios were unaffected by combination treatment. We conclude that concomitant dosing with a cardiac stimulant and endothelin antagonist can partially reverse loss of physical performance capacity under hypobaric hypoxia, independent from improving blood oxygen saturation.

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Section: Blood Pressurescontrasting

confidence: 81%

The combination of theophylline and endothelin receptor antagonism improves exercise performance of rats under simulated high altitude

Radiloff

Zhao

Boico

et al. 2012

Journal of Applied Physiology

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“…1) 1992 have emphasised that serum theophylline concentrations are generally unsatisfactory predictors of life-threatening events. Thus, even when no inhibition of theophylline metabolism can be demonstrated, the possibility of a pharmacodynamic interaction must be considered (Sessler 1990;Shannon & Lovejoy 1990;Skinner 1990). Reports of epileptic seizures and hallucinations in patients taking quinolones in combination with theophylline or certain nonsteroidal anti-inflammatory agents have led to the discovery that these combinations may inhibit y-aminobutyric acid (GABA) from binding with its receptor, resulting in general excitation of the central nervous system (Segev et al 1988).…”

Section: Discussionmentioning

confidence: 99%

Effects of 2 Quinolone Antibacterials, Temafloxacin and Enoxacin, on Theophylline Pharmacokinetics†

Sörgel

Mahr

Granneman

et al. 1992

Clinical Pharmacokinetics

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Certain quinolone and naphthyridone antibacterial agents reduce the clearance of theophylline, posing potential clinical risks for patients maintained on this bronchodilator. Whether temafloxacin also affects theophylline pharmacokinetics was assessed in a randomised double-blind 3-way crossover study in 12 healthy volunteers, using placebo and enoxacin as controls. Each volunteer participated in all 3 phases of the study, receiving theophylline plus daily divided doses of temafloxacin 800mg, enoxacin 800mg, or placebo, orally for 7 days. Aminophylline 200mg (containing 146mg theophylline) was given orally twice daily on the first 4 days. On the fifth morning, theophylline 200mg was administered intravenously, and serial blood and urine samples were collected for the following 72h. Coadministration of enoxacin significantly reduced the metabolic clearance of theophylline ("" 65%). In contrast, during coadministration of temafloxacin, theophylline pharmacokinetics did not differ significantly from those during coadministration of placebo. No clinically significant adverse events occurred; total reported adverse events during enoxacin-theophylline administration (n = 33) were higher than those reported during temafloxacin-theophylline administration (n = 22) and theophylline alone (n = 23). Administration of temafloxacin to patients on long term theophylline therapy appears to be a safe and rational choice when treatment with a broad spectrum antibiotic is indicated.

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“…Therefore, high doses of oral theophylline are required to elevate cAMP and cGMP levels; however, the high doses might result in increased adverse events such as tachycardia, tremor, restlessness, and gastrointestinal disorders. Also, theophylline has a life-threatening narrow therapeutic window that needs regular blood level monitoring ( Henkin et al, 2009 ; Skinner, 1990 ).…”

Section: Potential Therapeutic Agents Against Olfactory and Gustatory Dysfunctionsmentioning

confidence: 99%

Potential pharmacologic treatments for COVID-19 smell and taste loss: A comprehensive review

Khani

Khiali

Beheshtirouy

et al. 2021

European Journal of Pharmacology

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The acute loss of taste and smell following COVID-19 are hallmark symptoms that affect 20–85% of patients. However, the pathophysiology and potential treatments of COVID-19 smell and taste loss are not fully understood. We searched the literature to review the potential pathologic pathways and treatment options for COVID-19 smell and taste loss. The interaction of novel coronavirus with ACE-2 receptors expressed on sustentacular cells and taste buds results in direct damage to the olfactory and gustatory systems. Also, the invasion of the virus to the olfactory neurons and consequent local inflammation are other proposed mechanisms. Therefore, COVID-19 patients with smell or taste loss may benefit from neuroprotective, anti-inflammatory, or depolarizing agents. Based on the current evidence, phosphodiesterase inhibitors, insulin, and corticosteroids can be promising for the management of COVID-19 smell and taste loss. This review provided crucial information for treating COVID-19-related smell and/or taste loss, urging to perform large clinical trials to find optimum treatment options.

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Adverse Reactions and Interactions with Theophylline

Cited by 20 publications

References 110 publications

The combination of theophylline and endothelin receptor antagonism improves exercise performance of rats under simulated high altitude

The combination of theophylline and endothelin receptor antagonism improves exercise performance of rats under simulated high altitude

Effects of 2 Quinolone Antibacterials, Temafloxacin and Enoxacin, on Theophylline Pharmacokinetics†

Potential pharmacologic treatments for COVID-19 smell and taste loss: A comprehensive review

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