Effects Of Therapeutic Drug Monitoring Aminophylline In The Therapy Of Chronic Obstructive Pulmonary Disease

In order to compare the serum drug concentration, efficacy and toxic or side reaction of different aminophylline therapeutic regimen in patients with chronic obstructive pulmonary disease (COPD). and to study the effects on lung function and blood gas data of aminophylline with the different serum drug concentration, a clinial trial study conducted on patients with COPD. 102 patients were divided into oral, intravenous and oral plus intravenous administration groups. The samples of venous blood were collected at various time points after the administration of aminophylline. Then, the serum drug concentration was determined by high performance liquid chromatography (HPLC). For 59 patients with COPD whose serum drug concentration at 10 ?20 jig. ml ~?their lung function and blood gas data were measured before aminophylline therpy and measured again at2. 5, 4 and 8h aftei aminophylline treatment. For 43 patients with COPD who use relative low dosage o~ aminophylline (0. lg tid or 0. 2g qN), their lung function were measured before aminophylline and measured again at 4 months after aminophylline treatment. The results showed that in the oral group, 87 percents of the patients with the regimen of 0. 2g q 8h and 65 percents of those with the regimen of 0. 2g tid kept their bottom ?peak concentration among 10 ?20 pg. mh1 respectively. 78 .4. percent of patients with the regimen of 0. 5g iv drip qd and 82 percent of those with the regimen of 0. 25g iv drip qd pluds 0. lg tid kept their bottom ?peak concentration among 10?0 jig. ml1respectively. 93 percent of the patients with the regimen of 0. lg tid 82 percent of those with the regimen of 0. 2g qn kept their bottom concentration under 10 jig. mh1. Serum drug concentr~ation of 3 cases with the toxic effects was more than 20 jig. ink? For 59 patients with COPD whose serum drug concentration among 10?0 jig. ink? the forced vital capacity (FVC) ,percent forced vital capacity(FVC~), forced expiratory volume in second (FEy1), and maximum inidexpiratory flow (MMF) were significantly increased (P<0. 01,P<0. 05, P<0. 01, P<0. 05); the oxygen artery partial pressure (Pa02), saturation artery oxygen (5a02), oxygen venous partial pressure (Pv02) and saturation venous oxygen (Sv02) were risen, the carbon dioxide artery partail pressure (Pa C02) and carbon dioxide venous partial pressure (Pv C02) were reduced. For 43 patients with COPD who used relative low dosage of aminophylline (0. 11 tid or 0. 2 qn), their peak expiratory flow (PEF) and FVC are signficantly iné–žeased (P < 0. 01, P < 0. 01) after four months., There suggest that the dosage of aminophylline used for maintaining the serum drug concentration at 10?0 pg. ink? can significantly improve lung function in patients with COPD. For treatment and prevention of mild COPD, relative low dosage of aminophylline (0. 1 tid or 0. 2 qn ) should be used for maintaining the serum drug concentration at 5?0 pg. ink?...