Post-mortem concentrations of salbutamol, terbutaline and theophylline in asthma patients

The concentrations of theophylline, terbutaline and salbutamol in post-mortem blood samples from 68 patients (17-85 years old) with asthma or chronic obstructive lung disease, 54 of whom had died of asthma, were analysed. Information on recent prescriptions was obtained for 61 patients. There was agreement between prescription and drug analysis in the blood in 87% of the patients with regard to theophylline and in 92% for salbutamol and terbutaline combined. Theophylline levels were generally low; 30 patients had concentrations below 25 mumol/l and only three above 110 mumol/l (therapeutic interval 55-110 mumol/l). Both salbutamol and terbutaline were detected in most samples. Fourteen patients had blood concentrations above 200 nmol/l. No definite explanation for these high values could be found. The majority of patients who died from asthma had low drug levels and had not been prescribed corticosteroids.