[Comparison of the bronchodilator and protective effect of methylxanthines]

In study I, carried out on 9 asthmatics to investigate whether the bronchodilator and protective effect of intravenous theophylline, dissolved in ethylene diamine (T.E.) or proxyphylline and diprophylline (T.P.D.), showed different dose-effect relationships, 100 mg theophylline with T.E., T.P.D. or NaCl (placebo) were infused 5 times at 30 minute intervals. This was followed by inhalation of 0.4 mg fenoterol. Results showed that the bronchodilator effect of 500 mg theophylline with a serum concentration greater than 15 mg/l was only about 60% of that for fenoterol alone. In study II, 11 patients with exercise-induceable respiratory obstruction received 200 and 351 mg theophylline with T.E., 200 mg with T.P.D. or placebo prior to exercise and cold air inhalation. Here theophylline had a dose-dependent protective effect. With a theophylline serum concentration of 5 mg/l there was already a reduction in exercise asthma by more than 60% in comparison to placebo. At comparable serum concentrations the effect of T.P.D. was better than T.E. in both studies although the difference was not statistically significant.

Since the bronchodilator effect of methylxanthines is less than the protective effect, the prophylactic use of theophylline should be given more attention.