Intravenous therapy of chronic obstructive pulmonary disease with sodium glycinate theophylline monitored by a new bed side theophylline assay.

Although the therapy of airway obstruction with theophylline is well established, unwanted side effects can occur: overdosage and reactions to ethylendiamine, an additive to increase the solubility of theophylline. Frequent measurements of the theophylline blood levels and the use of ethylendiamine free preparations can avoid such problems. Therefore, we studied the validity of a new immunochromatographic bed side assay (Acculevel) prior and after infusion of sodiumglycinate-theophylline (Theospirex) in 13 patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Although theophylline levels increased above the therapeutic range (20 mg/L) in half of the patients after the infusion of 400 mg Theospirex in 1 hour, no toxic effects could be denoted. In addition, no influence on blood pressure and heart rate were found. We observed good correlations between this new immunochromatographic assay and theophylline levels measured with 2 well established reference methods (HPLC and turbidimetry, r = 0.87 and 0.91, respectively), although Acculevel revealed slightly higher values. Thus, the use of sodium-glycinate-theophylline and the new, fast bed side test system seems of practical importance in the therapy of COPD by potentially avoiding undesirable side effects.