Effect of a methylxanthine preparation in the form of a retention enema on pulmonary function and theophylline levels in patients with acute bronchospasm.

The goal of the current study was to determine whether administration of a methylxanthine preparation in the form of a retention enema (theophylline-diprophylline-proxyphylline combination, Neobiphyllin-Clys) has an effect similar to that of intravenous theophylline in the treatment of acute bronchospasm. In a randomized cross-over study 16 patients with a history of asthma were given 0.48 g of theophylline-ethylenediamine (TE) in the form of rapid intravenous infusion or a retention enema containing 400 mg theophylline, 600 mg diprophylline and 600 mg proxyphylline (TDP). Forced expiratory volume in the first second (FEV1) airways resistance (Rt) and serum theophylline levels were determined before administration of the drug and at 15 min, 30 min and hourly for a period of 6 h after administration of the medication. The results were significant at the 5% level. There were significant increases in serum theophylline levels with both TE and TDP. After administration of TE there were significant changes in FEV1 at 15 min and Rt at 30 min which persisted for 5 h after administration of the drug. Statistically significant differences in FEV1 were observed 60 min and in Rt 30 min after administration of TDP. These effects persisted for 6 h. The data document that a retention enema offers the advantage of prolonged action in comparison to intravenous infusion of theophylline in the treatment of acute bronchospasm.