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Doxophylline  The safer methylxanthine Dr. B. K. Iyer
Topics for discussion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Topics for discussion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What is doxophylline? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What are methylxanthines? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Is there scope for doxophylline? ,[object Object],[object Object],[object Object],[object Object]
Limitations to Theophylline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Theophylline concentrations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mechanism of action [MOA] ,[object Object],[object Object],[object Object],[object Object]
Uses of doxophylline ,[object Object],[object Object],[object Object],[object Object],[object Object],What is COPD, Asthma, chronic bronchitis and emphysema?
Respiratory system Physiology
Airway innervations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Respiratory defense mechanism Phagocyte system Muco- Ciliary clearance Goblet Cell function Cough / Sneeze Respiratory Defense mechanism
Respiratory defense mechanism ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Respiratory defense mechanism ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Respiratory defense mechanism
Respiratory system Pathophysiology of diseases
Airway Inflammation [AI] ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Receptors & mediators ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Receptors & mediators - outcomes
[object Object],What is COPD?
What is COPD?
What is COPD? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What is Asthma? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What happens in Asthma? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
How do you define Asthma? ,[object Object],[object Object],[object Object],[object Object]
Severity classifications of asthma ,[object Object],[object Object],[object Object],[object Object]
What is emphysema? ,[object Object]
What is emphysema?
What is chronic bronchitis? ,[object Object]
Principles of management of COPD
What is the therapeutic approach? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Respiratory system Drugs
What are the therapy approaches? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Bronchodilators Sympathomimetic Adrenaline Adrenergic Ipratropium bromide Anticholinergics Theophylline Aminophylline Doxophylline Methylxanthines Salmetrol, Salbutamol, Terbutaline Non adrenergic
Sympathomimetics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Methylxanthines ,[object Object],[object Object],[object Object],[object Object],[object Object]
Respiratory investigations… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Assessment / Monitoring measures  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Goals of Asthma Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Success of Asthma Management ,[object Object],[object Object],[object Object],[object Object],[object Object]
Recommended monitoring ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Doxophylline Details
Doxophylline  ,[object Object],Dioxolane Ring CH 3 N O H 3 C N O N N CH 2 O O
Doxophylline  ,[object Object],[object Object],Reference:  Cirillo R et al .  Arch Int Pharmacodyn Ther 1988;295:221-237 . Interaction with A1 adenosine receptors:
Doxophylline - MOA ,[object Object],[object Object],[object Object],[object Object],[object Object]
Doxophylline and sleep  ,[object Object],[object Object],[object Object]
Doxophylline studies  ,[object Object],[object Object]
Clinical studies ,[object Object],Dolcetti A at al.  J Int Med Res 1988;16:264-269 .
Comparative clinical studies in ADRs ,[object Object],Reference: Eandi M: Farmacoeconomia e Percorsi Terapeutici 2002;3:2. 3 ADR Doxophylline Theophylline 1 ADR 2 ADR
Comparative clinical studies in Asthma ,[object Object],Reference: Marino O et al.  Uomo Med 1988;4:33-37.
Comparative clinical studies in COPD ,[object Object],Reference: Marino O et al.  Uomo Med 1988; 4: 33-37 .
Comparative clinical studies in heart rate ,[object Object],[object Object],Reference: Giorgi M et al.  (Abstr) Eur Respir J 1993;6 (Suppl 17):417.
Doxophylline and heart  ,[object Object],[object Object],[object Object]
Doxophylline and ventilation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Doxophylline and chronic bronchitis ,[object Object],Reference: Cogo R et al.  Farmaci 1990; 14: 295-299 .
Doxophylline and histopathologic abnormalities ,[object Object],Cogo R, Castronuovo A:  Eur Rev Med Pharmacol Sci 2000;4:15-20. Basal 3 Months After Therapy Basal
Summary ,[object Object],Safer No activity on adenosine receptors No side effects on heart No CNS / sleep disturbances Better functional improvement Better histological improvement Better tolerated

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Doxophylline and asthma