To examine the cardiotoxic interaction between beta-adrenergic bronchodilators and theophylline, we tested the effects of isoproterenol or bitolterol alone and in combinations with aminophylline in experimental animals, both electrocardiographically and histologically. The sc LD50 values for isoproterenol in 4- to 5-month-old, 500-600 g (heavy) and 1.5- to 2-month-old, 150-200 g (small) male Sprague-Dawley rats were 0.6 mg/kg and 1300 mg/kg, respectively, and values for bitolterol were 4 mg/kg and greater than 1800 mg/kg, respectively. Results of the electrocardiographic studies in heavy rats, using the calculated LD20 dosage of isoproterenol with or without pretreatment of aminophylline, demonstrated that both mortality and the arrhythmia-inducing effect of isoproterenol were significantly potentiated by aminophylline but only mortality was increased in small rats. Aminophylline also potentiated the electrocardiographic effects of 1/40 of the LD50 dosage of isoproterenol in heavy rats but did not enhance the effects of bitolterol at this dose level. Potentiation of the arrhythmogenic effect of isoproterenol was also observed in rabbits. The severity of the myocardial lesions produced by isoproterenol or bitolterol in heavy rats was significantly enhanced by aminophylline. The heavy rat appears to be a sensitive model for studying the interaction of these classes of drugs.
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