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September 1982, Vol 136, No. 9 >
Article | September 1982

Sustained-Release Theophylline for Treatment of Asthma in Preschool Children FREE

F. Estelle R. Simons, MD; George H. Luciuk, MD; Keith J. Simons, PhD
[+] Author Affiliations

Reprint requests to Children's Hospital, 678 William Ave, Winnipeg, Manitoba, Canada R3E 0W1 (Dr F. Simons).


Am J Dis Child. 1982;136(9):790-793. doi:10.1001/archpedi.1982.03970450032008.
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References
Comments

• Theo-Dur, a sustained-release theophylline formulation, was administered every 12 hours for three months to ten asthmatic children aged 3 to 7 years, with no evidence of adverse reaction or tolerance. There was significant temporal variation in serum theophylline concentrations. The mean difference between the peak and trough concentrations was 6.5 μg/mL (range, 3 to 14 μg/mL) in a 12-hour period. Serum theophylline concentrations correlated well with pulmonary function test results. Nine or more hours after a Theo-Dur dose, some children needed additional bronchodilator treatment and had impairment of pulmonary function. We recommend that children aged 7 years or younger who are given Theo-Dur have monitoring of predose serum theophylline concentrations, symptoms, and signs, as many will require a dose frequency greater than every 12 hours.

(Am J Dis Child 1982;136:790-793)

REFERENCES

1 +
Kelly HW, Murphy S:  Serum theophylline levels in asthmatic children receiving sustained-release theophylline tablets . Am J Hosp Pharm 1979;;36:1698-1701.
2 +
Kelly HW, Murphy S:  Efficacy of a 12-hour sustained release preparation in maintaining therapeutic serum theophylline levels in asthmatic children . Pediatrics 1980;;66:97-102.
3 +
Domson JF, Hein EW, Sheen A, et al:  Comparison of Theolair SR and Theo-Dur tablets . Ann Allergy 1979;;43:220-222.
4 +
Lonnerholm G, Foucard T, Lindstrom B:  Treatment of chronic asthma in children with a sustained-release preparation of theophylline in addition to β2-stimulating agents . Eur J Respir Dis 1980;;61( (suppl 109) ):95-97.
5 +
Scott PH, Tabachnik E, MacLeod S, et al:  Sustained-release theophylline for childhood asthma: Evidence for circadian variation of theophylline pharmacokinetics . J Pediatr 1981;; 99:476-479.
6 +
Bell T, Bigley J:  Sustained-release theophylline therapy for chronic childhood asthma . Pediatrics 1978;;62:352-358.
7 +
Simons KJ, Frith EM, Simons FER:  Dissolution and bioavailability studies of whole and halved sustained-release theophylline tablets . J Pharm Sci , in press.
8 +
Ross AJ, Raber MB, Kirk BW, et al:  Direct readout of respiratory impedance . Med Biol Eng 1976;;14:558-564.
9 +
Wright BM:  A miniature Wright Peak Flow Meter . Br Med J 1978;;2:1627-1628.
10 +
Mansell A, Levison H, Kruger K, et al:  Measurement of respiratory resistance in children by forced oscillations . Am Rev Respir Dis 1972;;106:710-714.
11 +
Lindquist EF:  Controlling individual differences in factorial experiments through the use of 'mixed' designs , in Design and Analysis of Experiments . Boston, Houghton Mifflin Co, 1956;, p 266.
12 +
Rachelefsky GS, Katz RM, Siegel SC:  A sustained release theophylline preparation: Efficacy in childhood asthma with low serum theophylline levels . Ann Allergy 1978;;40:252-257.
13 +
Lesko LJ, Brousseau D, Canada AT, et al:  Temporal variations in trough serum theophylline concentrations at steady state . J Pharm Sci 1980;;69:358-359.
14 +
Shively CA, Vesell ES:  Temporal variations in acetaminophen and phenacetin half-life in man . Clin Pharm Ther 1975;;18:413-424.
15 +
Weinberger M, Hendeles L, Bighley L:  The relation of product formulation to absorption of oral theophylline . N Engl J Med 1978;;299:852-857.
16 +
Weinberger M, Hendeles L, Wong L, et al:  Relationship of formulation and dosing interval to fluctuation of serum theophylline concentration in children with chronic asthma . J Pediatr 1981;;99:145-152.
17 +
Welling PG, Lyons LL, Craig WA, et al:  Influence of diet and fluid on bioavailability of theophylline . Clin Pharm Ther 1975;;17:475-480.
18 +
Spangler DL, Kalof DD, Bloom FL, et al:  Theophylline bioavailability following oral administration of six sustained release preparations . Ann Allergy 1978;;40:6-11.
19 +
Loughnan PM, Sitar DS, Ogilvie RI, et al:  Pharmacokinetic analysis of the disposition of intravenous theophylline in young children . J Pediatr 1976;;88:874-879.
20 +
Mitenko PA, Ogilvie RI:  Rational intravenous doses of theophylline . N Engl J Med 1973;;289:600-603.
21 +
Levy G, Koysooko R:  Pharmacokinetic analysis of the effect of theophylline on pulmonary function in asthmatic children . J Pediatr 1975;;86:789-793.
22 +
McFadden ER Jr, Kiser R, deGroot W:  Acute bronchial asthma: Relations between clinical and physiologic manifestations . N Engl J Med 1973;;288:221-225.
23 +
Hogg JC, Williams J, Richardson JB, et al:  Age as a factor in the distribution of lower airway conductance and in the pathologic anatomy of obstructive lung disease . N Engl J Med 1970;;282:1283-1287.
24 +
Lenney W, Milner AD:  Recurrent wheezing in the preschool child . Arch Dis Child 1978;; 53:468-473.
25 +
Tinkelman DG, Vanderpool GE, Carroll MS, et al:  Compliance differences following administration of theophylline at six and 12 hour intervals . Ann Allergy 1980;;44:283-286.

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References

1 +
Kelly HW, Murphy S:  Serum theophylline levels in asthmatic children receiving sustained-release theophylline tablets . Am J Hosp Pharm 1979;;36:1698-1701.
2 +
Kelly HW, Murphy S:  Efficacy of a 12-hour sustained release preparation in maintaining therapeutic serum theophylline levels in asthmatic children . Pediatrics 1980;;66:97-102.
3 +
Domson JF, Hein EW, Sheen A, et al:  Comparison of Theolair SR and Theo-Dur tablets . Ann Allergy 1979;;43:220-222.
4 +
Lonnerholm G, Foucard T, Lindstrom B:  Treatment of chronic asthma in children with a sustained-release preparation of theophylline in addition to β2-stimulating agents . Eur J Respir Dis 1980;;61( (suppl 109) ):95-97.
5 +
Scott PH, Tabachnik E, MacLeod S, et al:  Sustained-release theophylline for childhood asthma: Evidence for circadian variation of theophylline pharmacokinetics . J Pediatr 1981;; 99:476-479.
6 +
Bell T, Bigley J:  Sustained-release theophylline therapy for chronic childhood asthma . Pediatrics 1978;;62:352-358.
7 +
Simons KJ, Frith EM, Simons FER:  Dissolution and bioavailability studies of whole and halved sustained-release theophylline tablets . J Pharm Sci , in press.
8 +
Ross AJ, Raber MB, Kirk BW, et al:  Direct readout of respiratory impedance . Med Biol Eng 1976;;14:558-564.
9 +
Wright BM:  A miniature Wright Peak Flow Meter . Br Med J 1978;;2:1627-1628.
10 +
Mansell A, Levison H, Kruger K, et al:  Measurement of respiratory resistance in children by forced oscillations . Am Rev Respir Dis 1972;;106:710-714.
11 +
Lindquist EF:  Controlling individual differences in factorial experiments through the use of 'mixed' designs , in Design and Analysis of Experiments . Boston, Houghton Mifflin Co, 1956;, p 266.
12 +
Rachelefsky GS, Katz RM, Siegel SC:  A sustained release theophylline preparation: Efficacy in childhood asthma with low serum theophylline levels . Ann Allergy 1978;;40:252-257.
13 +
Lesko LJ, Brousseau D, Canada AT, et al:  Temporal variations in trough serum theophylline concentrations at steady state . J Pharm Sci 1980;;69:358-359.
14 +
Shively CA, Vesell ES:  Temporal variations in acetaminophen and phenacetin half-life in man . Clin Pharm Ther 1975;;18:413-424.
15 +
Weinberger M, Hendeles L, Bighley L:  The relation of product formulation to absorption of oral theophylline . N Engl J Med 1978;;299:852-857.
16 +
Weinberger M, Hendeles L, Wong L, et al:  Relationship of formulation and dosing interval to fluctuation of serum theophylline concentration in children with chronic asthma . J Pediatr 1981;;99:145-152.
17 +
Welling PG, Lyons LL, Craig WA, et al:  Influence of diet and fluid on bioavailability of theophylline . Clin Pharm Ther 1975;;17:475-480.
18 +
Spangler DL, Kalof DD, Bloom FL, et al:  Theophylline bioavailability following oral administration of six sustained release preparations . Ann Allergy 1978;;40:6-11.
19 +
Loughnan PM, Sitar DS, Ogilvie RI, et al:  Pharmacokinetic analysis of the disposition of intravenous theophylline in young children . J Pediatr 1976;;88:874-879.
20 +
Mitenko PA, Ogilvie RI:  Rational intravenous doses of theophylline . N Engl J Med 1973;;289:600-603.
21 +
Levy G, Koysooko R:  Pharmacokinetic analysis of the effect of theophylline on pulmonary function in asthmatic children . J Pediatr 1975;;86:789-793.
22 +
McFadden ER Jr, Kiser R, deGroot W:  Acute bronchial asthma: Relations between clinical and physiologic manifestations . N Engl J Med 1973;;288:221-225.
23 +
Hogg JC, Williams J, Richardson JB, et al:  Age as a factor in the distribution of lower airway conductance and in the pathologic anatomy of obstructive lung disease . N Engl J Med 1970;;282:1283-1287.
24 +
Lenney W, Milner AD:  Recurrent wheezing in the preschool child . Arch Dis Child 1978;; 53:468-473.
25 +
Tinkelman DG, Vanderpool GE, Carroll MS, et al:  Compliance differences following administration of theophylline at six and 12 hour intervals . Ann Allergy 1980;;44:283-286.

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