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October 1982, Vol 136, No. 10 >
Article | October 1982

Theophylline Blood Levels as a Guide to Intravenous Therapy in Children FREE

James Fox, MD; Patricia Hicks, MD; Bernard R. Feldman, MD; William J. Davis, MD; Charles H. Feldman, MD
[+] Author Affiliations

Reprint requests to Health Sciences, Columbia University, 620 W 168th St, New York, NY 10032 (Dr C. Feldman).


Am J Dis Child. 1982;136(10):928-930. doi:10.1001/archpedi.1982.03970460058012.
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References
Comments

• A retrospective analysis of the records of 56 children admitted In status asthmaticus was done to assess the Impact of serum theophylline levels on subsequent therapeutic decisions. In 39% of the cases, levels obtained following the initial theophylline bolus were below therapeutic range and in 6% they were above therapeutic range. In 31% of Instances of theophylline levels obtained during the phase of continuous aminophylline infusion, the physician decided to administer additional theophylline. The median hospital stay was 2.65 days. Monitoring serum theophylline levels following intravenous loading and during continuous infusion provides the physician with a valuable clinical tool and may help to shorten the period of hospitalization for patients In status asthmaticus.

(Am J Dis Child 1982;136:928-930)

REFERENCES

1 +
Leffert F:  Management of acute severe asthma . J Pediatr 1980;;96:1-12.
2 +
Jenne JW, Wyze E, Rood BS, et al:  The pharmacokinetics of theophylline: Application to adjustment of the clinical dose of aminophylline . Clin Pharmacol Ther 1972;;13:349-360.
3 +
Masselli R, Casal GL, Ellis EF:  Pharmacologic effects of intravenously administered aminophylline in asthmatic children . J Pediatr 1980;;76:777-782.
4 +
Nicholson DP, Chick TW:  A reevaluation of parenteral aminophylline . Am Rev Respir Dis 1973;;108:241-247.
5 +
Weinberger M:  Theophylline for treatment of asthma . J Pediatr 1978;;92:1-7.
6 +
 I.V. dosage guidelines for theophylline products . FDA Drug Bull 1980;;10:4-6.
7 +
Hendeles L, Weinberger M:  Guidelines for avoiding theophylline overdose . N Engl J Med 1979;;300:1217.
8 +
Weidner N, McDonald JM, Tieber VL, et al:  Assay of theophylline: Comparison of EMIT on the ABA-100 to HPLC, GLC and UV procedures with detailed evaluation of interferences . Clin Chem Acta 1979;;97:9-17.
9 +
Koup JR, Brodsky B:  Comparison of homogeneous enzyme immunoassay and high-pressure liquid chromatography for the determination of theophylline concentration . Am Rev Respir Dis 1978;;117:1135-1138.
10 +
Ellis EF, Yaffe SJ, Levy G:  Pharmacokinetics of theophylline in asthmatic children . J Allergy Clin Immunol 1974;;53:79.
11 +
Ellis EF, Koysooko R, Levy G:  Pharmacokinetics of theophylline in children with asthma . Pediatrics 1972;;58:542-547.
12 +
Feldman CF, Hutchinson VE, Pippenger CE, et al:  Effect of dietary protein and carbohydrate on theophylline metabolism in children . Pediatrics 1980;;66:956-962.
13 +
Piafsky KM, Sitar DS, Rangno RE, et al:  Theophylline kinetics in acute pulmonary edema . Clin Pharmacol Ther 1977;;21:310-316.
14 +
Chang KC, Lauer BA, Bell TD, et al:  Altered theophylline pharmacokinetics during acute respiratory viral illness . Lancet 1978;; 1:1132-1133.
15 +
Prince RA, Wing DS, Weinberger M, et al:  Effect of erythromycin on theophylline kinetics . J Allergy Clin Immunol 1981;;68:427-431.
16 +
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.
17 +
Hendeles L, Weinberger M, Bighley L:  Disposition of theophylline following a single intravenous aminophylline infusion . Am Rev Respir Dis 1978;;118:97-103.
18 +
Ginchansky E, Weinberger M:  Relationship of theophylline clearance to oral dosage in children with chronic asthma . J Pediatr 1977;; 91:655-660.
19 +
La Force CF, Miller MF, Chai H:  Effect of erythromycin on theophylline clearance in asthmatic child . J Pediatr 1981;;99:153-156.
20 +
Weinberger M, Matthay RA, Ginchansky EJ, et al:  Intravenous aminophylline dosage, use of serum theophylline levels for guidance . JAMA 1976;;235:2110-2113.
21 +
Canavan JW, Ellerstein NS, Sullivan TD:  Intravenous administration of aminophylline . J Pediatr 1980;;97:301-303.
22 +
Mitenko PA, Ogilvie RI:  Rational intravenous doses of theophylline . N Engl J Med 1973;;289:600-603.
23 +
Length of Stay in PAS Hospitals by Diagnosis in Northeastern Region . Ann Arbor, Mich, Commission on Professional and Hospital Activities, 1979;.
24 +
Pippenger CE:  Rationale and clinical application of therapeutic drug monitoring . Pediatr Clin North Am 1980;;27:891-925.

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References

1 +
Leffert F:  Management of acute severe asthma . J Pediatr 1980;;96:1-12.
2 +
Jenne JW, Wyze E, Rood BS, et al:  The pharmacokinetics of theophylline: Application to adjustment of the clinical dose of aminophylline . Clin Pharmacol Ther 1972;;13:349-360.
3 +
Masselli R, Casal GL, Ellis EF:  Pharmacologic effects of intravenously administered aminophylline in asthmatic children . J Pediatr 1980;;76:777-782.
4 +
Nicholson DP, Chick TW:  A reevaluation of parenteral aminophylline . Am Rev Respir Dis 1973;;108:241-247.
5 +
Weinberger M:  Theophylline for treatment of asthma . J Pediatr 1978;;92:1-7.
6 +
 I.V. dosage guidelines for theophylline products . FDA Drug Bull 1980;;10:4-6.
7 +
Hendeles L, Weinberger M:  Guidelines for avoiding theophylline overdose . N Engl J Med 1979;;300:1217.
8 +
Weidner N, McDonald JM, Tieber VL, et al:  Assay of theophylline: Comparison of EMIT on the ABA-100 to HPLC, GLC and UV procedures with detailed evaluation of interferences . Clin Chem Acta 1979;;97:9-17.
9 +
Koup JR, Brodsky B:  Comparison of homogeneous enzyme immunoassay and high-pressure liquid chromatography for the determination of theophylline concentration . Am Rev Respir Dis 1978;;117:1135-1138.
10 +
Ellis EF, Yaffe SJ, Levy G:  Pharmacokinetics of theophylline in asthmatic children . J Allergy Clin Immunol 1974;;53:79.
11 +
Ellis EF, Koysooko R, Levy G:  Pharmacokinetics of theophylline in children with asthma . Pediatrics 1972;;58:542-547.
12 +
Feldman CF, Hutchinson VE, Pippenger CE, et al:  Effect of dietary protein and carbohydrate on theophylline metabolism in children . Pediatrics 1980;;66:956-962.
13 +
Piafsky KM, Sitar DS, Rangno RE, et al:  Theophylline kinetics in acute pulmonary edema . Clin Pharmacol Ther 1977;;21:310-316.
14 +
Chang KC, Lauer BA, Bell TD, et al:  Altered theophylline pharmacokinetics during acute respiratory viral illness . Lancet 1978;; 1:1132-1133.
15 +
Prince RA, Wing DS, Weinberger M, et al:  Effect of erythromycin on theophylline kinetics . J Allergy Clin Immunol 1981;;68:427-431.
16 +
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.
17 +
Hendeles L, Weinberger M, Bighley L:  Disposition of theophylline following a single intravenous aminophylline infusion . Am Rev Respir Dis 1978;;118:97-103.
18 +
Ginchansky E, Weinberger M:  Relationship of theophylline clearance to oral dosage in children with chronic asthma . J Pediatr 1977;; 91:655-660.
19 +
La Force CF, Miller MF, Chai H:  Effect of erythromycin on theophylline clearance in asthmatic child . J Pediatr 1981;;99:153-156.
20 +
Weinberger M, Matthay RA, Ginchansky EJ, et al:  Intravenous aminophylline dosage, use of serum theophylline levels for guidance . JAMA 1976;;235:2110-2113.
21 +
Canavan JW, Ellerstein NS, Sullivan TD:  Intravenous administration of aminophylline . J Pediatr 1980;;97:301-303.
22 +
Mitenko PA, Ogilvie RI:  Rational intravenous doses of theophylline . N Engl J Med 1973;;289:600-603.
23 +
Length of Stay in PAS Hospitals by Diagnosis in Northeastern Region . Ann Arbor, Mich, Commission on Professional and Hospital Activities, 1979;.
24 +
Pippenger CE:  Rationale and clinical application of therapeutic drug monitoring . Pediatr Clin North Am 1980;;27:891-925.

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