The Clinical Use and Measurement of Theophylline

Rowe, David J.; Watson, Ian; Williams, John G.; Berry, David J.

doi:10.1177/000456328802500102

Cited by 45 publications

(28 citation statements)

References 95 publications

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“…This concentration is within the safe therapeutic range (5±20 mg ml 71 ) employed for humans, 30 and similar doses have been employed for bronchodilation and/or in the management and prevention of neonatal apnea. 31 Our present study demonstrated that daily theophylline feeding for several weeks caused a marked elevation of FC, AC, SC, LC and TC in the kidney of rats. The results further indicated that the ratio of AC/FC was signi®cantly increased in theophylline-treated Table 1.…”

Section: Discussionsupporting

confidence: 58%

Investigation of the effect of theophylline administration on total, free, short-chain acyl and long-chain acyl carnitine distributions in rat renal tissues

Alhomida

1998

Cell Biochem. Funct.

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This study is conducted to investigate the effect of oral theophylline administration on total (TC), free (FC), short-(SC), long-chain acyl (LC), acyl (AC) carnitine distributions as well as the ratio of acyl to free carnitine (AC/FC) in rat renal tissues. Theophylline was administrated at 100 mg kg-1 body weight day-1, and effects were monitored after a treatment period that lasted between 1 week and 5 weeks. The results indicated that theophylline administration leads to significantly higher concentrations of TC, FC, SC, L and AC in renal tissues as compared to those of control and placebo groups (P < 0.001). Moreover, the ratio of AC/FC was significantly increased (P < 0.001) as compared to either control or placebo groups. These changes may result from theophylline-enhanced mobilization of lipids from adipose tissues, which consequently stimulates an increased carnitine transport into the renal tissues to form acylcarnitines for subsequent beta-oxidation inside the renal mitochondria.

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Section: Discussionsupporting

confidence: 58%

Investigation of the effect of theophylline administration on total, free, short-chain acyl and long-chain acyl carnitine distributions in rat renal tissues

Alhomida

1998

Cell Biochem. Funct.

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“…Dávkovanie. Plazmatické liekové koncentrácie musia byť vždy interpretované vo vzťahu k celkovej dennej dávke farmaka (mg/kg/deň) a nikdy nie na základe celkovej dennej dávky lieku (mg/deň) (63,64,65,66,67,68,69,70,83,84,85,86).…”

Section: Klinický Význam Terapeutického Monitorovania Liekových Hladíunclassified

Clinical significance of therapeutic drug monitoring in pharmacotherapy rationalization and individualization

Novotný¹

2005

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The monitoring of drug levels has not only academic significance, but it also enables pharmacotherapy rationalization and protects the patient in case of high dose therapy often in the field of toxic doses that damage vital organs (kidney, heart, hematoporesis, mucous membranes etc.).Therapeutic Drug Monitoring (TDM) is one of the means to increase safety and efficiency of pharmacotherapy, enabling dose adaptation to the individual patient. It is based on the possibility of fixing the drug concentration in biological liquids, most often in plasma or in urine, but also in saliva etc. TDM is a part of monitoring of treatment of chronically and critically ill patients. It is substantiated in patients with different pharmakinetics of drugs -older patients, newborns, children etc.The monitoring of drug levels during therapy, or therapeutic drug monitoring, is complex analytic activity that, unlike simple drug analytics in biologic material (intoxication etc.), studies also other factors that are important with regard to dynamics of organism during illness and therapy. The aim of monitoring of drug levels during pharmacotherapy is:analysis of drugs with narrow therapeutic range; application at drugs with well defined relation between drug concentration and effect (either therapeutic or toxic); analysis of drugs with great interindividual or intraindividual differences in pharmaceutical distribution or its clearance; to define the right regime and program of medication dosage for individual patients, i.e. individualization of pharmacotherapy; to reach optimally efficient drug concentration for therapy result; to forestall origin of toxic manifestations, e.g. gentamycine, digoxine, cyclosporine etc.; to follow continuously the changes during certain pharmacotherapy and to adapt it to current patient's condition and needs; to follow patient's compliance during the introduced therapy.Key words: therapeutic drug monitoring -rational pharmacotherapy -pharmacotherapy individualization -complex analytic activity -therapeutic range of medication -compliance -polytherapy -drug interaction -patient's age -interpretation of drug levels SúhrnMonitorovanie liekových hladín má význam nielen akademický, ale umožňuje aj racionalizáciu farmakoterapie a chráni pacienta pri vysokodávkovanej terapii často v oblasti toxických dávok, ktoré poškodzujú vitálne dôležité orgány (obličky, srdce, hematopoézu, sliznice a ďalšie). Terapeutické monitorovanie hladín liekov (TDM, Therapeutic Drug Monitoring) je jedným z prostriedkov na zvýšenie bezpečnosti a efektívnosti farmakoterapie a umožňuje prispôsobenie dávok individuálnemu pacientovi. Je založené na možnosti stanovenia koncentrácie liečiva v biologických tekutinách, najčastejšie v plazme alebo v moči, ale i v slinách a pod. TDM je súčasťou monitorovania liečby chronicky a kriticky chorých pacientov. Je zdôvodnené u pacientov s odlišnou farmakinetikou liečiv -starších pacientov, novorodencov, detí a i.Sledovanie liekových hladín v priebehu terapie, alebo terapeutické monitorovanie liekov, je kom...

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“…distribution (Yd) (7). It is mainly metabolized by the liver (with a half-life averaging about 3.5 h in children and 8 h in adults) and its major metabolites are 3-methylxanthine, I-methyluric acid and 1,3-dimethyluric acid (7,(18)(19)(20). Although theophylline's metabolism could be represented by linear kinetics (21), there is evidence that at least one metabolic pathway exhibits saturation kinetics that follows the general form of the Michaelis-Menten equation (18,22).…”

Section: Theophylline Eliminationmentioning

confidence: 99%

“…at time t = 0, total theophylline plasma concentration is equal to To: SYSTEM IDENTIFICATION Identification of the system (Eq, la-d) requires accurate simultaneous measurement of theophylline and its major metabolites in blood and urine samples. Since theophylline is structurally related to its metabolites and caffeine, which is present from various dietary sources in many samples, it is important that any assay employed is free from interference from such compounds (19). High-performance liquid chromatography based techniques not only meet these requirements, but also can be used in emergency clinical situations and a number of such assays have been recently developed (20,26).…”

Section: Analytical Solutionmentioning

confidence: 99%

Individualization of theophylline infusion rate on the basis of a nonlinear compartmental pharmacokinetic model

Nikiforidis

Argyropoulos

Kassimatis

et al. 1997

European Journal of Drug Metabolism and Pharmacokinetics

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In the present paper, a nonlinear compartmental model for theophylline pharmacokinetics is developed. The analytical solution of the model, in parametric form, is derived under plateau conditions for plasma metabolite concentration. The parameters are obtained from plasma and urine data using best fitting techniques and their values are used in order to calculate maintenance intravenous infusion. Numerical simulation is then performed in order to compare the drug concentration obtained by our approach with that of alternative intravenous regimens. The differences argue for individualized dosage regimens, since theophylline is a drug with a narrow therapeutic window and its concentration at the active sites strongly depends on characteristic parameters of the patient's response. Our results show that it is possible to estimate the patients' parameters during the first 8 h after intravenous administration of the drug and these parameters can be used to design an individualized dosage regimen in patients receiving theophylline intravenously.

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The Clinical Use and Measurement of Theophylline

Cited by 45 publications

References 95 publications

Investigation of the effect of theophylline administration on total, free, short-chain acyl and long-chain acyl carnitine distributions in rat renal tissues

Investigation of the effect of theophylline administration on total, free, short-chain acyl and long-chain acyl carnitine distributions in rat renal tissues

Clinical significance of therapeutic drug monitoring in pharmacotherapy rationalization and individualization

Individualization of theophylline infusion rate on the basis of a nonlinear compartmental pharmacokinetic model

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