Investigation of a Dosage Regimen for Intravenous Theophylline

1982 ◽  
Vol 16 (4) ◽  
pp. 301-305 ◽  
Author(s):  
Marshall C. Hughey ◽  
Richard L. Yost ◽  
J. Daniel Robinson ◽  
Eloise M. Harman
Keyword(s):  
Dosage Regimen ◽  
Serum Concentrations ◽  
Theophylline Concentration ◽  
Serum Theophylline Concentration ◽  
Serum Theophylline ◽  
Dosage Guidelines ◽  
The Mean

A study was designed to evaluate the validity of the dosage guidelines for theophylline recommended by Hendeles and Weinberger. A total of seven asthmatic smokers and non-smokers were entered and studied. Theophylline serum concentrations were determined prior to the start of therapy and at intervals following initiation of an infusion. The mean theophylline concentration attained for all subjects was 10 μg/ml, however, five of the six patients completing the study did not achieve the predicted serum theophylline concentration. Further study of higher dosage designed to achieve a concentration of 12 μg/ml is suggested.

Clinafloxacin-Theophylline Drug Interaction

1995 ◽  
Vol 29 (4) ◽  
pp. 378-380 ◽  
Author(s):  
Paul R Matuschka ◽  
Richard S Vissing
Keyword(s):  
Drug Interaction ◽  
Pharmacokinetic Interaction ◽  
Hepatic Metabolism ◽  
Chronic Obstructive ◽  
Serum Concentrations ◽  
Theophylline Concentration ◽  
Serum Theophylline Concentration ◽  
Serum Theophylline ◽  
Obstructive Pulmonary Disease ◽  
The Right

Objective: To report an apparent pharmacokinetic interaction between clinafloxacin and theophylline in a patient with chronic obstructive pulmonary disease (COPD). Case Summary: A patient with a history of COPD was admitted for a fracture of the right femoral neck. Admission medications included extended-release theophylline 400 mg bid. The initial serum theophylline concentration was 81.03 µmol/L (normal 55—110). A subsequent concentration was subtherapeutic (46.62 µmol/L) and the theophylline dosage was increased to 300 mg tid. Therapeutic steady-state concentrations were achieved. The patient later developed pneumonia and was enrolled in a study of nosocomial acquired pneumonia involving clinafloxacin versus ceftazidime. He was randomized to receive clinafloxacin 200 mg iv ql2h. After clinafloxacin therapy was initiated, the serum theophylline concentration increased into the toxic range (155.96 µmol/L). Theophylline administration was held for 2 doses and the dosage then reduced to 200 mg tid. Serum concentrations decreased to within the therapeutic range. Discussion: The fluoroquinolones have been shown to interact with the hepatic metabolism of theophylline and increase serum theophylline concentrations. The quinolone metabolite, 4-oxo-quinolone, inhibits the N-demethylation of theophylline, leading to a decrease in the clearance of theophylline. The resultant rise in theophylline concentrations corresponds with the decrease in clearance and possible toxicity. In our patient, careful monitoring of theophylline concentrations and dosage adjustments resulted in the restoration of therapeutic serum concentrations. Conclusions: The observation of this drug interaction between clinafloxacin and theophylline suggests a need for prudent monitoring of theophylline concentrations. Dosage adjustments may be warranted when this combination of medications is used. Such action may prevent significant toxicities and prolonged hospitalization. Further controlled clinical trials in healthy volunteers are needed to substantiate the interaction between clinafloxacin and theophylline.

Prevention of Apnea and Bradycardia in Low-Birthweight Infants

PEDIATRICS ◽  
1975 ◽  
Vol 55 (5) ◽  
pp. 589-594
Author(s):  
Daniel C. Shannon ◽  
Felicita Gotay ◽  
Israel M. Stein ◽  
Mark C. Rogers ◽  
I. David Todres ◽  
...  
Keyword(s):  
Low Birthweight ◽  
Serum Levels ◽  
Serum Concentrations ◽  
Theophylline Concentration ◽  
Serum Theophylline Concentration ◽  
Serum Theophylline ◽  
Recording Technique ◽  
Alarm Systems ◽  
On Line ◽  
Oral Doses

The efficacy of theophylline in preventing severe apnea was evaluated in 17 low-birthweight infants (mean weight, 1,400 gm). Apnea was detected and accurately quantified by 13-hour pneumogram recordings and correlated with serum theophylline levels. Nursing observations coupled with on-line alarm systems detected only 39% of severe apneic episodes as compared to the pneumogram recording technique. Theophylline in six hourly oral doses (1.5 to 4.0 mg/kg) yielded two-hour serum concentrations of 6.6 to 11.Oµg/ml which completely controlled apneic spells exceeding 20 seconds in duration and markedly reduced 10- 19-second apneic episodes and any resultant bradycardia. At these serum levels, toxicity was not observed. Therapy with theophylline should be instituted at a dose of 2 to 3 mg/kg every six hours and the optimum therapeutic dose should be individualized as determined by objective quantitation of apnea and serum theophylline concentration.

Management of Asthma—A Correction

PEDIATRICS ◽  
1982 ◽  
Vol 69 (5) ◽  
pp. 663-663
Author(s):  
Miles Weinberger
Keyword(s):  
Side Effects ◽  
Term Therapy ◽  
Serum Concentrations ◽  
Theophylline Concentration ◽  
Serum Theophylline Concentration ◽  
Short Term ◽  
Serum Theophylline ◽  
Short Term Therapy ◽  
Higher Doses ◽  
Optimal Effect

In the paper "Management of Asthma," table 1 presents the theophylline dose for short-term therapy of acute symptoms when serum concentrations will not be monitored.1 The data from which these recommendations were derived have subsequently been published.2 Unfortunately, it is now apparent that there is an error in the data of table 1. Safer dosage recommendations are presented in the Table. As stated in "Management of Asthma," even these doses may cause minor side effects in some patients, and higher doses may be needed for optimal effect in others but should be guided by measurement of serum theophylline concentration.

Effect of intravenous furosemide on serum theophylline concentration

1981 ◽  
Vol 38 (9) ◽  
pp. 1345-1347
Author(s):  
Paul F. Conlon ◽  
Geoffrey R. Grambau ◽  
Cary E. Johnson ◽  
John G. Weg
Keyword(s):  
Theophylline Concentration ◽  
Serum Theophylline Concentration ◽  
Serum Theophylline

scholarly journals Management of Theophylline Overdose Patients in the Intensive Care Unit

1992 ◽  
Vol 20 (1) ◽  
pp. 56-62 ◽  
Author(s):  
A. Henderson ◽  
D. M. Wright ◽  
S. M. Pond
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Muscle Relaxation ◽  
Theophylline Concentration ◽  
Serum Theophylline Concentration ◽  
Serum Theophylline ◽  
Release Preparation ◽  
Effective Delivery ◽  
Grand Mal ◽  
Theophylline Poisoning

In a retrospective survey of all adults admitted to the Intensive Care Unit with acute theophylline poisoning over the last five years, we identified 38 patients (6.8% of all admissions for poisoning), two of whom died. Thirty-five (92%) had taken a sustained-release preparation. Eight patients had grand mal seizures and six developed arrhythmias (ventricular fibrillation, 3; atrial fibrillation, 2; supraventricular tachycardia, 1). Severe vomiting was present in 34 (89%) and proved to be a serious obstacle to the administration of enteral charcoal. The vomiting was controlled by intravenous metoclopramide in seventeen patients (50%), but the remaining seventeen required mechanical ventilation with sedation and muscle relaxation for the effective delivery of nasogastric charcoal. Importantly, in nine (24%), the serum theophylline concentration continued to rise despite enteral charcoal. Charcoal haemoperfusion was used in seven (18%). We present an algorithm for the management of severe, acute theophylline poisoning.

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