Correlation of serum and saliva theophylline concentrations after administration of a sustained release preparation

Jonkman, Jhg; Koeter, Gh; Schoenmaker, R.; Vries, K. de; Greving, Je; Zeeuw, Rokus A. de

doi:10.1007/bf00554670

Cited by 16 publications

(4 citation statements)

References 15 publications

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“…Theophylline determination in saliva was proposed several years ago as a convenient and noninvasive alternative to monitoring plasma levels in children , in adults and more recently in neonates (Khanna etal, 1980). All previous published data demonstrated that theophylline saliva concentration correlates linearly plasma concentration Levy et al, 1974;Shah et (11, 1974;Johnson et al, 1975;Eney and Goldstein, 1976;Hendeles et al, 1977;Galant et al, 1977;Danhof et al, 1978;Boobis et al, 1979;Lena et al, 1980;Khanna et ul, 1980;Kelly et al, 1981;Goldsworthy et al, 1981;Jonkman et al 1981;Munch et (11, 1981;Sharma et al, 1981;Knott et al 1984;Gozal et (11, 1985;Ohmori et al, 1986;Boner et (11, 1986;Trnavska et al, 1987;Jaber et al, 1987;Orlowski et ul, 1987;Iwasaki and Baba, 1987;Aviram et rrl, 1987;Juntunen et al, 1988;Siege1 et al, 1990;Bidat et ul, 1990). However, the variability found in interindividual serudsaliva ratios and the wide scattering among the data points obtained with nonstimulated saliva actually precluded the clinical use of non-stimulated saliva measurements for the assessement of serum concentration of theophylline (Hendeles et al, 1977;Galant et ul, 1977;Danhof and Breimer, 1978;Boobis et ul, 1979;Jonkman et al, 1981;Kelly et ul, 1981;Munch et al 1981;Sharma et al, 1981;Boner et id, 1986;Iwasaki and Baba, 1987).…”

Section: Introductionmentioning

confidence: 95%

Could saliva stand for plasma in theophylline monitoring in asthmatic children? Still a controversial problem

Gao

Pons

Rey

et al. 1992

Fundamemntal Clinical Pharma

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Theophylline determination in saliva was proposed several years ago as a convenient and non-invasive alternative to monitoring plasma in children and adults. Published data demonstrated that theophylline saliva concentration linearly correlates plasma concentration. However, the variability found in interindividual serum/saliva ratios and the wide scattering among the data points precluded the clinical use of saliva for theophylline monitoring. The purpose of this study was to compare different standardized methods for obtaining stimulated saliva intending to reduce the variability in plasma/saliva ratios and to determine the most reliable one. A group of 150 ambulatory chronic asthmatic 4.5 to 20.83 (10 +/- 3.7; M +/- SD) year-old patients receiving theophylline 6.85 +/- 1.88 mg/kg every 12 h as slow release preparations for 4 to 100 days was studied. One ml venous blood and salivary specimens were simultaneously collected 5.15 +/- 0.36 h after the morning maintenance dose. In a subgroup of 75 patients, saliva was collected using first a new device called salivette, immediately followed by the collection of an expectorated sample 30 s after citric acid crystals stimulation. In the other patients saliva was collected using citric acid containing salivette. Theophylline concentration was determined using HPLC. For all types of saliva collection, salivary and plasma theophylline concentrations correlated significantly. However whichever method was used, based on the -2 to +2 SD interval, a large range of plasma theophylline was predicted from a single salivary theophylline concentration. Despite a further standardization of the sampling of saliva, saliva theophylline could not accurately predict plasma concentration.

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Section: Introductionmentioning

confidence: 95%

Could saliva stand for plasma in theophylline monitoring in asthmatic children? Still a controversial problem

Gao

Pons

Rey

et al. 1992

Fundamemntal Clinical Pharma

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“…standard deviation; range, [4][5][6][7][8][9][10][11][12][13][14][15][16][17] were collected simulta-Theophylline is widely used in the treatment of chronic obstructive airway diseases in children. Because of the low therapeutic index of theophylline ' careful monitoring of serum-theophylline levels has been advocated.…”

Section: Introductionmentioning

confidence: 99%

A prospective trial using salivary‐theophylline levels to guide asthma therapy

Virchow¹,

Mansfeld²,

Matthys³

et al. 1992

Pediatric Pulmonology

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In three prospectively designed studies, first saliva (SA) samples were collected simultaneously with serum (SE) from 86 children who received slow-release theophylline (Th) b.i.d. for treatment of bronchial asthma. SA was collected with a standardized sampling procedure. Regression analysis revealed a close correlation between SE and SA-Th levels (r = 0.959; SE = 1.87 x SA + 0.05) and yielded a "therapeutic SA-Th range" of 5.8 to 10.7 mg/L. In 16 children the diurnal variation was then assessed by measuring 6 SA-Th levels within 24 hr, using the same sampling method. At 0, 9, and 24 hr SE-Th levels were also measured. The levels of SE-Th and SA-Th were again closely correlated (0.914 less than or equal to r less than or equal to 0.949) and both remained constant over the 24-hr period. In the third prospective trial only SA levels were used to monitor Th therapy in 50 asthmatic children. Seven days after starting therapy SA-Th levels were measured and then the Th dose was increased weekly until SA-Th levels above 5.8 mg/L were reached. The following day SE and SA samples were collected simultaneously and their Th levels compared. In 36 of the 47 children who completed the study therapeutic SE-Th levels (greater than or equal to 10 and less than or equal to 20 mg/L) were measured; in one patient it was greater than or equal to 20 mg/L, in 6 it was between 8.0 and 10 mg/L, and only 4 had SE levels less than 8.0 mg/L.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…Monitoring of serum theophylline levels is well established because of the narrow range of optimal serum concentration and the great interindividual differences in pharmacokinetics especially in ~h i l d r e n .~.~ Knowledge of theophylline levels is also useful in assessing and improving patient ~o m p l i a n c e .~ In order to make theophylline drug monitoring more convenient for the patient, numerous investigators have studied the accuracy of salivary theophylline levels in predicting serum levels and have obtained conflicting results . [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] In this study we have investigated the accuracy and predictive value of saliva theophylline measurements using fluorescence polarization immunoassay (FPIA), which has been proven to be a reliable The Seralyzer (reagent strip reflectance photometer method), which can be used for rapid theophylline determination in an ambulatory setting,21,22 was simultaneously tested. We tried to make sampling of saliva easier by using a special device.…”

Section: Introductionmentioning

confidence: 99%

Monitoring theophylline levels in serum and saliva using fluorescence polarization immunoassay and seralyzer

Schulte¹,

W²,

Schmidt³

et al. 1989

Pediatric Pulmonology

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The reliability and predictive value of salivary theophylline levels was investigated in 58 children who were treated with oral sustained-release theophylline preparations for bronchial asthma. Serum and saliva levels were assessed by fluorescence polarization immunoassay (FPIA), and Seralyzer (reagent strip reflectance photometer method). Forty-six paired serum and saliva samples from 28 patients (Group 1) were used to develop a linear regression formula. This formula was tested on 130 paired serum and saliva samples from 32 patients (Group 2). When saliva theophylline levels were assayed using FPIA, 95% of serum levels were predicted within 30% of the measured value. Using Seralyzer, 95% of serum levels were predicted within 45% of the measured value. For patients with three and more paired serum and saliva specimens, individual regression formulas were determined showing considerable variation. This study indicates that salivary theophylline levels provide for an estimation of serum levels if FPIA is used. The Seralyzer technique is only useful for serum theophylline measurements. Using a special device it is now easier to obtain saliva samples than by conventional methods.

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Correlation of serum and saliva theophylline concentrations after administration of a sustained release preparation

Cited by 16 publications

References 15 publications

Could saliva stand for plasma in theophylline monitoring in asthmatic children? Still a controversial problem

Could saliva stand for plasma in theophylline monitoring in asthmatic children? Still a controversial problem

A prospective trial using salivary‐theophylline levels to guide asthma therapy

Monitoring theophylline levels in serum and saliva using fluorescence polarization immunoassay and seralyzer

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