Plasma theophylline concentrations in patients with chronic obstructive airways disease after administration of a new sustained release theophylline formulation.

Taylor, Simon; Kinney, C. D.; McDevitt, DG

doi:10.1111/j.1365-2125.1982.tb01423.x

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…In theory, the dose required to produce a 'mean' concentration to 10 ,g/ml should be less than that needed to produce a similar trough concentration, although the differences should be minimised with a slow-release preparation. In a previous study using the same slow-release theophylline preparation in patients with obstructive airways disease (Taylor et al, 1982), the steady-state trough theophylline concentration was 7.7 + 1.7 ,ug/ml (mean + s.e. mean) and was not significantly different from the 'mean' steady-state level (area under the curve/dosing interval) of 8.0 + 1.5 ,ug/ml.…”

Section: Discussionmentioning

confidence: 85%

Prediction of optimum oral theophylline dose in patients with obstructive airways disease.

Taylor¹,

Kinney²,

McDevitt³

1983

Brit J Clinical Pharma

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1 The hypothesis that a logarithmic correlation exists between the plasma theophylline concentrations 6 h after a test dose C(6) and the maintenance dose calculated to achieve a desired drug concentration during chronic oral administration (DM,CALC) was tested. A nomogram based on this relationship was evaluated as a means of predicting the optimum dose of theophylline in 14 patients with obstructive airways disease (DM,PMRD).2 Each patient was given 5 mg/kg theophylline intravenously (i.v.) and plasma theophylline concentrations were measured for 12 h thereafter including one exactly 6 h after commencing the i.v. infusion C(6). Pharmacokinetic parameters derived from the plasma concentration-time curve were used to establish DM,CALC for a concentration of 10 ,ug/ml. DM,PPED was obtained from the nomogram using both the optimum and the actual values for C(6). Subsequently oral sustained-release theophylline was administered and the dose adjusted to establish a trough concentration of approximately 10 ,ug/ml. This dose was then corrected arithmetically, assuming a linear relationship between dose and plasma level, to represent that required to achieve a plasma concentration of exactly 10 ,ug/ml (DM,AC-)- 3 The correlation between C(6) and log DM,CALC was confirmed (r = 0.97 P < 0.001), validating the hypothesis. DM,ACT was found to correlate significantly with DM,PRED (r = 0.90, P < 0.01) substantiating the value of the nomogram. In nine of the 14 patients, DM,ACr corresponded satisfactorily to DM,PRED. In the remaining five, for whom DM,ACT lay outside the 95% confidence limits for the predicted dose, DM,PRED in general underestimated DMACT, an advantage in a drug with a low therapeutic index. The predictive error for DM,PRED was lower than that for DM,CALC and the bias using either method was not significant. 4 The results suggest that a single plasma theophylline assay following a test dose, and the nomogram may be useful in simplifying optimal theophylline administration.

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Section: Discussionmentioning

confidence: 85%

Prediction of optimum oral theophylline dose in patients with obstructive airways disease.

Taylor¹,

Kinney²,

McDevitt³

1983

Brit J Clinical Pharma

Self Cite

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“…Other investigators have also observed a large interpatient variability in theophylline pharmacokinetics in the elderly with COPD using other sustained release formulations. In the study reported by Taylor et al [14] in hospitalized patients with COPD aged 56-78 years, a mean dosage of 13 mg/day per kg of BW of Nuelin 1 achieved a Css min between 3.7 and 14.5 mg/l and a Css max between 5.1 and 18.6 mg/l. In the study reported by Montgomery et al [15] in hospitalized patients with COPD aged 55-88 years, a median dosage of 12.6 mg/day per kg of BW of Theo-Dur 1 (range 5.8-24.5) was needed to achieved a median trough concentration of 9.1 mg/l (range 6.8-16.5 mg/l).…”

Section: Interpatient Variabilitymentioning

confidence: 93%

Pharmacokinetics of an ultralong sustained‐release theophylline formulation when given twice daily in elderly patients with chronic obstructive pulmonary disease: Monitoring implications

Armijo

Sánchez

Peralta

et al. 2003

Biopharm & Drug Disp

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The steady-state pharmacokinetics of an ultralong sustained release formulation of theophylline (Unilong) twice daily (bid) in elderly hospitalized patients suffering from chronic obstructive pulmonary disease (COPD) have been studied in order to establish guidelines for monitoring. The study was carried out in 37 patients (33 men), aged 60-87 years. Samples were collected from 0 to 12 h after the morning dose on day 9 of treatment with 250 mg bid (n=25) or 375 mg bid (n=12). Considerable variability in apparent clearance (range 0.33-1.49 ml/min per kg of ideal body weight), Css(min)/D (range 0.28-1.86), Css(max)/D (range 0.65-2.33) and (Css(max)-Css(min))/Css(avg) (range 0.18-0.80) was observed. There was no significant correlation between the patient's age and apparent clearance within this elderly population. The concentration-to-dose ratio and the relationship between the steady-state plasma concentration at different times during the dosage interval and Css(avg) are described. It is concluded that the interpatient variability in peak-trough fluctuation of this formulation was higher than that described in healthy volunteers by other investigators, and that the apparent clearance did not decrease with age within this elderly population with COPD. The importance of theophylline monitoring is emphasized and rules to estimate Css(avg) and Css(5h) from Css(0h) when only a single sample obtained before the morning dose is available are given.

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“…Patients are usually hospitalised in-patients [14][15][16], and both the patients or volunteers selected, as well as the conditions of the study, are careful ly controlled. For example, diet is often restricted to avoid xanthine-containing food and drinks on blood sampling days, patients are rested in hospital wards or in out-patient clinics rather than being ac tive, smoking is controlled or selected groups of smokers/non-smokers only are used [17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Sustained-Release Theophylline Preparations

Steenhoek¹,

Palmen

1984

Respiration

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The comparative efficacy and patient compliance with treatment using three sustained-release theophylline preparations currently available in The Netherlands were evaluated by measuring the plasma concentration achieved in a survey of 282 hospital and 185 out-patients. Compliance was dramatically better amongst in-patients than those attending out-patient clinics. Complete treatment avoidance was higher than expected. Compliance was better among non-smokers than among patients who were still smoking. Patients clearly preferred preparations which permitted a simple daily dosing schedule requiring the minimum number of tablets. On this basis and that of the parameters measured, Theolair Retard was the preparation of choice. Plasma concentration should be monitored during long-term theophylline treatment.

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Plasma theophylline concentrations in patients with chronic obstructive airways disease after administration of a new sustained release theophylline formulation.

Cited by 4 publications

References 7 publications

Prediction of optimum oral theophylline dose in patients with obstructive airways disease.

Prediction of optimum oral theophylline dose in patients with obstructive airways disease.

Pharmacokinetics of an ultralong sustained‐release theophylline formulation when given twice daily in elderly patients with chronic obstructive pulmonary disease: Monitoring implications

Sustained-Release Theophylline Preparations

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