Usefulness of Theophylline Saliva Levels in Neonates

Jw, Toback; P, Gál; Nv, Erkan; Roop, Carly; Robinson, Hugh P.

doi:10.1097/00007691-198306000-00006

Cited by 11 publications

(9 citation statements)

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“…Khanna et al 7 reported that saliva levels are reliable for monitoring the therapy with both theophylline and caffeine in premature infants. Three years later, Toback et al 9 revealed a ratio between serum and saliva of 1.02±0.09, which is smaller than in other studies. They estimated that saliva concentration in premature infants is approximately equal to serum concentration of theophylline.…”

Section: Discussionmentioning

confidence: 63%

“…They estimated that saliva concentration in premature infants is approximately equal to serum concentration of theophylline. 9 In the study of Aviram et al, 8 the ratio was 1.78±0.22 and the correlation coefficient r ¼ 0.96. These authors included both premature infants and older children with asthma in their study group.…”

Section: Discussionmentioning

confidence: 88%

“…Only a few studies have been conducted in premature infants and the results are not satisfactory. [7][8][9] The purpose of this study was to evaluate the correlation between serum and saliva concentration of theophylline in infants with apnoea of prematurity. A secondary variable studied was the influence of PCA on theophylline metabolism.…”

Section: Introductionmentioning

confidence: 99%

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Reliability of salivary theophylline in monitoring the treatment for apnoea of prematurity

Cherecheş-Panţa¹,

Nanulescu²,

Culea

et al. 2007

J Perinatol

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Objective: To evaluate the reliability of salivary levels of theophylline in monitoring therapy of apnoea of prematurity.Study Design: Aminophylline was administered intravenously in 13 infants with apnoea, in a loading dose of 5 mg/kg and maintenance dose of 3 mg/kg, every 8 h. The patients were divided into two groups according to their postconceptional age (PCA): group A, of infants with small PCA (32.8±2.0 weeks; n ¼ 6 cases), and group B, infants with higher PCA (37.1±0.8 weeks; n ¼ 7 cases).Result: A total of 57 paired samples of serum and saliva were obtained in all 13 infants. The mean serum level of theophylline was 7.8±5.8 mg/ml and the ratio between serum and salivary concentration of theophylline was 1.53±0.28. A strong correlation between the serum and salivary concentration of theophylline (r ¼ 0.973) was found. Infants with small PCA had significant higher serum concentration of theophylline than those with higher PCA (10.6 vs 5.3 mg/ml; P ¼ 0.0002). The difference between the mean ratios of serum/salivary theophylline levels in the two groups was low (1.44 vs 1.62; P ¼ 0.0155). Conclusion:The strong correlation of theophylline in serum and in saliva recommends the salivary levels as a reliable method for monitoring the treatment of apnoea of prematurity.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 88%

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Reliability of salivary theophylline in monitoring the treatment for apnoea of prematurity

Cherecheş-Panţa¹,

Nanulescu²,

Culea

et al. 2007

J Perinatol

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“…In contrast to the Toback et al . study, just 3 years later Khanna et al . reported a correlation value as low as 0.7 compared to Toback's 0.98.…”

Section: Resultsmentioning

confidence: 84%

“…'s study was similar to the observations of others , while Toback et al . suggest the ratio to be closer to 1. Also, that found by Culea et al .…”

Section: Resultsmentioning

confidence: 91%

A descriptive systematic review of salivary therapeutic drug monitoring in neonates and infants

Hutchinson

Sinclair

Reid

et al. 2018

Brit J Clinical Pharma

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AIMSSaliva, as a matrix, offers many benefits over blood in therapeutic drug monitoring (TDM), in particular for infantile TDM. However, the accuracy of salivary TDM in infants remains an area of debate. This review explored the accuracy, applicability and advantages of using saliva TDM in infants and neonates. METHODSDatabases were searched up to and including September 2016. Studies were included based on PICO as follows: P: infants and neonates being treated with any medication, I: salivary TDM vs. C: traditional methods and O: accuracy, advantages/disadvantages and applicability to practice. Compounds were assessed by their physicochemical and pharmacokinetic properties, as well as published quantitative saliva monitoring data. RESULTSTwenty-four studies and their respective 13 compounds were investigated. Four neutral and two acidic compounds, oxcarbazepine, primidone, fluconazole, busulfan, theophylline and phenytoin displayed excellent/very good correlation between blood plasma and saliva. Lamotrigine was the only basic compound to show excellent correlation with morphine exhibiting no correlation between saliva and blood plasma. Any compound with an acid dissociation constant (pKa) within physiological range (pH 6-8) gave a more varied response. CONCLUSIONThere is significant potential for infantile saliva testing and in particular for neutral and weakly acidic compounds. Of the properties investigated, pKa was the most influential with both logP and protein binding having little effect on this correlation. To conclude, any compound with a pKa within physiological range (pH 6-8) should be considered with extra care, with the extraction and analysis method examined and optimized on a case-by-case basis.

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Serum/Saliva Correlations for Theophylline in Asthmatics

Blanchard¹,

Harvey²,

Morgan³

1991

The Journal of Clinical Pharma

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Theophylline levels in mixed saliva (both stimulated and unstimulated) were compared with total and free (unbound) serum theophylline levels in 28 asthmatic outpatients using theophylline regularly. Stimulated saliva predicted both total and unbound serum theophylline concentrations within +/- 1 microgram/mL in 62.5% and 92.9%, respectively, of the samples examined. In addition, the total serum levels could be used to predict unbound serum concentrations to within +/- 1 mg/L in 100% of the cases that were examined. These results indicate that saliva levels predict the unbound serum theophylline levels with greater accuracy and precision than they predict total serum theophylline levels. In addition, total serum levels can be used to reliably predict unbound serum levels. The use of mixed stimulated saliva is recommended as a reliable non-invasive method for monitoring unbound serum theophylline levels. The therapeutic range for saliva, which corresponds to the accepted total serum concentration range of 10-20 mg/L, is approximately 5.6-11.3 mg/L.

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Usefulness of Theophylline Saliva Levels in Neonates

Cited by 11 publications

References 0 publications

Reliability of salivary theophylline in monitoring the treatment for apnoea of prematurity

Reliability of salivary theophylline in monitoring the treatment for apnoea of prematurity

A descriptive systematic review of salivary therapeutic drug monitoring in neonates and infants

Serum/Saliva Correlations for Theophylline in Asthmatics

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