In 15 acutely ill asthmatics the steady-state serum theophylline concentration was predicted by the method of Chiou et al. using two serum concentration measurements obtained 1 and 5h after starting a continuous infusion of aminophylline. Two theophylline assays with different precision characteristics were compared. With a precise HPLC-assay the prediction was excellent: prediction error (predicted minus measured concentration)=−0.22±1.97 mg/l (mean ± SD); r=0.922. When the theophylline concentration was determined by a rapid enzyme immunoassay of lower precision, but convenient for clinical use, the prediction was less accurate (prediction error=0.58±3.88, r=0.852). However, it was still clearly superior to dosing recommendations based on the population average of theophylline clearance, even after taking into consideration the effect of smoking, congestive heart failure and cirrhosis (prediction error=3.62±13.36, r=0.560). As employed in this study, the method may be useful in helping the physician to choose the optimal dose in severely ill asthmatics.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Piafsky KM, Sitar DS, Rangno RE, Ogilvie RJ (1977) Theophylline disposition in patients with hepatic cirrhosis. N Engl J Med 296: 1495–1497
Powell JR, Vozeh S, Hopewell P, Costello J, Sheiner LB, Riegelman S (1978) Theophylline disposition in acutely ill hospitalized patients. Am Rev Respir Dis 118: 229–238
Snider GL (1978) The treatment of asthma. N Engl J Med 298: 397–399
Hendeles L, Weinberger M (1979) Guidelines for avoiding theophylline overdose. N Engl J Med 300: 1217
Chiou WL, Gadalla MAF, Peng GW (1978) Method for the rapid estimation of the total body clearance and adjustment of dosage regimens in patients during a constant rate intravenous infusion. J Pharmacokinet Biopharm 6: 135–151
Mangione A, Imhoff TE, Lee RV, Shum LY, Jusko WJ (1978) Pharmacokinetics of theophylline in hepatic disease. Chest 73: 616–622
Jusko WJ, Gardner MJ, Mangione A, Schentag JJ, Koup JR, Vance JW (1979) Factors affecting theophylline clearances: Age, tobacco, marijuana, cirrhosis, congestive heart failure, obesity, oral contraceptives, benzodiazepines, barbiturates, and ethanol. J Pharm Sci 68: 1358–1366
Vozeh S, Kewitz G, Perruchoud A, Tschan M, Kopp C, Herzog H, Follath F (1980) Theophylline serum concentration and the therapeutic effect in patients with acute exacerbation of bronchial obstruction. Presented at the annual meeting of the Swiss Medical Society, Lugano, Switzerland
Vozeh S, Powell JR, Riegelman S, Costello JF, Sheiner LB, Hopewell PC (1978) Changes in theophylline clearance during acute illness. J Am Med Assoc 240: 1882–1884
About this article
Cite this article
Vozeh, S., Kewitz, G., Wenk, M. et al. Rapid prediction of steady-state serum theophylline concentration in patients treated with intravenous aminophylline. Eur J Clin Pharmacol 18, 473–477 (1980). https://doi.org/10.1007/BF00874658
- serum theophylline
- prediction of serum level