Variations in theophylline concentrations detected by 24-hour saliva concentration profiles in ambulatory children with asthma

J Allergy Clin Immunol. 1990 Aug;86(2):238-43.

Abstract

Sustained-release theophylline (SRT) therapy was monitored in ambulatory children with asthma by measuring theophylline in citric acid-stimulated saliva. Ninety-six around-the-clock saliva theophylline profiles were performed in 59 children (median age, 8.3 years) under routine life conditions. Five to seven stimulated saliva samples were collected by parents at home during a 24-hour period. Highest (Cmax) and lowest (Cmin) saliva theophylline concentrations (Sal-TC) were not consistently found after or before medication, respectively. Cmax occurred during morning hours (before or after medication) in 82% of patients. Cmax was found immediately before morning or evening dose in as many as 25% of patients. Cmin occurred in 70% of children during evening hours. Cmin was found 4 hours after morning or evening dose in 19% of patients. Excessive fluctuation in Sal-TC between pre- and post-SRT doses during both day and night hours occurred in six patients (286% +/- 87% (mean +/- SD)). Marked circadian variation in Sal-TC was disclosed in 23% of children. The first profile performed was therapeutically satisfactory in only 39% of patients; satisfactory profiles were achieved in other children after changing daily SRT dose or dosing interval. Determination of theophylline concentration in stimulated saliva specimens obtained frequently during a 24-hour period and under routine life conditions is practical and extremely valuable for close monitoring and individualization of theophylline therapy in ambulatory children with asthma.

MeSH terms

  • Adolescent
  • Asthma / drug therapy*
  • Child
  • Child, Preschool
  • Citrates
  • Citric Acid
  • Delayed-Action Preparations
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Male
  • Saliva / metabolism*
  • Theophylline / administration & dosage
  • Theophylline / pharmacokinetics*

Substances

  • Citrates
  • Delayed-Action Preparations
  • Citric Acid
  • Theophylline