Pharmacokinetic Evaluation of Two Doses of Aminophylline/Theophylline Administered as Multiple Intermittent Infusions to Iranian Apneic Premature Neonates Pharmacokinetic of multiple intermittent infusions aminophylline/theophylline
Iranian Journal of Pharmaceutical Sciences,
Vol. 7 No. 3 (2011),
1 July 2011
,
Page 151-163
https://doi.org/10.22037/ijps.v7.41312
Abstract
Many premature neonates suffer from apnea, and aminophylline is administrated for them. The objective of this study was to reveal pharmacokinetic (PK) parameters of theophylline in Iranian premature neonates. Premature neonates (68) who were admitted in the Neonatal Intensive Care Unit (NICU) of Namazi, Hafez, and Zeinabieh Hospitals were included in the study. All of them received 5 mg/kg aminophylline. One group received 1 mg/kg/8 h and the other group received 2 mg/kg/8 h as maintenance dose. One blood sample was taken in steady-state on just before eleventh dose. Theophylline level was determined with immunoassay kit. There was a significant difference in average serum concentration (Cave ss ) between two dosing levels (7.69±2.92 µg/ml vs. 11.44±3.80 µg/ml). Furthermore, the total clearance and volume of distribution were significantly different in two groups. No significant correlation could be found between the gender and Cave ss in different dosing levels. Postnatal age and postconceptional age have significant relationship with Cave ss just in the second group. According to theophylline serum concentrations, these two dosages produce therapeutically safe and effective blood levels. Pharmacokinetic parameters in these patients–in two dosing groups–approximately are correlated with other reported and recommended amounts.
- Aminophylline;
- Apnea;
- Pharmacokinetics;
- Premature neonates;
- Theophylline.
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References
[2] Murophy JE. Theophylline. In: Clinical Pharmacokinetic. 4th ed. ASHP, 2008; pp. 301-13.
[3] Jones RA, Baillie E. Dosage schedule for intravenous aminophylline in apnoea of prematurity; based on pharmacokinetic studies. Arch Dis Child 1979; 54: 190-3.
[4] Shannon DC, Gotay F, Stein IM, Rogers MC, Todres ID, Moylan FMB. Prevention of apnea and bradycardia I: low-birthweight infants. Pediatrics 1975; 55: 589-94.
[5] Lagercrantz H, Rane A, Tunell R. Plasma concentration-effect relationship of theophylline in treatment of apnea in preterm infants. E J Clin Pharmacol 1980; 18: 65-8.
[6] Pesce AJ, Rashkin M, Kotagal U. Standards of laboratory practice: theophylline and caffeine monitoring. Clin Chem 1998; 44: 1124-8.
[7] Jenne JW, Wyze E, Rood FS, Mac Donald FM. Pharmacokinetic of theophylline: application to adjustment of the clinical dose of aminophylline.Clin Pharmacol Ther 1972; 13: 349-60.
[8] Weinberger M, Ginchansky E. Dose-dependent kinetic of theophylline disposition in asthmatic children. J Pediatr 1977; 91: 820-4.
[9] Macnamary DG, Nixon GM, Anderson BJ. Methylxanthine for the treatment of apnea associated with bronchiolitis and anesthesia. Pediatr Anesthesia 2004; 14: 541-550.
[10] Lowry JA, Jarrett RV, Wasserman G, Pettett G, Kauffman RE. Theophylline toxicokinetics in premature newborns. Arch Pediatr Adolesc Med 2001; 155: 934-9.
[11] Muttitt SC, Tierney AJ, Finer NN. The doserespond of theophylline in the treatment of apnea of prematurity.J Pediatr 1988;112:115-21.
[12] McEvoy GK. AHFS drug information essentials.USA: American Society of Health-System Pharmacists, 2006; pp. 3554-78.
[13] Aranda JV, Sitar DS, Parsons WD, Loughnan PM, Neims AH. Pharmacokinetic aspects of theophylline in premature newborns. N Eng J Med 1976; 295: 413-6.
[14] Giacoia G, Jusko WJ, Menke J, Koup JR. Theophylline pharmacokinetic in premature infants with apnea. J Pediatr 1976; 89: 829-32.
[15] Dothey CI, Tserng KY, Kaw S, King KC.Maturational changes of theophylline pharmacokinetic in preterm ifants. Clin Pharmacol Ther 1989; 45:461-8.
[16] Eriksson M, Paalzow L, Mariam TW. Pharmacokinetic of theophylline in Ethiopian children of differing nutritional status. Eur J Clin Pharmacol 1983; 24:89-92.[17] Gilman JT, Gal P, Levine RS, Hersh CB, Erkan NV. Factors influencing theophylline disposition in 179 newborns. Ther Drug Monit 1986; 8: 4-10.
[18] Fukuda T, Yukawa E, Kondo G, Maeda T, Shino T, Kondo Y, Imamura T, Irikura M, Irie T. Population pharmacokinetics of theophylline in very premature Japanese infants with apnea. J Clin Phar Ther 2005; 30: 591-6.
[19] Nassif EG, Weinberger MM, Shannon D, Guiang SF, Hendeles L, Jimenez D, Ekwo E. Theophylline disposition in infancy. J Pediatr 1981; 98: 158-61.
[20] Aranda JV, Turmen T, Sasyniuk Betty I. Pharmacokinetic of diuretics and methylxanthines in the neonates. Eur J Clin Pharmacol 1980;18:55-63.
[21] Lönnerholm G, Lindström B, Paalzow L, Sedin G. Plasma theophylline and caffeine and plasma clearance of theophylline during theophylline treatment in the first year of life. Eur J Clin Pharmacol 1983; 24: 371-4.
[22] Kraus DM, Fischer JH, Reitz SJ, Kecskes SA, Yeh TF, McCulloch KM, Tung EC, Cwik MJ. Alterations in theophylline metabolism during the first year of life. Clin Pharmacol Ther 1993;54: 351-9.
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