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Altered clearance of theophylline in children with Down syndrome: a case series
1Department of Pharmacy Practice and Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA.
Insights
Infants with Down syndrome (DS) may experience altered theophylline pharmacokinetics, with prolonged clearance observed in most cases. This suggests a higher risk for DS patients requiring careful monitoring of theophylline therapy.
Area of Science:
- Pharmacology
- Genetics
- Pediatrics
Background:
- Down syndrome (DS), a genetic disorder due to trisomy 21, is associated with intellectual disability.
- Previous research indicates potential alterations in drug metabolism and effects in individuals with DS.
- Theophylline is a medication commonly used for respiratory conditions.
Observation:
- This study observed six infants diagnosed with Down syndrome, aged 2 to 19 months.
- These infants exhibited altered theophylline pharmacokinetics, specifically prolonged clearance in the majority of cases.
- No adverse theophylline toxicity was reported in any of the observed patients.
Findings:
- Infants with Down syndrome demonstrate a predisposition to altered theophylline pharmacokinetics.
- Prolonged theophylline clearance is a key pharmacokinetic change noted in this population.
- The precise mechanisms involve potential interactions between developmental factors, genetic variations in DS, and other health conditions or medications.
Implications:
- Patients with Down syndrome may require individualized theophylline dosing and closer therapeutic drug monitoring.
- Further research is warranted to elucidate the specific genetic and environmental factors contributing to altered drug metabolism in DS.
- These findings highlight the importance of considering genetic syndromes when managing medication therapy in pediatric patients.
Abstract:
Down syndrome (DS) is a common cause of mental retardation resulting from trisomy 21. Previous reports have described altered pharmacokinetics and pharmacodynamics in patients with DS. The authors report six cases of infants (2-19 months) with DS who demonstrated altered theophylline pharmacokinetics. Clearance was prolonged in most of these patients. No overt toxicity to theophylline was noted in any of the cases. The authors propose that patients with DS are at increased risk for altered theophylline pharmacokinetics. The etiology for altered pharmacokinetics of theophylline may be due to the interface between normal developmental changes and pharmacogenetic differences associated with DS and/or the secondary disease states and concomitant drug therapy.