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An evaluation of theophylline dosing. Suggested by the Saudi national protocol for children with severe asthma

S I Islam1, A S Ali, N M Fida

  • 1Drug Monitoring Unit, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. dmukauh@yahoo.com

Saudi Medical Journal
|January 22, 2002
PubMed

Insights

The Saudi national protocol improved theophylline use in children with severe asthma, with 70% achieving therapeutic levels. This study recommends individualized dosing based on drug levels for better asthma management.

Area of Science:

  • Pediatric Pulmonology
  • Clinical Pharmacology

Background:

  • Severe asthma management in children requires precise medication dosing.
  • Theophylline is a key bronchodilator, but its narrow therapeutic index necessitates careful monitoring.
  • Optimizing theophylline use is crucial for effective severe asthma control in pediatric patients.

Purpose of the Study:

  • To assess the Saudi national protocol's effectiveness in optimizing theophylline use for severe pediatric asthma.
  • To analyze theophylline clearance in children and establish guidelines for individualized dosing.
  • To improve therapeutic outcomes for children with severe asthma through better theophylline management.

Main Methods:

  • Blood theophylline levels were measured in 66 children with severe asthma.
  • Patients were grouped based on adherence to Saudi national protocol dosing recommendations.
  • Theophylline clearance was calculated using steady-state levels and pharmacokinetic equations.

Main Results:

  • 70% of patients on protocol-recommended doses achieved therapeutic theophylline levels, compared to 10% in the under-dosed group.
  • Theophylline clearance was significantly higher in younger children (1-8 years) than in older children (9-13 years).
  • Mean theophylline clearance was 0.092 L/hr/kg in younger children and 0.069 L/hr/kg in older children.

Conclusions:

  • The Saudi national protocol positively impacted theophylline optimization in severe pediatric asthma.
  • Individualized theophylline dosing, guided by drug level monitoring, is recommended for optimal therapeutic effects.
  • Age-specific clearance data supports tailored dosing strategies for pediatric asthma patients.
Abstract

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