Theophylline toxicity in Thai children

Area of Science:

• Pediatric Pharmacology
• Clinical Toxicology
• Respiratory Medicine

Background:

• Theophylline is a bronchodilator for respiratory diseases but has a narrow therapeutic index.
• Theophylline toxicity can lead to severe adverse events, necessitating careful monitoring.

Purpose of the Study:

• To determine the association between plasma theophylline levels and the occurrence of toxicity symptoms in Thai children.
• To investigate the prevalence and clinical manifestations of theophylline toxicity in a pediatric population.

Main Methods:

• A study involving 44 admitted Thai children with plasma theophylline levels exceeding 20 microg/ml.
• Correlation analysis between measured theophylline blood levels and observed toxicity symptoms.

Main Results:

• The prevalence of theophylline toxicity (plasma theophylline level > 20 microg/ml) was approximately 11% in Thai children.
• A significant correlation was observed, with 34% of patients below 30 microg/ml and 78% above 30 microg/ml exhibiting toxicity symptoms.
• Common symptoms involved gastrointestinal (34%), cardiovascular (18.2%), neurological (6.8%), and metabolic (54.5%) systems.

Conclusions:

• Theophylline remains a valuable medication for pediatric respiratory conditions but requires cautious use.
• Factors contributing to toxicity include overdosage, drug interactions, impaired liver function, and specific patient conditions like congenital heart disease.
• Regular monitoring of theophylline blood levels is recommended for all pediatric patients receiving this medication.