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Theophylline disposition in adolescents with asthma
1Department of Pediatrics, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10467-2490.
Therapeutic Drug Monitoring
|July 1, 1991
Summary
Adolescent medication dosing needs adjustment during puberty. Changes in body size and composition significantly impact drug half-life, making dose adjustments crucial for effective treatment.
Area of Science:
- Pharmacology
- Pediatric Medicine
- Adolescent Health
Background:
- Adolescents require careful medication management due to rapid physiological changes.
- Optimizing drug efficacy and safety necessitates understanding pharmacokinetic alterations during puberty.
Purpose of the Study:
- To investigate the relationship between pubertal development, body composition, and theophylline disposition in adolescents.
- To determine if changes in body size and organ function influence drug half-life and dosage requirements.
Main Methods:
- Studied theophylline disposition in 70 asthmatic adolescents (ages 8-18).
- Measured chronological age, anthropometric parameters, and derived lean body mass (LBM).
- Calculated half-life (t1/2), volume of distribution, and clearance.
Main Results:
- Half-life significantly correlated with developmental stage (Tanner), age, height, LBM, and weight.
- Lean body mass was significantly correlated with the volume of distribution.
- Developed predictive models for half-life incorporating sex and height or LBM.
Conclusions:
- Chronological age alone is insufficient for adolescent medication dosing.
- Drug half-life increases with height and LBM during puberty.
- Dose adjustments are critical during rapid growth phases to ensure therapeutic efficacy and prevent toxicity.