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Re-evaluation of saliva for monitoring theophylline concentrations

Insights

Saliva theophylline concentrations showed good correlation with plasma levels but exhibited significant variability. Accurate prediction of plasma theophylline from saliva is not reliable in children.

Area of Science:

  • Pharmacokinetics
  • Clinical Chemistry

Background:

  • Theophylline is a medication used to treat respiratory diseases.
  • Monitoring theophylline levels is crucial for effective treatment and avoiding toxicity.
  • Saliva is a potential non-invasive matrix for drug monitoring.

Purpose of the Study:

  • To examine the relationship between mixed saliva and plasma theophylline concentrations in children.
  • To assess the variability in this relationship across different occasions and patients.

Main Methods:

  • Seven children aged 2 to 13 years were included in the study.
  • Mixed saliva and plasma samples were collected.
  • Theophylline concentrations in both matrices were measured.

Main Results:

  • A good correlation was observed between plasma and saliva theophylline concentrations.
  • Significant inter- and intrapatient variability in the saliva/plasma theophylline ratio was found.
  • No consistent relationship was found between unstimulated/stimulated saliva concentrations or saliva volume and plasma levels.

Conclusions:

  • While a correlation exists, plasma theophylline concentrations cannot be accurately predicted from saliva values in children.
  • The considerable variability limits the clinical utility of saliva for routine theophylline monitoring in this population.

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