Changes in Theophylline Clearance During Acute Illness
- Samuel Vozeh, MD;
- J. Robert Powell, PharmD;
- Sidney Riegelman, PhD;
- John F. Costello, MB, BCh, MRCP;
- Lewis B. Sheiner, MD;
- Philip C. Hopewell, MD
- From the Division of Clinical Pharmacology, Department of Medicine (Drs Vozeh and Sheiner), and the Department of Pharmacy, School of Pharmacy (Drs Powell and Riegelman), University of California at San Francisco; and the Chest Service, San Francisco General Hospital (Drs Costello and Hopewell), San Francisco. Dr Vozeh is now with the University of Basel, Kantonsspital, Basel, Switzerland. Dr Powell is now with the College of Pharmacy, University of Arizona, Tucson. Dr Costello is now with King's College Hospital, London.
Abstract
Three patients demonstrated twofold to threefold changes in total-body theophylline clearance during the course of a single hospitalization for an acute illness. These changes paralleled the changes in the patients' clinical status. Theophylline clearance decreased in one patient with worsening airway obstruction, whereas clearance increased in one patient with resolving pneumonia and in one patient with improving congestive heart failure. Total-body theophylline clearance may be unstable in acute, severe illness. Close monitoring of plasma theophylline concentration in such situations will allow appropriate dose adjustments to be made and is, therefore, indicated.
(JAMA 240:1882-1884, 1978)
Footnotes
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Reprint requests to Department of Pharmaceutical Sciences, College of Pharmacy, University of Arizona, Tucson, AZ 85721 (Dr Powell).
