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Theophylline Toxicity in Term Infants

Theophylline Toxicity in Term Infants Abstract • The pharmacokinetics of theophylline were studied in 1-month-old term infants who received accidental overdoses of theophylline during treatment for bronchiolitis. Both infants survived without neurologic sequelae. Elimination half-life values of 14.5 and 15.2 hours, respectively, were shorter than reported in premature infants but longer than in infants aged 3 months or older. Caffeine appeared in the sera of both patients, who had not received it in any form. In term infants, elimination of theophylline may occur by N-methylation in contrast to older patients in whom the drug is chiefly eliminated by demethylation and oxidation. Theophylline has not been proved effective for the treatment of bronchiolitis. It should be used with caution for wheezing in very young infants until its pharmacokinetics have been studied further in nontoxic, full-term infants younger than age 3 months. (Am J Dis Child 134:39-41, 1980) References 1. Evenson MA, Warren BL: Serum theophylline analysis by high-pressure liquid chromatography . Clin Chem 22:851-855, 1976. 2. Simons KJ, Simons FER, Briggs CJ, et al: Theophylline protein binding in humans . J Pharm Sci 68:252-253, 1979.Crossref 3. Gibaldi M, Perrier D: Pharmacokinetics . New York, Marcel Dekker Inc, 1975, pp 1-6. 4. White BH, Daeschner CW: Aminophylline (theophylline ethylenediamine) poisoning in children . J Pediatr 49:262-271, 1956.Crossref 5. Vaucher Y, Lightner ES, Walson PD: Theophylline poisoning . J Pediatr 90:827-830, 1977.Crossref 6. Nobel PA, Light GS: Theophylline-induced diuresis in the neonate . J Pediatr 90:825-826, 1977.Crossref 7. Loughnan PM, McNamara JM: Paroxysmal supraventricular tachycardia during theophylline therapy in a premature infant . J Pediatr 92:1016-1018, 1978.Crossref 8. Aranda JV, Dupont C: Metabolic effect of theophylline in the premature neonate . J Pediatr 89:833-834, 1976.Crossref 9. Zwillich CW, Sutton FD, Neff TA, et al: Theophylline-induced seizures in adults: Correlation with serum concentrations . Ann Intern Med 82:784-787, 1975.Crossref 10. Lawyer C, Aitchison J, Sutton J, et al: Treatment of theophylline neurotoxicity with resin hemoperfusion . Ann Intern Med 88:516-517, 1978.Crossref 11. Piafsky KM, Sitar DS, Rangno RE, et al: Theophylline disposition in patients with hepatic cirrhosis . N Engl J Med 296:1495-1497, 1977.Crossref 12. Russo ME: Management of theophylline intoxication with charcoal-column hemoperfusion . N Engl J Med 300:24-26, 1979.Crossref 13. Weinberger M, Ginchansky E: Dose-dependent kinetics of theophylline disposition in asthmatic children . J Pediatr 91:820-824, 1977.Crossref 14. Simons FER, Simons KJ: Pharmacokinetics of theophylline in infancy . J Clin Pharmacol 18:472-476, 1978.Crossref 15. Aranda JV, Sitar DS, Parsons WD, et al: Pharmacokinetic aspects of theophylline in premature newborns . N Engl J Med 295:413-416, 1976.Crossref 16. Neese AL, Soyka LF: Development of a radioimmunoassay for theophylline: Application to studies in premature infants . Clin Pharmacol Ther 21:633-641, 1977. 17. Giacoia G, Jusko WJ, Menke J, et al: Theophylline pharmacokinetics in premature infants with apnea . J Pediatr 89:829-832, 1976.Crossref 18. Landay RA, Gonzalez MA, Taylor JC: Effect of phenobarbital on theophylline disposition . J Allergy Clin Immunol 62:27-29, 1978.Crossref 19. Piafsky KM, Sitar DS, Ogilvie RI: Effect of phenobarbital on the disposition of intravenous theophylline . Clin Pharmacol Ther 22:336-339, 1977. 20. Thompson RD, Nagasawa HT, Jenne JW: Determination of theophylline and its metabolites in human urine and serum by high-pressure liquid chromatography . J Clin Lab Med 84:584-593, 1974. 21. Bory C, Baltassat P, Porthault M, et al: Metabolism of theophylline to caffeine in premature newborn infants . J Pediatr 94:988-993, 1979.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1980 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1980.02130130031009
Publisher site
See Article on Publisher Site

Abstract

Abstract • The pharmacokinetics of theophylline were studied in 1-month-old term infants who received accidental overdoses of theophylline during treatment for bronchiolitis. Both infants survived without neurologic sequelae. Elimination half-life values of 14.5 and 15.2 hours, respectively, were shorter than reported in premature infants but longer than in infants aged 3 months or older. Caffeine appeared in the sera of both patients, who had not received it in any form. In term infants, elimination of theophylline may occur by N-methylation in contrast to older patients in whom the drug is chiefly eliminated by demethylation and oxidation. Theophylline has not been proved effective for the treatment of bronchiolitis. It should be used with caution for wheezing in very young infants until its pharmacokinetics have been studied further in nontoxic, full-term infants younger than age 3 months. (Am J Dis Child 134:39-41, 1980) References 1. Evenson MA, Warren BL: Serum theophylline analysis by high-pressure liquid chromatography . Clin Chem 22:851-855, 1976. 2. Simons KJ, Simons FER, Briggs CJ, et al: Theophylline protein binding in humans . J Pharm Sci 68:252-253, 1979.Crossref 3. Gibaldi M, Perrier D: Pharmacokinetics . New York, Marcel Dekker Inc, 1975, pp 1-6. 4. White BH, Daeschner CW: Aminophylline (theophylline ethylenediamine) poisoning in children . J Pediatr 49:262-271, 1956.Crossref 5. Vaucher Y, Lightner ES, Walson PD: Theophylline poisoning . J Pediatr 90:827-830, 1977.Crossref 6. Nobel PA, Light GS: Theophylline-induced diuresis in the neonate . J Pediatr 90:825-826, 1977.Crossref 7. Loughnan PM, McNamara JM: Paroxysmal supraventricular tachycardia during theophylline therapy in a premature infant . J Pediatr 92:1016-1018, 1978.Crossref 8. Aranda JV, Dupont C: Metabolic effect of theophylline in the premature neonate . J Pediatr 89:833-834, 1976.Crossref 9. Zwillich CW, Sutton FD, Neff TA, et al: Theophylline-induced seizures in adults: Correlation with serum concentrations . Ann Intern Med 82:784-787, 1975.Crossref 10. Lawyer C, Aitchison J, Sutton J, et al: Treatment of theophylline neurotoxicity with resin hemoperfusion . Ann Intern Med 88:516-517, 1978.Crossref 11. Piafsky KM, Sitar DS, Rangno RE, et al: Theophylline disposition in patients with hepatic cirrhosis . N Engl J Med 296:1495-1497, 1977.Crossref 12. Russo ME: Management of theophylline intoxication with charcoal-column hemoperfusion . N Engl J Med 300:24-26, 1979.Crossref 13. Weinberger M, Ginchansky E: Dose-dependent kinetics of theophylline disposition in asthmatic children . J Pediatr 91:820-824, 1977.Crossref 14. Simons FER, Simons KJ: Pharmacokinetics of theophylline in infancy . J Clin Pharmacol 18:472-476, 1978.Crossref 15. Aranda JV, Sitar DS, Parsons WD, et al: Pharmacokinetic aspects of theophylline in premature newborns . N Engl J Med 295:413-416, 1976.Crossref 16. Neese AL, Soyka LF: Development of a radioimmunoassay for theophylline: Application to studies in premature infants . Clin Pharmacol Ther 21:633-641, 1977. 17. Giacoia G, Jusko WJ, Menke J, et al: Theophylline pharmacokinetics in premature infants with apnea . J Pediatr 89:829-832, 1976.Crossref 18. Landay RA, Gonzalez MA, Taylor JC: Effect of phenobarbital on theophylline disposition . J Allergy Clin Immunol 62:27-29, 1978.Crossref 19. Piafsky KM, Sitar DS, Ogilvie RI: Effect of phenobarbital on the disposition of intravenous theophylline . Clin Pharmacol Ther 22:336-339, 1977. 20. Thompson RD, Nagasawa HT, Jenne JW: Determination of theophylline and its metabolites in human urine and serum by high-pressure liquid chromatography . J Clin Lab Med 84:584-593, 1974. 21. Bory C, Baltassat P, Porthault M, et al: Metabolism of theophylline to caffeine in premature newborn infants . J Pediatr 94:988-993, 1979.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Jan 1, 1980

References

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