Assessment of Clinical Application of Test-Dose Concept for Theophylline in Patients with Respiratory Failure
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概要
- 論文の詳細を見る
The possibility of clinical application of test-dose concept for theophylline was assessed in 11 patients with serious underlying disease who required theophylline. Based on the pharmacokinetic parameters calculated from the single intravenous aminophylline administration, they received a continuous infusion of aminophylline in order to maintain about 10 μg/ml plasma which is considered to be the lowest therapeutic level. Plasma levels during a constant rate infusion were assayed at 6 : 00,noon, 18 : 00 and midnight on the 3rd or 4th day after the infusion had started. There were no significant differences among plasma levels at each sampling time, but plasma levels varied ranging from 5.1 to 24.8 μg/ml (12.1±5.5 μg/ml : mean±S.D.), which values were in disagreement with the predicted value in some cases. The correlations of the theophylline clearance ratio to dose, pH, arterial partial pressures of oxygen (Pao_2) and carbon dioxide (Paco_2) ratios, which were calculated by dividing the value during continuous infusion by the value at the test dose, were investigated to evaluate which factor largely contributed to the failure of this dosing method. Although the clearance ratio did not correlate to pH and Pao_2 ratios, significant negative relationships were observed between the clearance ratio and the dose (p < 0.05) or Paco_2 ratios (p < 0.02). In other words, the alternation of dose or Paco_2 resulted in the change of theophylline clearance. These findings suggest that the test-dose concept should not be used in the seriously ill patients whose theophylline clearance can change easily in relation to dose and/or Paco_2 change.
- 社団法人日本薬学会の論文
著者
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YOSHIDA Hiroshi
Department of Clinical Laboratory Medicine, Fukushima Medical College
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Terashima Toshio
Department of Internal Medicine, Fujita-Gakuen University School of Medicine
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Terashima Toshio
名古屋記念病院
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Terashima Toshio
Department Of Internal Medicine Nagoya Memorial Hospital:department Of Hospital Pharmacy School Of M
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GOTO Mitsuyoshi
Department of Hospital Pharmacy Nagoya Memorial Hospital
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KUSAFUKA Hiromitsu
Department of Internal Medicine Nagoya Memorial Hospital
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HORIUCHI Tadashi
Department of Internal Medicine Nagoya Memorial Hospital
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MIZUGAKI Ichiro
Department of Internal Medicine Nagoya Memorial Hospital
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JOHNO Ikuo
Department of Internal Medicine Nagoya Memorial Hospital
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KITAZAWA Shikifumi
Department of Internal Medicine Nagoya Memorial Hospital
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Johno I
Department Of Internal Medicine Nagoya Memorial Hospital:department Of Hospital Pharmacy School Of M
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HAYAMI Yumi
Japan Fine Ceramics Center
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Yoshida Hiroshi
Department Of Biophysics Graduate School Of Science Kyoto University
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Kitazawa S
Nihon Univ. Chiba Jpn
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Terashima T
Department Of Anatomy And Neurobiology Kobe University Graduate School Of Medicine
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Terashima Toshio
Department Of Anatomy Kobe University School Of Medicine
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Horiuchi T
Soka Univ. Tokyo Jpn
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Kusafuka Hiromitsu
Department Of Internal Medicine Nagoya Memorial Hospital:department Of Hospital Pharmacy School Of M
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Yoshida H
Department Of Hospital Pharmacy Nagoya Memorial Hospital
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Mizugaki Ichiro
Department Of Internal Medicine Nagoya Memorial Hospital:department Of Hospital Pharmacy School Of M
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Yoshida Hiroshi
Departmen Of Radiology School Of Medicine Asahikawa Medical University
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TERASHIMA Toshio
Department of Anatomy and Developmental Neurobiology, Kobe University Graduate School of Medicine
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KITAZAWA Shikifumi
Department of Hospital Pharmacy, Keio University School of Medicine
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KITAZAWA Shikifumi
Department of Hospital Pharmacy, Keio University Hospital
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