THEOPHYLLINE DISPOSITION IN ADOLESCENTS WITH ASTHMA
THEOPHYLLINE DISPOSITION IN ADOLESCENTS WITH ASTHMA
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DOI：
10.1097/00007691-199107000-00005
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发表时间：
1991-07-01
影响因子：
2.5
通讯作者：
DELL, R
中科院分区：
文献类型：
--
作者：
CARY, J;HEIN, K;DELL, R
青少年经常需要药物治疗急性和慢性疾病。在身体大小和器官功能有明显变化的青春期，需要适当的剂量表以达到无毒性的效果。研究了70名8-18岁的哮喘青少年的茶碱倾向，以确定青春期身体大小、组成和器官功能的变化是否与药物倾向的变化有关。48名青少年作为门诊患者接受研究，22名在住院期间接受研究。计算所有患者的半衰期（t1/2）。仅在住院患者中测定分布量和清除率。测量实足年龄和人体测量生长参数。瘦体重（LBM）是由人体测量得出的。半衰期与发育阶段（Tanner r = 0.42，年龄r = 0.33, p < 0.01）、体型（身高r = 0.39，体重r = 0.33, p < 0.01）显著相关。体重（kg/kg）与分布体积（L/kg）极显著相关（r = 0.59, p < 0.01）。t1/2的最佳拟合包含两个变量：t1/2 = -4.57 + 1.31（性别）+ 0.0687（身高）（r = 0.48）和t1/2 = -3.54 + 1.32（性别）+ 0.0725 (LBM) （r = 0.43）。由于青少年发育速度和体型的异质性，单凭实际年龄并不是确定用药剂量的有用依据。半衰期随高度或LBM的增加而增加。虽然依从性显然是实现症状最佳控制的重要因素，但本研究表明，在青春期快速生长时期调整剂量同样重要。
Adolescents frequently require medication for acute and chronic illnesses. A proper dosage schedule is needed to achieve efficacy without toxicity during adolescence when there are marked changes in body size and organ function. Theophylline disposition was studied in 70 asthmatic adolescents, ages 8-18 years, to determine if pubertal changes in body size, composition, and organ function are associated with changes in drug disposition. Forty-eight youngsters were studied as outpatients and 22 while hospitalized. Half-life (t1/2) was computed for all patients. Volume of distribution and clearance were determined for inpatients only. Chronological age and anthropometric growth parameters were measured. Lean body mass (LBM) was derived from anthropometric measurements. Half-life was significantly correlated with developmental stage (Tanner r = 0.42, age r = 0.33, p < 0.01), and body size (height r = 0.39, LBM r = 0.33, weight r = 0.33, p < 0.01). LBM (kg/kg) was significantly correlated with volume of distribution (L/kg) (r = 0.59, p < 0.01). Best-fits for t1/2 contained two variables: t1/2 = -4.57 + 1.31 (sex) + 0.0687 (height) (r = 0.48) and t1/2 = -3.54 + 1.32 (sex) + 0.0725 (LBM) (r = 0.43). Chronological age alone is not a useful basis for determining medication dosages due to the heterogeneity in rates of development and body size among adolescents. Half-life increases with increasing height or LBM. Although compliance is clearly an important factor in achieving optimal control of symptoms, this study demonstrates that dose adjustment during times of rapid growth during puberty is equally important.