Zur Überwachung der Theophyllin-Therapie über die Saliva-Konzentration bei Kindern mit Asthma bronchiale

Abstract

Concentrations of theophylline in plasma und saliva of 84 chronic asthmatic children were determined by means of high-performance liquid chromatography. The dose of theophylline (given as dragee) varied between 12 and 28 mg/kg/die. Plasma/saliva ratios of theophylline ranged from 0.43 to 3.05 (mean value 1.39). In 16 patients measurements of theophylline in plasma and saliva were repeated. The correlation between the first and second determination of the theophylline plasma/saliva ratio was rather low (r = 0.66). Although the variation of plasma/ saliva ratios is high, the determination of theophylline levels in saliva seems to be a helpful tool to monitor the initial theophylline therapy: When a saliva concentration of 7 mg/1 theophylline was reached, 86 % of the patients were within the therapeutic range of theophylline (10–20 mg/1) in plasma. Consequently a determination of theophylline in plasma seems to be useful, if theophylline levels in saliva are above 7 mg/l. Therefore venous puncture, which is more reliable for the establishment of precise dosis regimens for theophylline, needs to be performed less frequently when premeasurements on saliva are carried out. The main goal is to standardize the collecting procedure for saliva samples so as to improve their usefulness in the prediction of serum theophylline levels.