Abstract
Theophylline (T) and caffeine (C) serum concentrations were measured in 32 low birthweight premature infants using high performance liquid chromatography(HPLC).All infants were treated for apnea with T if clinically indicated with a loading dose of 4-6mg/kg followed by a maintenance dose of 2mg/kg Q12 hrs. None of the infants were receiving breast milk at the time the serum T and C concentrations were determined and there was no other known source of C intake. The mean birthweight of the infants studied was 0.92kg(range 0.65-1.20kg)and the mean gestational age was 27 wks(range 25-32wks). The mean weight of the infants was 0.86kg (range 0.46-1.05kg)after approximately 7 days of therapy when the serum concentrations were measured. Mean serum T concentration was 8mg/L(range 4 -12mg/L)and the corresponding rate of T clearance was determined to be 18.6L/kg per hr. The mean serum concentration determined simultaneously was found to be 3.2mg/L(range 1.8-5.6mg/L). Caffeine serum concentrations were found to be approximately 40% of the corresponding serum T concentration. Since no infants received C from any known source, it is suggested the C detected resulted from T metabolism. The extent of the apparent metabolism of T to C is significantly greater than that noted in adults and children. Because of the known poor clearance of C in the neonate, clinically significant C accumulation may occur in infants being treated with T only.
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Harralson, A., Hodding, J., Tejani, N. et al. 334 METABOLISM OF THEOPHYLLINE TO CAFFEINE IN THE LOW BIETHWEIGHT INFANT. Pediatr Res 15 (Suppl 4), 495 (1981). https://doi.org/10.1203/00006450-198104001-00345
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DOI: https://doi.org/10.1203/00006450-198104001-00345