Pharmacokinetics in drug therapy II: Applications of clinical pharmacokinetics in the assessment of theophylline therapy.

A patient case is presented to illustrate a systematic approach to the assessment and modification of theophylline therapy by the pharmacist using serum level analysis. The pharmacist is a pulmonary disease service is responsible for: (1) determining relevant aspects of the patient's clinical condition; (2) defining an initial theophylline administration regimen, including route, dose and schedule; (3) estimating expected theophylline levels based upon the regimen and known or assumed parameters of theophylline in the patient; (4) defining and recommending number and timing of serum samples to be drawn for analysis; (5) obtaining laboratory results and comparing with preliminary estimations; (6) assessing clinical response or toxicity, or both; and (7) recommending appropriate modifications in the theophylline regimen.