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Date of Award

1992

Document Type

Thesis - Pacific Access Restricted

Degree Name

Master of Science (M.S.)

Department

Graduate School

First Advisor

Arthur F. Harralson

First Committee Member

Bertram L. Lum

Second Committee Member

Robert Oberlender

Third Committee Member

Paul J. Williams

Fourth Committee Member

Robert W. Coleman

Abstract

The theophylline clearance was evaluated in patients with liver dysfunction and/or congestive heart failure. One hundred and twenty two patients were categorized into four groups; Group I: Liver dysfunction (n=20), Group II: Congestive heart failure (CHF, n=22), Group III: Both liver dysfunction and CHF (n=12), and Group IV: Control group (n=68). The severity of liver dysfunction and CHF were evaluated using Child-Turcotte- Pugh index (CTP) and a Cardiac Function index, respectively. Theophylline clearance was significantly decreased in Groups I, II, and III when compared to the control group; but, no significant difference was found among these three groups (mean values were 0.515, 0.479, 0.417, and 0.682 mllmin/kg, respectively). Moreover, patients with compensated cirrhosis or moderate to severe CHF had the lowest theophylline clearance values (mean values 0.344, and 0.335 ml/min/kg, respectively). There was a significant correlation between Cardiac Function index and theophylline clearance (r=-0.621) in Group II. Smokers had larger theophylline clearance values than those of nonsmokers in Groups I, II, and IV. Impairment of theophylline clearance did not correlate well with any of the indices of liver function or the CTP index. A model for prediction of the clearance in CHF was developed, which consisted of a Cardiac Function index and smoking habit. This model accounts for approximately 60% of the variation of theophylline clearance. However, models describing theophylline clearance in liver dysfunction and in congestive heart failure with liver dysfun ction did not appear to be useful. Thus, routine laboratory data and indices of liver function were not helpful in evaluating the impaired hepatic theophylline elimination. The Cardiac Function index appeared to be useful in estimation of theophylline clearance in CHF; however, the association between the theophylline clearance and severe CHF needs to be evaluated further.

Pages

89

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