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Dr. Mueller wrote: > Caffeine and theophylline are widely used as a treatment for > bradycardia and hypoxemia in premature infants. Because of the > toxicity of both substances TDM is recommended. In a review of > dozens of papers I found no clear recommendations for drug > monitoring. > > What are your opinions about TDM for caffein. is it useful or not, > in what cases, .....? All comments are welcome. > > Dr.H.Mueller > Institut fuer Laboratoriumsmedizin > Klinik am Eichert > Postfach 660 > 73006 Goeppingen > Deutschland > > Tel.: +49 (0)7161 642248 > Fax : +49 (0)7161 641818 > > [log in to unmask] (dienstl.) > [log in to unmask] (intern.) > [log in to unmask] (priv.) Yes, TDM for caffeine is useful as in neonates the line between therapeutic effect and toxicity is small. It has also been useful in cases where jittery babies have been admitted with normal calcium, glucose and magnesium. It is a local custom to give small children (still in prams) a bottle of cold sweet tea to suck - the caffeine levels in some have been impressvely toxic. -- Dr D G Williams Department of Biochemistry Sunderland Royal Hospital [log in to unmask] %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%