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Does a One-Size Drug Dose Fit All?

Or, Why All the Variability in the Theophylline Blood Concentrations?


Kathleen Boje
Department of Pharmaceutical Sciences
University at Buffalo


The purpose of this case study is to make students aware that some patients may require individualized drug dosing regimens based on a variety of patient variables. The central classroom activity consists of small group work in which students analyze a set of patient data cards to identify patient characteristics that influence theophylline blood levels. It was developed for an introductory pharmaceutical sciences course but would be suitable for other students with a biological, biomedical, health sciences, or chemistry/medicinal chemistry background. A set of patient data cards is included with the case as a supplemental material. There is no separate answer key for this case, although the teaching notes identify key factors influencing theophylline concentrations.


  • Explain each of the following terms and concepts in his/her own words: pharmacokinetics, pharmacodynamics, therapeutic drug concentration range, individual variability, absorption, distribution, metabolism, and excretion.
  • Describe the pharmacokinetics of theophylline.
  • Identify individual patient characteristics that would signal a need for theophylline dosage adjustment.
  • Appreciate the complexity of dosing a prescription medication to a diverse population.
  • Analyze pharmacokinetic data similar to the kind presented in the case to make inferences and derive conclusions.


pharmacokinetics; pharmacodynamics; theophylline; therapeutic drug concentration range; individual variability; dosing; absorption; distribution; metabolism; excretion; asthma

Topical Areas


Educational Level

Undergraduate lower division, Undergraduate upper division



Type / Methods

Directed, Discussion



Subject Headings

Medicinal Chemistry  |   Nursing  |   Medicine (General)  |   Pharmacy / Pharmacology  |  

Date Posted


Teaching Notes

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Teaching notes are intended to help teachers select and adopt a case. They typically include a summary of the case, teaching objectives, information about the intended audience, details about how the case may be taught, and a list of references and resources.

Supplemental Materials

The use of the file below (Appendix A) is described in the teaching notes for this case. The file consists of 144 hypothetical patient data cards and a tracking grid.

  Appendix A