Theophylline Drug Study

In making a Drug Study, the following elements must be present:

Generic Name and the Brand name (not all brands, just the brand
used by the patient), Action, Indication, Pregnancy Category, Drug
Classification, and Contraindication, Adverse Effect, Drug
interaction and Nursing Consideration/Intervention. Most clinical
instructors preferred this to be in a long bond paper in printed or
handwritten with paper in landscape.
Theophylline
Brand Name: Bronkodyl, Elixophyllin, Quibron-T Dividose, SloPhyllin, Theolair, theophylline sodium glycinate, Elixir: Acet-Amp (CAN)
Pregnancy Category C
Drug classes: Bronchodilator, Xanthine
Therapeutic actions
Relaxes bronchial smooth muscle, causing bronchodilation and increasing
vital capacity that has been impaired by bronchospasm and air trapping;
actions may be mediated by inhibition of phosphodiesterase, which increases
the concentration of cyclic adenosine monophosphate; in concentrations that
may be higher than those reached clinically, it also inhibits the release of
slow-reacting substance of anaphylaxis and histamine.
Indications
Symptomatic relief or prevention of bronchial asthma and
reversible bronchospasm associated with chronic bronchitis and
emphysema
Unlabeled use of 2 mg/kg/day to maintain serum concentrations
between 3 and 5 mcg/mL: treatment of apnea
and bradycardia of prematurity
Contraindications
Contraindicated with hypersensitivity to any xanthines, peptic ulcer,
active gastritis, pregnancy (neonatal tachycardia, jitteriness, and
withdrawal apnea), underlying seizure disorders (unless receiving
appropriate anticonvulsant medication).

Adverse effects
Irritability (especially children); restlessness, dizziness, muscle twitching,
convulsions, severe depression, stammering speech; abnormal behavior
characterized by withdrawal, mutism and unresponsiveness alternating with
hyperactive periods
Palpitations, sinus tachycardia, ventricular tachycardia, life-threatening
ventricular arrhythmias, circulatory failure
Loss of appetite, hematemesis, epigastric pain, gastroesophageal reflux
during sleep
Proteinuria, increased excretion of renal tubular cells
and RBCs; diuresis (dehydration), urinary retention in men with prostate
enlargement
Tachypnea, respiratory arrest
Drug Interactions:
Increased effects and toxicity with cimetidine,
erythromycin, troleandomycin, ciprofloxacin, norfloxacin, ofloxacin,
hormonal contraceptives, ticlopidine, ranitidine
Possibly increased effects with rifampin
Increased serum levels and risk of toxicity in hypothyroid patients,
decreased levels in patients who are hyperthyroid; monitor patients
on thioamines, thyroid hormones for changes in serum levels as
patients become euthyroid
Increased cardiac toxicity with halothane
Decreased effects in patients who are cigarette smokers (12
packs/day); theophylline dosage may need to be increased 50%100%
Decreased effects with barbiturates, charcoal
Decreased effects of phenytoins, benzodiazepines,
and theophylline preparations
Decreased effects of nondepolarizing neuromuscular blockers
Mutually antagonistic effects of beta-blockers
and theophylline preparations

Nursing considerations
Caution patient not to chew or crush enteric-coated timed-release
preparations.
Give immediate release, liquid dosage forms with food if GI effects
occur.
Do not give timed-release preparations with food; these should be
given on an empty stomach, 1 hr before or 2 hr after meals.
Advise patients that this drug should not be used during pregnancy;
use of barrier contraceptives is recommended.
Monitor results of serum theophylline level determinations carefully,
and reduce dosage if serum levels exceed therapeutic range of 1020
mcg/mL.
Monitor carefully for clinical signs of adverse effects, particularly if
serum theophylline levels are not available.
Maintain diazepam on standby to treat seizures.