Theophylline Derivatives may enhance the hypokalemic effect of Formoterol. Select one or more newsletters to continue. Increased theophylline clearance: Hyperthyroidism; cystic fibrosis; smoking (ie, marijuana or tobacco). The client may require higher doses of theophylline than a nonsmoker Smoking cigarettes may decrease serum theophylline levels. Management: Seek alternatives when possible. "I need to drink at least 2 liters of fluid per day." CPT codes are provided only as guidance to assist clients with billing. Infants exposed to theophylline during the third trimester should be monitored for adverse events (irritability, tachycardia, vomiting) (ERS/TSANZ [Middleton 2020]). Theophylline Derivatives may enhance the hypokalemic effect of Indacaterol. Theophylline may also be used for purposes not listed in this medication guide. Patients not currently receiving methylxanthines: Oral: Immediate-release product: 5 mg/kg. (See Indications for enteral feeding.) On the average, for every 1 mg/kg theophylline given, blood concentrations will rise 2 mcg/mL. Wait at least 24 hours after the procedure to resume such agents. description Substance description Substance description. Theophylline is a weak bronchodilator and other agents are more effective for acute bronchospasm. Theophylline is typically administered orally at a dose of 400 mg/day or 6 mg/kg, whichever is lower, or intravenously as aminophylline at 0.4 mg/kg/hour. It can also be given intravenously (into a vein) for treatment for severe asthma attacks or COPD exacerbations. However, low dosage of theophylline shows anti-inflammatory and immunomodulatory effect, which raises the reconsideration of it for the treatment of severe asthma, smoking asthma, and COPD. Generic alternatives may be available. Patients who have received theophylline in the previous 24 hours: A loading dose should not be given before obtaining a serum theophylline concentration. If you miss a dose, skip the missed dose and take your next dose at the regular time. Theophylline. In addition, maternal asthma symptoms should be monitored monthly during pregnancy. Oral theophylline is a potential alternative option (not preferred) in adolescents and adults as a long-term control medication in mild asthma or as an add-on long-term control medication in moderate to severe asthma; however, a stepwise approach using inhaled corticosteroids (+/- inhaled long-acting beta agonists depending on asthma severity) is preferred to theophylline due to efficacy … Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Oral theophylline is a potential alternative option (not preferred) in adolescents and adults as a long-term control medication in mild asthma or as an add-on long-term control medication in moderate to severe asthma; however, a stepwise approach using inhaled corticosteroids (+/- inhaled long-acting beta agonists depending on asthma severity) is preferred to theophylline due to efficacy concerns and potential for adverse events (GINA 2020). As a member of the xanthine family, it bears structural and pharmacological similarity to caffeine. Tedizolid may enhance the tachycardic effect of Sympathomimetics. Brief Profile - Last updated: 13/01/2021 Print. Drinking or eating foods high in caffeine, like coffee, tea, cocoa, and chocolate, may increase the side effects caused by theophylline. Note: For maintenance treatment of asthma, experts have recommended lower doses to reduce incidence of adverse events: Initial: ~10 mg/kg/day in children and adolescents (maximum daily dose: 300 mg/day); if after at least 3 days the dose is tolerated, increase to ~13 mg/kg/day (maximum daily dose: 450 mg/day); if after at least 3 days dose increase is tolerated, increase to ~16 mg/kg/day (maximum daily dose: 600 mg/day) (Weinberger 1996). Bronchodilators are medicines that relax the muscles in the bronchial tubes (air passages) of the lungs. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information. • Cystic fibrosis: Use with caution in patients with cystic fibrosis; increased theophylline clearance may occur. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. A client receives education regarding self-administration of enoxaparin (Lovenox) on discharge to home. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. The nurse determines that the client is experiencing theophylline toxicity in which of the following? Monitor therapy, Zafirlukast: Theophylline Derivatives may decrease the serum concentration of Zafirlukast. Consider therapy modification, CYP1A2 Inhibitors (Strong): May increase the serum concentration of Theophylline Derivatives. Due to pregnancy-induced physiologic changes, some pharmacokinetic properties of theophylline are altered. Brief exposure up to 40°C (104°F) or up to 2 weeks to ultraviolet or fluorescent light does not adversely affect the product. What should I know about storage and disposal of this medication? Base once-daily dosing on the twice daily dosing and initiate at the end of the last every 12-hour dosing interval. Consider therapy modification, Iopamidol: Agents With Seizure Threshold Lowering Potential may enhance the adverse/toxic effect of Iopamidol. Theophylline is used to treat lung diseases such as asthma and COPD (bronchitis, emphysema).It must be used regularly to prevent wheezing and shortness of breath. Theophylline is not a preferred agent for COPD exacerbations due to its potential for toxicity. Management: Reduce initial doses of sympathomimetic agents, and closely monitor for enhanced pressor response, in patients receiving linezolid. Avoid combination, Ritonavir: May decrease the serum concentration of Theophylline Derivatives. NUR 292 986) A client with a prescription to take theophylline daily has been given medication instructions by the nurse. 2. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. After several dosages, the client started to become restless and complains of palpitations. Oral: Monitor serum concentrations at 6 month intervals for rapidly growing children and at yearly intervals for all others (if symptoms are well controlled). 10 to 15 mcg/mL: If symptoms controlled and current dose tolerated, maintain dosage; recheck serum concentrations at 24-hour intervals (IV) or at 6- to 12-month intervals (oral). Consider therapy modification, Lithium: Theophylline Derivatives may decrease the serum concentration of Lithium. Expand Section. Take theophylline exactly as directed. Injection: Treatment of acute exacerbations of the symptoms and reversible airflow obstruction associated with asthma and other chronic lung diseases (eg, chronic bronchitis, emphysema) as an adjunct to inhaled beta-2 selective agonists and systemically administered corticosteroids. Don't delay your care at Mayo Clinic. Which of the following statements by the client indicates an understanding of the teaching? ER capsule and tablet should be swallowed. Talk with the doctor. An Anti-Inflammatory Diet Plan Diabetes Smart Tips Living Well with Rheumatoid Arthritis Living Well with Colitis or Crohn's Manage Your Child's ADHD Managing Relapsing Multiple Sclerosis Talking to Your Doctor About Hepatitis C Talking to Your Doctor About Psoriasis Talking to Your Doctor About Rheumatoid Arthritis Your Guide to Diabetes Management Your Guide to … 24-hour extended-release tablets: Children ≥12 years and Adolescents: Administer every 24 hours. Schedule your appointment now for safe in-person care. When providing client education about nitroglycerin to the client, ... A client is in the clinic to have blood drawn to assess theophylline levels. It works in the airways by relaxing muscles, opening breathing passages, and decreasing the lungs' response to irritants. Monitor therapy, Fosphenytoin: May decrease the serum concentration of Theophylline Derivatives. Englisch: theophylline. 25 to 30 mcg/mL: Stop infusion for 24 hours or skip next oral dose; decrease subsequent doses or infusion rate at least 25% even if no adverse effects present; recheck serum concentrations after 24 hours (IV) or 3 days (oral) to guide further dosage adjustments; if symptomatic, discontinue infusion and consider if overdose treatment is needed. Maternal treatment improves pregnancy outcomes by reducing the risk of some adverse events (eg, preterm birth, gestational diabetes) (ERS/TSANZ [Middleton 2020]; GINA 2020). Monitor therapy, Macrolide Antibiotics: May decrease the metabolism of Theophylline Derivatives. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Such an approach is either unnecessary or unsuitable for most drug therapies, but for a limited number of drugs including lithium, digoxin and theophylline, measurement of serum or plasma concentration is the preferred method of optimising dosage … Metreleptin may increase the serum concentration of Theophylline. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. Stable for 90 days at room temperature. Heart rate, CNS effects (insomnia, irritability); respiratory rate (COPD patients often have resting controlled respiratory rates in low 20s); arterial or capillary blood gases (if applicable); fluid balance, electrolyte concentrations, and acid-base balance during prolonged IV therapy. Indications. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. The mechanism of action is through the inhibition of phosphodiesterase which increases cyclic-AMP and endogenous e… 1. • Seizure disorder: Use with caution in patients with seizure disorders; use may exacerbate seizure disorder. Monitor therapy, Disulfiram: May increase the serum concentration of Theophylline. Theophylline increases the force of contraction of diaphragmatic muscles through enhancement of calcium uptake through adenosine-mediated channels. Monitor for seizures. Monitor therapy. Inhaltsverzeichnis. Last updated on July 24, 2020. Schedule your appointment now for safe in-person care. Theophylline helps relieve symptoms such as cough, wheeze and shortness of breath. Include the … Avoid excessive heat. Don't delay your care at Mayo Clinic. COVID-19 Vaccine Grants. What special dietary instructions should I follow? Theophylline Derivatives may decrease the serum concentration of CarBAMazepine. Adolescents 12 to <16 years (otherwise healthy, nonsmokers): 0.5 mg/kg/hour; maximum daily dose: 900 mg/day unless serum concentrations indicate need for larger dose. Reversal of adenosine should rarely be required given adenosine's short half-life [ASNC [Henzlova 2016]]. Contributions & Partnerships . 1 Definition; 2 Wirkmechanismus; 3 Strukturformel; 4 Wirkungen; 5 Intoxikation; 1 Definition. This is a quiz that contains NCLEX review questions about COPD (chronic obstructive pulmonary disease). Instead, the best way to dispose of your medication is through a medicine take-back program. Monitor therapy, Phenytoin: May decrease the serum concentration of Theophylline Derivatives. As the rate of theophylline clearance may be dose-dependent, an increase in dose based upon a subtherapeutic serum concentration measurement should be limited to ~25% increase of the previous infusion rate or daily dose. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. Maintenance: 600 mg/day in divided doses every 12 hours. ¶ This branded product is no longer on the market. Management: Discontinue agents that may lower the seizure threshold 48 hours prior to intrathecal use of iopamidol. Theophylline Derivatives may decrease the serum concentration of Phenytoin. A nurse is providing education to a 56-year-old man who is admitted to … Some side effects can be serious. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. 15 to 19.9 mcg/mL: Consider 10% decrease in dose or infusion rate even if current dosage is tolerated. What side effects can this medication cause? Monitor therapy, CYP1A2 Inhibitors (Moderate): May increase the serum concentration of Theophylline Derivatives. Sub. Wait at least 24 hours after the procedure to resume such agents. 2 Wirkmechanismus. Theophylline works by relaxing the smooth muscles of the airways while relieving inflammation and a… Theophylline, 1,3-dimethylxanthine (23.3.5), is present in small quantities in tea leaves.It is synthesized synthetically by the Traube method, a general method suggested for making purine bases. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. A 70-year-old man is being treated for chronic obstructive pulmonary disease (COPD) with theophylline (Theo-Dur). What is theophylline? Data from small observational studies suggest that theophylline may be beneficial for the treatment of bradycardia following heart transplantation [Bertolet 1996], [Ellenbogen 1988], [Redmond 1993]. Oral theophylline dosage for the management of chronic asthma. Protect from freezing. Loading dose: Oral (immediate release oral solution), IV: Refer to adult dosing. Monitor for toxic effects of theophylline derivatives if a macrolide is initiated/dose increased. The loading dose should be calculated as follows: C desired = desired serum theophylline concentration, C measured = measured serum theophylline concentration. Inwood, N.Y. — Bureaucratic red tape has slowed Inwood Laboratory's distribution of theophylline. Management: Discontinue agents that may lower the seizure threshold 48 hours prior to intrathecal use of iohexol. Monitor therapy, Antithyroid Agents: May increase the serum concentration of Theophylline Derivatives. >26 weeks: Divide in 4 equal doses and administer every 6 hours. Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Patients who require a high dose (ie, ≥900 mg or 13 mg/kg, whichever is less), should take medication less than 1 hour before a high-fat meal (significant increase in peak serum level and absorption may occur). • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat. What special precautions should I follow? difficulty falling asleep or staying asleep. Adolescents 16 to 18 years (otherwise healthy, nonsmokers): 0.4 mg/kg/hour; maximum dose: 900 mg/day unless serum concentrations indicate need for larger dose. Canadian labeling: Additional contraindications (not in US labeling): Hypersensitivity to xanthine derivatives; coronary artery disease (where cardiac stimulation might prove harmful); peptic ulcers; coadministration with ephedrine in children. Extended-release formulations: Oral: Note: If at risk for impaired clearance or not feasible to monitor serum theophylline concentrations then do not exceed 16 mg/kg/day; maximum daily dose: 400 mg/day. Theophylline antibody is covalently coupled to microparticles and the drug derivative is linked to a macromolecule. Theophylline systemic 200 mg (WARRICK 1660). Maintenance dose: IV: 0.3 mg/kg/hour; maximum: 400 mg/day unless serum levels indicate need for larger dose. As you will recall, Lovenox is used to prevent deep venous thrombosis by preventing clots from forming. Specifically, concentrations of 1-methylxanthine, a metabolite of unknown clinical importance, may become elevated. Days 4 to 6: 400 mg/day in divided doses every 12 hours. Adults ≤60 years: 0.4 mg/kg/hour; maximum: 900 mg/day unless serum levels indicate need for larger dose. et al. The client may require higher doses of theophylline than a nonsmoker Smoking cigarettes may decrease serum theophylline levels. Clearance: Certain conditions may significantly alter theophylline clearance; severe and potentially fatal theophylline toxicity may occur if reduced theophylline clearance occurs. Management: Seek alternatives to this combination when possible. BSAVA library: We promote excellence in small animal practice through education and science. Talk to your doctor if you have questions. It relaxes and opens air passages in the lungs, making it easier to breathe. Adverse events observed at therapeutic serum levels. Recheck serum concentrations. • Peptic ulcer disease: Use with caution in patients with active peptic ulcer disease; use may exacerbate peptic ulcer. Use a rescue inhaler. • It is used to treat breathing problems. Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. Monitor therapy, Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Enteral feedings deliver nourishment through a tube directly into the GI tract. Consult drug interactions database for more information. Monitor therapy, Tedizolid: May enhance the hypertensive effect of Sympathomimetics. Theophylline Derivatives may diminish the neuromuscular-blocking effect of Pancuronium. tell your doctor if you use tobacco products. They’re ordered for patients with a functioning GI tract who can’t ingest enough nutrition orally to meet their needs. Management: Concomitant use of ozanimod with sympathomimetic agents is not recommended. “I can take my medication in the morning with my coffee.” “I may sprinkle the medication in applesauce.” 10 to 14.9 mcg/mL: If symptoms controlled and current dose tolerated, maintain dose and recheck serum concentrations at 24-hour intervals (IV) or 6- to 12-month intervals (oral); if symptoms are not controlled and current dose is tolerated, consider adding additional medications. Patients currently receiving methylxanthines: A loading dose is not recommended without first obtaining a serum theophylline concentration in patients who have received aminophylline or theophylline within the past 24 hours. The half-life is similar to that observed in otherwise healthy, nonsmoking adults with asthma during the first and second trimesters (~8.7 hours) but may increase to 13 hours (range: 8 to 18 hours) during the third trimester. If you experience any of the following symptoms, call your doctor immediately: If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). Quality Improvement. Immediate-release formulation: Oral: Note: If at risk for impaired clearance or not feasible to monitor serum theophylline concentrations then do not exceed 16 mg/kg/day; maximum daily dose: 400 mg/day. Avoid large amounts of these substances while you are taking theophylline. Swallow the tablets or capsules whole - do not crush or chew them. Twice-daily dosing may be considered in patients who metabolize theophylline rapidly (eg, younger patients, smokers, and some nonsmoking adults) and who have symptoms at the end of a dosing interval; administer one dose in the morning and the second dose 10 to 12 hours later (but before the evening meal); avoid administration at night (after the evening meal). Theophylline may decrease triiodothyronine. The effect of ciprofloxaicn on theophylline pharmacokinetics in healthy subjects. tell your doctor and pharmacist what prescription, nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Ask your pharmacist any questions you have about refilling your prescription. Theophylline may favorably impact functional impairment in COPD patients, but exact effects are unclear. Management: Seek alternatives when possible. Dosing interval (frequency based on age): ≤26 weeks: Divide in 3 equal doses and administer every 8 hours. 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