Theophylline: What you need to know

         As a future Adult Nurse Practitioner, I am seeing the effects of chronic disease on the human body. One disease I encounter every time I am working on my residency hours is chronic obstructive pulmonary disease (COPD). COPD is progressive disease that basically blocks airflow as you exhale making it harder for the individual to breathe. One medicine that is a common treatment for COPD is Theophylline. The main action of Theophylline is to relax bronchial smooth muscle to help the individual breathe easier. But there are other effects on the body such as increased heart rate, blood pressure and central nervous stimulation. Theophylline is absorbed orally and metabolized by the liver and the half life is 3-15 hours normally. This medication should be used with caution in individuals with arrhythmias, peptic ulcers, hyperthyroidism, hypertension, alcoholism, GERD, and impaired hepatic function. Almost every patient come in contact with deals with one or more of these conditions.

            Besides the drug warnings, there are different drug interactions with theophylline practitioners need to be aware of. Several of the common drugs that inhibit or increase the effects of theophylline are ciprofloxacin, ketoconazole, erythromycin, and rofecoxib. The drugs that are an  inducer or they decrease in the effects of theophylline are phenytoin, carbamazepine and rifampin. It is very important as a healthcare provider to monitor for Drug toxicity. Therapeutic range for an individual is 10-20 mcg/ml and toxic levels are >20. When a patient presents with nausea, vomiting, and tachycardia and are found to be on Theophylline, the practitioner should check levels as a differential diagnosis. The treatment for Theophylline toxicity is treatment with a short acting beta blocker and monitor for arrhythmias.

Reference

Semla, T., Beizer, J., Higbee, M. (2008). Geriatric Dosage Handbook (13^th ed.). Hudson,   OH,Lexicomp