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 (13th ed.). Hudson, OH,Lexicomp
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