Theophylline: Difference between revisions
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==General== | ==General== | ||
*Type: | *Type: Bronchodilator | ||
*Dosage Forms: | *Dosage Forms: Oral | ||
*Common Trade Names: Elixophyllin, Theo-24, Uniphyl | *Common Trade Names: Elixophyllin, Theo-24, Uniphyl | ||
==Adult Dosing== | ==Adult Dosing== | ||
*300-600mg PO q6-8h (immediate-release) or q12h (ER) | |||
*IV theophylline no longer recommended for use inpatient or in the ED due to lack of added benefit over other treatments and high risk of adverse events<ref>National Heart, Lung, and Blood Institute: Expert panel report 3: guidelines for the diagnosis and management of asthma. National Heart, Lung, and Blood Institute. Bethesda, MD. 2007. http://www.nhlbi.nih.gov/health-pro/guidelines/current/asthma-guidelines</ref><ref>Kallstrom TJ. Evidence-based asthma management. Respir Care. 2004;49(7):783-92.</ref> | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
*Apnea in neonate: 4 mg/kg IV load, then 2 mg/kg IV q12h | |||
*Pediatric theophylline doses for asthma are very complicated, and with the narrow therapeutic window, probably not even worth trying it! | |||
==Special Populations== | ==Special Populations== | ||
| Line 13: | Line 17: | ||
*Renal Dosing | *Renal Dosing | ||
**Adult: no adjustment | **Adult: no adjustment | ||
**Pediatric: <3 mo: | **Pediatric: <3 mo: decrease dose amount not defined; >3 mo: no adjustment | ||
*Hepatic Dosing | *Hepatic Dosing | ||
**Adult: | **Adult: decrease dose amount not defined | ||
**Pediatric: | **Pediatric: decrease dose amount not defined | ||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*Known allergy to corn or corn products (IV form) | |||
*caution if PUD, active | *caution if PUD, active | ||
*caution if seizure disorder | *caution if seizure disorder | ||
| Line 29: | Line 34: | ||
*caution if hypothyroidism | *caution if hypothyroidism | ||
*caution if febrile | *caution if febrile | ||
*caution if sepsis | *caution if sepsis with multi-organ failure | ||
*caution if shock | *caution if shock | ||
*caution if smoking habit changes | *caution if smoking habit changes | ||
| Line 36: | Line 41: | ||
==Adverse Reactions== | ==Adverse Reactions== | ||
''See [[theophylline toxicity]] for overdose information'' | |||
===Serious=== | ===Serious=== | ||
*seizures | *seizures | ||
*arrhythmias | *arrhythmias | ||
*hypotension | *hypotension, shock | ||
*exfoliative dermatitis | *exfoliative dermatitis | ||
===Common=== | ===Common=== | ||
*nausea | *nausea/vomiting, diarrhea | ||
*headache | *headache | ||
*insomnia | *insomnia, irritability, restlessness, tremor | ||
*diuresis, transient | *diuresis, transient | ||
| Line 61: | Line 61: | ||
==See Also== | ==See Also== | ||
*[[Theophylline toxicity]] | |||
*[[Bronchodilators]] | |||
== | ==References== | ||
<references/> | |||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
Latest revision as of 06:38, 13 July 2017
General
- Type: Bronchodilator
- Dosage Forms: Oral
- Common Trade Names: Elixophyllin, Theo-24, Uniphyl
Adult Dosing
- 300-600mg PO q6-8h (immediate-release) or q12h (ER)
- IV theophylline no longer recommended for use inpatient or in the ED due to lack of added benefit over other treatments and high risk of adverse events[1][2]
Pediatric Dosing
- Apnea in neonate: 4 mg/kg IV load, then 2 mg/kg IV q12h
- Pediatric theophylline doses for asthma are very complicated, and with the narrow therapeutic window, probably not even worth trying it!
Special Populations
- Pregnancy Rating: C
- Lactation: Probably Safe
- Renal Dosing
- Adult: no adjustment
- Pediatric: <3 mo: decrease dose amount not defined; >3 mo: no adjustment
- Hepatic Dosing
- Adult: decrease dose amount not defined
- Pediatric: decrease dose amount not defined
Contraindications
- Allergy to class/drug
- Known allergy to corn or corn products (IV form)
- caution if PUD, active
- caution if seizure disorder
- caution if arrhythmias
- caution if CHF
- caution if pulmonary edema, acute
- caution if cor pulmonale
- caution if hepatic impairment
- caution if hypothyroidism
- caution if febrile
- caution if sepsis with multi-organ failure
- caution if shock
- caution if smoking habit changes
- caution if neonates or infants
- caution in elderly patients
Adverse Reactions
See theophylline toxicity for overdose information
Serious
- seizures
- arrhythmias
- hypotension, shock
- exfoliative dermatitis
Common
- nausea/vomiting, diarrhea
- headache
- insomnia, irritability, restlessness, tremor
- diuresis, transient
Pharmacology
- Half-life: 8h
- Metabolism: liver; CYP450: 1A2, 2E1, 3A3
- Excretion: urine (10% unchanged)
- Mechanism of Action: exact mechanism unknown; increases cAMP; antagonizes adenosine receptors (methylxanthine)
See Also
References
- ↑ National Heart, Lung, and Blood Institute: Expert panel report 3: guidelines for the diagnosis and management of asthma. National Heart, Lung, and Blood Institute. Bethesda, MD. 2007. http://www.nhlbi.nih.gov/health-pro/guidelines/current/asthma-guidelines
- ↑ Kallstrom TJ. Evidence-based asthma management. Respir Care. 2004;49(7):783-92.