Theophylline
| Drug monograph · NCLEX study reference | |
| Trade names | Theo-24 |
|---|---|
| Therapeutic class | Bronchodilator |
| Pharmacologic class | Methylxanthine (NTI) |
| Onset / peak / duration | ER provides sustained levels; effect depends on serum concentration. |
| Half-life / level | Half-life 3 to 13 hours; therapeutic level 5 to 15 mcg/mL. |
| Routes | PO (oral), IV |
| High-alert (ISMP) | No |
| Black box warning | None |
| Antidote / reversal | Activated charcoal for overdose; supportive care. |
| Pregnancy / lactation | Use with caution. |
Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.
Theophylline (brand name Theo-24) — Bronchodilator; Methylxanthine (NTI).
Identification
- Therapeutic class: Bronchodilator.
- Pharmacologic class: Methylxanthine (NTI).
Pharmacology
- Mechanism of action: Relaxes bronchial smooth muscle and stimulates respiration through phosphodiesterase inhibition and other effects.
- Onset / peak / duration: ER provides sustained levels; effect depends on serum concentration.
- Half-life / therapeutic level: Half-life 3 to 13 hours; therapeutic level 5 to 15 mcg/mL.
Clinical use
- Indications: COPD, chronic asthma (less common now).
- Usual dose, route, frequency: PO ER once or twice daily; IV as aminophylline in acute care.
- Maximum dose / adjustments: Titrate to serum level; lower in heart failure, hepatic disease, and elderly; many interacting drugs.
Safety
- Contraindications: Uncontrolled arrhythmia, active peptic ulcer, seizure disorder.
- Black box warning: None formal; narrow therapeutic index requires level monitoring.
- Interactions: Ciprofloxacin and many CYP1A2 inhibitors raise levels; smoking and certain drugs lower levels; caffeine (food) adds stimulation.
- Pregnancy / lactation: Use with caution.
- High-alert: No.
Adverse effects
- Common side effects: Nausea, insomnia, tremor, palpitations.
- Serious effects to report: Toxicity (severe nausea, tachyarrhythmia, seizures).
- Antidote / reversal: Activated charcoal for overdose; supportive care.
Nursing process
- Assessment before administration: Serum level, heart rate and rhythm, interacting drugs and smoking status.
- Interventions during therapy: Draw levels as ordered; review interactions at every change.
- Monitor: Serum theophylline level, heart rate, symptoms.
- Evaluation / expected outcome: Improved breathing within the therapeutic range.
Patient teaching
- Patient teaching: Report nausea, palpitations, or shakiness; consistency in smoking status matters.
- Notify provider if: Persistent vomiting, racing heart, tremor, seizure.
- Administration tips: Swallow ER whole; keep level draws on schedule.