Pharm
Theophylline
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Theophylline
, Methylxanthine, Aminophylline
Precautions
Theophylline is listed here for completeness, not for recommended use
In the developed world, Theophylline and its adverse effects are largely supplanted by better agents
Limited roles may be found in refractory cases under specialty care, and in underdeveloped world regions
Indications
Limited utility where standard of care
Asthma Management
is available
Preparations
Methylxanthines
Aminophylline
Caffeine
Pentoxifylline (Trental)
Theophylline
Mechanism
Xanthines are isolated from plants Camellia sinensis and Coffea arabica
Activity: Xanthines and Methylxanthines in general
Xanthines inhibit phosphodiesterase and prostaglandin production
Moderate cellular calcium
Block
Adenosine
Effects: Theophylline
Bronchi
al smooth muscle relaxation (high doses of Theophylline)
Peripheral vasodilation (not central)
CNS and cardiac stimulant
Diuretic
Anti-inflammatory (at low doses of Theophylline)
Dosing
Theophylline 150 to 300 mg twice daily
Adverse Effects
Serum Theophylline Level <20 mg/L
Headache
Insomnia
Nausea
Vomiting
Serum Theophylline Level >20 mg/L
Arrhythmia
s
Seizure
s
Drug Interactions
Agents that increase Theophylline serum concentrations
Alcohol
Ciprofloxacin
Diltiazem
Erythromycin
Oral Contraceptive
s
Propranolol
(very strong effect, doubles the Theophylline concentration)
Verapamil
Agents that decrease Theophylline serum concentrations
Phenytoin
(
Dilantin
)
References
Falk (2016) Am Fam Physician 94(6): 454-62 [PubMed]
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