Gas Exchange
5.14 Xanthine Derivatives
Xanthine Derivatives
Theophylline is a xanthine derivative.
Mechanism of Action
Theophylline relaxes bronchial smooth muscle by inhibition of the enzyme phosphodiesterase and suppresses airway responsiveness to stimuli that cause bronchoconstriction.
Indications for Use
Theophylline is used for the long-term management of persistent asthma that is unresponsive to beta agonists or inhaled corticosteroids.
Adverse/Side Effects
Theophylline can cause nausea, vomiting, CNS stimulation, nervousness, and insomnia.[1]
Nursing Considerations Across a Life Span
The long term use of these drugs with childhood asthma needs to be reassessed. Although for alleviating symptoms in children they are considered a first line preventer, evidence questions the reliability of these drugs. Currently, used as prescribed by a medical professional, they are deemed safe, however as research advances these indications may change. Further research is indicated.
Client Teaching & Education
Clients should be sure to take medications as prescribed and at appropriate intervals. They should avoid irritants and drink fluids to help thin secretions. Clients will need to have their serum blood levels tested every six to twelve months.[2]
Theophylline Medication Card
Now let’s take a closer look at the medication card on theophylline.[3][4],[5] Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication.
Medication Card 5.14.1: Theophylline
Class: Xanthine Derivatives
Prototypes: Theophylline
Mechanism: Theophylline relaxes bronchial smooth muscle by inhibition of the enzyme phosphodiesterase and suppresses airway responsiveness to stimuli that cause bronchoconstriction
Therapeutic Effects
- Prevents wheezing
- Shortness of breath
- Chest tightness caused by asthma and other lung diseases like chronic bronchitis, emphysema
Administration
- PO and extended release PO once a day dosage
Indications
- Theophylline is used for the long-term management of persistent asthma and COPD that is unresponsive to beta agonists or inhaled corticosteroids
Contraindications
- Active peptic ulcer disease
- Seizure disorders
- Cardiac arrhythmias
- Long acting sustained release should not be used in patients with chronic clearance disorders
- smoking
Side Effects
- Nausea and Vomiting
- CNS stimulation
- Nervousness
- Insomnia
- Safety: Can be used with diminished kidney and liver activity with specific monitoring to avoid fatal toxicities –prescribing professional to determine risk to benefit ratio. If vomiting occurs- toxicity is a possibility so checking labs and going to ER is important to understand
Nursing Considerations
- Avoid respiratory irritants
- Drink 2-3 L of water per day to help thin secretions
- Serum blood levels q6-12 months to follow and track labs and prevent toxicity
- Avoid caffeine
- Stop smoking interactions occur
- This drug is not a rescue medication
- Frandsen, G. & Pennington, S. (2018). Abrams’ clinical drug: Rationales for nursing practice (11th ed.). Wolters Kluwer. ↵
- uCentral from Unbound Medicine. https://www.unboundmedicine.com/ucentral ↵
- This work is a derivative of Pharmacology Notes: Nursing Implications for Clinical Practice by Gloria Velarde licensed under CC BY-NC-SA 4.0. ↵
- Frandsen, G. & Pennington, S. (2018). Abrams’ clinical drug: Rationales for nursing practice (11th ed.). Wolters Kluwer. ↵
- This work is a derivative of Daily Med by U.S. National Library of Medicine in the public domain. ↵