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CHADS G (cardiac dx, hepatic dx, age, drug interactions, smoking, gender)
Theophylline dosing depends on what factors?
200-300mg po TID/QID (non-sustained release), 200-400mgpo BID (sustained release)
average Maintenance dose of oral theophylline is ____
toxic (85% increase in FEV1 can be achieved at 15mcg/ml)
With a serum level of 20mcg/ml, you would see what effect?
TRUE/FALSE - intermittent bolus administration of theophylline is more efficacious than continuous infusion
TRUE (only see a reduction of dyspnea)
TRUE/FALSE - no improvement in COPD pulmonary function tests is seen with theophylline
CNS, CV, kidneys, GI, lungs (caffeine effects to an extreme, tachycardia, diuresis, nervousness, seizures, insomnia)
What systems does theophylline affect?
parenteral, oral soln, regular and enteric coated oral tablets, IR and SR capsules, granules, rectal solutions and suppositories
How is theophylline available? (dosage forms)
0.5 (higher in premies and cyctic fibrosis)
What is the Vd of theophylline in adults and peds over 1yr?
neonates (under 1 year old)
In what population does theophylline change to caffeine during metabolism?
CHF, influenza, pulmonary disease, hepatic cirrhosis, renal disease (all decrease clearance)
What diseases affect the clearance of theophylline?
erythromycin, cipro, cimetidine, propranolol, fluvoxamine (and many more)
What drugs cause a decrease in theophylline clearance?
8hrs (shorter/faster in kids and smokers, longer/slower in CHF,elderly and obese, much slower in neonates)
What is the average theophylline halflife in an adult?
CHF, elderly, obese, neonates (VERY slow in neonates)
Theophylline has a longer/slower half-life in what populations?
2hrs (for IR) 4hrs (for SR) 10hrs (for QD formulations)
When should theophylline levels be sampled on oral administration?
100mcg/ml (patients young, suicide)
Acute ingestion of theophylline that reach levels of ______ can cause seizures and arrhythmias
60mcg/ml (older patients, more serious)
Chronic ingestion of theophylline that reach levels of ______ can cause seizures and arrhythmias
6mg/kg IV amino, 2mg/kg q8-12hrs (no more than 6mg daily - 5mg/kg po theophylline)
LD and MD of theophylline for apnea of prematurity
trough on day 4 (levels more accurate - 1hr after IV or 2hrs after po)
In the treatment of apnea of prematurity, when should levels be drawn?
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