Interpretation involves the correlation of the diameter obtained in the disk test with the minimum inhibitory concentration MIC for enoxacin. In patients with end-stage renal disease, 3-methylxanthine may accumulate to concentrations that approximate the unmetabolized Theophylline concentration. Caffeine concentrations are usually undetectable in adults regardless of renal function. In neonates, caffeine may accumulate to concentrations that approximate the unmetabolized Theophylline concentration and thus, exert a pharmacologic effect. CYP1A2 Inducers Strong: May increase the metabolism of CYP1A2 Substrates. Management: Consider an alternative for one of the interacting drugs. Some combinations may be specifically contraindicated. Consult appropriate manufacturer labeling.
Ask your doctor if you are a candidate for allergy shots. Sublingual Immunotherapy SLIT is an alternative to allergy shots. The medicine is dissolved under your instead of through a shot. Refer to for further information regarding table. Consider 10% decrease in dose to provide greater margin of safety even if current dosage is tolerated.
Combination controller medications exist for patients whose asthma symptoms are not well controlled on inhaled corticosteroids alone. Infants 1 to 3 months: Consider dose reduction and frequent monitoring of serum theophylline concentrations. Therefore, it is important to consider this in patients who present with subsequent to the administration of antibacterial agents. COPD: The Global Initiative for Chronic Obstructive Lung Disease Guidelines 2013 suggest that while higher doses of slow release formulations of theophylline have been proven to be effective for use in COPD, it is not a preferred agent due to its potential for toxicity.
Theophylline extended-release tablets are recommended for chronic or long-term management and prevention of symptoms, and not for use in treating acute symptoms of asthma and reversible bronchospasm. Loading dose: Oral, IV: Refer to adult dosing. Do not crush, chew, break, or open an extended-release tablet or capsule. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time. Theophylline or another drug or occurrence of adverse effects without a change in serum Theophylline concentration.
Bahls FH, Ma KK, Bird TD "Theophylline-associated seizures with "therapeutic" or low toxic serum concentrations: risk factors for serious outcome in adults. Cl is decreased at least 50% in patients with hepatic impairment. Theophylline concentrations at above average doses have the greatest likelihood of experiencing large changes in serum Theophylline concentration in response to dosage changes. Levine JH, Michael JR, Guarnieri T "Multifocal atrial tachycardia: a toxic effect of theophylline. United States for delivery via a nebulizer. Cromolyn is suggested as an alternative medication to inhaled corticosteroids for asthma control, usually in mild asthma. It is not a commonly used asthma medication.
Decrease dose by 25%even if no adverse effects are present. The Effect of Other Drugs on Theophylline Serum Concentration Measurements: Most serum Theophylline assays in clinical use are immunoassays which are specific for Theophylline. Other xanthines such as caffeine, dyphylline, and pentoxifylline are not detected by these assays. Therapy with theophyllines should be administered cautiously in patients presenting with one or more of these risk factors, and the dosage should be appropriately reduced to prevent toxicity. More intensive monitoring of serum theophylline concentrations may be required. Note: Serum Theophylline concentrations may continue to increase after presentation of the patient for medical care. Consider 10% dose reduction in infusion rate to improve safety margin even if dose is tolerated. Crush one 300 mg extended release tablet in a mortar and reduce to a fine powder. Hold each position for 5 minutes to help the mucus drain from your lungs. This medication does not work right away and should not be used for sudden attacks of breathing trouble. Methotrexate: May increase the serum concentration of Theophylline Derivatives. Your doctor or may already be aware of any possible and may be monitoring you for them. not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first. crixivan
The molecular formula of anhydrous theophylline is C 7H 8N 4O 2 with a molecular weight of 180. If symptoms are not controlled and current dosage is tolerated consider adding additional medications to treatment regimen. Monitor the patient and obtain serial theophylline concentrations every 2 - 4 hours to gauge the effectiveness of therapy and to guide further treatment decisions. Patient may experience agitation, diarrhea, tablet shell in stool, or polyuria. Have patient report immediately to prescriber nausea, vomiting, tachycardia, arrhythmia, severe dizziness, passing out, severe anxiety, severe headache, confusion, insomnia, seizures, behavioral changes, irritability, or muscle spasm HCAHPS. Children may be more sensitive to the side effects of this drug. Careful monitoring of side effects and drug levels is recommended. Propafenone: May increase the serum concentration of Theophylline Derivatives. Metabolic side effects have included hypokalemia, hyperglycemia, respiratory alkalosis, hypophosphatemia, and hypomagnesemia, especially in the situation of acute overdosage. The magnitude of these abnormalities have been correlated with theophylline concentrations. Hypercalcemia has been reported in a patient with hyperthyroid disease with theophylline at therapeutic concentrations. Clinical Interventions in Aging: “Can cellulite be treated with low-energy extracorporeal shock wave therapy? Cardiovascular disease: Use with caution in patients with tachyarrhythmias eg, sinus tachycardia, atrial fibrillation since use may exacerbate these arrhythmias. Moderate. These medicines may cause some risk when taken together. Educate patient about signs of a significant reaction eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat. Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions. nmed.info mirtazapine
MTX, higher dose MTX may have a greater effect. What other drugs will affect theophylline? Nervous system side effects have included generalized seizures, most commonly in patients with elevated serum concentrations, although seizures have occurred at therapeutic concentrations. Theophylline may also cause nervousness and tremor at therapeutic dosages, which become worse as serum concentrations increase. Appropriate and susceptibility tests should be performed before treatment in order to and identify organisms causing the and to determine their susceptibility to enoxacin. with enoxacin may be initiated while awaiting the results of these studies; therapy should be adjusted if necessary once the results are known. Your dose and the number of times you take theophylline daily will depend on the reason you are taking this medication.
Theophylline extended-release tablets were administered with and without food. Subjects were fasted overnight and received a single 300 mg tablet early the following morning. Anti-IgE can be used in moderate to severe allergic asthma. Omalizumab Xolair is an anti-IgE medication. Have persistent nighttime symptoms. Formoterol. Theophylline Derivatives may enhance the hypokalemic effect of Formoterol. What happens if I miss a dose? Ask your doctor or pharmacist about using this product safely. Theophylline increases renal lithium clearance. propranolol cost private prescription
Product Information. Theo-Dur theophylline. Uniphyl theophylline anhydrous tablet Tablet regimens. Oral: Long-acting preparations should be taken with a full glass of water, swallowed whole, or cut in half if scored. Do not crush. Extended release capsule forms may be opened and the contents sprinkled on soft foods; do not chew beads. Theophylline clearance see or if it is not feasible to monitor serum Theophylline concentrations. Acebrophylline: May enhance the stimulatory effect of Theophylline Derivatives. But if you or your child needs to use quick-relief medicine a lot, the amount and number of controller medicines may be changed. Oriordan JI, Hutchinson J, Fitzgerald MX, Hutchinson M "Amnesic syndrome after theophylline associated seizures: iatrogenic brain injury. Uniphyl theophylline anhydrous tablet Tablet. These reactions may occur following the first dose. If these reactions occur in patients receiving enoxacin, the drug should be discontinued and appropriate measures instituted. Table II are added or discontinued. Children 1-15 years and adults 16-60 years without risk factors for impaired clearance. Take the missed dose as soon as you remember. Decrease dose by 25% even if no adverse effects are present. Recheck serum concentration after 3 days to guide further dosage adjustment. Larger diazepam doses may be required to produce desired level of sedation. Discontinuation of Theophylline without reduction of diazepam dose may result in respiratory depression. buy avodart yahoo
People of all sizes can have cellulite. Decreases Theophylline clearance by inhibiting cytochrome P450 1A2. Table I. Mean and range of total body clearance and half-life of theophylline related to age and altered physiological states. Erythromycin metabolite decreases theophylline clearance by inhibiting cytochrome P450 3A3. Dennis RJ, Solarte I 2011. Asthma in adults chronic search date April 2010. BMJ Clinical Evidence. Ginoza GW, Strauss AA, Iskra MK, Modanlou HD. Potential treatment of theophylline toxicity by high surface area activated charcoal. Before having surgery, tell your doctor or dentist that you are taking this medication.
Macrolide Antibiotics: May decrease the metabolism of Theophylline Derivatives. Exceptions: Azithromycin Systemic; Fidaxomicin; Roxithromycin; Spiramycin; Telithromycin. Treatment with broad-spectrum antibacterial agents alters the normal of the and may permit overgrowth of clostridia. United States and its territories. Indications, uses and warnings on Drugs. What are the possible side effects of theophylline Uniphyl? Get medical help right away if your asthma symptoms worsen or if you are using your quick-relief inhaler more than usual or more often than prescribed. In selected patients at high risk for theophylline-induced seizures, consideration should be given to the administration of prophylactic anticonvulsant therapy. Reversible airflow obstruction: Treatment of acute exacerbations of symptoms and reversible airflow obstruction due to asthma or other chronic lung diseases eg, emphysema, chronic bronchitis as an adjunct to inhaled beta-2 selective agonists and systemically administered corticosteroids. Skip next dose and decrease subsequent doses at least 25% even if no adverse effects are present. Recheck serum concentration after 3 days to guide further dosage adjustment. If symptomatic, consider whether overdose treatment is indicated see recommendations for chronic overdosage. Caffeine and 3-methylxanthine are the only theophylline metabolites with pharmacologic activity. Theophylline clearance are continued. Phenobarbital may cause respiratory depression, particularly in elderly patients and patients with COPD. Table VI. Dosage adjustment guided by serum theophylline concentration. Theophylline concentration when afebrile may be at greater risk of toxic effects from decreased clearance during sustained fever. In patients with chronic asthma, including patients with severe asthma requiring inhaled corticosteroids or alternate-day oral corticosteroids, many clinical studies have shown that theophylline decreases the frequency and severity of symptoms, including nocturnal exacerbations, and decreases the "as needed" use of inhaled beta-2 agonists. Theophylline has also been shown to reduce the need for short courses of daily oral prednisone to relieve exacerbations of airway obstruction that are unresponsive to bronchodilators in asthmatics. Sessler CN, Glauser FL, Cooper KR. Treatment of theophylline toxicity with oral activated charcoal. May lower theophylline seizure threshold. While the mechanisms of action of theophylline are not known with certainty, studies in animals suggest that bronchodilatation is mediated by the inhibition of two isozymes of phosphodiesterase PDE III and, to a lesser extent, PDE IV while non-bronchodilator prophylactic actions are probably mediated through one or more different molecular mechanisms, that do not involve inhibition of PDE III or antagonism of adenosine receptors. canada medicine suprax
Theophylline clearance is decreased by 50% or more in patients with CHF. The extent of reduction in theophylline clearance in patients with CHF appears to be directly correlated to the severity of the cardiac disease. Since theophylline clearance is independent of liver blood flow, the reduction in clearance appears to be due to impaired hepatocyte function rather than reduced perfusion. Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. It is possible that some side effects of theophylline may not have been reported. Phenobarbital may cause respiratory depression, particularly in elderly patients and patients with COPD. What are the specific controller medications for asthma? Theo-24 theophylline anhydrous is supplied in extended-release capsules containing 100, 200, 300 or 400 mg of anhydrous theophylline. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take. ranitidine
Do not start or stop smoking without first talking to your doctor. Clinical, Cosmetic and Investigational Dermatology: “Cryolipolysis for noninvasive body contouring: clinical efficacy and patient satisfaction. Treatment of cardiac arrhythmias Sinus tachycardia and simple ventricular premature beats are not harbingers of life-threatening arrhythmias, they do not require treatment in the absence of hemodynamic compromise, and they resolve with declining serum theophylline concentrations. Other arrhythmias, especially those associated with hemodynamic compromise, should be treated with antiarrhythmic therapy appropriate for the type of arrhythmia. If symptoms are controlled and current dosage is tolerated, maintain dose and recheck serum concentration at 6-12 month intervals. In contrast, approximately 50% of the administered theophylline dose is excreted unchanged in the urine in neonates. Berlinger WG, Spector R, Goldberg MJ, Johnson GF, Quee CK, Berg MJ. Enhancement of theophylline clearance by oral activated charcoal.
Diffusion Techniques: methods that require measurement of zone diameters give the most precise estimate of susceptibility of to agents. One such standardized procedure 1 that has been recommended for use with disks to test susceptibility of organisms to enoxacin uses the 10-µg enoxacin disk. Keep with you. If your are severe, you should keep two injection kits with you at all times and readily available. If you experience any sign of anaphylaxis, do not hesitate to use the epinephrine auto-injector, even if those symptoms do not appear to be allergy related. Using the auto-injector as a precaution will not harm you and could save you. Dial 911 after being injected. Children 12-15 years and adults 16-60 years without risk factors for impaired clearance. AST SGOT elevated ALT SGPT. It is not known whether these abnormalities were caused by the drug or the underlying conditions. Theophylline has two distinct actions; smooth muscle relaxation ie, bronchodilation and suppression of the response of the airways to stimuli ie, non-bronchodilator prophylactic effects. Bronchodilation is mediated by inhibition of two isoenzymes, phosphodiesterase PDE III and, to a lesser extent, PDE IV while non-bronchodilation effects are mediated through other molecular mechanisms. Theophylline increases the force of contraction of diaphragmatic muscles through enhancement of calcium uptake through adenosine-mediated channels. Do not give this medication to anyone under 18 years old without medical advice. Treatment of Cardiac Arrhythmias. However, dose reduction and frequent monitoring of serum theophylline concentration are required in patients with decreased hepatic function eg, cirrhosis, acute hepatitis, cholestasis. vidalta
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Park GD, Radomski L, Goldberg MJ, Spector R, Johnson GF, Quee CK. Effects of size and frequency of oral doses of charcoal on theophylline clearance. Is theophylline available as a generic drug? Store at room temperature away from moisture, heat, and light. Teriflunomide: May decrease the serum concentration of CYP1A2 Substrates. Estrogen Derivatives: May increase the serum concentration of Theophylline Derivatives.
The listing of drugs in Tables II and III are current as of February 9, 1995. New interactions are continuously being reported for Theophylline, especially with new chemical entities. Frequency not defined. Adverse events observed at therapeutic serum levels. Do I need a prescription for theophylline?
Make sure lab personnel and all your doctors know you use this drug. Convulsions and electroencephalograms have been reported in some patients receiving enoxacin. Increased pressure, and toxic psychoses have been reported in patients receiving drugs in this class. Similar to cimetidine, also increases renal clearance of theophylline. It flows down your throat and into a series of air passageways called bronchial tubes. Theophylline toxicity: Severe and potentially fatal theophylline toxicity may occur if reduced theophylline clearance occurs.
Drug Interactions Theophylline interacts with a wide variety of drugs. Always consult a healthcare professional for medical advice. For a given population there is no single theophylline dose that will provide both safe and effective serum concentrations for all patients. Administration of the median theophylline dose required to achieve a therapeutic serum theophylline concentration in a given population may result in either sub-therapeutic or potentially toxic serum theophylline concentrations in individual patients. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment.