In general, maintaining peak serum theophylline concentrations between 10 and 15 mcg/mL will achieve most of the drug's potential therapeutic benefit while minimizing the risk of serious adverse events.Theophylline is rapidly and completely absorbed after oral administration in solution or immediate-release solid oral dosage form.
Children with rapid rates of theophylline clearance (i.e., those who require a dose that is substantially larger than average [e.g., >22 mg/kg/day] to achieve a therapeutic peak serum theophylline concentration when afebrile) may be at greater risk of toxic effects from decreased clearance during sustained fever. In patients with hypoxia secondary to COPD, multifocal atrial tachycardia and flutter have been reported at serum theophylline concentrations ≥15 mcg/mL. The magnitude and duration of the fever appear to be directly correlated to the degree of decrease of theophylline clearance. More frequently, however, the interaction is pharmacokinetic, i.e., the rate of theophylline clearance is altered by another drug resulting in increased or decreased serum theophylline concentrations.
In neonates, the N-demethylation pathway is absent while the function of the hydroxylation pathway is markedly deficient. Administer CEFTIN tablets or oral suspension as described in the appropriate dosage guidelines [see Dosage and Administration (2.2, 2.3, 2.4)]. At serum theophylline concentrations >20 mcg/mL, both the frequency and severity of adverse reactions increase. Table VI contains recommendations for theophylline dosage adjustment based upon serum theophylline concentrations. Careful attention to dose reduction and frequent monitoring of serum theophylline concentrations are required in patients with CHF (see Tobacco and marijuana smoking appears to increase the clearance of theophylline by induction of metabolic pathways.
May contain sodium citrate for pH adjustment.
Available for Android and iOS devices. Demethylation to 1-methylxanthine appears to be catalyzed either by cytochrome P-450 1A2 or a closely related cytochrome.
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. In one health maintenance organization, the frequency of hospital admissions for chronic overdosage of theophylline was about 1 per 1000 person-years exposure.
6 - 12 years (20 - 35kg) … This medicine is available without a prescription.
If you have questions about side effects, call your doctor. Learn about the reported side effects, related class drugs, and how these medications will affect your daily lifestyle.
Pre-existing or concurrent disease may also significantly increase the susceptibility of a patient to a particular toxic manifestation, e.g., patients with neurologic disorders have an increased risk of seizures and patients with cardiac disease have an increased risk of cardiac arrhythmias for a given serum theophylline concentration compared to patients without the underlying disease.The frequency of various reported manifestations of theophylline overdose according to the mode of overdose are listed in Table IV.Other manifestations of theophylline toxicity include increases in serum calcium, creatine kinase, myoglobin and leukocyte count, decreases in serum phosphate and magnesium, acute myocardial infarction, and urinary retention in men with obstructive uropathy.Seizures associated with serum theophylline concentrations >30 mcg/mL are often resistant to anticonvulsant therapy and may result in irreversible brain injury if not rapidly controlled. Death from theophylline toxicity is most often secondary to cardiorespiratory arrest and/or hypoxic encephalopathy following prolonged generalized seizures or intractable cardiac arrhythmias causing hemodynamic compromise.Increasing the rate of theophylline clearance by extracorporeal methods may rapidly decrease serum concentrations, but the risks of the procedure must be weighed against the potential benefit. If you think there has been an overdose, call your poison control center or get medical care right away. In neonates, caffeine may accumulate to concentrations that approximate the unmetabolized theophylline concentration and thus, exert a pharmacologic effect.Both the N-demethylation and hydroxylation pathways of theophylline biotransformation are capacity-limited. Be ready to tell or show what was
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