Theophylline monitoring

 

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1.    An accurate and thorough patient history is essential for proper dosing of theophylline.

Take special note the following conditions:

Smoking history
Previous theophylline therapy
CHF or other serious cardiac disease
Hepatic disease
Drug interactions: macrolide antibiotics, quinolones, cimetidine.

 

2.    Serum theophylline level monitoring

If the patient has taken a theophylline product within the previous 24 hours, obtain a level before administering any IV theophylline.
Monitoring IV theophylline

Obtain theophylline levels at 1, 7 and 24 hours after initiating IV therapy and every 24 hours while receiving IV theophylline.

Monitoring oral theophylline

When initiating oral therapy obtain theophylline levels daily until stable.

 

3.    Other monitoring parameters

Pulse and blood pressure four times a day
Signs of toxicity daily (nausea, insomnia, etc.)

 

4.    Therapeutic range (mcg/ml)

The traditional therapeutic range of theophylline has been 10 to 20 mcg/ml, however there is recent trend to lower the target range to 5 to 15 mcg/ml. This lower target range may be especially suited to outpatients in order to avoid potential toxicity.

 


See also:

Introduction

Precautions

Pharmacokinetic formulas

Bibliography

 

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