DRUG CLASS AND MECHANISM: Theophylline belongs to a
class of
medications called bronchodilators, used in treating asthma and
other
airway diseases. Asthma is a breathing problem involving
narrowing of the
airways. Airways are breathing passages that allow air to move
in and out
of the lungs. Airways can be narrowed due to accumulation of
mucus, spasm
of the muscles that surround these airways, or swelling of the
lining of
the airways. Airway narrowing leads to symptoms of shortness of
breath,
wheezing, cough and congestion. The narrowed airways can open
either
spontaneously or from medications. Medications that open
airways are
called bronchodilators. Theophylline opens airways by relaxing
the smooth
muscles in the walls of the airways. Theophylline can also be
helpful in
patients with emphysema and chronic bronchitis when their
symptoms are
partially related to reversible airway narrowing. Theophylline
also
strengthens right heart function and diaphragm movement.
STORAGE: Theophylline should be stored at room
temperature in a
tightly closed container.
PRESCRIBED FOR: Theophylline is used in the relief and
prevention of airway narrowing (bronchospasm) in patients with
asthma.
Theophylline can also be used in treating patients with
emphysema and
chronic bronchitis when their symptoms are related to
reversible airway
narrowing. Theophylline can be administered together with other
bronchodilators, such as albuterol (Ventolin, Proventil) for
added
bronchodilator effect.
DOSING: Theophylline may be taken with or without food,
but
should not be crushed or chewed. Theophylline is metabolized
mainly by the
liver and dosages should be reduced in patients with liver
dysfunction. On
the other hand, theophylline is generally metabolized more
rapidly in
smokers (both tobacco and marijuana) and higher dosages may be
required.
High blood theophylline levels can lead to symptoms of toxicity
(see
below). Therefore, theophylline blood levels are monitored
periodically
during treatment to assure achievement of optimal and safe
levels.
DRUG INTERACTIONS: Certain groups of patients
metabolize
theophylline slowly, and can develop elevated blood levels and
potential
toxicity even on usual doses. These patients include those with
liver
disease, older men with chronic lung diseases, infants,
patients with high
fever or heart failure, and patients taking other medications
that
increase blood theophylline levels. Examples of medications
that can
elevate theophylline blood levels include ephedrine, allopurinol (Zyloprim), cimetidine
(Tagamet), ciprofloxacin (Cipro),
erythromycin,
oral contraceptives, and propranolol (Inderal). Theophylline
toxicity can
cause nausea, vomiting, insomnia, seizures, agitation and life-
threatening
heart rhythm abnormalities. Theophylline should be used
cautiously in
patients with high blood pressure, peptic ulcer disease, seizure
disorders, and serious heart disease, especially with heart
rhythm
problems.
SIDE EFFECTS: Common side effects include nausea,
vomiting,
diarrhea, headaches, irritability, flushing and palpitations.
More serious
side effects include seizures and ventricular heart
arrhythmias.
Bronchitis is a disease of the respiratory system in which the bronchial passages become inflamed. There are two types of bronchitis, acute and chronic. Symptoms of acute bronchitis include frequent cough with mucus, lack of energy, wheezing, and possible fever. Treatment may require medication such as bronchial inhalers and predinsone. Supportive treatment is focused on relieving the symptoms with fever reducers, cough suppressants, and rest. Treatment may be more aggressive in patients with pre-existing conditions such as empyema, COPD, or cigarette smoking.
COPD (chronic obstructive pulmonary disease) is a disorder that persistently obstructs bronchial airflow. COPD mainly involves three related conditions, chronic bronchitis, chronic asthma, and emphysema. Symptoms of COPD include chronic cough, shortness of breath, frequent respiratory infections, wheezing, morning headaches, and pulmonary hypertension. Treatment of COPD is focused on the related condition(s).
Asthma is a common disorder in which
chronic inflammation of the bronchial tubes (bronchi) makes them swell, narrowing the airways. Signs and symptoms include shortness of breath, chest tightness,
cough and wheezing.
Emphysema is a progressive disease of the lungs. The primary cause of emphysema is smoking. Alpha 1-antitrypsin deficiency is a rare disorder that has a genetic predisposition to emphysema. Aging, IV drug use, immune deficiencies, and connect tissue illnesses are also risk factors for emphysema. Emphysema is a subtype of COPD (chronic obstructive pulmonary disease, COLD). Symptoms include shortness of breath and wheezing. Management of symptoms may be achieved with medications, quitting smoking, pulmonary rehabilitation, or surgery.
There are two types of asthma medications: long-term control with anti-inflammatory drugs and quick relief from bronchodilators. Asthma medicines may be inhaled using a metered dose inhaler or nebulizer or they may be taken orally. People with high blood pressure, diabetes, thyroid disease, or heart disease shouldn't take OTC drugs like Primatene Mist and Bronkaid.
If you have a COPD such as emphysema, avoiding chronic bronchitis and colds is important to avoid a more severe respiratory infection such as pneumonia. Avoiding cigarette smoking, practice good hygeine, stay away from crowds, and alerting your healthcare provider if you have a sinus infection or cold or cough that becomes worse. Treatment options depend upon the severity of the emphysema, bronchitis, or cold combination.
Chronic obstructive pulmonary disease (COPD) is comprised primarily of three related conditions - chronic bronchitis,
chronic asthma, and
emphysema. In each condition there is chronic obstruction of the flow of air through the airways and out of the lungs, and the obstruction generally is permanent and may be progressive over time.
While asthma features obstruction to the flow of air out of the lungs, usually, the obstruction is reversible. Between "attacks" of asthma the flow of air through the airways typically is normal. These patients do not have COPD. However, if asthma is left untreated, the chronic inflammation associated with this disease can cause the airway obstruction to become fixed. That is, between attacks, the asthmatic patient may then have abnormal air flow. This process is referred to as lung remodeling. These asthma patients with a fixed component of airway obstruction are also considered to have COPD.
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