Xanthine Derivatives

Theophylline is a xanthine derivative.

Mechanism of Action

Theophylline relaxes bronchial smooth muscle by inhibition of the enzyme phosphodiesterase and suppresses airway responsiveness to stimuli that cause bronchoconstriction.

Indications for Use

Theophylline is used for the long-term management of persistent asthma that is unresponsive to beta agonists or inhaled corticosteroids.

Adverse/Side Effects

Theophylline can cause nausea, vomiting, CNS stimulation, nervousness, and insomnia.[1]

Nursing Considerations Across a Life Span

The long term use of these drugs with childhood asthma needs to be reassessed. Although for alleviating symptoms in children they are considered a first line preventer, evidence questions the reliability of these drugs.  Currently, used as prescribed by a medical professional, they are deemed safe, however as research advances these indications may change. Further research is indicated.

Client Teaching & Education

Clients should be sure to take medications as prescribed and at appropriate intervals.  They should avoid irritants and drink fluids to help thin secretions.  Clients will need to have their serum blood levels tested every six to twelve months.[2]

Theophylline Medication Card

Now let’s take a closer look at the medication card on theophylline.[3][4],[5] Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication.

Medication Card 5.14.1: Theophylline

Class: Xanthine Derivatives

Prototypes: Theophylline

Mechanism: Theophylline relaxes bronchial smooth muscle by inhibition of the enzyme phosphodiesterase and suppresses airway responsiveness to stimuli that cause bronchoconstriction

Therapeutic Effects

  • Prevents wheezing
  • Shortness of breath
  • Chest tightness caused by asthma and other lung diseases like chronic bronchitis, emphysema

Administration

  • PO and extended release PO once a day dosage

Indications

  • Theophylline is used for the long-term management of persistent asthma and COPD that is unresponsive to beta agonists or inhaled corticosteroids

Contraindications

  • Active peptic ulcer disease
  • Seizure disorders
  • Cardiac arrhythmias
  • Long acting sustained release should not be used in patients with chronic clearance disorders
  • smoking

Side Effects

  • Nausea and Vomiting
  • CNS stimulation
  • Nervousness
  • Insomnia
  • Safety: Can be used with diminished kidney and liver activity with specific monitoring to avoid fatal toxicities –prescribing professional to determine risk to benefit ratio. If vomiting occurs- toxicity is a possibility so checking labs and going to ER is important to understand

Nursing Considerations

  • Avoid respiratory irritants
  • Drink 2-3 L of water per day to help thin secretions
  • Serum blood levels q6-12 months to follow and track labs and prevent toxicity
  • Avoid caffeine
  • Stop smoking interactions occur
  • This drug is not a rescue medication

  1. Frandsen, G. & Pennington, S. (2018). Abrams’ clinical drug: Rationales for nursing practice (11th ed.). Wolters Kluwer.
  2. uCentral from Unbound Medicine. https://www.unboundmedicine.com/ucentral
  3. This work is a derivative of Pharmacology Notes: Nursing Implications for Clinical Practice by Gloria Velarde licensed under CC BY-NC-SA 4.0.
  4. Frandsen, G. & Pennington, S. (2018). Abrams’ clinical drug: Rationales for nursing practice (11th ed.). Wolters Kluwer.
  5. This work is a derivative of Daily Med by U.S. National Library of Medicine in the public domain.

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Fundamentals of Nursing Pharmacology - Mohawk College Edition Copyright © 2023 by Chippewa Valley Technical College; Amanda Egert; Kimberly Lee; and Manu Gill is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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