Xanthines

Question 1

Drug names

Answer 1

Caffeine

Theophylline

Question 2

Action

Answer 2

Direct effect on the smooth muscles of the respiratory tract, both in the bronchi and in the blood vessels

Exact MOA not known

Question 3

Indications

Answer 3

Symptomatic relief or prevention of bronchial asthma and for reversal of bronchospasm associated with COPD

Question 4

Contraindication

Answer 4

Lactation

Question 5

Caution

Answer 5

Pregnancy

GI problems, coronary disease, respiratory dysfunction, renal or hepatic disease, alcoholism, or hyperthyroidism

Question 6

Adverse Effects

Answer 6

Related to theophylline levels in the blood

GI upset, irritability, tachycardia, hyperglycemia, seizures, brain damage, and even death

Question 7

Drug-Drug Interactions

Answer 7

Any drug metabolized in the liver has the potential to interact with xanthines

Substances in cigarettes

Question 8

Assessment

Answer 8

History
	Allergy
	Cigarette use
	Peptic ulcer, gastritis, 
        renal or hepatic 
        dysfunction, and 
        coronary disease
	Pregnancy and lactation
	Cardiac disease, 
        vascular disease, 
        arrhythmias, diabetes, 
        and hyperthyroidism
Physical
	Baseline 
        Electrocardiogram
	Vital signs

Lab tests: liver and renal function, theophylline levels

Question 9

Diagnosis

Answer 9

Acute pain

Disturbed sensory perception

Deficient knowledge

Question 10

Implementation

Answer 10

Administer with food or milk to relieve GI upset

Comfort measures to minimize adverse effects

Patient teaching

Question 11

Evaluation

Answer 11

Patient response

Effectiveness of teaching plan

Effectiveness of comfort measures

Compliance