Xanthines

Question 0

Caffeine (xanthine)

Answer 0

Ventilatory stimulation in neonates. CNS stimulation, compared to theophylline, has less bronchodilation effect.

Question 1

Clinical indications for Xanthines

Answer 1

Use in asthma(maintenance)
5-15 ug/mL

COPD(alternative)
5-10 ug/mL

apnea of prematurity(first line)
-caffeine citrate preferred over theophylline (loading dose is 20mg/kg then 5mg/kg daily.)

(THEOPHYLLINE, negative therapeutic index)
Therapeutic range is 10-20 ug/mL

Question 2

Drugs that affect Theophylline

Answer 2

Increase its levels
-beta blockers, steroids, flu vaccine, estrogen

Decrease its levels
-barbiturates, beta-agonists, rifampin, nicotine

Question 3

Nonbronchodilating effects of Theophylline

Answer 3

Increased force of resp. muscle contractility, endurance, and ventilatory drive. Increased CO, decrease PVR, anti-inflammatory effects