Table I. Mean and range of total body clearance and half-life of theophylline related to age and altered physiological states. Stenius-aarniala B, Riikonen S, Teramo K "Slow-release theophylline in pregnant asthmatics. Mcdonald CF, Burdon JGW "Asthma in pregnancy and lactation - a position paper for the thoracic society of australia and new zealand. Elderly patients are at significantly greater risk of experiencing serious toxicity from theophylline than younger patients due to pharmacokinetic and pharmacodynamic changes associated with aging. Theophylline clearance is reduced in patients greater than 60 years of age, resulting in increased serum theophylline concentrations in response to a given theophylline dose. Protein binding may be decreased in the elderly resulting in a larger proportion of the total serum theophylline concentration in the pharmacologically active unbound form. Elderly patients also appear to be more sensitive to the toxic effects of theophylline after chronic overdosage than younger patients. cheap lamotrigine online uk lamotrigine
Carry an ID card at all times that says you take Quibron. Begin the maintenance dose 24 hours after the loading dose. Caffeine has demonstrated the ability to reduce pulmonary resistance and increase lung compliance with a concomitant reduction in the requirement for inspired oxygen in preterm infants.
Following oral dosing, theophylline does not undergo any measurable firstpass elimination. In adults and children beyond one year of age, approximately 90% of the dose is metabolized in the liver. If symptoms are not controlled and current dosage is tolerated, increase dose about 25%. Recheck serum concentration after three days for further dosage adjustment. Tell your doctor or dentist that you take Quibron-T before you receive any medical or dental care, emergency care, or surgery. If the serum sample is drawn more than two hours after the dose, the results must be interpretedwith caution since the concentration may not be reflective of the peak concentration. In contrast, when signs or symptoms of theophylline toxicity are present, the serum sample should be obtained as soon as possible, analyzed immediately, and the result reported to the clinician without delay.
Increases theophylline clearance by increasing cytochrome P4501A2 and 3A3 activity. Caffeine and alcohol can increase the side effects of this medication. Avoid drinking large amounts of beverages containing alcohol or caffeine such as coffee, tea, colas eating large amounts of chocolate, or taking nonprescription products that contain caffeine. For a given population there is no single theophylline dose that will provide both safe and effective serum concentrations for all patients. Administration of the median theophylline dose required to achieve a therapeutic serum theophylline concentration in a given population may result in either sub-therapeutic or potentially toxic serum theophylline concentrations in individual patients.
Demethylation to 1- methylxanthine appears to be catalyzed either by cytochrome P-450 1A2 or a closely related cytochrome. In neonates, the N-demethylation pathway is absent while the function of the hydroxylation pathway is markedly deficient. The activity of these pathways slowly increases to maximal levels by one year of age. Theophylline only rarely alters the pharmacokinetics of other drugs. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. May lower theophylline seizure threshold. Patients should be instructed to inform all clinicians involved in their care that they are taking theophylline, especially when a medication is being added or deleted from their treatment. Patients should be instructed to not alter the dose, timing of the dose, or frequency of administration without first consulting their clinician. If a dose is missed, the patient should be instructed to take the next dose at the usually scheduled time and to not attempt to make up for the missed dose. Caffeine has been shown to significantly increase respiratory rate and significantly reduces the number of short and prolonged apnea attacks in premature infants.
Congestive Heart Failure CHF Theophylline clearance is decreased by 50% or more in patients with CHF. The extent of reduction in theophylline clearance in patients with CHF appears to be directly correlated to the severity of the cardiac disease. Since theophylline clearance is independent of liver blood flow, the reduction in clearance appears to be due to impaired hepatocyte function rather than reduced perfusion. Drug information contained herein may be time sensitive. Several studies have described the clinical manifestations of theophylline overdose and attempted to determine the factors that predict life-threatening toxicity. Get medical help right away if your asthma symptoms worsen or if you are using your quick-relief inhaler more than usual or more often than prescribed. Before having surgery, tell your doctor or dentist about all the products you use including prescription drugs, nonprescription drugs, and herbal products. It is very important that your doctor check the progress of you or your child at regular visits, especially for the first few weeks after you begin using this medicine. Blood tests may be needed to check for unwanted effects. While the mechanisms of action of theophylline are not known with certainty, studies in animals suggest that bronchodilation is mediated by the inhibition of two isozymes of phosphodiesterase PDE III and, to a lesser extent, PDE IV while non-bronchodilator prophylactic actions are probably mediated through one or more different molecular mechanisms that do not involve inhibition of PDE III or antagonism of receptors. Quibron-T is to be used only by the patient for whom it is prescribed. Do not share it with other people. Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. The dosage is based on your medical condition, response to treatment, age, weight, lab tests theophylline blood levels and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use including prescription drugs, nonprescription drugs, and herbal products. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. Must be diluted prior to administration. Carcinogenesis studies and animal reproduction studies have not been performed with Infasurf. A single mutagenicity study Ames assay was negative. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs including any herbal medicines or supplements or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you. lasix
Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment. Do not consider WebMD User-generated content as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately. Store Quibron at room temperature, between 59 and 77 degrees F 15 and 25 degrees C in tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Do not refrigerate. Keep Quibron out of the reach of children and away from pets. Use: Short-term treatment of apnea of prematurity in infants. Safety and efficacy of this drug has not been established; its limited use in pediatric patients has been inadequate to fully define the proper dosage and limitations of use. Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. Phenytoin increases theophylline clearance by increasing microsomal enzyme activity. Theophylline decreases phenytoin absorption. Our Uniphyl theophylline, anhydrous Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. Guaifenesin and theophylline can pass into breast milk and may harm a nursing baby.
If your symptoms do not improve or if they become worse, check with your doctor. What are the possible side effects of theophylline Theo-24? Have started or stopped taking another medicine in the last few weeks. This information is a summary only. It does not contain all information about Quibron-T. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider. Oral Tablets: Protect from light and moisture; dispense in tight, light resistant container. Similarly, a patient with decreased theophylline binding may have a sub-therapeutic total drug concentration while the pharmacologically active unbound concentration is in the therapeutic range. If only total serum theophylline concentration is measured, this may lead to an unnecessary and potentially dangerous dose increase. In patients with reduced protein binding, measurement of unbound serum theophylline concentration provides a more reliable means of dosage adjustment than measurement of total serum theophylline concentration. Patients were given an initial dose and one repeat dose 12 hours later if intubation was still required. The dose was instilled in two aliquots through a side port adapter into the proximal end of the endotracheal tube. Each aliquot was given in small bursts over 20-30 inspiratory cycles. After each aliquot was instilled, the infant was positioned with either the right or the left side dependent. Serum theophylline concentration measurements are readily available and should be used to determine whether the dosage is appropriate. generic femara spray
If you have any questions about Quibron-T, please talk with your doctor, pharmacist, or other health care provider. Overview Theophylline is rapidly and completely absorbed after oral administration in solution or immediate-release solid oral dosage form. Theophylline does not undergo any appreciable pre-systemic elimination, distributes freely into fat-free tissues and is extensively metabolized in the liver. Infasurf has been administered every 12 hours for a total of up to 3 doses. TRANSIENT EPISODES OF REFLUX OF Infasurf INTO THE ENDOTRACHEAL TUBE, CYANOSIS, BRADYCARDIA, OR AIRWAY OBSTRUCTION HAVE OCCURRED DURING THE DOSING PROCEDURES. These events require stopping Infasurf administration and taking appropriate measures to alleviate the condition. After the patient is stable, dosing can proceed with appropriate monitoring. Consider prophylactic anticonvulsant therapy. Your dose and the number of times you take theophylline daily will depend on the reason you are taking this medication. Consult the manufacturer product information. Each of the aliquots was administered with the patient in one of four different positions prone, supine, right, and left lateral. Caffeine Citrate: Data not available. Irritability; mild, temporary caffeine-like effects eg, headache, nausea, diarrhea, trouble sleeping; mild, temporary changes in behavior; restlessness; temporary increased urination. At first, 300 milligrams mg per day, divided and given every 6 to 8 hours. Your doctor may adjust your dose as needed. However, the total dose is usually not more than 600 mg per day. Store theophylline at room temperature, away from moisture, heat, and light. Theophylline interacts with a wide variety of drugs. Administer a single dose of oral activated charcoal. Avoid drinks or foods that contain caffeine, such as coffee, tea, cola, and chocolate.
If symptoms are not controlled and current dosage is tolerated consider adding additional medications to treatment regimen. In contrast, approximately 50% of the administered theophylline dose is excreted unchanged in the urine in neonates. After each aliquot was instilled, the infant was positioned with either the right or the left side dependent. Administration was made while ventilation was continued over 20-30 breaths for each aliquot, with small bursts timed only during the inspiratory cycles. A pause followed by evaluation of the respiratory status and repositioning separated the two aliquots. After multiple doses of theophylline, steady state is reached in 30-65 hours average 40 hours in adults. At steady state, on a dosage regimen with 6-hour intervals, the expected mean trough concentration is approximately 60% of the mean peak concentration, assuming a mean theophylline half-life of 8 hours. The difference between peak and trough concentrations is larger in patients with more rapid theophylline clearance. In patients with high theophylline clearance and half-lives of about 4-5 hours, such as children age 1 to 9 years, the trough serum theophylline concentration may be only 30% of peak with a 6-hour dosing interval. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. Store at room temperature away from moisture, heat, and light. The patient should be instructed to contact their clinician if they develop a new illness, especially if accompanied by a persistent fever, if they experience worsening of a chronic illness, if they start or stop smoking cigarettes or marijuana, or if another clinician adds a new medication or discontinues a previously prescribed medication. Patients should be instructed to inform all clinicians involved in their care that they are taking theophylline, especially when a medication is being added or deleted from their treatment. Patients should be instructed to not alter the dose, timing of the dose, or frequency of administration without first consulting their clinician. If a dose is missed, the patient should be instructed to take the next dose at the usually scheduled time and to not attempt to make up for the missed dose. Ask your healthcare professional how you should dispose of any medicine you do not use. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment. Some medical conditions may interact with Quibron. Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of theophylline in the elderly. However, elderly patients may be more sensitive to the effects of theophylline than younger adults, and are more likely to have kidney, liver, heart, or lung problems, which may require caution and an adjustment in the dose for patients receiving theophylline. Do not start, stop, or change the dosage of any medicines without your doctor's approval. If any of these effects last or get worse, tell your doctor or promptly. Average effect on steady state theophylline concentration or other clinical effect for pharmacologic interactions. Individual patients may experience larger changes in serum theophylline concentration than the value listed. cheap adapalene online uk
Lab tests, including blood theophylline levels, may be performed while you use Quibron. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Increasing the rate of theophylline clearance by extracorporeal methods may rapidly decrease serum concentrations, but the risks of the procedure must be weighed against the potential benefit. Pratt WR "Allergic diseases in pregnancy and breast feeding. Increasing the rate of theophylline clearance by extracorporeal methods may rapidly decrease serum concentrations, but the risks of the procedure must be weighed against the potential benefit. Charcoal hemoperfusion is the most effective method of extracorporeal removal, increasing theophylline clearance up to six fold, but serious complications, including hypotension, hypocalcemia, platelet consumption and bleeding diatheses may occur. Hemodialysis is about as efficient as multiple-dose oral activated charcoal and has a lower risk of serious complications than charcoal hemoperfusion. Hemodialysis should be considered as an alternative when charcoal hemoperfusion is not feasible and multiple-dose oral charcoal is ineffective because of intractable emesis. Store Quibron-T at room temperature, between 59 and 86 degrees F 15 and 30 degrees C in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Do not refrigerate. Keep Quibron-T out of the reach of children and away from pets. Serum theophylline concentration monitoring. Mild and temporary changes in behavior; temporary increased urination. Caffeine Citrate: Use with caution in infants with impaired renal function; monitor serum drug concentrations and adjust dose accordingly to avoid toxicity. Theophylline increases the force of of diaphragmatic muscles. This action appears to be due to enhancement of uptake through an adenosine-mediated channel. Prophylaxis and treatment study results for each surfactant are combined. Get medical help right away if you have any very serious side effects, including: seizures. Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
This is not a complete list of side effects and others may occur. Most serum theophylline assays in clinical use are immunoassays which are specific for theophylline. Other xanthines such as caffeine, dyphylline, and pentoxifylline are not detected by these assays. Theophylline increases the force of contraction of diaphragmatic muscles. This action appears to be due to enhancement of calcium uptake through an adenosine-mediated channel. Avoid eating foods that are high in fat within 1 hour before or after taking theophylline. What should I avoid while taking theophylline Theo-24? Skip next dose and decrease subsequent doses at least 25% even if no adverse effects are present. Recheck serum concentration after 3 days to guide further dosage adjustment. If symptomatic, consider whether overdose treatment is indicated see recommendations for chronic overdosage. venlor
Do not stop taking any medications without consulting your healthcare provider. Weeks of age; divide dose into 4 equal amounts administered at 6 hour intervals. Diabetes patients - Quibron-T may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. Severe toxicity from theophylline overdose is a relatively rare event. In one health maintenance organization, the frequency of hospital admissions for chronic overdosage of theophylline was about 1 per 1000 person-years exposure. The listing of drugs in Tables II and III are current as of October 8, 1996. New interactions are continuously being reported for theophylline, especially with new chemical entities. Tell your doctor or dentist that you take Quibron before you receive any medical or dental care, emergency care, or surgery.
Institute supportive care, including establishment of intravenous access, maintenance of the airway, and electrocardiographic monitoring. F. THE 3mL VIAL MUST BE STORED UPRIGHT. Date and time need to be recorded on the carton when Infasurf is removed from the refrigerator. Warming of Infasurf before administration is not necessary. Whenever signs or symptoms of theophylline toxicity are present. Drug-Drug Interactions Theophylline interacts with a wide variety of drugs. Inactive Ingredient: magnesium stearate. Decrease in theophylline plasma concentrations. Not reported in a comparable manner. In patients with chronic asthma, including patients with severe asthma requiring inhaled corticosteroids or alternate-day oral corticosteroids, many clinical studies have shown that theophylline decreases the frequency and severity of symptoms, including nocturnal exacerbations, and decreases the “as needed” use of inhaled Beta 2 agonists. Theophylline has also been shown to reduce the need for short courses of daily oral prednisone to relieve exacerbations of that are unresponsive to bronchodilators in asthmatics. boots carbamazepine
The pharmacokinetics of theophylline vary widely among similar patients and cannot be predicted by age, sex, body weight or other demographic characteristics. In addition, certain concurrent illnesses and alterations in normal physiology see Table I and co-administration of other drugs see Table II can significantly alter the pharmacokinetic characteristics of theophylline. Within-subject variability in metabolism has also been reported in some studies, especially in acutely ill patients. In patients with end-stage renal disease, 3-methylxanthine may accumulate to concentrations that approximate the unmetabolized theophylline concentration. Caffeine concentrations are usually undetectable in adults regardless of renal function. In neonates, caffeine may accumulate to concentrations that approximate the unmetabolized theophylline concentration and thus, exert a pharmacologic effect. Such patients require rapid relief of symptoms and should be treated with an immediate-release or theophylline preparation or other bronchodilators and not with extended-release products. Arwood LL, Dasta JF, Friedman C "Placental transfer of theophylline: two case reports. Disclaimer: Every effort has been made to ensure that the information provided by Multum, Truven Health Analytics, Inc. The drugs listed in Table II have the potential to produce clinically significant pharmacodynamic or pharmacokinetic interactions with theophylline. The information in the “Effect” column of Table II assumes that the interacting drug is being added to a steadystate theophylline regimen. The use of the Truven Health products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Truven Health and Drugs. Do not use this medication without telling your doctor if you are breast-feeding a baby. WebMD User Reviews should not be considered as medical advice and are not a substitute for professional medical advice, diagnosis, or treatment. Never delay or disregard seeking professional medical advice from your physician or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences may be a helpful health information resource but they are never a substitute for professional medical advice from a qualified healthcare provider. Do not stop or change the dose of this medicine without checking first with your doctor. Table VI. Dosage adjustment guided by serum theophylline concentration. F and protect from light. THE 3mL VIAL MUST BE STORED UPRIGHT. Vials are for single use only. After opening, discard unused drug. Consult a healthcare provider if your baby continues to have apnea events; do not increase the dose of caffeine citrate without medical consultation. Use Quibron-T as directed by your doctor. Check the label on the medicine for exact dosing instructions.
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Older adults may be more likely to have side effects from theophylline. Infasurf was administered through a 5 French feeding catheter inserted into the endotracheal tube. Serum theophylline concentrations may continue to increase after presentation of the patient for medical care as a result of continued absorption of theophylline from the gastrointestinal tract. Serial monitoring of serum theophylline serum concentrations should be continued until it is clear that the concentration is no longer rising and has returned to non-toxic levels. While the mechanisms of action of theophylline are not known with certainty, studies in animals suggest that bronchodilatation is mediated by the inhibition of two isozymes of phosphodiesterase PDE III and, to a lesser extent, PDE IV while non-bronchodilator prophylactic actions are probably mediated through one or more different molecular mechanisms, that do not involve inhibition of PDE III or antagonism of adenosine receptors. ufco.info vistaril
If you have more than one doctor, be sure to tell each of your doctors that you are taking Quibron. Keep out of the reach of children. Dose is based on body weight and must be determined by your doctor. At first, the dose is 12 to 14 milligrams mg per kg of body weight per day, divided and given every 4 to 6 hours. Your doctor may adjust your dose as needed. However, the total dose is usually not more than 20 mg per kg of body weight per day or 600 mg per day. Do not take other medicines unless they have been discussed with your doctor.
Children may be more sensitive to the side effects of this drug. Careful monitoring of side effects and drug levels is recommended. Tell your doctor if you have any major changes in your diet. Your doctor may need to adjust your dose. Shomon M. endocrinologues défendre Synthroid Wall Street Journal. Careful monitoring of side effects and drug blood levels is recommended.
Follow the directions on your prescription label. CNS depressant, while theophylline blocks adenosine receptors. Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.