Theophylline

Toxic dose is also where therapeutic effect is seen
Not a great drug.

Uses: bronchodilation
Mechanism of action methylxanthine class
- phosphodiesterase inhibitor → ↑ cAMP
- adenosine antagonist
- activates histone deacetylase 2, thereby reversing steroid resistance in treatment-refractory asthma and COPD
Pharmacokinetics Absorption PO bioavailability nearly 100%
Distribution 60% protein bound
Metabolism liver
Elimination urine, t½ 7h
Time course of action
Adverse effects - inodilation (may or may not be a plus, depending) - peripheral vasodilation
- lowers seizure threshold
- ↑ uric acid
- hypokalaemia

toxicity

clinical features, considering effects:

  • A: they probably gonna get tubed if it's that bad
  • B: ↑ RR
  • C: hypertension, widened pulse pressure, tachycardia/SVT
  • D: seizures, tremor
  • E: vomiting++, dilated pupils, agitation
    • Hypokalemia
    • Hypomagnesemia
    • Hypophosphataemia
    • Hyperglycaemia
    • Hypercalcemia
    • Lactic acidosis
    • Respiratory alkalosis
    • Rhabdomyolysis