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5.5: Xanthine Derivatives

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    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]

    Patient Teaching & Education

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

    Now let’s take a closer look at the medication grid on theophylline in Table 5.14.[3], [4],[5]

    Table 5:14 Theophylline Medication Grid

    Class/Subclass

    Prototype/Generic

    Administration Considerations

    Therapeutic Effects

    Adverse/Side Effects
    Xanthine theophylline Avoid caffeine

    Requires evaluation of therapeutic blood level to prevent toxicity

    		 Long-term treatment of chronic asthma and COPD unresponsive to other treatment GI: Nausea, vomiting

    CNS stimulation

    Nervousness and insomnia
    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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