PROBLEM SHEET
Date Problem and Management
DRUG-DRUG INTERACTION: Albuterol +
Theophylline
Concomitant use of Beta2-adrenergic
agonists with theophylline may increase risk
and/or severity of hypokalemia and adverse
cardiovascular effects such as palpitation,
tachycardia, and elevated blood pressure.
DRUG-DRUG INTERACTION: Phenytoin +
Theophylline
Phenytoin has been reported to increase the
clearance of theophylline by 40% to 50%,
presumably by enhancing the hepatic CYP450
metabolism theophylline. Also,
coadministration of otheophylline has been
reported to lower serum phenytoin
concentrations.
DRUG-DRUG INTERACTION: Albuterol +
Hydrochlorothiazide
Coadministration with beta2-adrenergic
agonists may potentiate the hypokalemic
effects of potassium-wasting diuretics. Beta2-
agoonists can cause clinically significant but
usually transient decreases in serum
potassium concentration
DRUG-FOOD INTERACTION: theophylline +
caffeine
Coadministration of caffeine may increase
the serum concentration of theophylline.
Clinical Pharmacists: Angie Baguec | Beverlyn Banog | Joyce Bayona ---- BSPharmacy IV Set A
Intervention/ Action Status
Although theophylline and beta2-agonists are
commonly used together to produce
bronchodilation, it may be appropriate to
monitor closely the patient response as well
as serum potassium level, blood pressure and
heart rate during coadministration, especially
if the beta2-agonist is administered
systematically or by nebulizer.
Monitor clinical response and serum
concentration of both drugs and adjusting
dosages as necessary. Patients should be
advised to report loss of seizure control or
worsening of respiratory symptoms to their
physician.
Serum potassium level and cardiovascular
status should be monitored, especially if the
beta2-agonist is administered systematically
or by nebulizer. Patients should be advised to
notify their physician if they experience
potential signs and symptoms of hypokalemia
such as fatigue, weakness, myalgia, muscle
cramps, numbness, tingling, abdominal pain,
constipation, palpitation, and irregular
heartbeat.
Given the narrow therapeutic index of
theophylline; patients should limit or avoid
significant fluctuations in their intake of
pharmacologic as well as dietary caffeiene.
Rapid release formulations are preferable ,
and theophylline levels should be monitored.