Page 1618 - Saunders Comprehensive Review For NCLEX-RN

4. Contraindicated in individuals with

hypersensitivity, peptic ulcer disease, severe cardiac
disease and cardiac dysrhythmias, hyperthyroidism,
or uncontrolled seizure disorders

5. Used with caution in clients with hypertension,

diabetes mellitus, or narrow-angle glaucoma
6. Theophylline increases the risk of digoxin toxicity and
decreases the effects of lithium and phenytoin.
Theophylline should be a last-line medication.
7. If theophylline and a β -adrenergic agonist are
2
administered together, cardiac dysrhythmias may
result.
8. Beta blockers, cimetidine, and erythromycin increase
the effects of theophylline.
9. Barbiturates and carbamazepine decrease the effects of
theophylline.
B. Side and adverse effects

1. Palpitations and tachycardia

2. Dysrhythmias

3. Restlessness, nervousness, tremors
4. Anorexia, nausea, and vomiting
5. Headaches and dizziness
6. Hyperglycemia
7. Mouth dryness and throat irritation with inhalers
8. Tolerance and paradoxical bronchoconstriction with
inhalers

C. Interventions

1. Assess lung sounds.
2. Monitor for cardiac dysrhythmias.
3. Assess for cough, wheezing, decreased breath sounds,
and sputum production.
4. Monitor for restlessness and confusion.
5. Provide adequate hydration.
6. Administer the medication at regular intervals around
the clock to maintain a sustained therapeutic level.
7. Administer oral medications with or after meals to
decrease gastrointestinal irritation.
8. Monitor for a therapeutic serum theophylline level of
10 to 20 mcg/mL (55.5 to 111 mcmol/L).
9. Intravenously administered theophylline preparations
should be administered slowly and always via an

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