A patient who takes theophylline (Theochron) twice daily for ...

[sarasara]

A patient who takes theophylline (Theochron) twice daily for chronic stable asthma develops an infection and will take ciprofloxacin. The nurse will contact the provider to discuss:
 
  a. changing to a different antibiotic.
  b. reducing the theophylline dose.
  c. giving theophylline once daily.
  d. switching from theophylline to a LABA.

Question 2

A patient with asthma comes to a clinic for treatment of an asthma exacerbation. The patient uses an inhaled glucocorticoid, montelukast (Singulair), and a SABA via MDI.
 
  The nurse assesses the patient and notes a respiratory rate of 18 breaths per minute, a heart rate of 96 beats per minute, and an oxygen saturation of 95. The nurse auscultates mild expiratory wheezes and equal breath sounds bilaterally. What will the nurse do?
  a. Contact the provider to request a systemic glucocorticoid.
  b. Contact the provider to suggest using a long-acting beta2 agonist.
  c. Evaluate the need for teaching about MDI use.
  d. Question the patient about how much albuterol has been used.

[onowka]

Answer to Question 1

ANS: B
Fluoroquinolone antibiotics increase theophylline levels, so the dose of theophylline may need to be reduced to prevent theophylline toxicity. Changing antibiotics, giving the theophylline once daily, and changing to a LABA are not indicated.

Answer to Question 2

ANS: D
To determine the next course of action, it is important to assess the drugs given before these symptoms were observed. Patients who continue to wheeze after using a SABA need systemic glucocorticoids and nebulized albuterol. If a SABA has not been used, that will be the first intervention. LABAs are not used for exacerbations. If a patient reports using a SABA without good results, evaluating the MDI technique may be warranted.

[sarasara]

Excellent

[bblaney]

TYSM