Home Drug Guide Oxtriphylline

Drug Guide

Generic Name

Oxtriphylline

Brand Names Choledyl, Choledyl Sa, Oxtriphylline Pediatric

Classification

Therapeutic: Bronchodilator, Methylxanthine Derivative

Pharmacological: Phosphodiesterase Inhibitor

FDA Approved Indications

  • Bronchospasm associated with chronic bronchitis and emphysema

Mechanism of Action

Oxtriphylline relieves bronchospasm by inhibiting phosphodiesterase enzymes, leading to increased levels of cyclic AMP and cyclic GMP, resulting in bronchodilation and anti-inflammatory effects.

Dosage and Administration

Adult: Typically, 300-900 mg in divided doses per day, titrated to response.

Pediatric: Dosing varies based on weight and age; consult specific pediatric dosing guidelines.

Geriatric: Start at lower end of dose range; monitor for increased sensitivity.

Renal Impairment: Adjust dose based on renal function; consult specific guidelines.

Hepatic Impairment: Use with caution; dose adjustment may be necessary.

Pharmacokinetics

Absorption: Good oral absorption.

Distribution: Widely distributed; crosses the placenta and enters breast milk.

Metabolism: Hepatic; minimal first-pass effect.

Excretion: Renally excreted as unchanged drug and metabolites.

Half Life: Approximately 4-8 hours (variable with renal and hepatic function).

Contraindications

  • Hypersensitivity to oxtriphylline or other methylxanthines.
  • Active peptic ulcer disease.

Precautions

  • Caution in patients with cardiac arrhythmias, seizure disorders, hepatic or renal impairment, and in recent myocardial infarction.
  • Use during pregnancy and lactation only if clearly needed; benefits outweigh risks.

Adverse Reactions - Common

  • Nausea, vomiting, abdominal discomfort (Frequent)
  • Headache, dizziness (Common)

Adverse Reactions - Serious

  • Arrhythmias, seizures, hypotension (Rare)
  • Gastrointestinal bleeding (Rare)

Drug-Drug Interactions

  • Cimetidine, ciprofloxacin, erythromycin (may increase plasma levels of oxtriphylline)

Drug-Food Interactions

  • High caffeine intake may exacerbate adverse effects.

Drug-Herb Interactions

  • St. John's Wort may decrease effectiveness.

Nursing Implications

Assessment: Monitor respiratory status, heart rate, blood pressure, and for signs of toxicity or adverse reactions.

Diagnoses:

  • Ineffective airway clearance related to bronchospasm

Implementation: Administer with food to reduce gastrointestinal upset; monitor plasma drug levels if indicated.

Evaluation: Assess for improvement in breathing and reduction in bronchospasm.

Patient/Family Teaching

  • Take the medication exactly as prescribed.
  • Report signs of toxicity: nausea, vomiting, headache, arrhythmias.
  • Avoid caffeine and other stimulants.
  • Do not crush or chew sustained-release forms.

Special Considerations

Black Box Warnings:

  • Not currently established.

Genetic Factors: Variations in CYP1A2 enzyme may affect metabolism.

Lab Test Interference: May increase blood glucose levels.

Overdose Management

Signs/Symptoms: Seizures, severe nausea/vomiting, tachycardia, hypotension.

Treatment: Supportive care, activated charcoal if ingestion was recent, and management of seizures and cardiac arrhythmias as needed.

Storage and Handling

Storage: Store at room temperature away from moisture, heat, and light.

Stability: Stable under recommended conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.