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.