Generic Name

Dyphylline

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Classification

FDA Approved Indications

• Management of chronic obstructive pulmonary disease (COPD)
• Bronchial asthma associated with bronchospasm

Mechanism of Action

Dyphylline acts as a phosphodiesterase inhibitor, leading to accumulation of intracellular cyclic AMP, resulting in relaxation of bronchial smooth muscle and dilation of airways.

Dosage and Administration

Adult: Typically 300-600 mg orally every 8-12 hours; dose may vary based on response and tolerability.

Pediatric: Use with caution; dosing based on weight and clinical response.

Geriatric: Start at lower end of dosing range due to potential for increased sensitivity and organ impairment.

Renal Impairment: Adjust dose; particular caution advised due to altered clearance.

Hepatic Impairment: Use with caution; hepatic metabolism may be impaired and necessitate dose adjustments.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed; crosses the placenta.

Metabolism: Metabolized mainly in the liver.

Excretion: Primarily excreted in urine as metabolites.

Half Life: Approx. 4-8 hours, varies with age and organ function.

Contraindications

• Hypersensitivity to dyphylline or other methylxanthines.
• History of serious arrhythmias.

Precautions

• Use with caution in heart disease, peptic ulcer, hyperthyroidism, and seizure disorders. Monitor for adverse cardiac and CNS effects.

Adverse Reactions - Common

• Nausea, vomiting (Often)
• Headache, dizziness (Common)
• Gastrointestinal upset (Common)

Adverse Reactions - Serious

• Arrhythmias (Rare)
• Seizures (Rare)
• Hypersensitivity reactions (Rare)

Drug-Drug Interactions

• Cimetidine increases dyphylline levels.
• Caffeine may potentiate side effects.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Take medication exactly as prescribed.
• Report signs of toxicity such as nausea, insomnia, palpitations, or seizures.
• Avoid caffeine and other methylxanthines to reduce side effects.

Special Considerations

Black Box Warnings:

• None currently; however, caution is advised regarding CNS and cardiac side effects.

Genetic Factors: No specific genetic considerations.

Lab Test Interference: May alter certain lab tests, including serum uric acid and blood glucose levels.

Overdose Management

Signs/Symptoms: Nausea, vomiting, seizures, tachycardia, hypotension, arrhythmias.

Treatment: Supportive care; activated charcoal if ingestion is recent; temporary control of arrhythmias and seizures as needed.

Storage and Handling

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

Stability: Stable under recommended conditions.