Pharmacology Reproductive & Maternity Meds #4

Question

A patient is prescribed a methylxanthine class medication. Which findings reflects the medication has achieved the desired therapeutic effect?

Answers

  1. The patient reports decreased chest tightness and wheezing
    • Rationale:

      This answer is correct because methylxanthine is a bronchodilator and its desired effect is to open the patient’s airway, decrease wheezing, and allow greater ease of breathing, decreased wheezing. Theophylline, is a common methylxanthine medication. It is a bronchodilator used to treat asthma, emphysema, and chronic bronchitis.

  2. The patient reports being able to cough mucus up effectively
    • Rationale:

      This answer is not correct because a medication that aids in being able to cough mucus up effectively is an expectorant. Methylxanthine is a bronchodilator and its desired effect is to open the patient’s airway, decrease wheezing, and allow greater ease of breathing, decreased wheezing.

  3. The patient reports decreased anxiety and increased mood
    • Rationale:

      This answer is not correct because the desired effect of methylxanthine is not decreased anxiety and increased mood. It is not a medication that treats anxiety or mood, nevertheless, being able to breath with ease may indirectly decrease anxiety and increase mood. Methylxanthine is a bronchodilator and it’s desired therapeutic effect is to open the patient’s airway, decrease wheezing, and allow greater ease of breathing, decreased wheezing.

  4. The patient reports increasing heart rate and respirations
    • Rationale:

      This answer is not correct because increasing heart rate and respirations are not the desired therapeutic effects of methylxanthine. Tachycardia can be a side effect of methylxanthine use. Shortness of breath or tachypnea (increasing respirations) are symptoms that are associated with the respiratory conditions (asthma, emphysema, chronic bronchitis) the medication is prescribed.

Overview

Methylxanthine medications are bronchodilators. Theophylline is a common methylxanthine medication. The finding that reflects the medication has achieved the desired therapeutic effect is the patient reporting decreased chest tightness and wheezing.

Explanation

The client should rinse the mouth following each scheduled dose because of irritation to the mucous membranes and possibility of creating an environment for candidiasis since the medication is a steroid. The inhaled medication is not just for use prior to sleep but will be at scheduled times during the day. It is not necessary to hold diabetic medications. Steroid use may raise blood sugar and holding diabetic medications may cause a higher blood sugar level. The client must not blow out the medication after inhaling.

Learning Outcomes

Theophylline, is a common methylxanthine medication. It is a bronchodilator used to treat asthma, emphysema, and chronic bronchitis. The medication’s desired effect is to open the patient’s airway, decrease wheezing, and allow greater ease of breathing, decreased wheezing. Theophylline has a narrow therapeutic range, 10-20 mcg/mL. Periodic blood tests should be performed to make sure the patient is receiving enough theophylline to produce the desired effects, yet not too much to produce toxicity. Toxicity symptoms can occur when levels are > 20 mcg/mL and symptoms increase as blood levels are higher. Toxicity symptoms include insomnia, tachycardia, anxiousness, nausea, vomiting, tremors, and seizures. The patient should be monitored carefully for toxicity.

Test Taking Tip

Read the question. The answer should address the “desired therapeutic effects” of the medication, not symptoms of toxicity or indications for use. Read the question.

Video Rationale