Risk Factors for Theophylline Intoxication

Are you evaluating a person who has been exposed to theophylline?

Yes

Gender of the patient

Male

Female

Did/Does/Is the patient?

• take an excessive dose due to a prescription error?

Yes

• receive excessive theophylline because of an error during administration?

Yes

• intentionally take or receive a large dose of theophylline?

Yes

• take a large dose of theophylline by accident?

Yes

• have cirrhosis?

Yes

• have congestive heart disease?

Yes

• hypothyroid?

Yes

Is the patient being treated with?

• cimetidine?

Yes

• a fluoroquinolone antibiotic?

Yes

• oral contraceptives?

Yes

• a beta blocker?

Yes

• a macrolide antibiotic?

Yes

• disulfiram?

Yes

Did the patient stop any of the following drugs without reducing the theophylline dose?

• phenobarbital?

Yes

• phenytoin?

Yes

• rifampin?

Yes

Did the patient do any of the following without reducing the theophylline dose?

• have hyperthyroidism corrected?

Yes

• stopped smoking cigarettes?

Yes

• stopped smoking marijuana?

Yes

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Data complete?

Evaluation appropriate?

Number of reasons for developing theophylline intoxication

Is the patient at risk for theophylline intoxication?

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Evaluation

Results

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Interpretation and Description

References

Specialty

Objective

ICD-10

Purpose: To identify situations which can result in theophylline intoxication.

Evaluation

Results

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Interpretation and Description

References

Specialty

Objective

ICD-10