Numerous drugs interfere with the metabolism of theophylline, so it's imperative to have a pharmacist review the patient's drug profile. Serum concentrations of theophylline are increased when given with cimetidine, propranolol, erythromycin, and ciprofloxacin due to altered liver metabolism. Rifampin and phenytoin decrease serum theophylline concentrations. Smokers have a higher level of drug metabolism and are prone to decreased serum levels, possibly requiring higher doses to achieve a therapeutic level. Your nurses should closely monitor a theophylline patient's vital signs.
Toxicity can occur rapidly without the occurrence of warning signs.
Insulin, a hormone produced by the pancreas, is needed for storage and use of carbohydrates, protein, and fat. It's used to treat all types of diabetes mellitus and is given with glucose to treat hyperkalemia. It may also be added to total parenteral nutrition to prevent hyperglycemia. Intravenous administration requires regular insulin. No other type of insulin can be administered by I.V. route.