You are a member of an interdisciplinary team that has

24. A patient receives a sustained-release form of theophylline in the morning. When should a serum theophylline level be obtained? a. 5 to 9 hours later b. 13 to 15 hours later c. 1 to 2 hours later d. 24 hours later 25. How is theophylline removed from the body? a. Metabolized by the liver b. Removed by the kidney c. Removed by the gastrointestinal tract d. Metabolized by the kidney CASE STUDY 1 Joe has been recently diagnosed with COPD. He is 57, has worked in the coal mines since he was 17, and suffers from severe dyspnea. Joe’s physician prescribed oxygen for home use at 2 L/min, B agonists, and corticosteroids. Joe has not responded as his physician had hoped. (Joe has had no change in his FEV,.) Joe’s physician has decided to initiate sustained-release theophylline and asks you to calculate the appropriate dose for Joe, who weighs 75 kg and is 6 feet tall. 1. What dose should Joe begin with? The following day, Joe calls his physician and states that he feels no improvement. The doctor sug- gests to Joe that he will increase Joe’s dose, but he will need to check Joe’s theophylline level first. 2. When is the best time to do this? Joe’s serum level comes back as 5 mcg/mL. Joe still feels no change or improvement since starting the medication. 3. What should be recommended? 4. Are there any other medications that can be added to his daily regimen?

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