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Theophylline and smoking cessation — GPhC CRA MCQ

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HardRespiratory TherapeuticsTheophylline and smoking cessationGPhC CRA

A 62-year-old man with COPD takes theophylline modified-release 300 mg twice daily. He has stopped smoking using nicotine patches and now reports nausea, tremor and palpitations. What monitoring is required?

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Correct answer: E — Check theophylline concentration and review dose because smoking cessation can increase levels

Smoking induces theophylline metabolism, so stopping smoking can raise theophylline levels and cause toxicity. Symptoms such as nausea, tremor and palpitations are consistent with elevated concentrations. Serum theophylline monitoring and dose review are required. Nicotine replacement does not maintain the same enzyme induction as smoking.

Reference: BNF