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Theophylline and smoking cessation — GPhC CRA MCQ

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HardRespiratory TherapeuticsTheophylline and smoking cessationGPhC CRA

A 60-year-old man taking theophylline modified-release 300mg twice daily for COPD says he stopped smoking 2 weeks ago. He now feels nauseated, tremulous and has palpitations. No theophylline level has been checked since he quit. What monitoring is required?

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Correct answer: D — urgent theophylline level assessment and prescriber review

Smoking induces theophylline metabolism, so stopping smoking can increase theophylline concentrations. Nausea, tremor and palpitations may indicate theophylline toxicity. A serum theophylline level and prescriber review are required urgently. Spirometry alone would miss the medicine safety issue.

Reference: BNF