A 67-year-old man with severe COPD presents with vomiting, tremor, and palpitations. Vital signs show HR 128/min, BP 148/92, RR 22/min, temperature 37.2°C, and SpO2 92% on home oxygen. He denies recent respiratory infections. Serum theophylline level is 24 mcg/mL (therapeutic range 10-20). He has taken an older bronchodilator for years. Electrocardiogram shows new supraventricular tachycardia. Which medication is most likely responsible for his acute presentation?

  1. A)Tiotropium
  2. B)Montelukast
  3. C)TheophyllineGABARITO
  4. D)Ipratropium
  5. E)Omalizumab

Explicação

Theophylline has a narrow therapeutic index and toxicity causes nausea, tremor, and tachyarrhythmias, with seizures in severe cases. It is a methylxanthine bronchodilator and board questions often emphasize its adverse effect profile. Ver explicação completa e trilha adaptativa →

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