# Theophylline 22 mcg/mL인 환자에서 사정해야 할 소견은?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391782&lang=ko  
> language: ko  
> subject: Medical Emergencies  
> category: PA

## 문제

Theophylline 22 mcg/mL인 환자에서 사정해야 할 소견은?

## 보기

1. 구역·구토·진전·빈맥·발작 가능성 **✔ 정답**
2. 서맥·저혈압·기면
3. 심부건반사 항진·근긴장·간대
4. 동공 축소·호흡 억제

**정답: 1**

## 해설

정답 (2): 치료 theophylline = 10-20 mcg/mL. 독성(>20): 구역·구토·진전·빈맥·초조; >30: 발작·부정맥. (1) 자극제 효과 반대. (3) 세로토닌 증후군. (4) 아편 독성.

## 심화 해설

Memory Tip Theophylline = "Tea + Coffee" 자극제; 독성은 카페인 과량과 유사(jittery·구토·빈맥·발작). 좁은 치료 지수; 정상 상태와 용량/상호작용 후 농도 확인.

## 임상 시나리오

시나리오 65세 남성 COPD로 theophylline 300 mg PO BID 1년 복용. trough 22 mcg/mL(치료 10-20). 새 구역·진전.

## 핵심 개념

- **Theophylline 치료 범위** — 혈청 10-20 mcg/mL; 일부 문헌은 독성 최소화를 위해 5-15 선호.
- **Theophylline 독성** — GI 증상 먼저, 그다음 CNS(진전·초조·발작)·심혈관(빈맥·부정맥).
- **Methylxanthine** — Theophylline·aminophylline·caffeine 등; PDE 억제 기관지 확장제.

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