Rosh Internal Medicine Boost Practice Exam

Administration of which medication is contraindicated for a man hospitalized with chronic bronchitis exacerbation?

1. Albuterol 2.5 mg per nebulizer

2. Levofloxacin 500 mg IV

3. Methylprednisolone 125 mg IV

4. Theophylline 200 mg orally

The correct answer is: Theophylline 200 mg orally

In the context of managing a man hospitalized with an exacerbation of chronic bronchitis, the administration of Theophylline is contraindicated primarily due to its narrow therapeutic window and potential for adverse effects, especially given the patient's likely respiratory compromise. Theophylline can lead to toxicity, particularly in patients with underlying respiratory conditions, where factors such as drug interactions, variable clearance, and fluctuating serum concentrations can place the patient at risk for harmful side effects, such as arrhythmias and seizures. The other options provided—Albuterol, Levofloxacin, and Methylprednisolone—are standard treatments for exacerbations of chronic bronchitis. Albuterol serves as a bronchodilator, effectively relieving bronchospasm. Levofloxacin provides necessary antibacterial coverage for potential bacterial infections contributing to the exacerbation. Methylprednisolone helps reduce inflammation, thus aiding in the management of exacerbations in chronic respiratory conditions. Therefore, due to Theophylline’s potential complications in a patient with chronic lung issues, its use is not recommended in this scenario.