Theophylline

Seizure A 63-year-old man was admitted with a 3-day history of breathlessness, and a 2-week history of cough with purulent sputum. A diagnosis of bronchitis with congesti ve heart failure was made. Treatment was started with aminophylline 250mg IV, frusemide (furosemide) 40mg, co-trimoxazole (trimethoprim­sulfamethoxazole) bid, nebuJised terbutaline, digitalis for atrial fibrillation, and slow release aminophylline 450mg bid. On the fourth day of admission, he had a grand mal seizure lasting 10 min. Serum theophylline level at the time was estimated at 33.2 mg/L, and aminophylline was withdrawn. No further seizures occurred, and the patient recovered without bronchodilators. The raised theophylline level (therapeutic range 10-20 mg/ L), probably due to reduced clearance in the presence of heart failure, was considered to be the cause of thc seizure. l·itlpal l' j(,: Io. . K.W.: Hnli~h l o urnal ur PhJ.rman~·U 1ica l

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