Theophylline overdose Bezoar: follow-up comment

A case of overdose of sustalned­release theophylline forming a pharmacobezoar requiring endoscopic removal was reported recently [Reactions 156 10. 22 Nov 1986]. A review of 11 patients admitted for theophylline overdose dUring 1 year in an English hospital revealed 4 With pharmacobezoars. including 1 which was vomited. 2 removed at endoscopy. and 1 found at postmortem examination. Endoscopy should be performed early in patients with severe theophylline overdose.

Smith WDF British Medical Journal 294 125, 10 Jan 1987

Propanolol counteracts the hypotension. hypokalaemia, hyperglycaemia and arrhythmias induced by theophylline overdose, and intravenous propanolol may have made gastroscopy safer in the patient mentioned above who, presumably, was not asthmatic, {:I-Blockers may even help patients with reversible airways obstruction in whom gastroscopy is unsafe, Cardioselective and water soluble {:I-blockers (which do not reduce theophylline clearance) may be useful although their place in theophylline overdose has not been evaluated,

Davis TME, Nicholls J British Medical Journal 294 125. 10 Jan 1987

0157-7271/87/0124-0015/0$01,00/0 © ADIS Press REACTIONS® 24 Jan 1987 15