Theophylline overdose Haemoperfuaion treatment

Case 1: A 15-year-old girl (who suffered from chronic obstructive pulmonary d isease and bronchitis) took 4 .5g long acting theophylline. In her local hospital 6 hours before transfer she was given oral charcoal after vomiting . and 2 hours before transfer an infusion of sodium chloride. On arrival at the second hospital she had mild tachycardia. hypotension. and a serum K-value of 3.1 mmol/L. Haemoperfusion was initiated 12 hours after ingestion. Over 4 hOUrs. her serum theophylline concentration dropped from 275 ).1mol/L to 79 ).1moljl.

Case 2: A 20-year-Old. otherwise

healthy. woman took 16-24g of long acting theophylline. She received immediate gastric lavage and oral charcoal. Despite treatment with diazepam. a ,B -blocker . and antacids she had tachycardia. hypotension. and vomiting and was restless and confused. Her serum K-value was 2.6 mmol/L and rose to 3.3 mmol/L. Both haemoperfusion and haemodialysis were begun 4 hours after admission with her serum theophylline concentration at 1290 /tmolfL. The patient was also given 2.2L isotonic sodium chloride. Over 2 hours of haemodialysis 0.2g theophylline was removed and over 6 hours of haemoperfusion. 6.0g was extracted. During treatment , the patient's BP rose, her tachycardia decreased and she was discharged after 3 days ' hospitalisation. Anlmen. J .. Healn. A ; He,IItz. H .. Kvist. L. and Mel/strand. T.: Acta Med.ca Scand.navica 2t6: 423·426 (No 4. 1984).