Reactions 624 - 26 Oct 1996

STheophylline overdose

Adverse effects: case reportA 50-year-old woman developed severe theophylline

toxicity after she ingested about 10g of the agent in a suicideattempt.

On hospitalisation, the woman was in a coma and sheresponded to noxious stimuli only. Her serum theophyllineconcentration was 148 mg/L. She had tachypnoea, dyspnoeaand peripheral cyanosis. She experienced several seizures thatdid not respond to treatment with diazepam. She alsoexperienced episodes of ventricular tachycardia andfibrillation; she reverted to to sinus rhythm after cardioversion.

The woman underwent repeated gastric lavage following theadministration of activated charcoal via a nasogastric tube. Shewas treated with normal saline, bicarbonate, potassiumchloride, magnesium chloride and propranolol, and placed ona respirator. Approximately 1.5 hours after admission,charcoal haemoperfusion was started. Haemoperfusion wascontinued for 7 hours. Twelve hours after admission, thewoman was awake. She recovered over the next few dayswithout sequelae.

Author comment: ‘In our opinion, this case clearlydemonstrates the utility of charcoal hemoperfusion in severetheophylline intoxication.’Shechter P, et al. Theophylline intoxication: clinical features and pharmacokineticsduring treatment with charcoal hemoperfusion. Israel Journal of Medical Sciences32: 766-770, Sep 1996 - Israel 800475200

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Reactions 26 Oct 1996 No. 6240114-9954/10/0624-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved