Cardiac arrhythmias as a result of intravenous infusions of theophylline in patients with airways obstruction

Chazan, R; Karwat, Krzysztof; Tymińska, K; Tadeusiak, W; Drozsz, W.

doi:10.1016/0962-8479(94)91151-7

Cited by 5 publications

(6 citation statements)

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“…Xanthines. The positive-inotropic, arrhythmogenic, and chronotropic effects of xanthines are well known (37)(38)(39). Atrial fibrillation associated with intravenous aminophylline has been reported in three patients without underlying cardiac disease.…”

Section: Respiratory System Drugsmentioning

confidence: 98%

Drug-induced atrial fibrillation

Hooft

Heeringa

Herpen

et al. 2004

Journal of the American College of Cardiology

118

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Atrial fibrillation (AF) is the most common sustained rhythm disorder observed in clinical practice and predominantly associated with cardiovascular disorders such as coronary heart disease and hypertension. However, several classes of drugs may induce AF in patients without apparent heart disease or may precipitate the onset of AF in patients with preexisting heart disease. We reviewed the literature on drug-induced AF, using the PubMed/Medline and Micromedex databases and lateral references. Successively, we discuss the potential role in the onset of AF of cardiovascular drugs, respiratory system drugs, cytostatics, central nervous system drugs, genitourinary system drugs, and some miscellaneous agents. Drug-induced AF may play a role in only a minority of the patients presenting with AF. Nevertheless, it is important to recognize drugs or other agents as a potential cause, especially in the elderly, because increasing age is associated with multiple drug use and a high incidence of AF. This may contribute to timely diagnosis and management of drug-induced AF.

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Section: Respiratory System Drugsmentioning

confidence: 98%

Drug-induced atrial fibrillation

Hooft

Heeringa

Herpen

et al. 2004

Journal of the American College of Cardiology

118

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“…Cafedrine/theodrenaline are theophylline-derivates. There are studies showing that theophylline may lead to tachycardia and arrhythmias (Bittar and Friedman, 1991 ; Chazan et al, 1995 ). In the course of developing cafedrine/theodrenaline, a number of theophylline-derivates were searched for candidates that combine the beneficial cardiovascular effect and a better side effect profile.…”

Section: Effects Of Cafedrine and Theodrenaline In Combinationmentioning

confidence: 99%

Cafedrine/Theodrenaline (20:1) Is an Established Alternative for the Management of Arterial Hypotension in Germany—a Review Based on a Systematic Literature Search

2017

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A 20:1 combination of cafedrine:theodrenaline (Akrinor®) is widely used in Germany for the treatment of hypotensive states during anesthesia and in emergency medicine. Although this drug formulation has been available since 1963, there are few studies relating to its use and many of the data are only available in German. In this article, we summarize the available data and propose mechanisms for the effects of cafedrine/theodrenaline on cardiac muscle cells and vascular smooth muscle cells. Cafedrine/theodrenaline leads to a rapid increase in mean arterial pressure that is characterized by increased cardiac preload, stroke volume, and cardiac output. Systemic vascular resistance and heart rate remain mostly unchanged. Factors which impact the effects of cafedrine/theodrenaline are gender, high arterial pressure at baseline, use of β-blockers, and heart failure. Importantly, the drug is frequently used in obstetric anesthesia without detrimental effects on umbilical cord pH or APGAR score.

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“…Large doses of caffeine and theophylline can cause tachycardia, arrhythmias, and extrasystoles (4,18,34). In severe cases, though rare, caffeine overdose was fatal (3,19).…”

Section: Effect Of Opening Caffeine-activated Lccsmentioning

confidence: 99%

Caffeine-activated large-conductance plasma membrane cation channels in cardiac myocytes: characteristics and significance

Zhang¹,

Tuft²,

Lifshitz³

et al. 2007

American Journal of Physiology-Heart and Circulatory Physiology

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Caffeine-activated, large-conductance, nonselective cation channels (LCCs) have been found in the plasma membrane of isolated cardiac myocytes in several species. However, little is known about the effects of opening these channels. To examine such effects and to further understand the caffeine-activation mechanism, we carried out studies using whole-cell patch-clamp techniques with freshly isolated cardiac myocytes from rats and mice. Unlike previous studies, thapsigargin was used so that both the effect of opening LCCs and the action of caffeine were independent of Ca2+ release from intracellular stores. These Ca2+-permeable LCCs were found in a majority of the cells from atria and ventricles, with a conductance of ∼370 pS in rat atria. Caffeine and all its direct metabolic products (theophylline, theobromine, and paraxanthine) activated the channel, while isocaffeine did not. Although they share some similarities with ryanodine receptors (RyRs, the openings of which give rise to Ca2+ sparks), LCCs also showed some different characteristics. With simultaneous Ca2+ imaging and current recording, the localized fluorescence increase due to Ca2+ entry through a single opening of an LCC (SCCaFT) was detected. When membrane potential, instead of current, was recorded, SCCaFT-like fluorescence transients (indicating single LCC openings) were found to accompany membrane depolarizations. To our knowledge, this is the first report directly linking membrane potential changes to a single opening of an ion channel. Moreover, these events in cardiac cells suggest a possible additional mechanism by which caffeine and theophylline contribute to the generation of cardiac arrhythmias.

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Cardiac arrhythmias as a result of intravenous infusions of theophylline in patients with airways obstruction

Cited by 5 publications

References 0 publications

Drug-induced atrial fibrillation

Drug-induced atrial fibrillation

Cafedrine/Theodrenaline (20:1) Is an Established Alternative for the Management of Arterial Hypotension in Germany—a Review Based on a Systematic Literature Search

Caffeine-activated large-conductance plasma membrane cation channels in cardiac myocytes: characteristics and significance

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