Haemodynamic study as guideline for the use of beta blockers in acute theophylline poisoning

Kempf, J. F.; Rusterholtz, Thierry; Ber, Charles-Éric; Gayol, Saul; Jaeger, Albert

doi:10.1007/bf01708101

Cited by 11 publications

(4 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some sources recommend using beta-adrenergic receptor antagonists to improve cardiac output by slowing the heart rate, prolonging diastole and increasing stroke volume. 6 However, some patients suddenly decompensate. Additionally, beta blockers may exacerbate pulmonary disease in patients who are prescribed theophylline.…”

Section: Discussionmentioning

confidence: 99%

Theophylline toxicity: An old poisoning for a new generation of physicians

Greene

Halmer

Carey

et al. 2018

Turkish Journal of Emergency Medicine

View full text Add to dashboard Cite

A healthy 4-year-old female presented to the emergency department for vomiting and diarrhea. She was diagnosed with a urinary tract infection, treated with antibiotics and anti-emetics and discharged. Within four hours, her symptoms recurred, followed by decreasing responsiveness and seizures. She had significant hypokalemia, hyperglycemia, and a combined respiratory and metabolic acidosis. A sibling then mentioned that the patient ingested their father's 200 mg sustained-release theophylline tablets the previous morning. A serum theophylline level was immediately ordered and returned >444 μmol/L. The patient was intubated and treated with activated charcoal, antiemetics, potassium and intravenous fluids. She underwent continuous renal replacement therapy and her levels declined over the next 24 hours. She was extubated on hospital day 2 and discharged without sequelae. Theophylline ingestions are rare but potentially very serious. Physicians need to know how to diagnose and treat these ingestions.

show abstract

Section: Discussionmentioning

confidence: 99%

Theophylline toxicity: An old poisoning for a new generation of physicians

Greene

Halmer

Carey

et al. 2018

Turkish Journal of Emergency Medicine

View full text Add to dashboard Cite

show abstract

“…Treatment of such hypotension has the possibility of being refractory to IV fluids and standard vasopressor therapy [83]. Consequently, the use of nonselective β-blockers such as propranolol has been used in theophylline toxicity [84][85][86]. By blocking β 1 -stimulated tachycardia, propranolol is able to increase end diastolic filling and subsequently, blood pressure.…”

Section: What Is the Role Of β Blockers In Methylxanthine Toxicity?mentioning

confidence: 99%

“…Propranolol is also able to counteract catecholamine-induced tachydysrhythmias, tremor, and agitation-all of which are likely to occur in caffeine toxicity [87]. While successful in their ability to ameliorate the toxic effects of caffeine, the safety of nonselective β-blockers has been questioned in patients with asthma or chronic obstructive pulmonary disease [85][86][87]. The use of β 1 -selective β blockers such as esmolol has been described.…”

Section: What Is the Role Of β Blockers In Methylxanthine Toxicity?mentioning

confidence: 99%

“…No significant persistent drug effects have been evident 30 min following its discontinuation [91]. Nevertheless, it has been reported that continued treatment (>1 h) with β-blocking agents such as esmolol for persistent tachycardia can cause a decrease in cardiac index and result in cardiogenic shock, although not all reports reached the same conclusion [86,91]. As a result, the use of continuous hemodynamic monitoring should be stressed.…”

Section: What Is the Role Of β Blockers In Methylxanthine Toxicity?mentioning

confidence: 99%

See 1 more Smart Citation

Combined Butalbital/Acetaminophen/Caffeine Overdose: Case Files of the Robert Wood Johnson Medical School Toxicology Service

Bryczkowski

Geib

2012

J. Med. Toxicol.

View full text Add to dashboard Cite

A 40-year-old woman with no previous medical problems presented to the Emergency Department (ED) 2 h after ingesting an unknown amount of Fioricet® (butalbital/acetaminophen/caffeine), oxycodone, and fentanyl patches about 90 min prior to emergency medical service (EMS) dispatch. The patient's husband reported they had had a fight, and he went down to the basement; when he came back upstairs, he found the patient unconscious with an empty pill bottle. A call to the patient's pharmacy by ED staff revealed that the patient had her prescription for butalbital/acetaminophen/caffeine tablets refilled 5 days earlier and that she had convinced the pharmacist to override the refill amount to dispense 540 tablets; according to the pharmacist, the patient stated she was going on a trip to Italy and needed a 6-month supply. EMS personnel removed a fentanyl patch (unknown strength) from her skin. The source of the fentanyl and the strength and formulation of the oxycodone were not recorded. Prehospital treatment included naloxone 4 mg IV without any noticeable clinical response, insertion of a nasal trumpet, and initiation of bag-valve-mask ventilation. A fingerstick glucose was 137 mg/dL.On arrival to the ED, the patient was unconscious with the following vital signs: blood pressure, 98/54 mmHg; pulse, 72 beats/min; respiratory rate, 14 breaths/min; and pulse oximetry, 100 % on a non-rebreather mask.

show abstract

Theophylline and Other Methylxanthines

Geib¹

2017

Critical Care Toxicology

View full text Add to dashboard Cite

Haemodynamic study as guideline for the use of beta blockers in acute theophylline poisoning

Cited by 11 publications

References 10 publications

Theophylline toxicity: An old poisoning for a new generation of physicians

Theophylline toxicity: An old poisoning for a new generation of physicians

Combined Butalbital/Acetaminophen/Caffeine Overdose: Case Files of the Robert Wood Johnson Medical School Toxicology Service

Theophylline and Other Methylxanthines

Contact Info

Product

Resources

About