Severe Toxic Effects From Aminophylline and Theophylline Suppositories in Children

Nolke, Anthony C.

doi:10.1001/jama.1956.02970080023008

Cited by 45 publications

(6 citation statements)

References 10 publications

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“…[1,2] We previously reported a 2-year-old girl with severe theophylline associated seizure that resulted in quadriparesis, who now at 15 years of age remains a bed-ridden life without any ability for meaningful communication. [5] Our studies of that case and the present case clearly indicate the risk of suppository use of theophylline especially for infants.…”

Section: Discussionmentioning

confidence: 99%

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Theophylline-associated status epilepticus in an infant: pharmacokinetics and the risk of suppository use

et al. 2009

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Section: Discussionmentioning

confidence: 99%

“…[1,2] We present a case of intoxication caused by add-on use of an aminophylline suppository during daily use of a sustained-release formulation. The pharmacokinetic study of this case suggests that the use of suppositories should be revised to avoid the possible adverse effects.…”

Section: Introductionmentioning

confidence: 99%

Theophylline-associated status epilepticus in an infant: pharmacokinetics and the risk of suppository use

et al. 2009

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“…The combination of several early studies (Gardner el a/. 1950, Frazier 1954, Pioppi 1954, Rounds 1954, Love and Corrado 1955, Nolke 1956, White and Daeschner 1956 produces the figures of eight deaths out of 33 affected children. Of the 0 244 survivors, includingeight with convulsions, one child was defined as being mentally retarded, without mention of motor function.…”

Section: Discussionmentioning

confidence: 99%

Theophylline Neurotoxicity Resulting in Significant Unilateral Brain‐damage

Noetzel

1985

Develop Med Child Neuro

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SUMMARY A case of theophylline neurotoxicity in a three‐month‐old infant is reported. Prolonged focal seizures with secondary generalization resulted in hemiparesis and developmental retardation, and CT demonstrated cerebral hemiatrophy. Later the infant developed recurrent focal and atonic convulsions, which were refractory to multiple anticonvulsants. Possible etiological factors. especially the pharmacological mechanisms by which theophylline can produce focal convulsions and result in brain damage, are discussed. RÉSUMÉ Neurotoxicité de la théophylline responsahle d' une lésion cérébrale unilatérale significative L'article rapporte un cas de neurotoxicité de la théophylline chez un nourrisson de trois mois. Des crises comitiales focales prolongées, secondairement généalisées provoquérent une hémiparésie et un retard de développement; le scanner démontra l' existence d'une hémiatrophie cérébrale. Plus tard, le nourrisson présenta des crises convulsives récidivantes focales et atoniques, résistant à de multiples anticomitiaux. Les facteurs étiologiques possibles, particuliérement les mécanismes pharmacologiques par lesquels la théophylline peut produire des convulsions focales et entrainer une lésion cérébrale sont discutés. ZUSAMMENFASSUNG Theophyllin Neurotoxizität als Ursache für einen signifikanten einseitigen Hirnschaden Es wird über einen drei Monate alten Säugling mit einer Theophyllin Neurotoxizität berichtet. Anhaltende fokale Krampfanfälle mit sekundärer Generalisation führten zu einer Hemiparese und Entwicklungsverzögerung und das CT zeigte eine cerebrale Hemiatrophie. Später entwickelte das Kind recurrente fokale und atonische Krämpfe, die durch die verschiedensten Antikonvulsiva nicht zu beeinflussen waren. Die möglichen aetiologischen Faktoren und besonders die pharmakologischen Mechanismen, aufgrund derer Theophyllin fokale Krampfanfälle hervorrufen und einen Hirnschaden verursachen kann, werden diskutiert. RESUMEN Neurotoxicidad teofilínica con el resultado de una lesión cerebral unilateral significativa Se describe un caso de neurotoxicidad teofilínica en un lactante de tres meses de edad. Unas convulsiones focales prolongadas con generalización secundaria, dieron lugar a una hemiparesia y a un retraso en el desarrollo, y la TAC demostró una hemiatrofia cerebral. Más tarde el niño desarrolló convulsiones recurrentes focales y atonicas, refractarias a múltiples anticomiciales. Se discuten 10s posibles factores etiológicos. especialmente 10s mecanismos farmacológicos por 10s que la teofilina puede producir convulsiones focales y dar lugar a una lesión cerebral

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“…Children have a high tolerance for barbiturates, and larger doses per pound of body weight than for adults are required. 7. Steroids.-If the child does not ex¬ perience relief in 12 to 24 hours after the onset of severe wheezing by the use of bronchodilators, expectorants, antibiotics, and the other measures as outlined above, steroid therapy should then be instituted.…”

Section: Managementmentioning

confidence: 99%

The Management of the Acute Attack of Asthma in Childhood

Levin¹

1959

AMA Am J Dis Child

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A number of reports 1-4 have appeared in the literature attesting to the great value of the steroids in the alleviation of the acute asthmatic attack in children. There is no question that such attacks are relieved by steroids with dramatic promptness in most cases, even when other methods fail. With the use of these hormones, the number of such children developing status asthmaticus requiring hospitalization has been very markedly reduced.4 This is not to say, however, that the time-tried and proven methods of treating the acute asthmatic attack in children have been displaced. Indeed, on the contrary, they need reemphasis so that the physician does not needlessly embark on the use of these powerful and potentially dangerous hormones without initially carrying out many other important and beneficial procedures. In this connection, one should note a recent report 5 on the immediate therapy of the acute attack of asthma comparing the use of epinephrine hypodermically with orally and intravenously administered prednisolone, which indicated that epinephrine is much more rapidly effec¬ tive against asthma than prednisolone given either by the oral or intravenous route.There was no indication from the data in that study that prednisolone and epinephrine potentiated each other's effect on the asthmatic attack when given together.The purpose of this paper, therefore, is to recapitulate the orthodox and standard methods of treating the acute attack of asthma in children and to indicate the proper and important place of the steroids in this therapeutic regimen. ManagementThe magement of the child with an acute attack of asthma has been fairly well standardized and can be summarized under the following headings:1. Bed Rest and Environment.-The child with an acute attack of asthma should be at bed rest in a room with an even tempera¬ ture of about 70 F. In the presence of a respiratory infection, recovery is much faster under these conditions. In some cases associated with respiratory infection, addi¬ tional humidification of the room and steam inhalations are desirable. Most asthmatics are sensitive to house dust or are aggravated by the mechanical irritation of dust, lint, and fuzzy particles. For this reason, the bedroom should be as dust-free and lint-free as possible. Despite instructions for this purpose parents frequently become careless. and this is an opportune time for the physi¬ cian to recheck the precautions for the preparation of a dust-free bedroom. In the main, these consist of covering the mattress, box spring, and pillows with nonallergic covers and eliminating quilts, comforters, chenille bedspreads, flannelette, and all Downloaded From: http://archpedi.jamanetwork.com/ by a University of Michigan User on 06/17/2015

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Severe Toxic Effects From Aminophylline and Theophylline Suppositories in Children

Cited by 45 publications

References 10 publications

Theophylline-associated status epilepticus in an infant: pharmacokinetics and the risk of suppository use

Theophylline-associated status epilepticus in an infant: pharmacokinetics and the risk of suppository use

Theophylline Neurotoxicity Resulting in Significant Unilateral Brain‐damage

The Management of the Acute Attack of Asthma in Childhood

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