Theophylline poisoning—a review of 64 cases

Parr, Michael; Anaes, F. C.; Day, AG; Kletchko, S; Crone, P D; Rankin, A. P. N.

doi:10.1007/bf01735178

Cited by 25 publications

(5 citation statements)

References 24 publications

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“…Sessler et al reported that the rate of hyperglycaemia in theophylline toxicities was 62% in their study (3). In other studies, hyperglycaemia rates were found to be 72%, 89% and 93%, respectively (4,11,12). Additionally, in the study of Shannon et al, the mean blood glucose level was 180 mg/dL for theophylline poisoning cases.…”

Section: Discussionmentioning

confidence: 90%

Demographic and Clinical Characteristics of Theophylline Exposures between 1993 and 2011

Hocaoğlu¹,

Yildiztepe²,

Bayram³

et al. 2015

Balkan Med J

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Theophylline, a member of the xanthine family, has been used in the treatment of asthma, chronic obstructive pulmonary disease and apnoea (1, 2). Because of the narrow therapeutic index of theophylline, therapeutic drug monitoring is indicated for safe and effective treatment (3). Clinical manifestations of theophylline toxicity include nausea, vomiting, hypokalaemia, hyperglycaemia, metabolic acidosis, tachycardia, cardiac arrhythmias, and seizures (3, 4). Although its clinical use has decreased remarkably because safer and more effective drugs have been introduced, theophylline use continues to result in potentially life-threatening toxicity (1, 4).The aim of this study was to investigate aetiological, demographic and clinical characteristics of the patients with theophylline exposure reported to the Dokuz Eylül University Drug and Poison Information Center (DPIC), in Turkey, in a 19-year period. There is no comprehensive descriptive research study available concerning theophylline toxicity in Turkey. The results of our study may therefore improve cliniBackground: Acute and chronic exposure to theophylline can cause serious signs and symptoms of poisoning. Additionally, with a narrow therapeutic range, toxicity could be observed even with therapeutic doses of theophylline. Epidemiological data on theophylline exposures in our country are extremely limited. The results of our study may improve the clinical management of theophylline poisoning in our country and elsewhere. Aims: To present aetiological and demographic features, clinical findings and treatment attempts with regard to theophylline exposures reported to Dokuz Eylül University Drug and Poison Information Center (DPIC), between 1993 and 2011. Study Design: Descriptive study. Methods: The data regarding demographics, date, time, type of exposure, route of and reason for exposure, signs and symptoms upon admission, clinical management and outcome were retrospectively evaluated. Results:The DPIC recorded 88,562 poisoning calls between 1993 and 2011; 354 (0.4%) of them were due to theophylline exposure. The mean age of all cases was 24.1±15.4 (range between 1 month and 90 years). Females dominated all age groups (72.6%, 257 females). Intentional exposure was significantly higher in women than in men (88.2% vs. 68.2% for all age groups; p<0.001 for children; p<0.001 for adults; p<0.001 for all age groups). While 60.5% of the cases had no symptoms, severe signs of toxicity were present in 1.9% of theophylline exposure cases during the telephone inquiry. Signs and symptoms were found to be significantly more prevalent in adults than in children (p<0.01). The serum theophylline level was regarded as toxic in 74% (65 toxic levels) of theophylline measured cases. Clinical signs and symptoms were found to be significantly prevalent in cases with toxic theophylline levels (p<0.001). The rate of gastrointestinal decontamination procedures was higher than that of recommended gastrointestinal decontamination procedures by DPIC (83% and 66%, respectively). There wer...

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Section: Discussionmentioning

confidence: 90%

Demographic and Clinical Characteristics of Theophylline Exposures between 1993 and 2011

Hocaoğlu¹,

Yildiztepe²,

Bayram³

et al. 2015

Balkan Med J

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“…Hyperglycemia is a frequent finding in theophylline poisoning 5,12 . Some studies have also reported that hyperglycemia has a high prevalence of poisoning 7,11,13,14 . Shannon et al reported the age distribution of theophylline poisoning in the range of 3 months to 98 years with a mean age of 34.5 years 13 .…”

Section: Discussionmentioning

confidence: 99%

“…Cardiac manifestations include dysrhythmias, hypotension, and cardiac arrest. Neurological manifestations include: tremors, convulsions, restlessness and headache 7,8 .…”

Section: Introductionmentioning

confidence: 99%

Epidemiological Survey of Theophylline Poisoning in a tertiary poison center

BAROONİAN,

RAMEZANİ,

ERFAN TALAB EVİNİ

et al. 2023

Eurasian Journal of Toxicology

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Background: Theophylline belongs to the category of bronchodilators and belongs to the family of methylxanthines. The purpose of this study was the epidemiological and clinical investigation of theophylline poisoning in patients admitted to Loghman Hakim Hospital in Tehran. Methods: This retrospective study reviewed the archived files of hospitalized patients from 2012 to 2022 by developing a questionnaire. All demographic information and results of examinations and laboratory tests were extracted from the files. The collected data were analyzed by SPSS version 25 software. Results: The age range of the patients was 3 months to 57 years. Out of 34 studied patients, 79.4% were female and 20.6% were male. The most common symptoms of poisoning were vomiting, nausea, sinus tachycardia, hyperglycemia and respiratory alkalosis. The incidence of hyperglycemia was 47.1%. One person had died. Conclusion: Poisoning with theophylline is uncommon and is mainly caused by self-harm. Except in severe poisonings, death and serious complications have not followed, and they have mostly recovered with supportive and symptomatic treatments.

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“…We described a case of attempted suicide and acute theophylline toxicity. Parr et al (4) reported 64 cases of acute theophylline toxicity, who were all but two Accepted on 13 December 2002 attempted suicide cases.Other causes of acute theophylline toxicity include prescription of high doses by physicians and accidental ingestion. Thus, prescription of theophylline should be accompanied by education of patients and/or their families about the potential dangers.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, this is the ¢rst case of successful treatment of acute theophylline toxicity by endoscopy.The reason that STCs can remain high is continued absorption of theophylline as it is released from the sustained-release tablet, throughout the digestive tract. Sustained-release theophylline could remain in the stomach for 8^12 h in acute overdose (4). For example, Macdonald et al reported a case whose STC was 138 mg/ml after 36 h later of 50'Phyllocontin'tablets (aminophylline, 225 mg slow release) ingestion (5).…”

Section: Discussionmentioning

confidence: 99%