Theophylline Toxicity Associated with the Administration of Ciprofloxacin in a Nursing Home Patient

Richardson, James P.

doi:10.1111/j.1532-5415.1990.tb03497.x

Cited by 6 publications

(2 citation statements)

References 22 publications

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“…The metabolic interaction between fluoroquinolones patients taking ciprofloxacin and theophylline is not and theophylline is well documented [1,2], with defined clearly [5,6,12,13], despite reports of subenoxacin and ciprofloxacin having a more potent stantially elevated plasma theophylline concentrations inhibitory effect on the cytochrome P450 system than and deaths [1, [14][15][16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

The effect of ciprofloxacin on theophylline pharmacokinetics in healthy subjects.

Batty

Davis

Ilett

et al. 1995

Brit J Clinical Pharma

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1 The mechanism of the interaction between ciprofloxacin and theophylline was investigated in nine healthy subjects. 2 Subjects were given a single oral dose of theophylline (3.4 mg kg-), before and after 60 h of ciprofloxacin therapy at a dose of 500 mg twice daily. 3 Ciprofloxacin reduced the oral clearance of theophylline by 19% (-7.73 ± 6.42 ml kg-' h-' (95% confidence limits -12.66, -2.79)). Some subjects (group A, n = 4) showed little decrease in clearance (mean 4.4%; -1.6 ± 0.7 ml kg-' h-1 (-2.6, -0.5)), whereas others (group B, n = 5) showed a marked decrease (mean 30%; -12.7 ± 3.7 ml kg-' h-1 (-17.2, -8.1)).4 Comparing groups A and B, the decrease in oral clearance of theophylline in group B could not be ascribed to differences in the AUC of ciprofloxacin. Group A subjects showed only slight inhibition of 1-demethylation (-12.8 ± 5.5% (-21.5, -4.0)), while group B subjects showed a significantly greater inhibition of 1-demethylation (-49.9 ± 9.8% (-62.1, -37.7)), 3-demethylation (-44.8 ± 8.6% (-55.4, -34.1)) and 8-hydroxylation (-27.0 ± 3.7% (-31.6, -22.4)). 5 The results suggest that inter-individual variability in the inhibition of theophylline metabolism by ciprofloxacin can be attributed to inter-individual differences in the level of CYP1A2 expression and/or in the degree of inhibition of hepatic CYP1A2 and CYP3A4. 6 The interaction between ciprofloxacin and theophylline can be clinically significant. However, uniform decrease in the theophylline dose is not warranted because there is a negligible change in theophylline clearance when ciprofloxacin is coadministered in a substantial proportion of patients.

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Section: Introductionmentioning

confidence: 99%

The effect of ciprofloxacin on theophylline pharmacokinetics in healthy subjects.

Batty

Davis

Ilett

et al. 1995

Brit J Clinical Pharma

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“…Аминофиллин/ 5,4-8,3% Нарушение автоматизма и повышение возбудимости кардиомиоцитов B Теофиллин [188][189][190][191][192][193] Теофиллин + 9,1% Межлекарственное взаимодействие приводит к повышению уровня концентрации теофиллина в Ципрофлоксацин сыворотке крови, особенно, у пациентов старше 60 лет. Нарушение автоматизма и повышение [194][195][196][197] возбудимости кардиомиоцитов B Ипратропия бромид Описание Неизвестен C [197] клинического случая (n=1)…”

Section: бронхолитические лекарственные средстваunclassified

Drug-Induced Atrial Fibrillation / Atrial Flutter

Остроумова

Chernyaeva

Кочетков

et al. 2022

Racionalʹnaâ farmakoterapiâ v kardiologii

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Drug-induced atrial fibrillation / flutter (DIAF) is a serious and potentially life-threatening complication of pharmacotherapy. Purpose of the work: systematization and analysis of scientific literature data on drugs, the use of which can cause the development of DIAF, as well as on epidemiology, pathophysiological mechanisms, risk factors, clinical picture, diagnosis and differential diagnosis, treatment and prevention of DIAF. Analysis of the literature has shown that many groups of drugs can cause the development of DIAF, with a greater frequency while taking anticancer drugs, drugs for the treatment of the cardiovascular, bronchopulmonary and central nervous systems. The mechanisms and main risk factors for the development of DIAF have not been finally established and are known only for certain drugs, therefore, this section requires further study. The main symptoms of DIAF are due to the severity of tachycardia and their influence on the parameters of central hemodynamics. For diagnosis, it is necessary to conduct an electrocardiogram (ECG) and Holter monitoring of an ECG and echocardiography. Differential diagnosis should be made with AF, which may be caused by other causes, as well as other rhythm and conduction disturbances. Successful treatment of DIAF is based on the principle of rapid recognition and immediate discontinuation of drugs (if possible), the use of which potentially caused the development of adverse drug reactions (ADR). The choice of management strategy: heart rate control or rhythm control, as well as the method of achievement (medication or non-medication), depends on the specific clinical situation. For the prevention of DIAF, it is necessary to instruct patients about possible symptoms and recommend self-monitoring of the pulse. It is important for practitioners to be wary of the risk of DIAF due to the variety of drugs that can potentially cause this ADR.

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