Presentation
When theophylline is not present, RNA probes are stable and their conformations remain unchanged. [ncbi.nlm.nih.gov]
Entire Body System
- Fever
In infants with idiopathic low seizure threshold and fever, theophylline administration might possibly trigger a seizure. [ncbi.nlm.nih.gov]
Acetylsalicylic acid Pain, fever, and inflammation Acetylsalicylic acid (ASA), in the regular tablet form (immediate-release), is indicated to relieve pain, fever, and inflammation associated with many conditions, including the flu, the common... [drugbank.ca]
PRECAUTIONS: Tell your doctor your medical history, especially of: heart disease, stomach/intestinal ulcers, liver disease, recent fever, thyroid problems, seizures, drug or food allergies. [web.archive.org]
Notify your doctor if you have a fever of 100 degrees F or more for 24 hours. May need a blood test to monitor levels in the blood. This information has been approved by Ronina Covar, MD and Ann Mullen, RN, MSN, CNS, AE-C (December, 2012). [nationaljewish.org]
Fever Acute illnesses associated with fever have been reported to prolong theophylline half-life. If fever is high and sustained, e.g., >102 for >24 hours, dosage should be reduced. [rxkinetics.com]
- Pallor
Severe pallid breath-holding spells (BHSs) are based on parasympathetic hyperactivity, leading to cardiac asystole, pallor, brain ischemia, loss of consciousness, and reflex anoxic seizures. [ncbi.nlm.nih.gov]
Gastrointestinal
- Vomiting
Clinical features common to severe theophylline toxicity include nausea and vomiting, tachydysrhythmias, metabolic disturbances, seizures, and cardiovascular collapse. Several reports have described these manifestations and their treatments. [ncbi.nlm.nih.gov]
Aggressive control of vomiting with antiemetics is needed (e.g. ondansetron 4 mg IV) Enhanced elimination – Haemodialysis is is the definitive life-saving intervention. [lifeinthefastlane.com]
- Nausea
Clinical features common to severe theophylline toxicity include nausea and vomiting, tachydysrhythmias, metabolic disturbances, seizures, and cardiovascular collapse. Several reports have described these manifestations and their treatments. [ncbi.nlm.nih.gov]
Studies of nausea and vomiting related to cancer chemotherapy included 317 patients receiving dronabinol and 68 receiving placebo. [web.archive.org]
Theophylline toxicity can cause nausea, vomiting, insomnia, seizures, agitation and life- threatening heart rhythm abnormalities. St. [medicinenet.com]
- Diarrhea
Elevated theophylline levels can cause extreme headaches, stomach aches, diarrhea, seizures, heart rhythm irregularities, irritability and tremors. At times, you may have a high serum level of theophylline and no adverse symptoms. [theasthmacenter.org]
However, regular ingestion of excess amounts of caffeine can lead to problems such as poor concentration, nervousness, heartburn, constipation and diarrhea. [web.archive.org]
In large amounts, theophylline can cause nausea, diarrhea, arrhythmia, headache, insomnia, irritability and dizziness, according to the “PDR Guide to Drug Interactions, Side Effects and Indications.” [livestrong.com]
Common side effects are: nausea, vomiting, diarrhea, headaches, irritability, flushing and palpitations. Other important and more serious side effects include seizures and heart arrhythmias. [medicinenet.com]
Cardiovascular
- Tachycardia
An electrocardiogram showed a sinus tachycardia. Arterial blood gas analysis revealed a mixed metabolic acidosis and respiratory alkalosis. Serum lactate level was 51 mmol/L (normal 0.7-2.1 mmol/L). [ncbi.nlm.nih.gov]
Early features anxiety, vomiting, tremor, tachycardia, tachypnoea Severe toxicity cardiotoxicity: cardiac dysrhythmias, supraventricular tachycardia, atrial fibrillation and flutter, ventricular tachycardia, refractory hypotension. neurotoxicity: seizures [lifeinthefastlane.com]
- Heart Disease
Do not take these medications without talking to your doctor; they can increase the side effects of theophylline. tell your doctor if you have or have ever had seizures, ulcers, heart disease, an overactive or underactive thyroid gland, high blood pressure [web.archive.org]
In a similar vein, treatment of patients with high cholesterol with cholesterol lowering agents is useful in treatment of heart disease, but there are many causes of heart disease besides elevated cholesterol.” [sciencedaily.com]
- Hypotension
In overdose, it causes hypotension, bradycardia and drowsiness. The natriuretic, kaliuretic and vasodilatory effects of indapamide are exaggerated in overdose, resulting in diuresis, hypokalaemia and hypotension. [ncbi.nlm.nih.gov]
The life-threatening multisystem effects – especially cardiac dysrhythmia, hypotension, and seizures – tend to be refractory to other treatment measures and supportive care alone will not prevent death. [lifeinthefastlane.com]
- Orthostatic Hypotension
Its effects on blood pressure are inconsistent, but subjects have experienced orthostatic hypotension and/or syncope upon abrupt standing [see WARNINGS AND PRECAUTIONS ]. [rxlist.com]
Eyes
- Blurred Vision
Symptoms of excess caffeine use Some examples of the symptoms that may occur in people who consume too much caffeine include: Anxiety Confusion Irritability Suppressed appetite Sleeplessness Dizziness Blurred vision Dry mouth Increased thirst Flushed [web.archive.org]
vision, weight loss ). [emedicinehealth.com]
Psychiatrical
- Euphoria
Nervous system: ( Amnesia ), anxiety/nervousness, ( ataxia ), confusion, depersonalization, dizziness*, euphoria*, ( hallucination ), paranoid reaction*, somnolence*, thinking abnormal*. [web.archive.org]
System Organ Class Adverse Reactions General Asthenia Cardiovascular Palpitations, tachycardia, vasodilation /facial flush Gastrointestinal Abdominal pain*, nausea*, vomiting* Central Nervous System Dizziness*, euphoria *, paranoid reaction*, somnolence [rxlist.com]
Neurologic
- Seizure
The case is presented of a 6-month-old girl with theophylline-induced focal seizures associated with tachycardia, tremor and irritability. [ncbi.nlm.nih.gov]
Among the 54 cases of TAS, 36 experienced generalized tonic–clonic seizures, with the remainder experiencing partial seizures. [oadoi.org]
- Tremor
The case is presented of a 6-month-old girl with theophylline-induced focal seizures associated with tachycardia, tremor and irritability. [ncbi.nlm.nih.gov]
Elevated theophylline levels can cause extreme headaches, stomach aches, diarrhea, seizures, heart rhythm irregularities, irritability and tremors. At times, you may have a high serum level of theophylline and no adverse symptoms. [theasthmacenter.org]
Potential side effects include: Nausea, vomiting Poor appetite Palpitations, tremors, muscle twitching Nervousness, restlessness, difficulty sleeping Note: The side effects listed are the most common. [my.clevelandclinic.org]
- Agitation
All newborns experienced sinus tachycardia and agitation. Sequential theophylline and caffeine serum levels were obtained periodically for 62 to 100 hours. [ncbi.nlm.nih.gov]
Theophylline toxicity can cause nausea, vomiting, insomnia, seizures, agitation and life- threatening heart rhythm abnormalities. St. [medicinenet.com]
- Excitement
CONCLUSION: A single dose of theophylline is well-tolerated by patients with chronic stroke, but does not alter cortical excitability. [ncbi.nlm.nih.gov]
We’re excited to announce the launch of two new resources on MedicinesComplete: Martindale’s ADR Checker and the Palliative Care Formulary. [about.medicinescomplete.com]
- Generalized Tonic-Clonic Seizure
Among the 54 cases of TAS, 36 experienced generalized tonic-clonic seizures, with the remainder experiencing partial seizures. [ncbi.nlm.nih.gov]
Among the 54 cases of TAS, 36 experienced generalized tonic–clonic seizures, with the remainder experiencing partial seizures. [doi.org]
Workup
Serum
- Hyperglycemia
Metabolic and electrolyte abnormalities, including hypokalemia, hyperglycemia and lactic acidosis, are associated with theophylline overdose. [ncbi.nlm.nih.gov]
Hypokalemia, hyperglycemia, hypercalcemia, hypophosphatemia, and acidosis commonly occur after an acute overdose. [emedicine.medscape.com]
Following acute overdose, hypokalemia, hyperglycemia, hypercalcemia, hypophosphatemia, and acidosis commonly occur. Theophylline is mainly metabolised in the liver by demethylation or oxidation using the cytochrome P450 system. [bjmp.org]
- Hypophosphatemia
Although his peak theophylline concentration was 157 mumol/L (28.2 micrograms/mL), it was associated with significant leukocytosis, hypokalemia, hypomagnesemia, hypophosphatemia, hyperglycemia, and lactic acidosis. [ncbi.nlm.nih.gov]
Hypokalemia, hyperglycemia, hypercalcemia, hypophosphatemia, and acidosis commonly occur after an acute overdose. [emedicine.medscape.com]
Following acute overdose, hypokalemia, hyperglycemia, hypercalcemia, hypophosphatemia, and acidosis commonly occur. Theophylline is mainly metabolised in the liver by demethylation or oxidation using the cytochrome P450 system. [bjmp.org]
Treatment
Several reports have described these manifestations and their treatments. [ncbi.nlm.nih.gov]
Prognosis
Thomas D Rea and Valentine L Paredes, Quality of life and prognosis among survivors of out-of-hospital cardiac arrest, Current Opinion in Critical Care, 10, 3, (218), (2004). [doi.org]
Dysrhythmias and seizures are late features of severe theophyline toxicity and suggest a very poor prognosis. Q5. Should this man be transferred to another hospital? If so, why and how? This is a life-threatening acute ingestion of theophylline. [lifeinthefastlane.com]
Relation of prognosis in sick sinus syndrome to age, conduction defects and modes of permanent cardiac pacing. Am J Cardiol. 1990 ; 65 :729-735. Crossref Medline Google Scholar 24 Hesselson AB, Parsonnet V, Bernstein AD, Bonavita GJ. [circ.ahajournals.org]
Etiology
Nasal mucus Shh levels were found significantly diminished in untreated hyposmic patients of multiple etiologies. [ncbi.nlm.nih.gov]
This pattern was present for both Alzheimer’s disease–related dementia and cerebrovascular disease etiologies, and persisted in analyses restricted to nonsmokers. [atsjournals.org]
Epidemiology
He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education. [lifeinthefastlane.com]
Descriptive epidemiology of asthma. Lancet 1997 ; 350 (Suppl 11): 1 -4. ↵ Holgate ST. The cellular and mediator basis of asthma in relation to natural history. Lancet 1997 ; 350 (Suppl 11): 5 -9. ↵ Lipworth BJ. Treatment of acute asthma. [clinchem.aaccjnls.org]
View Article PubMed Google Scholar Myers TR: Pediatric asthma epidemiology: incidence, morbidity, and mortality. Respir Care Clin N Am 2000, 6: 1–14. View Article PubMed Google Scholar O'Byrne PM: Leukotrienes in the pathogenesis of asthma. [respiratory-research.biomedcentral.com]
Pathophysiology
[…] are useful primarily for patients with asthma because bronchospasm is a key component of that disease state. 1 The use of theophylline in patients with chronic obstructive pulmonary disease is more controversial because these diseases have different pathophysiologic [accesspharmacy.mhmedical.com]
Useful For Suggests clinical disorders or settings where the test may be helpful Assessing and adjusting dosage for optimal therapeutic level Assessing toxicity Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, [mayomedicallaboratories.com]
We used a nonspecific phosphodiesterase inhibitor, PTX, in the present study because it has been used clinically in the treatment of a variety of conditions in which inflammation is an important component of the pathophysiology of the disease process. [doi.org]
Prevention
This drug ameliorates kidney dysfunction and prophylaxis given early after birth, preventing vasomotor nephropathy. [ncbi.nlm.nih.gov]
Examples: Theo-dur, Slo-phylline, Theo-24, Quibron and other generics Controller Medications: Prevent asthma symptoms from occurring Can reduce and/or prevent: Inflammation and scarring in the airways Tightening of the muscle bands around the airways [pamf.org]