The nadir in serum potassium concentrations was more severe among 25 patients who presented to the emergency department within 6 hours of the overdose than among 13 patients who presented later (mean +/- SE, 3.0 +/- 0.1 mEq/L vs 3.4 +/- 0.1 mEq/L, p less [ncbi.nlm.nih.gov]

Leading experts from Latin America, Africa, Near and Middle East, Indian Subcontinent, Far East, Oceania and Australia present their expert insights into specific conditions, as well as progress and challenges in the development of the specialty. [books.google.de]

• Pain

  Gastrointestinal findings include nausea, vomiting, abdominal pain, and diarrhea. Causes Acute toxicity occurs with accidental or intentional overdose. [emedicine.medscape.com]

  Toxicity is characterised by agitation, tremor, nausea, vomiting, abdominal pains, seizures, and tachyarrhythmias. Hypokalaemia and metabolic acidosis are more profound in acute toxicity, and hypercalcaemia is usually present. [ncbi.nlm.nih.gov]

  […] or stiffness nausea or vomiting nervousness numbness or tingling in the hands, feet, or lips pain or discomfort in the arms, jaw, back, or neck painful urination shakiness in the legs, arms, hands, or feet shortness of breath sweating unusual tiredness [drugs.com]

  Signs of mild theophylline toxicity are nausea, vomiting, abdominal pain, tachycardia, and muscle tremor and are usually seen with levels around 20 to 25 mg/L. [renalandurologynews.com]

• Gastric Lavage

  Gastric lavage should be performed in all patients presenting early, and an oral multiple dose charcoal regimen started with 50 to 100g charcoal, repeating with 50g doses and checking theophylline concentrations at 2- to 4-hour intervals. [ncbi.nlm.nih.gov]

  Gastric lavage should be considered in intubated patients. Endoscopic bezoar fragmentation and retrieval may be utilized if lavage is not efficacious. Administer activated charcoal. [emedicine.medscape.com]

  If the ingestion had occurred less than an hour ago, a gastric lavage may be performed or a dose of activated charcoal may be given to the patient to reduce the amount of theophylline in the body. [overdoseinfo.com]

  Treatment is directed at impeding absorption by gastric lavage and overall, the oral administration of activated carbon, and at increasing the elimination by hemoperfusion and hemodialysis in addition to the application of adequate measures of support [archbronconeumol.org]

  How to proceed...Cont’d • Gastric lavage can be done in uncooperative patients or in patients with DCL. • Activated charcoal is a cornerstone in our management plan and should be given in multiple doses as a GI dialysis. • In severe intractable vomiting [fr.slideshare.net]

• Hyperthermia

  Theophylline poisoning with a blood level of 183 mg/l in a 38-year-old man was treated with activated charcoal by mouth, but despite this the blood level of theophylline rose and there was circulatory collapse with rhabdomyolysis, acute renal failure and hyperthermia [ncbi.nlm.nih.gov]

  • For hyperthermia: Cold fomentations +/- BZP to calm the patient down 14. Indications of ICU ADMISSION 1. Unstable vital data despite initial ER management. 2. Severe agitation +/- Seizures. 3. History of convulsions. 4. Comatosed patients. 5. [fr.slideshare.net]

• Fever

  They may present with fever and laboratory abnormalities hypothermia pancytopenia bradycardia hypoglycemia hypotension hypokalemia emaciation elevated bun acrocyanosis elevated cholesterol dry skin hypoalbuminemia lanugo mild transaminase elevations thinning [smj.org.sa]

  […] decrease in frequency of urination decreased urine diarrhea difficulty in passing urine (dribbling) dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position dry mouth fast, pounding, or irregular heartbeat or pulse fever [drugs.com]

• Tachypnea

  Initial symptoms of the toxicity include vomiting, tachycardia or increased heart rate, tachypnea or increased respirations, anxiety and development of tremors. [overdoseinfo.com]

  • Respiratory: Tachypnea 5. Take Care!! [fr.slideshare.net]

  General: Agitation, irritability, restlessness Cardiovascular: Sinus tachycardia, ventricular tachycardia atrial fibrillation, supraventricular tachycardia, hypotension, cardiac arrest Respiratory: Tachypnea, acute lung injury, respiratory alkalosis Gastrointestinal [ncbi.nlm.nih.gov]

• Vomiting

  We performed a prospective study of 26 patients with acute overdose of sustained release theophylline to characterize vomiting, and its possible interference with the acceptance of activated charcoal. Twenty five of 26 patients vomited. [ncbi.nlm.nih.gov]

  It is important to aggressively control nausea and vomiting in order to perform MDAC treatment. [emedicine.medscape.com]

  Presentation • Generally: Any patient with severe intractable vomiting + Tachycardia in the PCC ER unit = Theophylline toxicity till proved otherwise. • GIT: nausea, severe up to intractable vomiting +/- upper GI bleeding, diarrhea and abdominal pain. [fr.slideshare.net]

  A seven-year-old female patient presented with complaints of vomiting and headache. She had tachycardia and other physical examination findings were found to be normal. [go.gale.com]

• Nausea

  Clinical features included nausea, tremor, delirium, hypotension and cardiac arrhythmias, metabolic acidosis, hyperglycemia, hypokalemia and hypophosphatemia. [ncbi.nlm.nih.gov]

  Gastrointestinal findings include nausea, vomiting, abdominal pain, and diarrhea. Causes Acute toxicity occurs with accidental or intentional overdose. [emedicine.medscape.com]

  Relaxes smooth muscle (except cerebral vasculature), but increases contractility of skeletal muscle Acute rhabdomyolysis may occur Gastrointestinal effects1 Increased secretion of gastric acid, pepsin, and gastrin Toxicity frequently associated with nausea [dynamed.com]

• Abdominal Pain

  Gastrointestinal findings include nausea, vomiting, abdominal pain, and diarrhea. Causes Acute toxicity occurs with accidental or intentional overdose. [emedicine.medscape.com]

  Toxicity is characterised by agitation, tremor, nausea, vomiting, abdominal pains, seizures, and tachyarrhythmias. Hypokalaemia and metabolic acidosis are more profound in acute toxicity, and hypercalcaemia is usually present. [ncbi.nlm.nih.gov]

  Signs of mild theophylline toxicity are nausea, vomiting, abdominal pain, tachycardia, and muscle tremor and are usually seen with levels around 20 to 25 mg/L. [renalandurologynews.com]

• Diarrhea

  Gastrointestinal findings include nausea, vomiting, abdominal pain, and diarrhea. Causes Acute toxicity occurs with accidental or intentional overdose. [emedicine.medscape.com]

  • GIT: nausea, severe up to intractable vomiting +/- upper GI bleeding, diarrhea and abdominal pain. • CVS: palpitation and hypotension • CNS: Tremors, agitation, restlessness, seizures and coma in late severe stages. • Respiratory: Tachypnea 5. [fr.slideshare.net]

  […] the following symptoms of overdose occur while taking theophylline: Symptoms of Overdose Abdominal or stomach pain blurred vision confusion confusion about identity, place, and time dark-colored urine decrease in frequency of urination decreased urine diarrhea [drugs.com]

  It can also cause nausea, diarrhea, increase in heart rate, abnormal heart rhythms, and CNS excitation (headaches, insomnia, irritability, dizziness and lightheadedness ). [4] [5] Seizures can also occur in severe cases of toxicity, and are considered [en.wikipedia.org]

• Tachycardia

  Cardiovascular: Sinus, atrial, and ventricular tachycardias: Multifocal atrial tachycardia Atrial fibrillation Premature ventricular contractions Ventricular tachycardia Due to β ... Bring pill bottles/pill samples in suspected overdose. [5minuteconsult.com]

  If a severe toxicity had occurred, the tachycardia may develop into supraventricular tachycardia, atrial flutter and fibrillation and ventricular tachycardia. Metabolic changes include decreased potassium, magnesium and phosphate serum level. [overdoseinfo.com]

  The most common clinical symptoms were tachycardia (47%) and vomiting (52%); both occurred more frequently with higher theophylline concentrations (P < 0.002 and Ρ < 0.01). [scholars.northwestern.edu]

  General: Agitation, irritability, restlessness Cardiovascular: Sinus tachycardia, ventricular tachycardia atrial fibrillation, supraventricular tachycardia, hypotension, cardiac arrest Respiratory: Tachypnea, acute lung injury, respiratory alkalosis Gastrointestinal [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]

• Hypotension

  Clinical features included nausea, tremor, delirium, hypotension and cardiac arrhythmias, metabolic acidosis, hyperglycemia, hypokalemia and hypophosphatemia. [ncbi.nlm.nih.gov]

  CAVEAT: Barbiturates can precipitate hypotension. Phenobarbital has the added advantage of enhancing the hepatic metabolism of theophylline. [emedicine.medscape.com]

  Severe intoxication is characterized by ventricular and supraventricular tachyarrhythmias, hypotension, and seizures. Status epilepticus is common and often intractable to the usual anticonvulsants. [accessmedicine.mhmedical.com]

• Palpitations

  • CVS: palpitation and hypotension • CNS: Tremors, agitation, restlessness, seizures and coma in late severe stages. • Respiratory: Tachypnea 5. Take Care!! [fr.slideshare.net]

  A 35-year-old female was transferred to our hospital by ambulance because of palpitation and general fatigue. She had taken 28, 000mg of sustained-release theophylline preparation for a suicide attempt 5 hours before admission. [ci.nii.ac.jp]

• Seizure

  Seizures occur at lower concentrations after chronic over-medication than after acute overdose. [ncbi.nlm.nih.gov]

  even at usual therapeutic levels. 156 Seizures are generally benign. [epilepsy.com]

  Historically, phenobarbital prophylaxis was used in patients at high risk for seizures. [emedicine.medscape.com]

• Tremor

  Clinical features included nausea, tremor, delirium, hypotension and cardiac arrhythmias, metabolic acidosis, hyperglycemia, hypokalemia and hypophosphatemia. [ncbi.nlm.nih.gov]

  Initial symptoms of the toxicity include vomiting, tachycardia or increased heart rate, tachypnea or increased respirations, anxiety and development of tremors. [overdoseinfo.com]

  Signs of mild theophylline toxicity are nausea, vomiting, abdominal pain, tachycardia, and muscle tremor and are usually seen with levels around 20 to 25 mg/L. [renalandurologynews.com]

  Following admission she had a persistent sinus tachycardia (250 beats/min) resulting in left ventricular failure, intractable vomiting with haematemesis, hypokalaemia (K + 2.6 mmol/l), and tremor. [thorax.bmj.com]

• Convulsions

  Oral charcoal can double the rate of clearance 7 and is recommended in any overdose greater than 1 g. 1 Charcoal haemoperfusion is recommended if there are persistent convulsions, intractable vomiting, haemodynamic instability, rapidly deteriorating condition [thorax.bmj.com]

  The primary outcomes were 1) incidence of major theophylline toxicity (convulsions or life‐threatening cardiac dysrhythmias) during or after each procedure, 2) calculated theophylline clearance, and 3) procedure‐related complications. [onlinelibrary.wiley.com]

  History of convulsions. 4. Comatosed patients. 5. Severe metabolic acidosis. 6. Premorbid condition e.g. cardiac patients 7. ECG shows potentially dangerous arrhythmias e.g. multiple PVCs. 8. Initial blood level > 35 microgram/dl. 15. [fr.slideshare.net]

  Stone WE, Javid JM (1980) Aminophylline and imidazole as convulsants. Arch Int Pharmacodyn Ther 248:120–131 Google Scholar 26. [link.springer.com]

  Survenue de crises convulsives sous théophylline a doses thérapeutiques. Presse Méd, 17 (1988), pp. 1.206-1.208 [31.] M. Shannon, F.H. Lovejoy. Hypokalemia after theophylline intoxication The effects of acute vs chronic poisoning. [archbronconeumol.org]

• Agitation

  • CVS: palpitation and hypotension • CNS: Tremors, agitation, restlessness, seizures and coma in late severe stages. • Respiratory: Tachypnea 5. Take Care!! [fr.slideshare.net]

  Toxicity is characterised by agitation, tremor, nausea, vomiting, abdominal pains, seizures, and tachyarrhythmias. Hypokalaemia and metabolic acidosis are more profound in acute toxicity, and hypercalcaemia is usually present. [ncbi.nlm.nih.gov]

  Neurologic findings commonly include tremors, restlessness, agitation, and seizures. Gastrointestinal findings include nausea, vomiting, abdominal pain, and diarrhea. Causes Acute toxicity occurs with accidental or intentional overdose. [emedicine.medscape.com]

• Headache

  A seven-year-old female patient presented with complaints of vomiting and headache. She had tachycardia and other physical examination findings were found to be normal. [go.gale.com]

  Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Incidence Not Known Headache irritability restlessness sleeplessness trouble sleeping unable to sleep For [drugs.com]

  It can also cause nausea, diarrhea, increase in heart rate, abnormal heart rhythms, and CNS excitation (headaches, insomnia, irritability, dizziness and lightheadedness ). [4] [5] Seizures can also occur in severe cases of toxicity, and are considered [en.wikipedia.org]

[…] fibrillation, supraventricular tachycardia, hypotension, cardiac arrest Respiratory: Tachypnea, acute lung injury, respiratory alkalosis Gastrointestinal (GI): Nausea, vomiting, abdominal pain Neurological: Tremors, hallucinations, seizures[1][3] Evaluation Workup [ncbi.nlm.nih.gov]

An extensive workup excluded pre-diabetic status (Table I). An oral glucose tolerance test performed 6 days later was normal, and insulin release evaluated by the intravenous glucose tolerance test was normal. [em-consulte.com]

• Hyperglycemia

  The possible association of hyperglycemia and ketoacidosis with severe theophylline toxicity is discussed. [ncbi.nlm.nih.gov]

  (Turk Arch Ped 2013; 48:55-6) Key words: Hyperglycemia, intoxication, theophylline, vomiting Ozet Teofilin, tikayici havayolu hastaliklarinin tedavisinde kullanilan bir ilactir. [go.gale.com]

  Keywords: Hyperglycemia, intoxication, theophylline, vomiting Bir olgu nedeniyle teofilin zehirlenmesi Ertan Sal 1, Avni Kaya1, Hayrettin Temel2, Murat Başaranoğlu2, Hüseyin Çaksen2 1Van Kadın ve Çocuk Hastalıkları Hastanesi, Çocuk Kliniği, Van, Türkiye [turkpediatriarsivi.com]

Use of multiple dose activated charcoal appears to be a viable option in the treatment of young infants with theophylline poisoning. [ncbi.nlm.nih.gov]

Following completion of an 8 h MARS treatment plasma theophylline levels remained low, although it was necessary to administer intravenous potassium and magnesium supplements. Fig. 1. Plasma theophylline levels in response to MARS treatment. Fig. 1. [academic.oup.com]

It is a very effective method of elimination, and it is considered the mainstay treatment of theophylline toxicity. It is important to aggressively control nausea and vomiting in order to perform MDAC treatment. [emedicine.medscape.com]

Signs and symptoms range from mild gastrointestinal upset to serious central nervous system manifestations such as seizures, a symptom often associated with a bad prognosis. [ncbi.nlm.nih.gov]

The clinical manifestations of toxicity are fundamentally gastrointestinal, cardiovascular, neurologic and metabolic with some being of specially severity, conditioning the prognosis of the intoxication. [archbronconeumol.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]

Emergency department providers should become familiar with managing patients with theophylline toxicity since arrhythmias, seizures, hyperglycemia, and rhabdomyolysis are several of the complications that can arise.[1][2][3] Etiology Theophylline has [ncbi.nlm.nih.gov]

Neurology and Neurosurgery Czech and Slovak Ophthalmology Czech and Slovak Psychiatry Czech Geriatric Review Czech Gynaecology Czech Rheumatology Czech Dental Journal Czech Urology Czech-Slovak Dermatology Czecho-Slovak Pathology Czech-Slovak Pediatrics Epidemiology [prolekare.cz]

Epidemiology Toxic exposures to theophylline have decreased significantly since its management for asthma and COPD has declined. [ncbi.nlm.nih.gov]

He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education. [lifeinthefastlane.com]

Indications a wide range p.810 of epidemiologic and microbiologic flora. An alternative approach. [smj.org.sa]

Therefore it is essential that clinicians are aware of the pathophysiology, clinical presentation and treatment of this poisoning. Theophylline intoxication mainly affects the gastrointestinal, cardiovascular and central nervous systems. [ncbi.nlm.nih.gov]

Because several pathophysiologic factors can increase the risk of toxicity, the clinician often must rely on other laboratory tests, such as electrolytes and renal function, to monitor the patient effectively. [academic.oup.com]

Brenner/Rector remains the go-to resource for practicing and training nephrologists and internists who wish to master basic science, pathophysiology, and clinical best practices. [books.google.de]

Pneumothorax anatomy and pathophysiology the auricle and the globe and resultant outcome of scalp wound closure to achieve precise approximation and repair chest wall are the landmarks and is achieved by the epiglottis with the moistened cotton-tipped [smj.org.sa]

Prevention of gastrointestinal absorption should be the principal objective of treatment of an oral theophylline poisoning. [ncbi.nlm.nih.gov]

[…] theophylline toxicity Reference - National Heart, Lung, and Blood Institute (NHLBI) National Asthma Education and Prevention Program guideline on diagnosis and management of asthma (NHLBI 2007 OpenInNewPDF PictureAsPdf, or at 17983880J Allergy Clin Immunol [dynamed.com]

How to prevent Theophylline Toxicity? In order to prevent an overdose in theophylline, the medications must be taken as directed. [overdoseinfo.com]

These effects were either prevented or partially reversed after induction of beta-blockade with propranolol. Very high levels of theophylline were associated with elevated levels of norepinephrine and epinephrine in the animals. FULL TEXT [annals.org]