Presentation
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]
Respiratoric
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Aspiration
Dyspnoea is a serious symptom requiring causal and/or Aspiration of gastric contents while using the i-gel laryngeal mask: Case report of three cases The i-gel supraglottic airway is a second generation Atrial fibrillation in critically ill patients Arrhythmias [prolekare.cz]
It is also important that the patient is able to protect his or her airway in order to prevent aspiration of activated charcoal, which can be detrimental. Administer the cathartic, sorbitol, with the activated charcoal one time. [emedicine.medscape.com]
The airway of the patient must be covered prior to giving the charcoal in order to avoid aspiration. Electrolyte solution will also be administered to return them to normal levels. [overdoseinfo.com]
Serum theophylline levels continued to increase during the first 24 hours after admission so she was transferred to the intensive care unit (ICU) where she had a tonic-clonic seizure, aspirated, and required intubation and ventilation. [thorax.bmj.com]
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Prolonged Expiration
Respiratory system examination revealed prolonged expiration, in keeping with COPD, but the rest of the examination was unremarkable. [bjmp.org]
Cardiovascular
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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]
Psychiatrical
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Suggestibility
ECTR is also suggested if gastrointestinal decontamination cannot be administered (2D). ECTR should be continued until clinical improvement is apparent or the [theophylline] is 15 mg/L (83 μmol/L) (1D). [ncbi.nlm.nih.gov]
— The conclusions in the recent letter by Kossoy et al 1 and the reply by Sahney 2 regarding the original report 3 suggesting conservative treatment of high theophylline levels until neurologic signs are present do not adequately consider the high frequency [pediatrics.aappublications.org]
Face, Head & Neck
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Facial Spasm
Two days following admission, the patient developed facial spasms and twitching of her muscles of her upper limbs. Over the next 24 hours, the patient had two witnessed tonic-clonic seizures, which were terminated with intravenous Lorazepam. [bjmp.org]
Neurologic
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Hyperesthesia
More likely to develop hypotension, electrolyte disturbances, gastrointestinal bleeding, and acute rhabdomyolysis Mechanism of toxicity Central nervous system effects include1 Nervousness Insomnia Central respiratory stimulation Nausea Vomiting Tremors Hyperesthesia [dynamed.com]
Workup
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]
Treatment
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]
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]
Prognosis
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]
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]
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]
Epidemiology
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]
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]
Pathophysiology
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]
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]
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]
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]
Nakada T, Kwee IL, Lerner AM, Remler MP "Theophylline-induced seizures: clinical and pathophysiologic aspects." West J Med 138 (1983): 371-4 12. Hall RC, Beresford TP, Stickney SK, et al "Psychiatric reactions produced by respiratory drugs." [drugs.com]
Prevention
In summary, activated charcoal given by mouth may be unable to prevent a rise in blood levels and the development of complications after substantial theophylline overdose. [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]