What are signs of theophylline toxicity?
Neurological signs include tremors (most common), restlessness, agitation, and altered mental status. Persistent seizures may occur with serum levels > 25 mcg/mL. Gastrointestinal manifestions are nausea, vomiting, abdominal cramps, and diarrhea.
Which drug is most likely to cause theophylline toxicity?
Causes of chronic theophylline toxicity include the following: Drug interactions (eg, ethanol [ETOH], cimetidine, oral contraceptives, allopurinol, macrolide antibiotics, quinolone antibiotics)
How do you monitor theophylline?
In order to accurately measure serum theophylline levels after oral administration, blood should be drawn 3 days after the initiation of therapy or dose change, when the steady-state peak blood concentration has been reached.
What are the signs of xanthine toxicity?
Symptoms of overdose may include unusually fast or slow heartbeat, loss of appetite, nausea/vomiting, sleeplessness, irritability, restlessness, headache, increased thirst, fever, ringing in ears, delirium, muscle twitching or weakness, seizures, sweating, or fast breathing.
How can theophylline toxicity be corrected?
Extracorporeal treatments can be used in the treatment of theophylline poisoning, with hemodialysis being the preferred method due to it being able to both enhance the clearance of the toxin and help correct metabolic derangements.
What are contraindications of theophylline?
Who should not take THEOPHYLLINE?
- overactive thyroid gland.
- a condition with low thyroid hormone levels.
- diabetes.
- cystic fibrosis.
- alcoholism.
- high blood pressure.
- a heart attack.
- angina, a type of chest pain.
What is the effectiveness of theophylline?
Theophylline has been used to prevent recurrent apnea and bradycardia in preterm infants by stimulating breathing. It is effective in reducing episodes and the need for mechanical ventilation, although less effective than caffeine (47).
What do theophylline levels indicate?
Answer: A theophylline level is a measure of theophylline in the bloodstream. This is used to regulate the dose. A blood level between 5-15 µg/ml often gives good relief of symptoms with the fewest side effects. Some people may do better with a level less than 5 µg/ml.
What is the indication of theophylline?
Theophylline is indicated for the treatment of the symptoms and reversible airflow obstruction associated with chronic asthma and other chronic lung diseases, e.g., emphysema and chronic bronchitis.
Which symptoms does theophylline treat?
Theophylline is used to prevent and treat wheezing, shortness of breath, and chest tightness caused by asthma, chronic bronchitis, emphysema, and other lung diseases. It relaxes and opens air passages in the lungs, making it easier to breathe.
Is theophylline a xanthine?
The most widely used xanthine is theophylline. The xanthines also have other activities mediated by their effects on different tissue phosphodiesterases including inhibition of platelet function and arterial vasodilation.
What are the signs and symptoms of theophylline toxicity?
In theophylline toxicity, epinephrine levels can be 4- to 8-times higher than normal, and norepinephrine concentrations can be 4- to 10-times higher than normal. Increased catecholamine concentrations have a variety of adverse effects such as cardiac arrhythmias, metabolic acidosis, hyperglycemia, and hypokalemia.
What is a high level of theophylline?
Theophylline levels – correlate well with clinical severity and are repeated every 2 – 4 hours until falling. In the elderly and those with chronic toxicity severe intoxication can occur at the ‘moderate toxicity’ level >60 mg/L and >40 mg/L retrospectively.
Does theophylline have a therapeutic window?
Unfortunately, theophylline has a narrow therapeutic window, and even levels slightly above this therapeutic window can have many adverse effects in the setting of acute and chronic toxicity. The excess circulating catecholamines cause the serious clinical effects that are associated with theophylline toxicity.
What is the prognosis of seizures associated with theophylline toxicity?
Seizures associated with serum Theophylline concentrations >30 mcg/mL are often resistant to anticonvulsant therapy and may result in irreversible brain injury if not rapidly controlled.