See theophylline for general drug information.
- Primarily used as a bronchodilator, however rarely used now due to better available options
- Also studied for treatment of Acute Mountain Sickness and Contrast-Induced Nephropathy
- PO available as elixer and capsule (12 or 24-hour extended release)
- IV as aminophylline (shorter acting than PO)
- Mechanism of action:
- Release of endogenous catecholamines → β2 agonism → bronchodilation
- PDE inhibition → increases cAMP
- Adenosine antagonist
- Supportive care is the mainstay of treatment
- GI decontamination (Multidose Activated Charcoal, Whole Bowel Irrigation)
- Consider in recent severe overdose
- Contraindications: unsecured airway, nausea/vomiting, ileus, Bowel Obstruction, or need for emergent endoscopy
- Dialysis or plasmapheresis
- Indicated in seizures, severe arrhythmias, hypotension, serum level >90 μg/mL (>40 μg/mL in chronic ingestion)
- Almost all patients will require admission
- Can consider discharge with close followup (in conjunction with toxicology) if unintentional overdose, asymptomatic, and normal vital signs
- Fisher, J., & Graudins, A. (2015). Intermittent haemodialysis and sustained low-efficiency dialysis (SLED) for acute theophylline toxicity. Journal of medical toxicology : official journal of the American College of Medical Toxicology, 11(3), 359-63.
- Aggelopoulou, E., Tzortzis, S., Tsiourantani, F., Agrios, I., & Lazaridis, K. (2018). Atrial Fibrillation and Shock: Unmasking Theophylline Toxicity. Medical principles and practice : international journal of the Kuwait University, Health Science Centre, 27(4), 387-391.