临床毒理学杂志
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A Case of Severe Theophylline Toxicity and its Management

Vasudha Dinesh

Background: Theophylline poisoning can lead to toxic effects on multiple organ systems. Management of theophylline overdose focuses on stabilizing cardiovascular and pulmonary function, gastrointestinal decontamination to interrupt continued absorption, and minimizing end-organ effects. This report presents a case of theophylline overdose with hemodynamic instability and metabolic derangements, along with a review of the literature to update the management of theophylline toxicity.

Case presentation: An 80-year-old Indian gentleman presented with giddiness and vomiting after the deliberate ingestion of 20 tablets of theophylline. Serum levels confirmed severe theophylline poisoning, correlating with clinical manifestations. The patient was resuscitated and subsequently given supportive care.

Conclusion: Theophylline poisoning should be treated appropriately and promptly. Initial treatment for hypotension consists of rapid infusion of isotonic saline or balanced crystalloid solution. Multi-dose activated charcoal for the elimination of drugs should be administered in severe theophylline poisoning.