Acute theophylline intoxication

Environmentally oriented models and methods for the evaluation of drug × drug interaction effects

This detailed review compares known and widely used methods for drug interaction estimation, some of which now have historical significance. Pharmaceutical application has been noted as far back as several thousand years ago. Relatively late in the 20th century, however, researchers became aware that their fate and metabolism, which still remain a great challenge for environmental analysts and risk assessors. For the patient's well-being, treatment based on the mixing of drugs has to be effective and should not cause any side effects (or side effects should not have a significant impact on health and mortality). Therefore, it is important to carefully examine drugs both individually and in combinations. It should be also stated that application form/way of entering the living organism is of great importance as well as the age and the place in the trophic system of the organism in order to eliminate harmful dosages in the case of infants' accidental intoxication.

Pronounced metabolic response to modest theophylline overdose

OBJECTIVE

To describe a patient who developed significant metabolic abnormalities in response to a low-level theophylline ingestion.

CASE SUMMARY

An 18-year-old man was examined after ingesting theophylline 3 g in a suicide attempt. Although his peak theophylline concentration was 157 mumol/L (28.2 micrograms/mL), it was associated with significant leukocytosis, hypokalemia, hypomagnesemia, hypophosphatemia, hyperglycemia, and lactic acidosis. These abnormalities have been previously associated with theophylline intoxication, but only in conjunction with much higher peak concentrations of theophylline.

CONCLUSIONS

Significant metabolic abnormalities can occur with suicidal ingestion of relatively small amounts of theophylline. The presence of these abnormalities should be sought in theophylline overdoses. In the proper clinical circumstances, such abnormalities should raise suspicion of covert theophylline ingestion.