Theophylline poisoning cases are not uncommon. There was a middle-aged female patients, due to bronchial perennial oral theophylline sustained-release tablets. Once, due to cough to medical treatment, was diagnosed with bronchitis, the doctor opened the oral levofloxacin. Patient forgot to tell him that he was taking theophylline sustained release tablets, two days later, a sudden heartbeat, theophylline poisoning occurred.
Theophylline drugs include aminophylline, theophylline, doxofylline, dihydroepinophylline, etc. It is widely used in bronchial asthma, acute and chronic bronchitis, cardiogenic asthma, obstructive emphysema and other diseases. But more adverse drug reactions to theophylline, for example, intravenous injection too fast or plasma concentration greater than 20 micrograms / ml, there may be toxic reactions, manifested as arrhythmia, muscle fibrillation or epilepsy. Theophylline concentration over 40 Micrograms / ml, there may be fever, dehydration, convulsions, etc., severe cases can cause breathing, cardiac arrest and death. The rational use of theophylline drugs must pay our attention, especially with other drug interactions.
Antibacterials. In the treatment of respiratory diseases, theophylline often need and antibacterial drugs such as enoxacin, ciprofloxacin, levofloxacin and other quinolones, or erythromycin, roxithromycin, clarithromycin and other macrolides Class drugs, they will result in lower the theophylline clearance rate, blood concentration, increased the possibility of poisoning, especially enoxacin and erythromycin most significant combination with these drugs should reduce theophylline dose, Theophylline plasma concentration (total concentration in the plasma after drug absorption) is monitored as necessary, and the concentration should be maintained between 10 and 20 μg / ml.
Antiepileptic drugs. Such as phenytoin, phenobarbital, carbamazin equal combination, will induce liver microsomal enzymes, enhance the metabolism of theophylline in the liver.At the same time, theophylline will interfere with the absorption of phenytoin in the body, both in vivo drug concentration Therefore, theophylline combined with these drugs, the need to adjust the dose.In addition to the above drugs, cimetidine, verapamil, diltiazem, oral contraceptives will increase the blood concentration of theophylline in vivo, induced poisoning .
Life habits can also cause theophylline plasma concentration changes such as heavy consumption of caffeinated beverages, consumption of chocolate, will increase theophylline adverse reactions; smoking will enhance the metabolism of theophylline in the liver and reduce the blood concentration of theophylline ; Liver disease, congestive heart failure will delay theophylline metabolism.
When using theophylline drugs to be clearly indications and contraindications, under the guidance of a doctor taking the same service with other drugs, be sure to consult a doctor or pharmacist, a detailed account of medication.If you find that physical discomfort, such as nausea, vomiting, abdominal pain, Polyuria, tachycardia, muscle tremors, epileptic seizures and other symptoms, should consider the possibility of theophylline poisoning, promptly to the hospital for treatment .Development of children with imperfect organs, multiple organ dysfunction in the elderly, they are more prone to theophylline poisoning, Be sure to monitor blood concentration when using.
