Navigating the storm: A case of severe theophylline toxicity and its management

Abstract

Background

Theophylline poisoning can lead to toxic effects on multiple organ systems. Management of theophylline overdose is focused on early detection, stabilizing cardiovascular and pulmonary function, GI decontamination to interrupt continued absorption, and minimizing end organ effects. We present a case of theophylline overdose with hemodynamic instability and metabolic derangements and review the literature to update the management of theophylline toxicity.

Case presentation

An 80 year old Indian gentleman presented with dizziness and vomiting after deliberate ingestion of 20 tablets of theophylline. He was resuscitated successfully, and subsequently given supportive care. Serum theophylline levels were estimated to confirm theophylline toxicity.

Conclusion

Diagnosis of theophylline poisoning requires high degree of suspicion and needs prompt and appropriate treatment. Initial treatment consists of fluid resuscitation, correction of electrolyte abnormalities and hyperglycemia. Supportive treatment plays a key role. Multidose activated charcoal for elimination of drug should be administered in severe theophylline poisoning.