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Theophylline toxicity and the beta-adrenergic system.

T E Kearney, A S Manoguerra, G P Curtis

Annals of Internal Medicine

|June 1, 1985

Summary

Theophylline toxicity in humans and dogs caused hypokalemia, hyperglycemia, and hypotension. Beta-blockade with propranolol prevented or reversed these toxic effects, suggesting a therapeutic role.

Area of Science:

Pharmacology
Toxicology
Cardiovascular Physiology

Background:

Theophylline, a common medication, can cause severe toxicity.
An experimental canine model was developed to investigate human theophylline toxicity.

Observation:

Four protocols were used: low-dose, high-dose theophylline infusions, and high-dose infusions with and without propranolol (a beta-blocker).
Toxic theophylline levels were linked to hypokalemia, hypophosphatemia, hyperglycemia, metabolic acidosis, and hypotension.

Findings:

Beta-blockade with propranolol prevented or reversed the toxic effects of theophylline.
Very high theophylline levels increased norepinephrine and epinephrine in dogs.

Implications:

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Beta-blockade may be a potential treatment for theophylline toxicity.

Understanding the sympathomimetic effects of theophylline is crucial for managing toxicity.