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Fatal overdose from a sustained-release theophylline preparation.
Annals of Emergency Medicine
|February 1, 1985
Summary
Severe theophylline overdose in a young woman caused dangerous metabolic disturbances, including seizures and acute kidney injury. Despite treatment, she tragically died from complications of the intoxication.
Area of Science:
- Pharmacology
- Toxicology
- Nephrology
Background:
- Theophylline is a bronchodilator used to treat respiratory diseases.
- Theodur is a sustained-release formulation of theophylline.
- Theophylline overdose can lead to significant toxicity.
Observation:
- A 26-year-old woman ingested approximately 9 grams of theophylline.
- Initial symptoms included agitation, seizures, hyperglycemia, hypokalemia, hypomagnesemia, hypophosphatemia, and diuresis.
- Later complications included rhabdomyolysis, myoglobinuria, and acute renal failure.
Findings:
- The patient developed severe metabolic derangements due to theophylline toxicity.
- Hemodialysis was initiated to manage electrolyte imbalances.
- Despite medical intervention, the patient succumbed to intractable shock and hyperkalemia.
Implications:
- This case highlights the critical metabolic abnormalities associated with severe theophylline intoxication.
- It underscores the importance of prompt recognition and management of theophylline overdose.
- Understanding these complications is crucial for clinicians managing poisoned patients.