Pharmacokinetics of severe theophylline intoxication managed by peritoneal dialysis

In a patient severely poisoned with theophylline, saturation kinetics were demonstrated at serum concentrations > 35 micrograms/ml with subsequent conversion to first order kinetics (t 1/2 = 5.4 h). Peritoneal dialysis was used to enhance the drug's removal. The mean theophylline clearance was greater for dialysate (5.11 ml/min) than for urine (1.98 ml/min) or gastric fluid (0.32 ml/min). Urinary elimination occurred as a constant first order process (t 1/2 = 4.3 h). Peritoneal dialysis is a valuable early adjunct in the management of severe theophylline intoxication.