Demographic and Clinical Characteristics of Theophylline Exposures between 1993 and 2011

Yıl 2014, Cilt: 31 Sayı: 4, 322 - 327, 01.10.2014

Nil Hocaoğlu Burç Aydın Yeşim Tunçok Şule Kalkan Engin Yıldıztepe , Başak Bayram

Öz

Background: Acute and chronic exposure to theophylline can cause
serious signs and symptoms of poisoning. Additionally, with a narrow
therapeutic range, toxicity could be observed even with therapeutic
doses of theophylline. Epidemiological data on theophylline
exposures in our country are extremely limited. The results of our
study may improve the clinical management of theophylline poisoning
in our country and elsewhere.
Aims: To present aetiological and demographic features, clinical
findings and treatment attempts with regard to theophylline exposures
reported to Dokuz Eylül University Drug and Poison Information
Center (DPIC), between 1993 and 2011.
Study Design: Descriptive study.
Methods: The data regarding demographics, date, time, type of exposure,
route of and reason for exposure, signs and symptoms upon
admission, clinical management and outcome were retrospectively
evaluated.
Results: The DPIC recorded 88,562 poisoning calls between 1993
and 2011; 354 (0.4%) of them were due to theophylline exposure.
The mean age of all cases was 24.1±15.4 (range between 1 month and
90 years). Females dominated all age groups (72.6%, 257 females).
Intentional exposure was significantly higher in women than in men
(88.2% vs. 68.2% for all age groups; p<0.001 for children; p<0.001
for adults; p<0.001 for all age groups). While 60.5% of the cases
had no symptoms, severe signs of toxicity were present in 1.9% of
theophylline exposure cases during the telephone inquiry. Signs and
symptoms were found to be significantly more prevalent in adults than
in children (p<0.01). The serum theophylline level was regarded as
toxic in 74% (65 toxic levels) of theophylline measured cases. Clinical
signs and symptoms were found to be significantly prevalent in cases
with toxic theophylline levels (p<0.001). The rate of gastrointestinal
decontamination procedures was higher than that of recommended
gastrointestinal decontamination procedures by DPIC (83% and 66%,
respectively). There were two fatalities (4.6%) associated with chronic
theophylline toxicity and theophylline overdose in an acute setting for
suicide (a 90 year-old and 25 year-old, respectively).
Conclusion: Although most of the theophylline exposure cases had
no symptoms, some reported serious signs and symptoms of poisoning
such as hypokalaemia, tachycardia and hyperglycaemia. DPICs
have an important role in the management of theophylline exposure
without unnecessary gastrointestinal decontamination procedures

Anahtar Kelimeler

Exposure, Drug and Poison Information Center, poisoning, retrospective, theophylline

Kaynakça

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