https://padlet.com/aagouni78/r4i9dtdu5ds9 Made with a bold sensibility en-us 2017-12-07 07:57:11 UTC 2017-12-07 08:41:11 UTC hello@padlet.com https://padlet.com/aagouni78/r4i9dtdu5ds9/wish/214006065 2017-12-07 08:20:36 UTC https://padlet.com/aagouni78/r4i9dtdu5ds9/wish/214006065 https://padlet.com/aagouni78/r4i9dtdu5ds9/wish/214006710 1. MoA: It also is
known to release endogenous catecholamines at therapeutic concentrations
and may itself stimulate beta-adrenergic receptors.
2. Clinical presentation
Acute single overdose
1. Usual manifestations include vomiting (sometimes with hematemesis),
tremor, anxiety, and tachycardia. Metabolic effects include pronounced hypokalemia,
hypophosphatemia, hyperglycemia, and metabolic acidosis.
2. With serum levels above 90–100 mg/L, hypotension, ventricular arrhythmias,
and seizures are common; status epilepticus is frequently resistant
to anticonvulsant drugs.
3. Seizures and other manifestations of severe toxicity may be delayed
12–16 hours or more after ingestion, in part owing to delayed absorption of
drug from sustained-release preparations.

Chronic intoxication
1. Vomiting may occur but is not as common as in acute overdose. Tachycardia
is common, but hypotension is rare. Metabolic effects such as hypokalemia
and hyperglycemia do not occur.
2. Seizures may occur with lower serum levels (eg, 40–60 mg/L) and have
been reported with levels as low as 20 mg/L
3. Diagnosis
Diagnosis is based on a history of ingestion or the presence of tremor, tachycardia,
and other manifestations in a patient known to be on theophylline. Hypokalemia
strongly suggests acute overdose rather than chronic intoxication.
A. Specific levels. Serum theophylline levels are essential for diagnosis and determination
of emergency treatment. After acute oral overdose, obtain repeated
levels every 2–4 hours; single determinations are not sufficient, because
continued absorption from sustained-release preparations may result
in peak levels 12–16 hours or longer after ingestion.
1. Levels less than 90–100 mg/L after acute overdose are not usually associated
with severe symptoms such as seizures or ventricular arrhythmias.
2. However, with chronic intoxication, severe toxicity may occur with levels of
40–60 mg/L. Note: Acute caffeine overdose (see p 142) will cause a similar
clinical picture and will produce falsely elevated theophylline concentrations
with most commercial immunoassays.
B. Other useful laboratory studies include electrolytes, glucose, BUN, creatinine,
hepatic function tests, and ECG monitoring.
4. BB use: because the same ]]> 2017-12-07 08:22:55 UTC https://padlet.com/aagouni78/r4i9dtdu5ds9/wish/214006710 https://padlet.com/aagouni78/r4i9dtdu5ds9/wish/214007801 1) Theophylline is an antagonist of adenosine receptors, and it inhibits phosphodiesterase at high levels, and increasing  (cAMP). It also is known to release endogenous catecholamines at therapeutic concentrations and may itself stimulate beta-adrenergic receptors.

2)  Acute single overdose
1. Usual manifestations include vomiting (sometimes with hematemesis), tremor, anxiety, and tachycardia. Metabolic effects include pronounced hypokalemia, hypophosphatemia, hyperglycemia, and metabolic acidosis.
2. With serum levels above 90–100 mg/L, hypotension, ventricular arrhythmias, and seizures are common; status epilepticus is frequently resistant to anticonvulsant drugs.
3. Seizures and other manifestations of severe toxicity may be delayed 12–16 hours or more after ingestion, in part owing to delayed absorption of drug from sustained-release preparations.

 Chronic intoxication occurs when excessive doses are administered repeatedly over 24 hours or longer or when intercurrent illness or an interacting drug interferes with hepatic metabolism of theophylline.  The usual victims are very  young infants or elderly patients, especially those with chronic obstructive lung disease. 1. Vomiting may occur but is not as common as in acute overdose. Tachycardia is common, but hypotension is rare. Metabolic effects such as hypokalemia and hyperglycemia do not occur.
2. Seizures may occur with lower serum levels (eg, 40–60 mg/L) and have been reported with levels as low as 20 mg/L.

3)  Specific levels. Serum theophylline levels are essential for diagnosis and determination of emergency treatment. After acute oral overdose, obtain repeated levels every 2–4 hours; single determinations are not sufficient, because continued absorption from sustained-release preparations may result in peak levels 12–16 hours or longer after ingestion.
 1. Levels less than 90–100 mg/L after acute overdose are not usually associated with severe symptoms such as seizures or ventricular arrhythmias.
2. However, with chronic intoxication, severe toxicity may occur with levels of 40–60 mg/L. Note: Acute caffeine overdose (see p 142) will cause a similar clinical picture and will produce falsely elevated theophylline concentrations with most commercial immunoassays.
 B. Other useful laboratory studies include electrolytes, glucose, BUN, creatinine, hepatic function tests, and ECG monitoring.

4) ]]> 2017-12-07 08:27:48 UTC https://padlet.com/aagouni78/r4i9dtdu5ds9/wish/214007801