Prevention of drug absorption in simulated theophylline overdose.

1. The effects of emesis, gastric lavage and oral activated charcoal on theophylline absorption were compared in healthy volunteers. 2. One of four regimes (ipecacuanha-induced emesis, gastric lavage, oral activated charcoal and no treatment) was randomly chosen one hour after a simulated overdose with sustained-release theophylline on four separate occasions in twelve healthy volunteers. 3. Syrup of ipecacuanha produced emesis in all twelve volunteers but only seven vomited any tablets. Gastric lavage yielded tablets in only one volunteer. 4. The mean systemic availabilities (areas under the concentration-time curves relative to control) of theophylline for ipecacuanha-induced emesis, gastric lavage and charcoal, were 107.1%, 101.1% and 16.9%, respectively. 5. Oral activated charcoal was thus highly effective, while gastric lavage and emesis were ineffective in preventing theophylline absorption. Activated charcoal is potentially the most effective first-line treatment for acute overdosage with sustained-release theophylline tablets.

[1]  D. Yealy,et al.  The comparative efficacy of various multiple-dose activated charcoal regimens. , 1992, The American journal of emergency medicine.

[2]  D. Prentice,et al.  Ondansetron in the treatment of theophylline overdose , 1992, The Medical journal of Australia.

[3]  S. Pond,et al.  Management of Theophylline Overdose Patients in the Intensive Care Unit , 1992, Anaesthesia and intensive care.

[4]  R. Upton.  Pharmacokinetic Interactions Between Theophylline and Other Medication (Part II) , 1991 .

[5]  D. Buss,et al.  The Effects of Charcoal and Sorbitol (Alone and in Combination) on Plasma Theophylline Concentrations after a Sustained-Release Formulation , 1990, Human & experimental toxicology.

[6]  H. Markowe,et al.  Aminophylline toxicity--how many hospital asthma deaths does it cause? , 1989, Respiratory medicine.

[7]  B. McLellan,et al.  Effect of whole-bowel irrigation on the antidotal efficacy of oral activated charcoal. , 1988, Annals of emergency medicine.

[8]  E. Glucksman,et al.  Activated charcoal, emesis, and gastric lavage in aspirin overdose , 1988, British medical journal.

[9]  R. McNamara,et al.  Sorbitol catharsis does not enhance efficacy of charcoal in a simulated acetaminophen overdose. , 1988, Annals of emergency medicine.

[10]  C. Sessler.  Poor tolerance of oral activated charcoal with theophylline overdose. , 1987, The American journal of emergency medicine.

[11]  F. Lovejoy,et al.  Multiple dose activated charcoal for theophylline poisoning in young infants. , 1987, Pediatrics.

[12]  S. Cohen,et al.  Efficacy of ipecac-induced emesis, orogastric lavage, and activated charcoal for acute drug overdose. , 1987, Annals of emergency medicine.

[13]  R. Spector,et al.  The effect of sorbitol and activated charcoal on serum theophylline concentrations after slow‐release theophylline , 1987, Clinical pharmacology and therapeutics.

[14]  F. Lovejoy,et al.  Characteristics of vomiting associated with acute sustained release theophylline poisoning: implications for management with oral activated charcoal. , 1987, Journal of toxicology. Clinical toxicology.

[15]  R. Walstad,et al.  Self-poisoning with theophylline. The effect of repeated doses oral charcoal on drug elimination. , 2009, Acta medica Scandinavica.

[16]  A. Proudfoot,et al.  Syrup of ipecacuanha: is it really useful? , 1986, British medical journal.

[17]  D. T. Lim,et al.  Absorption inhibition and enhancement of elimination of sustained-release theophylline tablets by oral activated charcoal. , 1986, Annals of emergency medicine.

[18]  A. Yeung,et al.  Repetitive oral activated charcoal and control of emesis in severe theophylline toxicity. , 1986, Annals of internal medicine.

[19]  P. Neuvonen,et al.  Effect of Purgatives on Antidotal Efficacy of Oral Activated Charcoal , 1986, Human toxicology.

[20]  P. Gaudreault,et al.  Theophylline Poisoning , 1986, Medical toxicology.

[21]  W. Watson,et al.  Gastrointestinal obstruction associated with multiple-dose activated charcoal. , 1986, The Journal of emergency medicine.

[22]  J. Blumer,et al.  Continuous nasogastric administration of activated charcoal for the treatment of theophylline intoxication. , 1986, Pediatric pharmacology.

[23]  S. Pond.  Role of Repeated Oral Doses of Activated Charcoal in Clinical Toxicology , 1986, Medical toxicology.

[24]  R. Stewart,et al.  Gastrointestinal transit times of cathartics combined with charcoal. , 1985, Annals of emergency medicine.

[25]  N. Robertson.  Fatal overdose from a sustained-release theophylline preparation. , 1985, Annals of emergency medicine.

[26]  M. Tenenbein.  Inefficacy of gastric emptying procedures. , 1985, The Journal of emergency medicine.

[27]  J. McCue,et al.  Oral activated charcoal to enhance theophylline elimination in an acute overdose. , 1984, JAMA.

[28]  R. Spector,et al.  Model for theophylline overdose treatment with oral activated charcoal , 1984, Clinical pharmacology and therapeutics.

[29]  C. K. Mahutte,et al.  Treatment of theophylline toxicity with oral activated charcoal , 1984, Critical care medicine.

[30]  R. Spector,et al.  Effects of size and frequency of oral doses of charcoal on theophylline clearance , 1983, Clinical pharmacology and therapy.

[31]  C. K. Mahutte,et al.  Increased serum theophylline clearance with orally administered activated charcoal. , 1983, The American review of respiratory disease.

[32]  R. Spector,et al.  Enhancement of theophylline clearance by oral activated charcoal , 1983, Clinical pharmacology and therapeutics.

[33]  G Levy,et al.  Gastrointestinal clearance of drugs with activated charcoal. , 1982, The New England journal of medicine.

[34]  W. Thompson,et al.  Adsorbent and cathartic inhibition of enteral drug absorption. , 1982, The Journal of pharmacology and experimental therapeutics.

[35]  B. Comstock,et al.  Studies on the efficacy of gastric lavage as practiced in a large metropolitan hospital. , 1981, Clinical toxicology.

[36]  P. Crome,et al.  Haemoperfusion for theophylline overdose. , 1980, British medical journal.

[37]  J J Schentag,et al.  Factors affecting theophylline clearances: age, tobacco, marijuana, cirrhosis, congestive heart failure, obesity, oral contraceptives, benzodiazepines, barbiturates, and ethanol. , 1979, Journal of pharmaceutical sciences.