TY - JOUR
T1 - Failure of gastric emptying and charcoal administration in fatal sustained-release theophylline overdose
T2 - Pharmacobezoar formation
AU - Bernstein, George
AU - Jehle, Dietrich
AU - Bernaski, Edward
AU - Braen, G. Richard
PY - 1992/11
Y1 - 1992/11
N2 - We report the case of a fatal theophylline overdose from a sustained-release preparation in a 54-year-old woman. Initial serum theophylline concentration was 31.3 mg/L. Manifestations of mild toxicity cleared in the emergency department after treatment with gastric lavage, charcoal, and a cathartic. A life-threatening overdose was not suspected, and the patient arrested eight hours after discharge from the ED. At autopsy, her serum theophylline concentration was 190.1 mg/L. A white, waxy mass weighing 318.8 g and containing 29 g theophylline, representing the residue of many sustained-release tablets, was found in her stomach. This case reinforces the importance of obtaining repeat serum theophylline levels in patients with sustained-release theophylline overdose. Gastric pharmacobezoar formation should be considered in cases of sustained-release theophylline overdose with rising theophylline levels and patient deterioration, despite adequate gut decontamination.
AB - We report the case of a fatal theophylline overdose from a sustained-release preparation in a 54-year-old woman. Initial serum theophylline concentration was 31.3 mg/L. Manifestations of mild toxicity cleared in the emergency department after treatment with gastric lavage, charcoal, and a cathartic. A life-threatening overdose was not suspected, and the patient arrested eight hours after discharge from the ED. At autopsy, her serum theophylline concentration was 190.1 mg/L. A white, waxy mass weighing 318.8 g and containing 29 g theophylline, representing the residue of many sustained-release tablets, was found in her stomach. This case reinforces the importance of obtaining repeat serum theophylline levels in patients with sustained-release theophylline overdose. Gastric pharmacobezoar formation should be considered in cases of sustained-release theophylline overdose with rising theophylline levels and patient deterioration, despite adequate gut decontamination.
KW - theophylline, overdose
UR - http://www.scopus.com/inward/record.url?scp=0026743049&partnerID=8YFLogxK
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U2 - 10.1016/S0196-0644(05)81907-9
DO - 10.1016/S0196-0644(05)81907-9
M3 - Article
C2 - 1416337
AN - SCOPUS:0026743049
SN - 0196-0644
VL - 21
SP - 1388
EP - 1390
JO - Annals of Emergency Medicine
JF - Annals of Emergency Medicine
IS - 11
ER -