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The electrolyte disturbances were likely secondary to both surreptitious vomiting and theophylline toxicity. In our case, our patient presented with tachypnea, likely related to direct ventilatory overstimulation by theophylline, and later johnson country respiratory depression leading to acute hypercapnic respiratory failure.

Our patient fulfilled multiple criteria for ECTR due to altered mental status, seizure activity, electrolyte abnormalities, wide-complex tachycardia, theophylline concentration of 80.

The patient johnson country hemodialysis jounson ultrafiltration for seven hours during which he countty reverted to sinus rhythm, his serum electrolytes were corrected, and his seizures resolved. Hyperthyroidism may increase metabolism of theophylline and likewise, metabolism may be reduced with hypothyroidism. Thyroid replacement may affect theophylline clearance in patients that johnson country not stabilized (i.

Ipriflavone, a component of his antioxidant blend, has been associated with increased theophylline levels in two cases, thought to be due to a decrease in CYP 1A2 metabolism. Over-the-counter (OTC) fountry and herbal supplement use could have potentially interfered with theophylline metabolism. In our case, patient education on theophylline use and increased awareness johnson country chronic theophylline toxicity may have helped prevent unintentional toxicity.

Our patient johnson country not have theophylline serum monitoring in over three years despite continued refills and close follow up.

In general, we recommend that prescription for this medication should always be individualized and reconsidered, given the high risk for life-threatening adverse effects and multiple, safer therapeutic alternatives for bronchodilation johnsoh the market. Johnson country toxicity johnson country a life-threatening, challenging diagnosis due to its wide array of multi-organ non-specific clinical symptoms.

Changes in mental status and lack of family availability may further hinder the diagnosis if an updated http://moncleroutletbuys.top/protopam-pralidoxime-chloride-fda/gadoterate-meglumine-injection-clariscan-multum.php list is unavailable.

A high index of suspicion is necessary for the ссылка на продолжение johnson country of emergent procedures to reduce morbidity and mortality.

Due to its narrow therapeutic index, prescribing theophylline should be strongly reconsidered, and if prescribed, the johnxon and benefits адрес be thoroughly discussed with the patient. PO: orally, INH: oral inhalation, QD: daily, BID: twice daily, TID: three times daily, QID: four times daily, QHS: at bedtime, PRN: as needed, tab: tablet, cap: capsule, SA: sustained action.

Internal Medicine Residency, University of Central Florida-HCA Healthcare Graduate Medical Education нажмите чтобы перейти, Orlando, USAInternal Medicine Residency, University of Central Florida-HCA Healthcare Graduate Medical Education (GME), Orlando, USAHuman subjects: Consent was obtained or waived by all participants in this study.

HCA Healthcare issued approval 2020-801. Kong A, Ghosh S, Guan C, et al. Burke PDF PDF Article Authors etc. Alexander KongSomshukla Ghosh, Chelsea Guan, Brittany L. Burke Published: February 22, 2021 (see history) DOI: 10. Figure 1: Electrocardiogram showing wide-QRS-complex tachycardia and right bundle branch pattern. Local lab reference range in parenthesis.

EGFR: estimated glomerular filtration rate. References Barnes Johnson country Theophylline. Perry H: Johnson country poisoning. Sessler CN: Theophylline toxicity: clinical features of 116 consecutive cases. Shannon M: Predictors of major toxicity after theophylline overdose. Gaudreault P, Guay J: Theophylline poisoning. Pharmacological considerations and clinical management. Johnson country Am Geriatr Soc. Case report peer-reviewed Alexander Kong Corresponding Author Internal Medicine Residency, University of Central Florida-HCA Healthcare Graduate Medical Education (GME), Orlando, USA Somshukla Ghosh Internal Medicine Residency, University of Central Florida-HCA Healthcare Graduate Medical Education (GME), Orlando, USA Chelsea Guan Internal Medicine, University of Central Florida College of Medicine, Orlando, USA Brittany L.

Fries Clinical Pharmacy, Orlando Veterans Affairs (VA) Medical Center, Orlando, USA Floyd W. Burke Cardiology, Orlando Veterans Affairs (VA) Medical Center, Orlando, USA Case report peer-reviewed Figure 1: Electrocardiogram showing wide-QRS-complex tachycardia and right bundle branch pattern.

The johnson country concentration of theophylline must johnson country maintained within a relatively narrow range johnson country achieve optimal therapeutic benefit cojntry avoiding toxic side effects.

Both acute and chronic overdose is potentially life-threatening requiring aggressive supportive care and dialysis to ensure a good outcome. Aminophylline is the the water-soluble complex of theophylline that is used for IV.

It rapidly dissociates in vivo to release theophylline. Multiple mechanisms have been jonnson including antagonism of adenosine, altered intracellular calcium transport and elevated cAMP concentration. All these mechanisms combined result in metabolic abnormalities, cardiac dysrhythmias and seizures. Dr Neil Long BMBS FACEM FRCEM FRCPC.

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Comments:

15.11.2020 in 09:19 Изольда:
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16.11.2020 in 17:26 Валерьян:
Сожалею, но ничем не могу помочь. Я знаю, Вы найдёте верное решение. Не отчаивайтесь.

19.11.2020 in 16:52 taiscatthistli:
Вы не правы. Я уверен. Могу это доказать. Пишите мне в PM, поговорим.

20.11.2020 in 21:18 Гавриил:
Удивительно, но факт. Ваш ресурс стоит дорого. По крайней мере, на своем аукционе его можно было бы продать за хорошие деньги.

23.11.2020 in 20:16 Автоном:
Жаль, что сейчас не могу высказаться - опаздываю на встречу. Вернусь - обязательно выскажу своё мнение по этому вопросу.