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August 4, 1978

Massive Theophylline Overdose: Rapid Elimination by Charcoal Hemoperfusion

Author Affiliations

From the Departments of Medicine (Dr Ehlers) and Pharmacology (Dr Zaske), St Paul-Ramsey Hospital, St Paul, and the University of Minnesota Medical School, School of Medicine (Dr Ehlers) and College of Pharmacy (Drs Zaske and Sawchuk), Minneapolis.

JAMA. 1978;240(5):474-475. doi:10.1001/jama.1978.03290050064026

Shock, seizures, cardiac arrhythmias, and respiratory and cardiac arrests developed in a patient who ingested 8.5 g of theophylline. Her condition improved and her serum theophylline concentration decreased from 170 to 20 mg/ml during six hours of charcoal hemoperfusion. Theophylline was removed from the serum by the uncoated charcoal column, as shown by an extraction efficiency approaching 100%. The maximum charcoal clearance of theophylline was 163 ml/kg/hr. The average endogenous theophylline clearance in adults is 50 ml/kg/hr and that achieved with hemodialysis is only 24.3 ml/kg/hr. Uncoated charcoal efficiently removes theophylline from the serum; charcoal hemoperfusion should be considered in severe theophylline toxic reactions.

(JAMA 240:474-475, 1978)