Hypokalemia after theophylline intoxication. The effects of acute vs chronic poisoning

Shannon, Michael; Lovejoy, Frederick H.

doi:10.1001/archinte.149.12.2725

Cited by 19 publications

(6 citation statements)

References 29 publications

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“…Theophylline and caffeine stimulate cell membrane Na + /K + ATPase and promote K + entry into cells. Severe hypokalaemia is a characteristic feature of theophylline toxicity 8 9. Accidental ingestion of barium salts blocks K + exit from cells and causes hypokalaemia.…”

Section: Discussionmentioning

confidence: 99%

Secondary hypokalaemic paralysis: Figure 1

Gupta

Khanna²,

Rizvi

et al. 2012

BMJ Case Reports

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SummaryA 28-year-old man presented with acute onset, ascending-type and bilateral symmetrical areflexic motor paralysis. There was a history of fever 3 days prior to paralysis, multiple episodes of vomiting, chloroquine use and intravenous dextrose administration. Investigations revealed metabolic alkalosis with normal serum potassium level but ECG showed characteristic changes of hypokalaemia based on which patient was managed successfully. This case highlights the importance of ECG findings of hypokalaemia in the presence of nonconfirmatory laboratory values while evaluating a case of acute flaccid quadriplegia. BACKGROUND

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Section: Discussionmentioning

confidence: 99%

Secondary hypokalaemic paralysis: Figure 1

Gupta

Khanna²,

Rizvi

et al. 2012

BMJ Case Reports

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“…In other studies, patients with theophylline intoxication that led to hypokalemia (plasma K + less than 3.5 mmol/L) had average theophylline concentrations of 0.331 mmol/L, which more than doubles the highest average measured in our study (24.7ng/ml at time points 10 during theophylline single dose, eq. 0.137 mmol/L (Shannon et al 1989). Thus, although we dosed theophylline at the higher end of the therapeutic range, blood levels of the drug were insufficient to aggravate K + stores significantly.…”

Section: Combination Of Theophylline and Bambuterolmentioning

confidence: 93%

The novel combination of theophylline and bambuterol as a potential treatment of hypoxemia in humans

Strand

Khiabani

Boico

et al. 2017

Can. J. Physiol. Pharmacol.

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Hypoxemia can be life-threatening, both acutely and chronically. Because hypoxemia causes vascular dysregulation that further restricts oxygen availability to tissue, it can be pharmacologically addressed. We hypothesized that theophylline can be safely combined with the β2-adrenergic vasodilator bambuterol to improve oxygen availability in hypoxemic patients. Ergogenicity and hemodynamic effects of bambuterol and theophylline were measured in rats under hypobaric and normobaric hypoxia (12% O). Feasibility in humans was assessed using randomized, double-blind testing of the influence of combined slow-release theophylline (300 mg) and bambuterol (20 mg) on adverse events (AEs), plasma K, pulse, blood pressure, and drug interaction. Both drugs and their combination significantly improved hypoxic endurance in rats. In humans, common AEs were low K (<3.5 mmol/L; bambuterol: 12, theophylline: 4, combination: 13 episodes) and tremors (10, 0, 14 episodes). No exacerbation or serious AE occurred when drugs were combined. A drop in plasma K coincided with peak bambuterol plasma concentrations. Bambuterol increased heart rate by approximately 13 bpm. Drug interaction was present but small. We report promise, feasibility, and relative safety of combined theophylline and bambuterol as a treatment of hypoxemia in humans. Cardiac safety and blood K will be important safety endpoints when testing these drugs in hypoxemic subjects.

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“…Hypokalemia that possibly reflects stress-induced epinephrine release has been reported in cases of acute theophylline intoxication (123). Hyponatremia has also been found after theophylline administration.…”

Section: Theophyllinementioning

confidence: 95%

Acid-Base and Electrolyte Abnormalities Observed in Patients Receiving Cardiovascular Drugs

Miltiadous

Mikhailidis

Elisaf

2003

J Cardiovasc Pharmacol Ther

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Cardiovascular drugs can cause a variety of acid-base and electrolyte abnormalities that need to be considered when clinicians manage the large number of patients who receive these agents. Diuretic-induced metabolic alkalosis is the most common acid-base disorder observed and is associated with hypokalemia. Drug-induced hyperkalemia is the most important cause of increased potassium levels in everyday clinical practice. Multifactorial-origin diuretic-induced hyponatremia is mostly due to thiazides and should be carefully managed. This review focuses on the pathogenetic mechanisms as well as on the treatment of these metabolic derangements that are commonly encountered in patients who receive cardiovascular drugs.

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Hypokalemia after theophylline intoxication. The effects of acute vs chronic poisoning

Cited by 19 publications

References 29 publications

Secondary hypokalaemic paralysis: Figure 1

Secondary hypokalaemic paralysis: Figure 1

The novel combination of theophylline and bambuterol as a potential treatment of hypoxemia in humans

Acid-Base and Electrolyte Abnormalities Observed in Patients Receiving Cardiovascular Drugs

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