Theophylline Enhanced Elimination

Acute theophylline toxicity:

Acute charcoal hemoperfusion indications: Theophylline level >90 mcg/mL at any time.

Theophylline level >40 mcg/mL when combined with: Seizures

Hypotension, refractory to fluid loading Ventricular dysrhythmias Protracted vomiting, refractory to antiemetics Chronic theophylline toxicity:

Risks increase with advancing age, intercurrent illnesses/infections, and reduced hepatic perfusion.

No role for either emesis or orogastric lavage, unless to instill AC via orogastric tube. AC and MDAC for cardiovascular-stable patients.

Charcoal HP for unstable patients and for AC failures.

Monitor theophylline levels every 4-6 hours until <20 mcg/kg.

Coping with Asthma

Coping with Asthma

If you suffer with asthma, you will no doubt be familiar with the uncomfortable sensations as your bronchial tubes begin to narrow and your muscles around them start to tighten. A sticky mucus known as phlegm begins to produce and increase within your bronchial tubes and you begin to wheeze, cough and struggle to breathe.

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