Pediatric Theophylline Toxicity Workup
- Author: Tracey H Reilly, MD; Chief Editor: Timothy E Corden, MD more...
Serum theophylline levels should be determined every 2 hours until levels decline and every 4 hours until 2 successive findings are below therapeutic levels.
Check the basic metabolic panel (BMP) for metabolic acidosis and hyperglycemia and determine calcium, phosphorus, and magnesium levels. In the most severe cases, all organ systems may be affected and appropriate laboratory levels, such as creatine kinase and urine myoglobin levels, should be obtained to determine if rhabdomyolysis has occurred.
A radiograph of the kidneys, ureters, and bladder (KUB) rmay reveal radiopacities from undissolved sustained-release tablets or pharmacobezoars. Bead-filled capsules may appear as radiolucencies.
Nonenhanced head CT scans may be obtained if seizures occur.
Electrocardiography and ECG monitoring may be needed to observe for the development of atrial and ventricular tachydysrhythmias.
See the list below:
- Endotracheal intubation should be performed as indicated for airway protection in patients with an altered mental status and vomiting, status epilepticus, or hemodynamic instability.
- Nasogastric tube placement may be required to deliver multidose activated charcoal.
- Hemodialysis may be required in cases of severe toxicity.
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