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Vol. 29. Issue 3.
Pages 101-108 (April 1993)
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Vol. 29. Issue 3.
Pages 101-108 (April 1993)
DOI: 10.1016/S0300-2896(15)31246-1
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Toxicidad de la teofilina
The toxicity of theophylline
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F. Gómez Gómez, M.J. Otero López, J.A. Royo Prats
Servicios de Neumología y Farmacia. Hospital Clínico. Salamanca
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La frecuencia con que la teofilina presenta efectos tóxicos adversos no se conoce con certeza, aunque puede ser elevada y obligar, en no pocas ocasiones, a la retirada de la misma. La mayoría de los casos de intoxicación se producen por la administración continuada del fármaco y son de origen yatrogénico en su mayor parte.

Las manifestaciones clínicas de la toxicidad son fundamentalmente gastrointestinales, cardiovasculares, neurológicas y metabólicas, revistiendo algunas de ellas especial gravedad y condicionando el pronóstico de la intoxicación. La determinación de las concentraciones séricas de teofilina es esencial para confirmar el diagnóstico y orientar el tratamiento y, aunque generalmente tanto la frecuencia como la severidad de los efectos tóxicos se correlacionan con los niveles séricos, no sucede igual en la aguda y en la crónica, e incluso en ésta parece no existir tal correlación.

El tratamiento va encaminado a impedir la absorción mediante el vaciado gástrico y, sobre todo, la administración oral de carbón activado, y a aumentar la eliminación mediante la hemoperfusión y la hemodiálisis, así como a la aplicación de medidas adecuadas de soporte y de control de los síntomas graves.

The frequency with which theophylline presents adverse toxic effects is not well known although it may be high and, on many occasions, obliges the withdrawal of the same. Most of the cases of intoxication are produced by the continuous administration of the drug and in a great number of cases, are of iatrogenic origin.

The clinical manifestations of toxicity are fundamentally gastrointestinal, cardiovascular, neurologic and metabolic with some being of specially severity, conditioning the prognosis of the intoxication. The determination of serum concentrations of theophylline is essential to confírm diagnosis and orient treatment and although generally both the frequency and the severity of the toxic effects are correlated with the serum levels, the same does not occur in the acute and chronic cases and no correlation of the same seems to exist.

Treatment is directed at impeding absorption by gastric lavage and overall, the oral administration of activated carbon, and at increasing the elimination by hemoperfusion and hemodialysis in addition to the application of adequate measures of support and control of the severe symptoms.

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Copyright © 1993. Sociedad Española de Neumología y Cirugía Torácica
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