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Repetitive Oral Activated Charcoal and Control of Emesis in Severe Theophylline Toxicity

YONA AMITAI, M.D.; ALAN C. YEUNG, M.D.; JACK MOYE, M.D.; and FREDERICK H. LOVEJOY Jr., M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Yona Amitai, M.D.; Massachusetts Poison Control System, The Children's Hospital, 300 Longwood Ave.; Boston, MA 02115.


Ann Intern Med. 1986;105(3):386-387. doi:10.7326/0003-4819-105-3-386
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Treatment with multiple doses of oral activated charcoal increases theophylline clearance in patients receiving theophylline therapy and in patients with mild theophylline toxicity (1-3). However, patients with severe theophylline toxicity have persistent vomiting and are unable to tolerate oral activated charcoal (3, 4). Theophylline may induce vomiting by increasing the volume of gastric secretion (5). The control of xanthine-induced gastric hypersecretion and vomiting therefore may include administration of H2 antagonists (6). We report the cases of two patients with severe theophylline toxicity and vomiting that was controlled by ranitidine and droperidol; multiple doses of oral activated charcoal were tolerated by

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