Maintain airway and oxygenation. If a result of oral medication, follow above recommendations to prevent absorption of drug, but intubation and lavage will have to be performed instead of inducing emesis, and the cathartic and charcoal will need to be introduced via a large bore gastric lavage tube. Continue to provide full supportive care and adequate hydration while waiting for drug to be metabolized. In general, the drug is metabolized sufficiently rapidly so as not to warrant consideration of dialysis. If hypotension is not corrected by i.v. fluids, vasopressor drugs may be administered cautiously.
Theophylline is dialyzable.
However, in patients with very high serum theophylline levels and severe intoxication, charcoal hemoperfusion may be employed. This procedure is very effective in removing theophylline from the blood, and is to be preferred over peritoneal dialysis or hemodialysis. Because of the large inter-subject variability, monitoring of plasma theophylline concentrations is extremely important, especially in the initial stages of therapy. If the therapeutic effect is not observed, the dose may be increased to 250 mg 4 times a day. Not recommended for children under 12 years of age.