Guidelines for Avoiding Theophylline Overdose

Abstract

To the Editor: The report in which Dr. Russo¹ describes management of theophylline-induced seizures raises a broader issue about why toxicity with this drug continues to occur at major medical centers when the pharmacodynamics, pharmacokinetics and dosage requirements have been so carefully defined. The dosage administered to that patient was based on an earlier report in the Journal^,2 recommending an intravenous aminophylline loading dose of 5.6 mg per kilogram of body weight followed by a constant infusion of 0.9 mg per kilogram per hour. Although this dosage has been enthusiastically endorsed and widely used, subsequent reports from the University . . .