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Critical Care Toxicology pp 883–904Cite as

Theophylline and Other Methylxanthines

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Abstract

The methylxanthines are a group of pharmaceuticals that antagonize adenosine receptors in the central nervous system and peripheral tissues. Pharmaceutically active methylxanthines include caffeine, theophylline, and pentoxifylline. A fourth methylxanthine, theobromine, is present in cocoa products, but is not used as a pharmaceutical, and has toxicological importance in nonhuman animal species. Severe intoxication with methylxanthines may result in life-threatening arrhythmias and seizures and has a historic mortality of up to 10% [1–4].

Holly Perry and Michael W. Shannon contributed to the previous edition of this chapter.

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Authors and Affiliations

  1. Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA

    Ann-Jeannette Geib

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  1. Ann-Jeannette Geib
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Correspondence to Ann-Jeannette Geib .

Editor information

Editors and Affiliations

  1. Department of Medicine, Division of Clinical Pharmacology and Toxicology, University of Colorado, School of Medicine, Aurora, Colorado, USA

    Jeffrey Brent

  2. FDA, Office of New Drugs/Immediate Office, Center for Drug Evaluation and Research, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas’ Hospital, Silver Spring, Maryland, USA

    Paul Dargan

  4. Toxicology Associates, University of Colorado, School of Medicine, Denver, Colorado, USA

    Benjamin Hatten

  5. Medical Toxicological Intensive Care Unit, Lariboisiere Hospital, Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. Toxicology Associates, University of Colorado, School of Medicine, Denver, Colorado, USA

    Robert Palmer

  7. Toxinology Department, Women’s and Children’s Hospital, North Adelaide, South Australia, Australia

    Julian White

Additional information

This chapter is dedicated to the memory of Michael W. Shannon.

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2

    Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.

  4. II-3

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III

    Opinions of respected authorities, based on clinical experience, descriptive studies and case reports, or reports of expert committees.

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Geib, AJ. (2017). Theophylline and Other Methylxanthines. In: Brent, J., et al. Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-17900-1_30

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