Whole-bowel irrigation as adjunctive treatment for sustained-release theophylline overdose.
OBJECTIVE
To determine a therapeutic benefit for whole-bowel irrigation (with polyethylene glycol-electrolyte lavage solution) as adjunctive treatment to multiple doses of activated charcoal following an overdose of sustained-release theophylline.


METHODS
Randomized crossover study. Three treatment arms were separated by one-week intervals.


METHODS
Animal care facility housing.


METHODS
Eight female mongrel dogs.


METHODS
Unanesthetized dogs were given approximately 75 mg/kg of sustained-release theophylline. In treatment arm 1, 1 g/kg activated charcoal was administered by nasogastric tube at two hours after ingestion followed by 0.5-g/kg doses at five and eight hours. During treatment arm 2, beginning two hours after theophylline ingestion, 25 mL/kg whole-bowel irrigation solution was administered every 45 minutes for four doses followed by activated charcoal. In treatment arm 3, the first dose of activated charcoal was given ten minutes before beginning the whole-bowel irrigation protocol.


RESULTS
Serum theophylline levels were measured at zero, two, four, five, eight, 12, 16, and 24 hours after ingestion. Mean serum theophylline levels, area under the curve (P = .13), and terminal half-lives (P = .69) for each treatment group were not statistically different. This negative study had an 81% power to detect a 50% reduction in the area under the curve by whole-bowel irrigation treatment.


CONCLUSIONS
In this model, whole-bowel irrigation did not add to the therapeutic benefits of activated charcoal.
Burkhart
K K
KK
Division of Emergency Medicine, Milton S Hershey Medical Center, Pennsylvania State University, Hershey.
Wuerz
R C
RC
Donovan
J W
JW
D000818:Animals; D000932:Antiemetics / Q000627:therapeutic use; D002606:Charcoal / Q000008:administration & dosage / Q000627:therapeutic use*; D003692:Delayed-Action Preparations; D004285:Dogs; D062787:Drug Overdose / Q000628:therapy*; D005260:Female; D013806:Theophylline / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000506:poisoning*; D007507:Therapeutic Irrigation / Q000379:methods*
D000932:Antiemetics; D003692:Delayed-Action Preparations; D002606:Charcoal; D013806:Theophylline