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wikitox:2.1.11.4.6_xanthines [2018/09/01 09:00] (current)
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 +Link to [[:​wikitox:​problems_for_discussion_2_xanthines|Problems for Discussion]]
 +
 +----
 +
 +====== Xanthines ======
 +
 +There are three main xanthine derivatives. Theophylline and aminophylline are methylxanthines once widely used for the treatment of asthma, but now less commonly so. Caffeine is a trimethylxanthine closely related to theophylline. And theobromine,​ which is a plant extract.
 +
 +The exact mechanism of toxicity is not known.
 +
 +**Theophylline**
 +
 +   * inhibits phosphodiesterase at high levels, increasing intracellular cyclic adenosine monophosphate (cAMP).
 +  * releases endogenous catecholamines
 +  * stimulates beta-adrenergic receptors.
 +  * And is an antagonist of adenosine receptors.
 +
 +**Caffeine**
 +
 +  * acts primarily through inhibition of the adenosine receptor.
 +  * In addition, with overdose there is beta-1 and beta-2 adrenergic stimulation secondary to release of endogenous catecholamines.
 +
 +===== REFERENCES =====
 +
 +Shannon M, Amitai Y, Lovejoy FH Jr. Multiple dose activated charcoal for theophylline poisoning in young infants. Pediatrics 1987;​80(3):​368-70 [[https://​www.ncbi.nlm.nih.gov/​pubmed/​3627887|PMID3627887]] \\
 +Henderson A, Wright DM, Pond SM. Management of theophylline overdose patients in the intensive care unit. Anaesth Intensive Care 1992;​20(1):​56-62 [[https://​www.ncbi.nlm.nih.gov/​pubmed/​1609943|PMID1609943]]
 +
  
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