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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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