POTENTIAL TREATMENT OF THEOPHYLLINE TOXICITY BY HIGH SURFACE AREA ACTIVATED CHARCOAL

Abstract

Orally administered standard activated charcoal (surface area = 950 m2/g) has been shown to enhance clearance of theophylline in adults. The effect of SuperChar (Gulf Bio-Systems Inc., Dallas, TX), a high surface area (3376 m2/g) activated charcoal, on theophylline clearance was examined during a 48 hr study period in ten low birth weight “growing” status infants, treated with theophylline for apneic episodes, who were candidates for having the drug discontinued. Theophylline was given intravenously as aminophylline on a 12 hr schedule at normal maintenance dose. Each patient received 1g/kg/dose of SuperChar twice via orogastric tube, three hours apart between feedings. Serial theophylline levels were drawn (peak, mid-dose, trough) before and after the administration of SuperChar. Each patient tolerated the charcoal and no complications were encountered during the study. From a graph of serum levels vs. time, clearance of theophylline was calculated using the trapezoidal rule in estimating the area under the curve. There was a significant (p<0.001) increase in the clearance of theophylline after administration of SuperChar (Wilcoxon Signed Rank test). Conclusion: SuperChar enhances the clearance of theophylline in low birth weight infants and may be useful in the treatment of neonatal theophylline toxicity.