Theophylline toxicity results in substantial morbidity and mortality particularly due to its narrow therapeutic index. The development of new treatments for acute theophylline toxicity is a point of research interest. The aim of the present work was to assess the efficacy of L-carnitine (LC) and propranolol in the management of patients with acute theophylline toxicity. The study was conducted on 60 patients with acute theophylline toxicity admitted to the Poison Control Center or Intensive Care Unit at Alexandria Main University Hospital. The studied patients were equally classified into four groups (GPs, 15 patients each): the first group was the control group who received standard treatment protocol for theophylline toxicity. The other three GPs also received standard treatment protocol for theophylline toxicity in addition. The second group (LC group) received LC with a loading dose of 100 mg/kg IV over 30-60 min (maximum 6 g) and the maintenance dose was 50 mg/kg IV every 8 h. The third group (propranolol group) received propranolol, administered slowly intravenous 0.5-1 mg over 1 min; it may be repeated if necessary up to a total maximum dose of 0.1 mg/kg. The fourth group (propranolol and LC) received both IV propranolol and LC in the same doses as previous. Treatment with LC alone or in combination with propranolol resulted in a significant improvement of both clinical and laboratory findings. Although combined therapy yields the best results and outcome, LC can serve as an antidote for acute theophylline toxicity if there is any contraindication to propranolol administration.

中文翻译：

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左旋肉碱和普萘洛尔在急性茶碱毒性管理中的功效。

茶碱的毒性导致相当大的发病率和死亡率，特别是由于其狭窄的治疗指数。研发新的急性茶碱毒性治疗方法是研究的重点。本工作的目的是评估左旋肉碱（LC）和心得安在治疗急性茶碱毒性患者中的疗效。这项研究是针对60名患有急性茶碱中毒的患者进行的，这些患者被亚历山大总医院的毒物控制中心或加护病房收治。将研究的患者平均分为四组（每组15位患者）：第一组是接受茶碱毒性标准治疗方案的对照组。另外，另外三个GP也接受了茶碱毒性的标准治疗方案。第二组（LC组）在30-60分钟内接受LC负荷剂量为100 mg / kg IV（最大6 g），维持剂量为每8小时50 mg / kg IV。第三组（普萘洛尔组）接受普萘洛尔，在1分钟内缓慢静脉注射0.5-1 mg；如有必要，可以重复进行，直至最大最大剂量为0.1 mg / kg。第四组（普萘洛尔和LC）接受静脉普萘洛尔和LC的剂量与以前相同。单独使用LC或与普萘洛尔组合使用LC治疗可显着改善临床和实验室检查结果。尽管联合治疗可产生最佳结果和结果，但如果普萘洛尔给药有禁忌症，LC可​​作为急性茶碱毒性的解毒剂。