Symptoms: Theophylline: Anorexia, nausea, vomiting, nervousness, insomnia, agitation, irritability, headache, tachycardia, extrasystoles, tachypnea, tonic/clonic convulsions.
Treatment: If Seizure has not Occurred: Induce vomiting, even if emesis has occurred spontaneously. However, do not induce emesis in patients with impaired consciousness.
If Seizure Occurs: Establish an airway and administer oxygen. Administer IV diazepam 0.1-0.3 mg/kg up to 10 mg. Monitor vital signs, maintain blood pressure and provide adequate hydration.
Post-Seizure Coma: Maintain airway and oxygenation. Perform intubation and lavage instead of inducing emesis. Introduce the cathartic and activated charcoal via a large bore gastric lavage tube. Provide full supportive care and adequate hydration while the drug is metabolized. If repeated oral activated charcoal is inactive, charcoal hemoperfusion may be indicated.
The expected symptoms with overdosage of salbutamol are those of excessive β-stimulation and/or occurrence or exaggeration of any of the symptoms (see Adverse Reactions) eg, seizures, angina, hypertension or hypotension, tachycardia, arrhythmias, nervousness, headache, tremor, dry mouth, palpitation, nausea, dizziness, fatigue, malaise and insomnia. Hypokalemia may also occur.
Treatment consists of discontinuation of salbutamol together with appropriate symptomatic therapy.