Author Affiliations: Department of Pediatrics, Graduate School of Medicine, Gifu University, Yanagido 1-1, Gifu 501-1194, Japan (Kato Z, Yamagishi A, Kondo N); Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu 501-1194, Japan (Nakamura M)

Corresponding Author: Zenichiro Kato, MD, PhD, Department of Pediatrics, Graduate School of Medicine, Gifu University, Yanagido 1-1, Gifu 501-1194, Japan (Tel: +81 (58) 230 6386; Fax: +81 (58) 230 6387; Email: zen-k@gifu-u.ac.jp)

doi:10.1007/s12519-009-0061-y

Background: Theophylline has been widely used to treat asthma, but recent studies have revealed that the possible risks for seizure may result in the revision of the therapeutic guidelines.

Methods: An 8-month-old boy who had been treated with oral sustained-release theophylline and additional aminophylline suppository was hospitalized. A combination of diazepam, lidocaine and thiopental was required to stop his convulsion.

Results: The pharmacokinetic study indicated that the usage of a sustained-release formula should not usually be over 15 mg/ml, but the additional use of an aminophylline suppository elevated the concentration to over 20 mg/ml and resulted in the severe adverse effects.

Conclusion: The parents of children and also physicians should be educated to ensure the proper use of the suppository formula.

Key words: convulsion; pharmacokinetics; suppository; theophylline

                  World J Pediatr 2009;5(4):316-318