MRCP2-4202

MRCP2-4202

A 19-year-old-female is brought into the emergency room after experiencing a tonic-clonic seizure. Upon examination, she has a Glasgow coma scale of 11 (M4, E3, V4) and her blood pressure is 85/65 mmHg. Her heart rate is 135 bpm and an ECG shows atrial fibrillation. She has a medical history of asthma and is currently taking betamethasone, salbutamol, salmeterol, montelukast, and theophylline. She recently started taking erythromycin for a chest infection and has been consuming 6g of paracetamol per day for the past 3 days to alleviate fever and chest discomfort.

Fluid resuscitation with 0.9% saline is initiated, and a beta blocker is administered to treat the supraventricular tachycardia. The patient is suspected to have theophylline toxicity and is given repeated doses of activated charcoal. However, her condition continues to worsen.

What is the appropriate treatment in this case?