Q: 44-year-old asthmatic patient is admitted to ICU with frequent seizure episodes. There is a high suspicion of theophylline overdose Which of the commonly used anticonvulsants should not be used?

Answer: Phenytoin and fosphenytoin

Studies have shown phenytoin and/or fosphenytoin may make seizures worse  caused by  theophylline. Similarly, is true for seizures from Cocaine.


Reference:

Paloucek FP, Rodvold KA. Evaluation of theophylline overdoses and toxicities. Ann Emerg Med 1988; 17:135.