The Use of Small-Dose Theophylline for the Treatment of Bradycardia in Patients with Spinal Cord Injury

In Brief Small-dose theophylline can be a useful alternative in the treatment of bradycardia in patients with spinal cord injury. In this series of three cases, I describe its successful use for this indication. In one case, initiation of theophylline treatment also increased respiratory drive and minute ventilation. A possible mechanism is that theophylline increases the force of contraction of diaphragmatic muscles because of enhancement of calcium uptake through an adenosine-mediated channel. The antibradycardiac effect is probably mediated through one or more different molecular mechanisms, which seem to be mediated by inhibition of phosphodiesterase 3. IMPLICATIONS: Small-dose theophylline might be an interesting adjunct for the treatment of spinal cord injury-evoked bradycardia and respiratory dysfunction.