Aminophylline (Theophylline Ethylenediamine)



Aminophylline (Theophylline Ethylenediamine)





(am in off’ i lin)

PREGNANCY CATEGORY C


Drug Classes

Bronchodilator

Xanthine


Therapeutic Actions

Relaxes bronchial smooth muscle, causing bronchodilation and increasing vital capacity, which has been impaired by bronchospasm and air trapping; in higher concentrations, it also inhibits the release of slow-reacting substance of anaphylaxis
(SRS-A) and histamine and suppresses the response of airways to stimuli.


Indications



  • Symptomatic relief or prevention of bronchial asthma and reversible bronchospasm associated with chronic bronchitis and emphysema


  • As adjunct to inhaled beta2 selective adrenergic agonists and systemic corticosteroids for the treatment of acute exacerbations of the symptoms and reversible airflow obstruction associated with asthma and other obstructive lung diseases


  • Unlabeled uses: Respiratory stimulant in Cheyne-Stokes respiration; treatment of apnea and bradycardia in premature babies



Contraindications and Cautions



  • Contraindicated with hypersensitivity to any xanthine or to ethylenediamine, peptic ulcer, active gastritis.


  • Use cautiously with cardiac arrhythmias, acute myocardial injury, heart failure, cor pulmonale, severe hypertension, severe hypoxemia, renal or hepatic disease, hyperthyroidism, alcoholism, labor, lactation, pregnancy.


Available Forms

Injection—25 mg/mL; tablets—100, 200 mg


Dosages

Individualize dosage. Because of poor distribution of drug in body fat, dosing should be calculated based on ideal body weight. Base dosage adjustments on clinical response. Monitor serum theophylline levels and maintain a therapeutic range of 10–20 mcg/mL. Aminophylline is approximately 79% anhydrous theophylline by weight. To convert a theophylline dose to aminophylline, divide the theophylline dose by 0.8.

Adult and pediatric patients



IV Lines

Loading dose is 5.7 mg/kg (aminophylline) calculated on ideal body weight. Administer over 30 min. This should produce a peak serum level of 6–16 mcg/mL. Determine serum levels 30 min after administering dose. If patient has had theophylline within 24 hr, monitor levels before administering loading dose and adjust dosage accordingly.

Initial theophylline infusion rates after loading dose to target 10 mcg/mL serum level. (Divide theophylline dose by 0.8 to arrive at aminophylline dose.)







































Age Initial infusion rate
Neonates 24 days or younger 1 mg/kg every 12 hr
Neonates older than 24 days 1.5 mg/kg every 12 hr
Infants 6–52 wk mg/kg/hr = 0.008 × age in weeks + 0.21
Children 1–9 yr 0.8 mg/kg/hr
Children 9–12 yr and adolescent smokers 0.7 mg/kg/hr
Nonsmoking adolescents 12–16 yr 0.5 mg/kg/hr; do not exceed 900 mg theophylline/day
Healthy, nonsmoking adults 0.4 mg/kg/hr; do not exceed 900 mg theophylline/day
Adults older than 60 yr 0.3 mg/kg/hr; do not exceed 400 mg theophylline/day
Adults with cardiac decompensation, cor pulmonale, hepatic impairment, sepsis with multiorgan failure, shock 0.2 mg/kg/hr; do not exceed 400 mg theophylline/day; do not exceed 17 mg/hr
Infusion dosage should be adjusted based on serum theophylline levels as noted under oral dosing.

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Jul 20, 2016 | Posted by in NURSING | Comments Off on Aminophylline (Theophylline Ethylenediamine)

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