Paediatric Acute care Guidelines PMH Emergency Department


Aminophylline is a compound of theophylline with ethylenediamine.


The underlying mechanism of action of aminophylline is not fully understood but it probably causes bronchodilation, anti-inflammatory effects and central nervous system stimulation.


Severe asthma not responding to repeated inhaled or nebulised bronchodilator therapy in the emergency department.


Precaution: if patient is already on theophylline omit the loading dose of the aminophylline and just start the continuous infusion.


  • Nausea and vomiting (common)
  • Abdominal pain
  • Cardiac arrhythmias and seizures may result from excessive dosage
  • ß2-agonists and aminophylline lower serum potassium levels, and may result in hypokalaemia
  • Multiple drug interactions exist
  • Gastrointestinal bleeding
  • Hypotension and tachycardia if given too quickly
  • Insomnia and/or restlessness


Loading dose = 10 mg/kg

Maintenance :
(by this stage the patient should already be in a Paediatric Intensive Care Unit)

  • Child 1–35kg = 6 mg/kg 6 hourly by slow IV push over 20 minutes
    or 1 mg/kg/hr continuous infusion.
  • Child 35kg-16 years = 4 mg/kg 6 hourly by slow IV push over 20 minutes
    or 0.7 mg/kg/hr continuous infusion.


To prepare the loading dose:

  • Dilute in 100 – 200 mL 0.9% saline
  • Do not combine with any other medication
  • Do not prepare more than the calculated loading dose


Administer loading dose intravenously over 1 hour via infusion pump.


  • Continuous pulse oximetry
  • Continuous cardiac monitoring
  • Pulse, respiratory rate and BP every 15 minutes during the infusion, and hourly thereafter


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