Paediatric Acute care Guidelines PMH Emergency Department

Medication

Aminophylline is a compound of theophylline with ethylenediamine.

Actions

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

Indications

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

Contraindications

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

Adverse

  • 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

Dosage

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.

Preparation

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

Administration

Administer loading dose intravenously over 1 hour via infusion pump.

Special

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

Tags

We want your feedback!

Help us provide guidelines that are useful to you, the clinician.

Give feedback here