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
(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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