Class
Description
Onset and Duration
Indications
Contraindications
Adverse Reactions
Drug Interactions
How Supplied
Dosage and Administration
Special Considerations
Xanthine bronchodilator (theophylline derivative)
Aminophylline achieves bronchodilation via different mechanisms than sympathomimetics and may be effective when sympathomimetics are not. Aminophylline is a respiratory stimulant as well as a bronchodilator; it has mild diuretic properties and positive chronotropic and inotropic effects (in large doses). In emergency care, aminophylline is usually administered by slow intravenous infusion. It has been reduced to a second-line drug in the emergency setting with the advent of more efficacious agents and controversy over its usefulness; it is used in life-threatening conditions after other agents have proven ineffective.
Onset: Less than 15 min IV
Duration: 4 1/2 hr
Bronchospasm (associated with asthma, chronic bronchitis, emphysema)
Bronchospasm associated with pulmonary edema
May be effective when sympathomimetics have been ineffective
Congestive heart failure
Allergy to xanthine compound (for example, caffeine)
Hypersensitivity to the drug
Cardiac dysrhythmias
Tachycardia
Palpitations
PVCs
Angina pectoris
Dizziness
Anxiety
Headache
Seizure
Nausea and vomiting
Abdominal cramps
Beta blockers may oppose effects.
Barbiturates, phenytoin, and smoking may decrease theophylline levels.
500 mg/10-ml ampule (50 mg/ml)
500 mg/20-ml ampule, preload (25 mg/ml)
250 mg/10-ml ampule, preload (25 mg/ml)
Loading Dose
| Patient category | First 12 hours | Subsequently (based on serum aminophylline levels) |
|---|---|---|
| Children | 1 | 0.8 |
| Young adults (smokers) | 1 | 0.8 |
| Young adults (non-smokers) | 0.7 | 0.5 |
| Elderly patients | 0.6 | 0.3 |
| Patients with heart failure or liver disease | 0.5 | 0.1-0.2 |
Pregnancy safety: Category C.
Aminophylline should be used with caution in patients with cardiovascular disease, hypertension, or hepatic or renal insufficiency. Doses should be reduced by half in patients who have had a theophylline preparation within the past 6-24 hours. Hypotension may occur after rapid administration. Therapeutic-to-toxic ratio is narrow.