Drug Name

Dosage & Route

Action

Indication

Contraindication

Adverse Effects

Nursing Responsibility

AMINOPHYLLINE (theophylline ethylenediamide) (am-in-off'i-lin) Corophyllin , Paladron , Phyllocontin, Somophyllin, Somophyllin-DF, Truphylline Classifications: BRONCHODILATOR (RESPIRATORY SMOOTH MUSCLE RELAXANT); XANTHINE

Bronchospasm Adult: IV Loading Dose 6 mg/kg over 30 min IV Maintenance Dose nonsmoker, 0.5 mg/kg/h; smoker, 0.75 mg/kg/h; CHF or cirrhosis, 0.25 mg/kg/h PO nonsmoker, 0.5 mg/kg/h times 24 h in 4 divided doses; smoker, 0.75 mg/kg/h times 24 h in 4 divided doses; CHF or cirrhosis, 0.25 mg/kg/h times 24 h in 4 divided doses Child: IV Loading Dose 6 mg/kg IV over 30 min IV Maintenance Dose 19 y, 1 mg/kg/h; >9 y, 0.75 mg/kg/h PO 19 y, 1 mg/kg/h times 24 h in 4 divided doses; >9 y, 0.75 mg/kg/h times 24 h in 4 divided doses Infant: PO/IV 611 mo, 0.87 g/kg/h; 26 mo, 0.5 mg/kg/h Neonate: PO/IV 0.16 mg/kg/h Neonatal Apnea Neonate: PO/IV Loading Dose 5 mg/kg PO/IV Maintenance Dose 5 mg/kg/d divided q12h

Aminophylline is a salt of theophylline with effects similar to those of other xanthines (e.g., caffeine and theobromine). Action is dependent on theophylline content (approximately 80%) and is measured as theophylline in the serum.

To prevent and relieve symptoms of acute bronchial asthma and treatment of bronchospasm associated with chronic bronchitis and emphysema.

Hypersensitivity to xanthine derivatives or to ethylenediamine component; cardiac arrhythmias. Safety during pregnancy (category C) or lactation is not established.

CNS: Nervousness, restlessness, depression, insomnia, irritability, headache, dizziness, muscle hyperactivity, convulsions. CV: Cardiac arrhythmias, tachycardia (with rapid IV), hyperventilation, chest pain, severe hypotension, cardiac arrest. GI: Nausea, vomiting, anorexia, hematemesis, diarrhea, epigastric pain.

Assessment & Drug Effects

Monitor for S&S of toxicity (generally related to theophylline serum levels over 20 mg/mL). Observe patients receiving parenteral drug closely for signs of hypotension, arrhythmias, and convulsions until serum theophylline stabilizes within the therapeutic range. Note: High incidence of toxicity is associated with rectal suppository use due to erratic rate of absorption. Monitor & record vital signs and I&O. A sudden, sharp, unexplained rise in heart rate may indicate toxicity. Lab tests: Monitor serum theophylline levels. Note: Older adults, acutely ill, and patients with severe respiratory problems, liver dysfunction, or pulmonary edema are at greater risk of toxicity due to reduced drug clearance. Note: Children appear more susceptible to CNS stimulating effects of xanthines (nervousness, restlessness, insomnia, hyperactive reflexes, twitching, convulsions). Dosage reduction may be indicated.