{"id":1629,"date":"2023-06-25T17:28:42","date_gmt":"2023-06-25T17:28:42","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/aminophylline\/"},"modified":"2023-06-25T19:58:21","modified_gmt":"2023-06-25T19:58:21","slug":"aminophylline","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/aminophylline\/","title":{"rendered":"Aminophylline"},"content":{"rendered":"

<\/p>\n

Aminophylline<\/h1>\n

CLINICAL USE<\/h3>\n
  • Reversible airways obstruction<\/li>\n
  • Acute severe asthma
    \n

    DOSE IN NORMAL RENAL FUNCTION<\/h3>\n

    Modified release: 225\u2013450 mg twice daily
    \nIV loading dose: 5 mg\/kg (250\u2013500 mg)
    \nMaintenance dose: 0.5 mg\/kg\/hour adjusted
    \naccording to levels<\/p>\n

    PHARMACOKINETICS<\/h3>\n<\/li>\n
  • Molecular weight                           :
    \n420.4<\/li>\n
  • %Protein binding                           :
    \n40\u201360 (theophylline)<\/li>\n
  • %Excreted unchanged in urine     :<\/li>\n
  • <10           :<\/li>\n
  • Volume of distribution (L\/kg)       :
    \n0.4\u20130.7 (theophylline)<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      :
    \n4\u201312\/Unchanged
    \n(theophylline)<\/p>\n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n<\/li>\n
  • 20 to 50     : Oral: Dose as in normal renal
    \nfunction and adjust in accordance
    \nwith blood levels
    \nIV: Dose as in normal renal function
    \nand adjust in accordance with blood
    \nlevels<\/li>\n
  • 10 to 20     : Oral: Dose as in normal renal
    \nfunction and adjust in accordance
    \nwith blood levels
    \nIV: Dose as in normal renal function
    \nand adjust in accordance with blood
    \nlevels<\/li>\n
  • <10           :
    \nOral: Dose as in normal renal
    \nfunction and adjust in accordance
    \nwith blood levels
    \nIV: Dose as in normal renal function
    \nand adjust in accordance with blood
    \nlevels<\/p>\n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                :
    \nNot dialysed. Dose as in
    \nGFR <10 mL\/min Monitor blood
    \nlevels. See \u2018Other Information\u2019<\/li>\n
  • HD                     :
    \nNot dialysed. Dose as in
    \nGFR <10 mL\/min. Monitor blood
    \nlevels. See \u2018Other Information\u2019<\/li>\n
  • HDF\/high flux   :
    \nUnknown dialysability. Dose as in
    \nGFR <10 mL\/min Monitor blood
    \nlevels. See \u2018Other Information\u2019<\/li>\n
  • CAV\/VVHD      :
    \nNot dialysed. Dose as in GFR=10\u2013
    \n20 mL\/min Monitor blood levels.
    \nSee \u2018Other Information\u2019<\/p>\n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs<\/li>\n

  • Antibacterials: increased concentrationwith azithromycin, clarithromycin,
    \nerythromycin, ciprofloxacin, norfloxacin
    \nand isoniazid; decreased erythromycin
    \nlevels if erythromycin is given orally;
    \nincreased risk of convulsions if given
    \nwith quinolones; rifampicin accelerates
    \nmetabolism of theophylline<\/li>\n
  • Antidepressants: concentration increasedby fluvoxamine \u2013 avoid concomitant use
    \nor halve theophylline dose and monitor
    \nlevels; concentration reduced by St John\u2019s
    \nwort \u2013 avoid concomitant use<\/li>\n
  • Anti-epileptics: metabolism increasedby carbamazepine and primidone;
    \nconcentration of both drugs increased
    \nwith phenytoin<\/li>\n
  • Antifungals: concentration increased byfluconazole and ketoconazole<\/li>\n
  • Antivirals: metabolism of theophyllineincreased by ritonavir<\/li>\n
  • Calcium-channel blockers: concentrationincreased by diltiazem and verapamil and
    \npossibly other calcium-channel blockers<\/li>\n
  • Tacrolimus: may increase tacrolimus levels<\/li>\n
  • Ulcer-healing drugs: metabolism inhibitedby cimetidine; absorption possibly reduced
    \nby sucralfate<\/p>\n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    \u2013<\/p>\n

    Route<\/h4>\n

    IV, oral<\/p>\n

    Rate of Administration<\/h4>\n

    Loading dose over 20 minutes by slow IV<\/p>\n

    injection<\/p>\n

    Comments<\/h4>\n<\/li>\n
  • Can be added to glucose 5%, sodiumchloride 0.9% and compound sodium
    \nlactate<\/li>\n
  • Minimum volumes range from 2\u201325 mg\/mL, give concentrated solution via central
    \nline.<\/p>\n

    OTHER INFORMATION<\/h4>\n<\/li>\n
  • Aminophylline: 80% theophylline + 20%ethylenediamine<\/li>\n
  • In bodily fluids, aminophylline rapidlydissociates from ethylenediamine and
    \nreleases free theophylline in the body.
    \nIt is therefore not present in the body
    \nlong enough to be dialysed, whereas
    \ntheophylline is dialysed, see theophylline
    \nmonograph<\/li>\n
  • Optimum response obtained at plasmatheophylline levels of 10 to 20 mg\/L (55\u2013110
    \nmicromol\/L)<\/li>\n
  • Increased incidence of GI and neurologicalside effects in renal impairment at plasma
    \nlevels above optimum range<\/li>\n","protected":false},"excerpt":{"rendered":"

    Aminophylline CLINICAL USE Reversible airways obstruction Acute severe asthma DOSE<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-1629","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1629","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=1629"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1629\/revisions"}],"predecessor-version":[{"id":2924,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1629\/revisions\/2924"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=1629"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=1629"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=1629"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}