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Intravenous Aminophylline Treatment: Dosage Guidelines and Interactions, Summaries of Nursing

Guidelines for intravenous aminophylline treatment, including therapeutic range, signs of toxicity, plasma clearance, and dosing instructions. It also lists drugs that can increase or decrease plasma theophylline levels. Use this document to calculate doses based on patient weight and determine infusion rates.

Typology: Summaries

2021/2022

Uploaded on 09/12/2022

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Approved by Trust Drug and Therapeutics Committee: March 2021
Review Date: March 2024
INTRAVENOUS AMINOPHYLLINE TREATMENT (DBTH Formulary Guidance)
Therapeutic Range: 55 110 µmol/L
Signs of Toxicity:
Nausea, vomiting, diarrhoea, tremor, epigastric pain, headache, insomnia, hypotension, cardiac arrhythmias and convulsions
Plasma Clearance:
Theophylline clearance is reduced in patients with severe congestive heart failure, cor pulmonale, pulmonary oedema, severe liver
disease and hypoxaemic state. The dose may need to be lowered in these patients
Theophylline clearance is increased in smokers
Plasma Theophylline levels may be increased by
- macrolide antibiotics
- calcium channel blockers
- quinolone antibiotics
- cimetidine (see current BNF for complete listing)
Plasma Theophylline levels may be reduced by
- rifampicin
- lithium
- phenytoin
- carbamazepine (see current BNF for complete listing)
Is the patient obese?
Use Actual Weight (Kg)
For all calculations
Use Ideal Body Weight (Kg)
Men: 50 + (2·3) x (Height in inches >5ft)
Women: 45 + (2·3) x (Height in inches >5ft)
For all calculations
No
Yes
Is the patient prescribed oral Theophylline?
e.g. Uniphyllin
No
Yes:
Measure plasma
concentrations
Have they taken a dose in
the last 24 hours?
Give Loading Dose: 5mg/Kg
Add aminophylline loading dose to 100mls
N.Saline 0.9% and infuse over 30 minutes
Yes
Omit loading
dose
Give Maintenance Dose: 0.5mg/Kg/Hour
see chart for dose and infusion rates
Take plasma theophylline levels 6 hours after starting
maintenance dose infusion and adjust levels accordingly.
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Approved by Trust Drug and Therapeutics Committee: March 2021

Review Date: March 2024

INTRAVENOUS AMINOPHYLLINE TREATMENT (DBTH Formulary Guidance)

Therapeutic Range: 55 – 110 μmol/L Signs of Toxicity:  Nausea, vomiting, diarrhoea, tremor, epigastric pain, headache, insomnia, hypotension, cardiac arrhythmias and convulsions Plasma Clearance:  Theophylline clearance is reduced in patients with severe congestive heart failure, cor pulmonale, pulmonary oedema, severe liver disease and hypoxaemic state. The dose may need to be lowered in these patients  Theophylline clearance is increased in smokers  Plasma Theophylline levels may be increased by

  • macrolide antibiotics
  • calcium channel blockers
  • quinolone antibiotics
  • cimetidine (see current BNF for complete listing)  Plasma Theophylline levels may be reduced by
  • rifampicin
  • lithium
  • phenytoin
  • carbamazepine (see current BNF for complete listing) Is the patient obese? Use Actual Weight (Kg) For all calculations Use Ideal Body Weight (Kg) Men: 50 + (2·3) x (Height in inches >5ft) Women: 45 + (2·3) x (Height in inches >5ft) For all calculations No Yes Is the patient prescribed oral Theophylline? e.g. Uniphyllin No Yes: Measure plasma concentrations Have they taken a dose in the last 24 hours? Give Loading Dose: 5mg/Kg Add aminophylline loading dose to 100mls N.Saline 0.9% and infuse over 30 minutes No Yes Omit loading dose Give Maintenance Dose: 0.5mg/Kg/Hour see chart for dose and infusion rates Take plasma theophylline levels 6 hours after starting maintenance dose infusion and adjust levels accordingly.

Approved by Trust Drug and Therapeutics Committee: March 2021

Review Date: March 2024

AMINOPHYLLINE – MAINTENANCE DOSE

Presentation: 25mg/ml 10ml ampoule

Recommended infusion fluid: Sodium Chloride 0.9%

Dose & Rate of 1mg/ml infusion required for a 500micrograms/kg/hr infusion

Patient Weight

(Kg)

Dose

(mg/hour)

Infusion Rate

(ml/hour)