aminophylline (Amoline®, Somopphyllin®, Aminophyllin®)
Xanthine Bronchodilator (theophylline derivative)
Aminophylline achieves bronchodilation via different mechanisms than sympathomimetics, and may prove effective when sympathomimetics have been ineffective. In addition to bronchodilation, aminophylline is a respiratory stimulant; it has mild diuretic properties, and positive chronotropic and positive inotropic effects (in large doses). In emergency care, aminophylline is usually administered by slow intravenous infusion. Aminophylline has been reduced to a second-line drug in the emergency setting due to more efficacious agents and controversy over its usefulness; it is used in life-threatening conditions after other agents have proven ineffective.
Less than 15 minutes IV
4 ½ hours
Severe bronchospasm (associated with asthma, chronic bronchitis, emphysema).
Severe bronchospasm associated with pulmonary edema
May be effective when sympathomimetics have been ineffective
Congestive heart failure.
Allergy to xanthine compounds (for example, caffeine).
Currently taking theophylline containing medication
Hypersensitivity to the drug
Cardiac dysrhythmia
Tachycardia, palpitations, PVCs, angina pectoris, dizziness, anxiety, headache, seizure, nausea and vomiting, adbominal cramps.
Beta blockers may oppose effects.
Barbiturates, phenytoin and smoking may decrease theophylline levels.
500mg/10 ml ampule (50mg/ml)
500 mg/20 ml ampule, preload (25 mg/ml)
250 mg/10 ml ampule, preload (25 mg/ml)
Loading Dose
5 mg/kg (if wheezing) in 50-100 ml of diluent over 10 – 20 min, followed by 0.5 – 0.7 mg/kg/hr (max 200 mg/min)
0.01 - 0.03 ml (0.05 - 0.15 mg)/kg/dose to maximum of 0.50 ml/dose diluted in 2 ml of 0.9% saline solution adminstered by nebulizer. May be repeated q 20 minutes X 3
Maintenance infusion based on serum aminophylline levels.
Pregnancy Safety: Category C
Aminophylline should be used with caution in patients with cardiovascular disease, hypertension, or hepatic or renal insufficiency.
Avoid in patients with supraventricular dyshythmias.
Hypotension may occur following rapid administration.
Therapeutic-to-toxic ration is narrow.