AMINOPHYLLINE

TRADE NAME
Amicain, Aminophyllinum, Phyllocontin
-
INDICATIONS
Asthma and chronic obstructive pulmonary disease
-
CONTRAINDICATIONS
Hypersensitivity to theophylline and ethylendiamine
-
DOSE

    * Adults: Acute severe asthma is worsening and has not received treatment with Theophylline. Slow IV injection: 250-500mg (5 mg / kg) (injected over 20 minutes) with strict monitoring, can then be followed by a dose in severe acute asthma.
    * Adults: Acute severe asthma: IV infusion of 500 mcg / kg / hour (with strict monitoring) Theophylline plasma concentrations adjusted.
    * Children: severe acute asthma is worsening and has not received treatment with Theophylline. Slow IV injection: 5 mg / kg (injected over 20 minutes) with strict monitoring, can then be followed by a dose in severe acute asthma.
    * Children: Acute severe asthma: IV infusion: children aged 6 months - 9 years 1mg/kg/jam children aged 10-16 years 800 mcg / kg / hour adjusted to the concentration of theophylline in plasma.
-
Route of administration:

   1. Oral: can be used in conjunction with food
   2. Intravenous:

    * Can be administered by IV bolus or slow injection can be administered by IV infusion
    * Do not mix with other drugs in the syringe
    * Avoid the use of drugs that are unstable under acidic along with aminophylline
    * Do not use if there are crystals that separate from the solution
    * Do not use if solution is not clear.
-
SIDE EFFECTS

    * Side effects are common: Gastrointestinal: diarrhea, nausea and vomiting; Neurological: dizziness, headache, insomnia, and tremors; Renal: diuresis;
    * Serious adverse events: the Cardiovascular: Atrial fibrillation, bradyarrhythmias when the administration too quickly can cause cardiac arrest, tachyarrhythmia Dermatologic: Erythroderma; Gastrointestinal: Necrotizing enterocolitis in fetus OR newborn; immunologic: Immune hypersensitivity reaction; Neurologic: intracranial bleeding, seizures.
-
DRUG INTERACTION
With Other Drugs:
Drugs that can raise levels of Theophylline: Propranolol, allopurinol (> 600mg/day), erythromycin, Cimetidin, Troleandomycin, Ciprofloxacin (class of quinolones are the others), oral contraceptives, Beta-Blockers, Calcium Channel Blocker, Corticosteroids, Disulfiram, Ephedrine, Influenza vaccines, interferon, macrolides, Mexiletine, Thiabendazole, Thyroid Hormone, Carbamazepine, Isoniazid, Loop diuretics. Other drugs that can inhibit cytochrome P450 1A2, such as: Amiodarone, Fluxosamine, Ketoconazole, antibiotic quinolones).
Drugs that can reduce levels of Theophylline: Phenytoin, medications that induce CYP 1A2 (such as Aminoglutethimide, Phenobarbital, Carbamazepine, Rifampin), Ritonavir, IV isoproterenol, Barbiturate, hydantoin, Ketoconazole, Sulfinpyrazone, Isoniazid, Loop diuretic, Sympathomimetics .
With Food:
Avoid excessive consumption of Caffeine. Avoid dietary protein and carbohydrate overload. Limit consumption of charcoal-Broiled foods
-

WORKING MECHANISM
Theophylline, a bronchodilator, has 2 main mechanisms of action in the lungs is by way of smooth muscle relaxation and suppress the stimulant found in the airway (suppression of airway stimuli). The main mechanism of action is not known with certainty. Allegedly bronkodilasi effects caused by the presence of inhibition of two isoenzymes of phosphodiesterase (PDE III) and PDE IV. Meanwhile, in addition bronkodilasi effects associated with other molecular activity. Theophylline may also increase the contraction of the diaphragm muscle by increasing uptake through Adenosine-mediated Ca Chanels
-
OF SPECIMENS
225 mg Tablets, Ampoules 10ml
Storage Stability

    * Preparations Oral: Tablets should be stored at room temperature 20 ° C-25 ° C, protected against light and moisture.
    * Parenteral Preparations: Store at 15 ° C-30 ° C, protected from light. Store in carton until the time you want to use. Aminophylline is a solution that is stable at room temperature. At pH 3.5-8.6, stability at room temperature at a concentration of not less than 40 mg / mL can be maintained up to 48 hours. Aminofilin stability in plastic syringes ± 5 hours. Aminophylline is alkaline (pH around 8.8) so it has a tendency to melt plastic and rubber, therefore not recommended for storage in plastic syringes in a long time.
-

MONITORING PARAMETERS

    Decreased symptoms of asthma
    * Test pulmonary function
    * Serum Theophylline (normal range: 10-20 mcg / mL).
    * The solution should not be used when the color changes or when the crystal is formed.
-
PATIENT INFORMATION

    * Purpose of drugs: The use of drugs: appropriate recommended doker; can be taken on an empty stomach or with food. When taken on an empty stomach, then so be drunk on an empty stomach, if taken with food then so be drunk with food. If you forget to take medication: Use as soon as remembered. When the time remember, it's almost time to take the next dose, then it does not need to drink the previous dose, just take the next dose. Do not double doses.
    * Storage of drugs: Ask your doctor or pharmacist about medications and other foods that need to be avoided. Consult your doctor if side effects occur. Drug injection and what foods should be avoided. Tell your doctor about medication, food, vitamins or herbal what is used. If you experience side effects, tell your doctor.

STRUCTURE