Aminophylline Flashcards

Aminophylline Overview

• Trade name: Phyllocontin
• Generic name: Aminophylline
• Therapeutic classification: Bronchodilators
• Pharmacologic classification: Xanthines

Indications

• Used for long-term control of reversible airway obstruction due to asthma or COPD.
• Enhances diaphragmatic contractility.
• Unlabeled use as a respiratory and myocardial stimulant for premature infant apnea.

Mechanism of Action

• Inhibits phosphodiesterase, leading to increased tissue levels of cyclic adenosine monophosphate (cAMP).
• Elevated cAMP levels result in bronchodilation, CNS stimulation, positive inotropic and chronotropic effects, diuresis, and gastric acid secretion.
• Aminophylline is a salt of theophylline, releasing free theophylline upon administration.

Therapeutic Effects

• Principal effect: Bronchodilation.

Side Effects

• CNS: seizures, anxiety, headache, insomnia, irritability.
• Cardiovascular: arrhythmias, tachycardia, angina, palpitations.
• Dermatological: rash.
• Gastrointestinal: nausea, vomiting, anorexia.
• Neurological: tremor.

Assessment

• Monitor blood pressure, pulse, respiratory status before and during therapy.
• Ensure proper oxygen therapy during acute asthma attacks.
• Track intake and output to detect changes in diuresis or fluid overload.
• Assess patients with cardiovascular history for chest pain and ECG changes.
• Resuscitative equipment should be available.
• Conduct pulmonary function tests periodically.
• Monitor ABGs, acid-base status, and fluid/electrolyte balance if on parenteral therapy.
• Toxicity Monitoring: Regularly check drug levels, especially with high doses.
• Therapeutic range: 10-15 mcg/mL for asthma; 6-14 mcg/mL for apnea of prematurity. Levels above 20 mcg/mL indicate toxicity.
• Symptoms of toxicity include: anorexia, nausea, vomiting, confusion, tachycardia, seizures.

Implementation

• Administer around the clock to ensure therapeutic plasma levels.

Client Teaching

• Encourage adequate fluid intake (at least 2000 mL/day) to reduce airway secretion viscosity.
• Advise against using OTC cough, cold, or breathing medications without consulting a healthcare professional to prevent increased side effects and arrhythmias.
• Smoking cessation is encouraged; changes in smoking may require dose adjustments.
• Suggest minimizing the intake of xanthine-containing foods.