Aminophylline Infusion Administration

Indications and Protocol

• The British Medical Journal recommends aminophylline infusion for acute severe asthma that does not respond to initial treatment with oxygen, corticosteroids, and nebulized bronchodilators 3
• The Thorax journal suggests that aminophylline infusion is indicated for patients with potentially life-threatening asthma characteristics, such as peak expiratory flow (PEF) <33% of predicted, cyanosis, silent chest, fatigue, or exhaustion 1
• The Thorax journal also recommends aminophylline infusion for patients with clinical deterioration despite initial treatment 4

Administration Protocol

• The Thorax journal recommends administering aminophylline with a loading dose of 5 mg/kg over 20 minutes, followed by a maintenance infusion of 1 mg/kg/hour in children or 0.5-0.7 mg/kg/hour in adults, omitting the loading dose in patients already receiving oral theophyllines 1, 2
• The British Medical Journal suggests a maintenance dose of 750 mg/24 hours for small patients and 1500 mg/24 hours for large patients 3

Monitoring and Precautions

• The British Medical Journal recommends measuring serum theophylline concentrations if the infusion continues for more than 24 hours 3
• The Thorax journal suggests monitoring vital signs, oximetry, and PEF during administration 1, 4
• The Thorax journal also recommends not administering aminophylline in bolus to patients already taking oral theophyllines 4