What is the use of aminophylline (Aminophylline)?

From the Guidelines

Aminotriphylline, also known as aminophylline, is primarily used to treat respiratory conditions such as asthma, chronic obstructive pulmonary disease (COPD), and other breathing disorders. It works as a bronchodilator by relaxing the smooth muscles in the airways, which helps to open them up and make breathing easier 1. The medication is also sometimes used to treat symptoms of heart failure, as it can improve cardiac output and increase urine production. Aminophylline belongs to the xanthine class of medications and works by inhibiting phosphodiesterase enzymes, which increases levels of cyclic AMP in the body's cells, leading to bronchodilation.

Some key points to consider when using aminophylline include:

• It's typically administered intravenously in emergency situations or as oral tablets for maintenance therapy 1.
• The dosage varies based on the patient's weight, age, and specific condition being treated, with a common dosage being 5 mg/kg over 20 minutes followed by a maintenance infusion of 1 mg/kg/h 1.
• Common side effects include nausea, headache, insomnia, and irritability.
• Blood levels need to be monitored carefully as aminophylline has a narrow therapeutic window, meaning the difference between an effective dose and a toxic dose is relatively small 1.

In terms of specific guidelines, the British Thoracic Society recommends intravenous aminophylline for patients whose condition is very severe when they are first seen or who deteriorate or fail to improve rapidly when treated with oxygen, steroids, and agonists alone 1. Additionally, if life-threatening features are present, intravenous aminophylline should be given at a dose of 5 mg/kg over 20 minutes followed by a maintenance infusion of 1 mg/kg/h, omitting the loading dose if the child is already receiving oral theophyllines 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Aminotriphylline Use

• Aminotriphylline, also known as aminophylline, is used in the treatment of respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma 2, 3, 4.
• The primary outcome of using aminophylline in COPD patients is to improve lung function, particularly forced expiratory volume in 1 second (FEV1) 2.
• However, studies have shown that aminophylline may not provide significant additional benefits when used with high-dose nebulized bronchodilators and oral corticosteroids in COPD patients 2, 3.
• In asthma, aminophylline may be used as an alternative to intravenous infusion of beta-agonists, heliox, or magnesium sulfate administration in children with respiratory fatigue 4.
• Aminophylline has anti-inflammatory effects in asthma and COPD at lower concentrations, which may be useful in reversing corticosteroid resistance in severe asthma and COPD 5.

Side Effects and Considerations

• Aminophylline use is associated with side effects such as nausea, vomiting, and headaches due to phosphodiesterase inhibition 2, 5.
• Higher concentrations of aminophylline can lead to cardiac arrhythmias and seizures due to adenosine A1-receptor antagonism 5.
• The efficacy of aminophylline is related to blood concentrations, which can be affected by hepatic metabolism and concomitant drug therapy 5.

Treatment Recommendations

• Aminophylline is not recommended for use in the treatment of acute asthma in adults due to its possible adverse effects 4.
• In COPD patients, aminophylline may be considered as an add-on therapy in patients with severe disease not controlled by bronchodilator therapy 5.
• The use of aminophylline should be carefully considered, taking into account the potential benefits and risks, as well as the availability of alternative treatments 2, 3, 4, 5.